Successes and challenges in the implementation of the HOPE self-management programme for people living with and beyond cancer.


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Gemma Pearce1,Sally Pezaro1,Joanne Parsons1,Andy Turner1,Paramjit Gill2,Tracey Norris3
1Coventry University,2University of warwick,3Associate Learning and development Manager and regional lead for H.O.P.E Macmillan Cancer support

Abstract

Background

The HOPE Programme© is a self-management course developed with people living with and beyond cancer and licensed by Macmillan Cancer Support to be delivered across the UK. Despite this, delivery is inconsistent across regions. The aim of this research was to examine barriers and successes of implementation to improve future delivery.

Method

10 focus groups and 27 interviews were completed across 6 UK regions using an Interpretive Description approach. Participants (n=73) were recruited by Macmillan gatekeepers for being involved in the promotion and delivery of the HOPE Programme (Macmillan staff, commissioners, healthcare professionals, attendees and facilitators). Analysis was completed using Framework Analysis.

Results

Barriers to implementation included getting the course up-and-running regularly, incorporating the programme into the care pathway, buy in from professionals, time, money, venue, supporting people returning to work, recruiting men, younger people and BME groups.

Successes of implementing the course occurred when Macmillan staff, healthcare professionals, volunteers and management were involved in the plans from the beginning, actively referring and encouraging course retention. Cancer Information Centres were useful hubs to recruit onto the course. Patients liked the friendly neutral space and professionals found it useful to signpost patients. The most successful time to refer patients to the course was after being discharged from treatment when patients often felt isolated like “falling off of a cliff”. Professionals liked having the HOPE Programme to refer patients to meet their unmet psychosocial needs.

Conclusion

These findings help understand barriers further and provide examples of how some sites have successfully overcome them. Some felt that more of a nationwide recruitment strategy and advertisement scheme would be beneficial, encouraging regions to incorporate the programme into the patient’s care pathway. Sharing these lessons of implementation will hopefully improve implementation consistency across the nation, increase the impact of the course and inform the implementation science field.