Abstract

Background:
The efficacy of pulmonary rehabilitation (PR) is well established; however, its impact is limited by low uptake and completion. The IMPROVE trial investigated the effectiveness of volunteer lay health workers (PR-buddies), trained by PR staff to improve PR participation for people with chronic obstructive pulmonary disease (COPD).

Aim:
To explore the acceptability of the training and the PR-buddy role to volunteers using focus groups and a postal questionnaire.

Methods:
PR staff in trial intervention sites were trained to recruit PR-buddies and to deliver a three-day training course. People with COPD who had successfully completed PR were invited to volunteer for the PR-buddy role. The PR-buddy training included communication skills, role boundaries, confidentiality and selected behaviour change techniques to help patients overcome barriers to participating in PR.
In-person, semi-structured focus groups were conducted with PR-buddies who had completed the training and delivered the intervention. The sessions were recorded and transcribed verbatim for coding and reflexive thematic analysis. Postal feedback questionnaires and reminders were sent.

Results:
Fourteen PR services recruited 93 PR-buddies; 87 PR-buddies completed the training (mean PR-buddies per site = six).
Eight focus groups were held with 41 PR-buddies (range three to seven per group). Participants were positive about the training describing it as “very interesting” and “well informed” and felt confident to start supporting people referred to PR. The PR-buddies reported on the positive personal impact of being a PR-buddy. There was agreement that the PR-buddy role was rewarding. Some PR-buddies reported difficulties contacting patients, whilst most would have liked more patients to support.
Seventy-two questionnaires were sent, 53 (74%) completed questionnaires were returned. Satisfaction related to training was 91% and role acceptability was 84% based on a 5 or 6 score on a 6-point Likert scale.

Conclusions:
The PRB role was acceptable to the volunteers and they were satisfied with the training received. They reported enjoying helping others to get the benefits from PR that they had experienced. Using a train-the-trainer model of training PR staff to recruit and train PR-buddies enabled efficient dissemination of the training and set-up of the services across all 14 intervention sites.