Background

The Assessing outcomes of enhanced Chronic disease Care through patient Education and a value-based formulary Study (ACCESS) was a 2x2 factorial randomized trial that tested the impact of a tailored self-management education support (SMES) program, which demonstrated a 22% reduction in adverse clinical events. We sought to qualitatively explore participants’ perspectives on the SMES intervention, and the ways in which it may have improved self-management skills.

Methods

We used a qualitative descriptive approach and conducted individual semi-structured interviews. We conducted inductive and deductive thematic analysis using NVivo 12.

Results

We interviewed twenty participants who had recently completed the three-year SMES intervention. Three main themes emerged from the data: 1) empowerment, 2) intervention acceptability, and 3) suggestions for improvement. Under empowerment, we identified subthemes of health literacy, self-efficacy, self-management, and active role in health. Several participants reported that it promoted health behavior change or improved confidence in self-management. Under acceptability, we identified subthemes of ease of use and presentation style. Most participants expressed positive feelings towards the intervention and felt that it was easy to understand. Finally, we identified subthemes of learning style, content, and engagement strategies under suggestions for improvement. Some participants said that the messages were too general and did not address the complex health concerns they had.

Conclusion

Our results highlighted key strategies to promote patient engagement and self-management behaviors and demonstrated how they may have been used to improve clinical endpoints. Additionally, we demonstrated the novel use of marketing principles in SMES interventions.

Paltzat, K., Scott, S., Dhaliwal, K. K., Saunders-Smith, T., Manns, B. J., Campbell, T., Ivers, N., Pannu, R., & Campbell, D. J. T. (2023). Patient Perspectives on a Tailored Self-Management Education and Support Intervention for Low-Income Seniors with Chronic Health Conditions. CJC Open, 5(11), 808-815. https://doi.org/10.1016/j.cjco.2023.08.002