title: Lay Health Trainers Supporting Self-Management amongst Those with Low Heath Literacy and Diabetes: Lessons from a Mixed Methods Pilot, Feasibility Study.
abstract: This article reports a mixed methods process evaluation of a pilot feasibility randomised controlled trial comparing a Lay Health Trainer (LHT) intervention and usual care for those with poorly controlled Type 2 Diabetes Melitus (T2DM). Set in a deprived area in the UK, this research explores patient and health care practitioner (HCP) views on whether a structured interview between a patient and a Lay Health Trainer (LHT), for the purpose of developing a tailored self-management plan for patients, is acceptable and likely to change health behaviours. In doing so, it considers the implications for a future, randomised controlled trial (RCT). Participants were patients, LHTs delivering the intervention, service managers, and practice nurses recruiting patients to the study. Patients were purposively sampled on their responses to a baseline survey, and semistructured interviews were conducted within an exploratory thematic analysis framework. Findings indicate that the intervention is acceptable to patients and HCPs. However, LHTs found it challenging to work with older patients with long-term and/or complex conditions. In order to address this, given an ageing population and concomitant increases in those with such health needs, LHT training should develop skills working with these populations. The design of any future RCT intervention should take account of this.
authors.affiliation: Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK.
authors.forename: Bernadette
authors.identifier: 0000-0002-8557-6222
authors.initials: B
authors.lastname: Bartlam
authors.affiliation: Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK.
authors.forename: Trishna
authors.initials: T
authors.lastname: Rathod
authors.affiliation: Institute of Public Health, Aarhus University, Aarhus, Denmark; Institute of Health/Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Gillian
authors.initials: G
authors.lastname: Rowlands
authors.affiliation: Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK.
authors.forename: Joanne
authors.identifier: 0000-0002-9608-1487
authors.initials: J
authors.lastname: Protheroe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D057220:Health Literacy; D006282:Health Personnel; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D036301:Qualitative Research; D012648:Self Care / Q000379:methods*; D006113:United Kingdom