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Open Access Study protocol

Evaluating the implementation of HeLP-Diabetes within NHS services: study protocol

Jamie Ross1*, Fiona Stevenson1, Charlotte Dack1, Kingshuk Pal1, Carl May2, Susan Michie3, Steve Parrott4 and Elizabeth Murray1

Author Affiliations

1 1e-Health Unit, UCL Research Department of Primary Care & Population Health, Upper 3rd Floor, Royal Free Hospital, Rowland Hill Street, London, NW3 2PF,m, UK

2 Faculty of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, UK

3 Centre for Outcomes Research and Effectiveness Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK

4 Department of Health Sciences, Seebohm Rowntree Building, University of York, York, YO10 5DD, UK

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BMC Health Services Research 2014, 14:51  doi:10.1186/1472-6963-14-51

Published: 4 February 2014

Abstract

Background

Self-management by people with type 2 diabetes is central to good health outcomes and the prevention of associated complications. Structured education to teach self-management is recommended by the National Institute for Heath and Clinical Excellence; however, only a small proportion of patients report being offered this education and even fewer attend. This study aims to evaluate the implementation of a new internet-based self-management intervention: HeLP-Diabetes (Healthy Living for People with type 2 Diabetes) within the National Health Service. Specific objectives are to a) determine the uptake and use of HeLP-Diabetes by services and patients; b) identify the factors which inhibit or facilitate use; c) identify the resources needed for effective implementation; d) explore possible effects of HeLP-Diabetes use on self-reported patient outcome measures.

Methods/Design

This study will use an iterative design to implement HeLP-Diabetes into existing health services within the National Health Service. A two stage implementation process will be taken, whereby batches of General Practice surgeries and diabetes clinics will be offered HeLP-Diabetes and will subsequently be asked to participate in evaluating the implementation. We will collect data to describe the number of services and patients who sign up to HeLP-Diabetes, the types of services and patients who sign up and the implementation costs. Semi-structured interviews will be conducted with patients and health professionals and cohorts of patient participants will be asked to complete self-report measures at baseline, 3 months, and 12 months.

Discussion

This study will evaluate the implementation of a new online self-management intervention and describe what happens when it is made available to existing National Health Services and patients with type 2 diabetes. We will collect data to describe the uptake and use of the intervention and the resources needed for widespread implementation. We will report on patient benefits from using HeLP-Diabetes and the resources needed to achieve these in routine practice. Interviews with key stake holders will identify, define and explain factors that promote or inhibit the normalization of new patterns of patient and professional activity arising from HeLP-Diabetes.

Keywords:
Implementation; Diabetes; Health services research; Internet; Self-management