Identifying the processes of change and engagement from using a social network intervention for people with long‐term conditions. A qualitative study

Abstract

Background Personal and community networks are recognized as influencing and shaping self‐management activities and practices. An acceptable intervention which facilitates self‐management by mobilizing network support and improves network engagement has a positive impact on health and quality of life. This study aims to identify the processes through which such changes and engagement take place. Methods The study was conducted in the south of England in 2016‐2017 and adopted a longitudinal case study of networks design. Purposive sample of respondents with long‐term conditions (n = 15) was recruited from local groups. Barriers and facilitators to implementation were explored in interviews with key stakeholders (5). Results Intervention engagement leads to a deepening of relationships within networks, adding new links and achieving personal objectives relevant for improving the health and well‐being of users and network members. Such changes are supported through two pathways: the mobilization of network capabilities and by acting as a nudge. The first is a gradual process where potentially relevant changes are further contemplated by forefronting immediate concerns and negotiating acceptable means for achieving change, prioritizing objective over subjective valuations of support provided by network members and rehearsing justifications for keeping the status quo or adopting change. The second pathway changes are enacted through the availability of a potential fit between individual, network and environmental conditions of readiness. Conclusions The two pathways of network mobilization identified in this study illuminate the individual, network and environmental level processes involved in moving from cognitive engagement with the intervention to adopting changes in existing practice.

“An Expanded Window of Understanding a Changed Everyday Life”—Experiences From Patients With Long-Term Conditions After Attending Group Learning Sessions

“…It has been found that CoP is a powerful mechanism for solving problems ( 22 ). Mobilizing the capability of a group working together can be a useful pathway to support changes because it highlights the process of engagement with the current concerns of individuals and the group members ( 7 ). These point to the results showing that sharing experiences can lead to patients gaining an increased understanding of their health condition and how it affects everyday life, leading to the feeling of empowerment.…”

“…This perspective is missing when providers take the lead in self-management programs ( 5 ). Bringing a social environmental dimension to self-management support by providing socially based options to improve health and well-being has shown to be successful ( 6 , 7 ). This social dimension is based on deepening relationships within personal communities of support—such as personal networks—that link both social activities and the management of health and well-being of the members of the community ( 7 ).…”

A Web-Based Social Network Tool (GENIE) for Supporting Self-management Among High Users of the Health Care System: Feasibility and Usability Study

“…These topics mirrored those of the top 6 life and health goals identified by older adults in another study conducted in Ontario [ 32 ]. Furthermore, GENIE studies conducted in the United Kingdom also showed that most activities chosen in other related GENIE studies also tended to be health related [ 26 , 27 ]. This provides support that the topics in the GENIE tool are relevant to an adult population.…”

“…GENIE is a web-based tool that aims to support self-management by leveraging adults’ engagement with their personal social network to facilitate the uptake of relevant community-based activities and HSSs. Studies have shown that when GENIE was delivered by trained facilitators to adults with chronic health and social conditions in the community settings, there was an increase in the diversity of participants’ networks and greater engagement with community activities [ 26 , 27 ]. Given these positive results and the challenges faced by primary care providers in implementing self-management strategies [ 17 ], research is needed to understand the feasibility, usability, and perceived impacts of implementing GENIE within the primary context, with the use of trained facilitators as an extension of the primary care team.…”

The role of sport-based social networks in the management of long-term health conditions: Insights from the World Transplant Games

“…This shift aligns with the succinct idea that people do “self-manage” their conditions, but they do not self-manage on their own (Vassilev et al, 2013). This new direction has opened up a space for medical sociology with an emphasis on understanding the role that social networks play in helping patients to live well with their condition (Morris et al, 2016; Vassilev et al, 2019).…”