I'm interested in understanding existing self-management interventions for people with chronic disease. However, a systematic review is not appropriate when investigating complex interventions, and so a realist approach seems most appropriate. I'd be interested to hear if anybody has conducted an evidence synthesis / realist synthesis / realist review, and whether you have any suggestions for the approach. Many thanks in advance!
In another context (career education) I reviewed existing literature about self-management, -regulation and -direction. A conclusion is that often our expectations are too high and that we should pay more attention to the higher order learning processes that are needed to develop this kind of competencies. Maybe my article "Are we on the right track with career learning?" can be of interest to you.
Article Are we on the right track with career learning?
Hi Tom, thanks for sharing your article, I look forward to reading it! Based on my current reading, I feel that we really need to strip things back to the fundamental basics of learning processes, as you've alluded to. Many thanks again!
Hello Simon,
The self-management field is quite wide, so you will probably find it useful to specify a health condition or client group to narrow your focus.
With regard to realist synthesis, I know someone who is currently using this methodology in self-management. They are based in Wales. Please feel free to email me to [email protected], if you would like me to introduce you.
Best wishes,
Tino
HI Simon
We are also working to understand self-management interventions. We have done concept mapping (another technique that goes beyond systematic reviews), reviews of the outcomes that are being measured and are now also examining the content across a number of programs to figure out where the commonalities are. Realist or integrative reviews are appropriate. One of my colleagues is also very experienced in implementation science and is doing a realist review on a related topic. Email me if you would like more detail. [email protected]
I have always believed (note I do not say know) that pulling apart interventions to find the magic is like pulling apart a good cake--impossible or near impossible. I have also come to believe that interventions that offer a mix of content and methods are best as the participants then self-tailor the intervention to their needs and abilities. We do have some evidence that this is true.
I have been compiling all the literature I can find on the Stanford interventions. There are lots of articles--well over 100 and I also have many reports that have never gotten into the literature. It would be a terrific service for someone to do a synthesis. My collection is not complete but am happy to share what we have. I think that there is lots and lots of collective wisdom there that go well well beyond effect size.
Hi Simon,
I agree with Tanya's statement. You might want to check out integrative review techniques to address this question, e.g. Whittmore/Knafl (2005) ==> https://www.ncbi.nlm.nih.gov/pubmed/16268861
I have used the integrative review approach on a self-management topic as well, even though this was rather on user's needs/strategies than on interventions. ==> Haslbeck, J., McCorkle, R., & Schaeffer, D. (2012). Chronic illness self-management while living alone in later life: a systematic integrative review. Research on Aging, 34(5), 506–546. http://doi.org/10.1177/0164027511429808
You might also want to check out intervention mapping methods, which have evolved over the last decade in terms of self-management support in chronic illness, some examples (in particular check out papers from Michie et al.):
Detaille, S. I., van der Gulden, J. W., Engels, J. A., Heerkens, Y. F., & van Dijk, F. J. (2010). Using intervention mapping (IM) to develop a self-management programme for employees with a chronic disease in the Netherlands. BMC Public Health, 10, 353. http://doi.org/1471-2458-10-353 [pii] 10.1186/1471-2458-10-353
Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., … Wood, C. E. (2013). The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Annals of Behavioral Medicine : A Publication of the Society of Behavioral Medicine, 46(1), 81–95. http://doi.org/10.1007/s12160-013-9486-6
All the best, Joerg
Thank you so much Joerg, Kate, Tanya and Stefan for sharing your thoughts. It is greatly appreciated.