Development and content of a community-based reablement programme (I-MANAGE): a co-creation study

Objectives As age increases, people generally start experiencing problems related to independent living, resulting in an increased need for long-term care services. Investing in sustainable solutions to promote independent living is therefore essential. Subsequently, reablement is a concept attracting growing interest. Reablement is a person-centred, holistic approach promoting older adults’ active participation through daily, social, leisure and physical activities. The aim of this paper is to describe the development and content of I-MANAGE, a model for a reablement programme for community-dwelling older adults. Design The development of the programme was performed according to the Medical Research Council framework as part of the TRANS-SENIOR international training and research network. A co-creation design was used, including literature research, observations, interviews, and working group sessions with stakeholders. Setting and participants The interviews and working group sessions took place in the Dutch long-term home care context. Stakeholders invited to the individual interviews and working group sessions included care professionals, policymakers, client representatives, informal caregiver representatives, informal caregivers, and scientific experts. Results The co-creation process resulted in a 5-phase interdisciplinary primary care programme, called I-MANAGE. The programme focuses on improving the self-management and well-being of older adults by working towards their meaningful goals. During the programme, the person’s physical and social environment will be put to optimal use, and sufficient support will be provided to informal caregivers to reduce their burden. Lastly, the programme aims for continuity of care and better communication and coordination. Conclusion The I-MANAGE programme can be tailored to the local practices and resources and is therefore suitable for the use in different settings, nationally and internationally. If the programme is implemented as described, it is important to closely monitor the process and results.


P 8 -9
Report how any published intervention development approach contributed to the development process.
Many formal intervention development approaches exist and are used to guide the intervention development process (e.g.Squid or The Person Based Approach to Intervention Development).Where a formal intervention development approach is used, it is helpful to describe the process that was followed, including any deviations.More general approaches to intervention development also exist and have been categorised as follows: Target Population-centred intervention development; evidence and theorybased intervention development; partnership intervention development; implementation-based intervention development; efficacy-based intervention development; step or phased-based intervention development; and interventionspecific intervention development.These approaches do not always have specific guidance that describe their use.Nevertheless, it is helpful to give a rich description of how any published approach was operationalised P 8 BMJ Publishing Group Limited (BMJ) disclaims all liability and responsibility arising from any reliance Supplemental material placed on this supplemental material which has been supplied by the author(s) Some interventions are developed with components that have been adopted from existing interventions.Clearly identifying components that have been adopted or adapted and acknowledging their original source helps the reader to understand and distinguish between the novel and adopted components of the new intervention.P 10 Supplementary file 3 + [1] Report any guiding principles, people or factors that were prioritised when making decisions during the intervention development process.
Reporting any guiding principles that governed the development of the application helps the reader to understand the authors' reasoning behind the decisions that were made.These could include the examples of particular populations who views are being considered when designing the intervention, the modality that is viewed as being most appropriate, design features considered important for the target population, or the potential for the intervention to be scaled up.phase of intervention development does not necessarily mean that all uncertainties have been addressed.It is helpful to list remaining uncertainties such as the intervention intensity, mode of delivery, materials, procedures, or type of location that the intervention is most suitable for.This can guide other researchers to potential future areas of research and practitioners about uncertainties relevant to their healthcare context.Report any changes to the intervention required or likely to be required for subgroups.
Specifying any changes that the intervention development team perceive are required for the intervention to be delivered or tailored to specific sub groups enables readers to understand the applicability of the intervention to their target population or context.These changes could include changes to personnel delivering the intervention, to the content of the intervention, or to the mode of delivery of the intervention.

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Report important uncertainties at the end of the development process.
Intervention development is frequently an iterative process.The conclusion of the initial phase of intervention development does not necessarily mean that all uncertainties have been addressed.It is helpful to list remaining uncertainties such as the intervention intensity, mode of delivery, materials, procedures, or type of location that the intervention is most suitable for.This can guide other researchers to potential future areas of research and practitioners about uncertainties relevant to their healthcare context.

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Follow TIDieR guidance when describing the developed intervention.
Interventions have been poorly reported for a number of years.In response to this, internationally recognized guidance has been published to support the high quality reporting of health care interventions and public health interventions.This guidance should therefore be followed when describing a developed intervention.Brief name.
Provide the name or a phrase that describes the intervention.For each category of intervention provider (e.g.psychologist, nursing assistant), describe their expertise, background and any specific training given.P 14 -18 How the intervention was provided.
Describe the modes of delivery (e.g.face-to-face or by some other mechanism, such as internet or telephone) of the intervention and whether it was provided individually or in a group.

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Location where the intervention occurred (incl.necessary infrastructure relevant features).
Describe the type(s) of location(s) where the intervention occurred, including any necessary infrastructure or relevant features.P 8 -9 When and how much the intervention was delivered.
Describe the number of times the intervention was delivered and over what period of time including the number of sessions, their schedule, and their duration, intensity or dose.

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Tailoring -what, why, when and how. If Note. * e.g. if item is reported elsewhere, then the location of this information can be stated here.†If completing the TIDieR checklist for a protocol, these items are not relevant to the protocol and cannot be described until the study is complete.BMJ Publishing Group Limited (BMJ) disclaims all liability and responsibility arising from any reliance Supplemental material placed on this supplemental material which has been supplied by the author(s)