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Citation

Iglesias Urrutia CP, Erdem S, Birks YF, Taylor SJC, Richardson G, Bower P, van den Berg B & Manca A (2022) People's preferences for self-management support. Health Services Research, 57 (1), pp. 91-101. https://doi.org/10.1111/1475-6773.13635

Abstract
Objective To identify and assess the preferences of people with long‐term health conditions toward generalizable characteristics of self‐management support interventions, with the objective to inform the design of more person‐centered support services. Data Sources Primary qualitative and quantitative data collected on a representative sample of individuals with at least one of the fifteen most prevalent long‐term conditions in the UK. Study Design Targeted literature review followed by a series of one‐to‐one qualitative semistructured interviews and a large‐scale discrete choice experiment. Data Collection Digital recording of one‐to‐one qualitative interviews, one‐to‐one cognitive interviews, and a series of online quantitative surveys, including two best‐worst scaling and one discrete choice experiment, with individuals with long‐term conditions. Principal Findings On average, patients preferred a self‐management support intervention that (a) discusses the options available to the patient and make her choose, (b) is individual‐based, (c) face to face (d) with doctor or nurse, (e) at the GP practice, (f) sessions shorter than 1 hour, and (g) occurring annually for two‐third of the sample and monthly for the rest. We found heterogeneity in preferences via three latent classes, with class sizes of 41% (C1), 30% (C2), and 29% (C3). The individuals’ gender [P < 0.05(C1), P < 0.01(C3)], age [P < 0.05(C1), P < 0.05(C2)], type of long‐term condition [P < 0.05(C1), P < 0.01(C3)], and presence of comorbidity [P < 0.01(C1), P < 0.01(C3), P < 0.01(C3)] were able to characterize differences between these latent classes and help understand the heterogeneity of preferences toward the above mentioned features of self‐management support interventions. These findings were then used to profile individuals into different preference groups, for each of whom the most desirable form of self‐management support, one that was more likely to be adopted by the recipient, could be designed. Conclusions We identified several factors that could be used to inform a more nuanced self‐management support service design and provision that take into account the recipient's characteristics and preferences.

Keywords
long‐term conditions; mixed methods; person‐centered health care; preferences; self‐management support interventions

Journal
Health Services Research: Volume 57, Issue 1

• Published version