Exploring Facilitation in Primary Care: Workshops for Improved Supported Self-management in Asthma (ID 657)
Queen Mary, University of London
Abstract
Background and Aim
Supported self-management of asthma empowers patients with the knowledge to recognise exacerbations and seek timely medical care, thereby reducing asthma attacks. However, implementation in primary care remains low, due to challenges including lack of resources, insufficient staff training, and the reluctance of some people with asthma to attend for reviews. Facilitators may aid the implementation of supported self-management into routine care by signposting tailored education, support and challenging barriers. Limited empirical research exists on the strategies facilitators employ, how these differ between facilitators and change over time across a facilitation intervention. As part of the IMP²ART trial (IMPlementing IMProved Asthma self-management as RouTine), hour-long, first contact online facilitation workshops (n=65) were conducted to implement supported self-management. This PhD project employs video-based methods to understand facilitation in healthcare interventions.
Methods
Eight hour-long workshops, two early and two late workshops per facilitator (n=4), spanning 27 months of the trial to capture long-term strategy shifts, were selected for in-depth study. Qualitative thematic analysis was used to code and evaluate facilitation strategies.
Results
Facilitators deployed diverse strategies to secure participant buy-in and engagement, which varied from facilitator to facilitator, with evidence of refinement over time. For instance, facilitators empathised with practice challenges and leveraged their professional backgrounds to align themselves with workshop participants. Unique styles such as drawing on metaphors of ‘battle’ or ‘golden windows of opportunity’ were used to galvanise action. Facilitators conducting the most workshops demonstrated tailoring to enhance comprehension and engagement, with elements of the workshop either being dialled up or down in line with anticipated effectiveness.
Conclusions
This study provides critical insights into the multifaceted role of facilitation in driving change. These findings contribute to evolving facilitation models by highlighting adaptive strategies employed when building rapport and securing buy-in. Future analysis will investigate team creation and goal-setting processes to inform evidence-based strategies for facilitation professionals.
Funding: Funding: This work forms part of a research fellowship with The Healthcare Improvement Studies (THIS) Institute. The fellowship was funded by the Health Foundation as part of a grant to the University of Cambridge supporting THIS Institute.
Conflicts of interest: None
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