title: A process evaluation using a Self Determination Theory measure of the co-delivery of self management training by clinicians and by lay tutors.
abstract: OBJECTIVE
  To evaluate the co-delivery style of lay and clinician co-tutors of courses for patients, and courses for clinicians to support their patients' self-management skills.
  
  
  METHODS
  Motivational style of course delivery was assessed in 37 patient course sessions and 14 clinician workshops by independent observers using four Self Determination Theory rating scales and ethnographic notes. Forty-five tutors and 35 attendees were interviewed about their experience of co-delivered courses.
  
  
  RESULTS
  Lay and clinician tutors had similar motivational styles, with significant differences between the four motivational style scales; patient courses (F(3, 216)=3.437, p=.018); and clinician courses (F(3, 78)=3.37, p=.025). The courses were experienced as co productive in style as suggested during interviews, but adherence to manuals limited the tutors' contributions. Lay and clinician tutors scored higher on providing structure and engaging participants than they scored on supporting autonomous decision making and involvement.
  
  
  CONCLUSIONS
  Co-delivery was a successful model, affording opportunities to demonstrate co-production skills.
  
  
  CONCLUSIONS
  There is more scope to enable lay and clinician tutors to use their respective expertise in supporting self-management, and for tutor training to encourage a less didactic delivery style.
authors.affiliation: Applied Research Centre for Health and Lifestyle Interventions, Coventry University, England, UK. shilpi.cd2@gmail.com
authors.forename: Shilpi
authors.initials: S
authors.lastname: Sharma
authors.forename: Louise M
authors.initials: LM
authors.lastname: Wallace
authors.forename: Joanna
authors.initials: J
authors.lastname: Kosmala-Anderson
authors.forename: Andy
authors.initials: A
authors.lastname: Turner
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002908:Chronic Disease / Q000628:therapy; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007407:Interviews as Topic; D007858:Learning; D008297:Male; D009042:Motivation; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010353:Patient Education as Topic / Q000379:methods*; D018802:Patient-Centered Care; D010820:Physicians; D058996:Quality Improvement; D012648:Self Care; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods*; D014838:Volunteers