Delivering the WISE (Whole Systems Informing Self-Management Engagement) training package in primary care: learning from formative evaluation
Open accessAbstract
BACKGROUND: The WISE (Whole System Informing Self-management Engagement) approach encompasses creating, finding, and implementing appropriate self-care support for people with long-term conditions. A training package for primary care to introduce the approach was developed and underwent formative evaluation. This entailed exploring the acceptability of the WISE approach and its effectiveness in changing communication within consultations. The study aimed to refine the patient, practitioner, and patient level components of the WISE approach and translate the principles of WISE into an operational intervention deliverable through National Health Service training methods. METHODS: Normalisation Process Theory provided a framework for development of the intervention. Practices were recruited from an inner city Primary Care Trust in NW England. All practice staff were expected to attend two afternoon training sessions. The training sessions were observed by members of the training team. Post-training audio recordings of consultations from each general practitioner and nurse in the practices were transcribed and read to provide a narrative overview of the incorporation of WISE skills and tools into consultations. Face-to-face semi-structured interviews were conducted with staff post-training. RESULTS: Two practices out of 14 deemed eligible agreed to take part. Each practice attended two sessions, although a third session on consultation skills training was needed for one practice. Fifty-four post-training consultations were recorded from 15 clinicians. Two members of staff were interviewed at each practice. Significant elements of the training form and methods of delivery fitted contemporary practice. There were logistical problems in getting a whole practice to attend both sessions, and administrative staff founds some sections irrelevant. Clinicians reported problems incorporating some of the tools developed for WISE, and this was confirmed in the overview of consultations, with limited overt use of WISE tools and missed opportunities to address patients' self-management needs. CONCLUSIONS: The formative evaluation approach and attention to normalisation process theory allowed the training team to make adjustments to content and delivery and ensure appropriate staff attended each session. The content of the course was simplified and focussed more clearly on operationalising the WISE approach. The patient arm of the approach was strengthened by raising expectations of a change in approach to self-care support by their practice.
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Twenty-four RCTs examined the impact of interventions on health-related quality of life (HRQOL).
“Twenty-four RCTs examined the impact of interventions on HRQOL”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [61]
The Results section describes a formative pilot involving two primary-care practices, not an analysis of 24 RCTs. Searches for “twenty-four RCTs,” HRQOL, and health-related quality of life found no passage reporting the claimed count or outcome. (LLM, conf=0.76)
Experimental — accuracy not yet measuredPhysical, mental or social functioning were measured in 25 RCTs.
“Physical, mental or social functioning were measured in 25 RCTs”
From Helping patients help themselves: A systematic review of self-management support strategies in primary health care practice (2019) · cites this paper as [61]
The Results section describes a formative evaluation involving two primary-care practices, not a review of RCT outcomes. Searches for the quoted statement, “25 RCTs,” and “functioning” found no passage reporting that physical, mental, or social functioning was measured in 25 RCTs. (LLM, conf=0.76)
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- Authors
- Kennedy, A., Chew-Graham, C., Blakeman, T., Bowen, A., Gardner, C., Protheroe, J., Rogers, A., & Gask, L.
- Affiliations
- University of Manchester (GB)
- Corresponding author
- Kennedy, Anne
- ORCID
- Venue
- Implementation Science
- Published
- 2010-01-29
- Volume
- 5
- Issue
- 1
- Pages
- 7-7
- ISSN
- 1748-5908 (ISSN-L)
- PMC
- PMC2841580
- OpenAlex
- W2157707147
- Cited by
- 66
- References
- 36
- Citations by year
- 2026: 1 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 1 · 2020: 10 · 2019: 2 · 2018: 6 · 2017: 1 · 2016: 5 · 2015: 5 · 2014: 8 · 2013: 6 · 2012: 7
- FWCI
- 11.96
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Implementation Science (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Institute for Health and Care Research (RDA/01/05/009)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Innovations in Medical Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- self-management, self-care support, chronic disease, primary care, clinician training, Normalisation Process Theory, formative assessment, consultation skills, general practitioners, nurses, intervention development, acceptability
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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