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Improving uptake and completion of pulmonary rehabilitation in COPD with lay health workers: feasibility of a clinical trial

White, P; Gilworth, G; Lewin, S; Hogg, L; Tuffnell, R; Taylor, SJC; Hopkinson, NS; ... Wright, AJ; + view all (2019) Improving uptake and completion of pulmonary rehabilitation in COPD with lay health workers: feasibility of a clinical trial. International Journal of Chronic Obstructive Pulmonary Disease , 14 pp. 631-643. 10.2147/COPD.S188731. Green open access

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Abstract

Purpose: This study was designed to evaluate the feasibility of a cluster randomized controlled trial to test the efficacy of lay health workers (LHWs) in improving the uptake and completion of pulmonary rehabilitation (PR) in the treatment of COPD. Materials and methods: LHWs, trained in confidentiality, role boundaries, and behavior change techniques, supported patients newly referred for PR. Interactions between LHWs and participants were recorded with smartphones. Outcomes were recruitment and retention rates of LHWs, questionnaire and interview-evaluated acceptability and analysis of intervention fidelity. Results: Forty (36%) of 110 PR-experienced COPD patients applied to become LHWs. Twenty (18%) were selected for training. Twelve (11%) supported patients. Sixty-six COPD patients referred for PR received the intervention (5.5 participants per LHW). Ten LHWs were retained to the end of the study. Seventy-three percent of supported patients were satisfied or very satisfied with the intervention. LHWs delivered the intervention with appropriate style and variable fidelity. LHWs would welcome more intensive training. Based on this proof of concept, a cluster randomized controlled trial of an LHW intervention to improve uptake and completion of PR is feasible. Conclusion: PR-experienced COPD patients can be recruited, trained, and retained as LHWs to support participation in PR, and can deliver the intervention. Participant COPD patients found the intervention acceptable. A cluster randomized controlled clinical trial is feasible.

Type: Article
Title: Improving uptake and completion of pulmonary rehabilitation in COPD with lay health workers: feasibility of a clinical trial
Open access status: An open access version is available from UCL Discovery
DOI: 10.2147/COPD.S188731
Publisher version: https://doi.org/10.2147/COPD.S188731
Language: English
Additional information: This work is published by Dove Medical Press Limited, and licensed under a Creative Commons Attribution License. The full terms of the License are available at http://creativecommons.org/licenses/by/4.0/. The license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Science & Technology, Life Sciences & Biomedicine, Respiratory System, uptake, completion, recruitment, retention, intervention fidelity, BEHAVIOR-CHANGE, IMPLEMENTATION, ALTRUISM, FIDELITY, DISEASE, PEOPLE
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/10074306
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