Dr Fiona Leggat
Fiona works as a Research Associate from the Population Health Research Institute at St George’s, University of London. Her primary role is supporting the NIHR funded Long Covid personalised Self-management support co-design and evaluation (LISTEN) project. As part of the LISTEN project, Fiona’s supported the co-design of the trial intervention together with people with lived experience, and she now works on the trial mixed methods process evaluation.
Previously, Fiona was awarded her PhD in Applied Health Psychology from St Mary’s University, Twickenham, in 2021. Working within lower limb amputation rehabilitation, her thesis drew upon knowledge translation and narrative pedagogy, with a focus on co-design and qualitative methods.
Healthcare professionals (HPs) play primary roles in delivering complex rehabilitation interventions. However, when delivering a complex intervention within a trial context, additional training and support is critical to enhance HP’s ability to ensure fidelity and deliver as intended. Intervention delivery is recognised within implementation science frameworks, yet the appropriateness and influence of training on fidelity and adherence to core principles is often not evaluated. Developed for a clinical trial to co-design and evaluate self-management support for people with Long Covid (LISTEN), we report on the design and impact of a novel training and support package on HPs’ knowledge, confidence, and skills.
Underpinned by the Consolidated Framework for Implementation Research, the co-designed LISTEN training was formatively evaluated using a self-report online survey. All HPs (e.g., physiotherapists [PTs], occupational therapists [OTs], psychologists, nurses, and other practitioners) who undertook the 8-hour interactive group-based training took part in the survey. The survey asked HPs to separately score knowledge and confidence across 9 intervention fidelity criteria (37 items) . 3-point Likert scales (1-3) were used for each item. Impacts from the training and the support package will be assessed using focus groups and fidelity observations. Data were analysed using descriptive statistics.
57 HPs completed the survey and subsequently delivered intervention sessions. Average knowledge (94%) and confidence (90%) varied across skills and between professions. Psychologists’ self-assessment of overall knowledge (97%) and confidence (92%) post-training was higher than those of OTs (94%, 90%) and nurses (93%, 91%). PTs reported lowest levels of knowledge (88%) and confidence (81%), although for some skills (e.g., attentive listening, being curious) scores mirrored other professions .
HPs participating in shared professional training to deliver a complex intervention require tailored support to address profession specific needs. The influence of the support package on intervention fidelity continues to be evaluated within the ongoing LISTEN trial.