EU-WISE is an integrated project under the 7th Framework Programme of the European Commission designed to focus on understanding capabilities, resources, and changes in health related practices in community and cultural context across EUROPE. The €2.9M research and development effort brings together 5 European countries and 6 organisations that will collaborate on the EU-Wise project. We will be utilizing mixed methods including social networks analysis. We will conduct a number of reviews, surveys and undertake in-depth qualitative research to inform a work package designed to produce self care interventions.
EU-WISE focuses on the need to explore resources and relationships within peoples’ personal communities as a means of better understanding and helping to develop interventions that are fit for purpose for engaging with people who live in deprived circumstances. A central focus is the extent to which policies actions and resources as national and cross- national levels shape activities of health and voluntary sectors locally and thus on self care support capacity. EU WISE is being conducted by a multi-disciplinary group extending across the clinical, qualitative, quantitative and applied social sciences. With our roots in both social and clinical family medicine, our research spans from health policy through local clinical, community and social levels to a focus on personal communities and individual self care actions.
The key problem we address is overcoming the limitations of deploying a ‘one size fits all’ to self-management for long-term conditions. There is a need to devise and implement workable, personally sensitive strategies for self-management and behaviour change that make full use of available technologies (e.g. eHealth, tele-health, virtual networks), personal, community and institutional resources which are more adequately able to address the needs of socially disadvantaged people. Thus, the current focus on individuals (e.g. understanding and improving their knowledge and capabilities)requires a complementary focus on understanding capabilities, resources, and change in health related practices as an integral part of peoples’ social networks and as being co-shaped by wider determinants of health). There is also a need to focus on the translation of efforts within health services to explore how professionally defined priorities of chronic illness management are translated acted upon and resourced outside of the consultation.
Using diabetes and heart disease as examples our research aims to understand the role and influences of resources external to health services which have an impact on people’s capacities to manage a long term condition in order to develop more acceptable and appropriate interventions.
We expect to produce a cross cultural in-depth understanding of the key influences on individuals and communities capacity to support self-management support. A qualitative meta-synthesis of existing interventions, a survey of personal networks and regional community organizations together with the integration of qualitative studies will provide the evidence needed to develop new interventions. The latter will also allow us to identify additional mechanisms involved in behavior change that are located within a persons’ personal and community networks as well as additional barriers which are located at the level of economic, social and health care policies that might be relevant for the effectiveness of our key intervention.
Figure 1: Self management and systems of support
Figure 2: Systems of support for people with diabetes and heart disease
We will feed the findings of the empirical research into an evaluation of existing interventions, as well as in revising and adapting the set of interventions developed to different national contexts. Drawing on the project findings from a number of work packages, we will develop a set of interventions that will include patient assessment and feedback materials, and practice training materials.