Table 2 Key bodies of theory and their contribution to the development of the CSP Model, implementation and spread

Empowerment [46], Self-management [47], self-efficacy [48], person centred consultation [49, 50], counselling [51]

Set of theoretical approaches to changing the aims and approaches to diabetes management and the consultation in diabetes and wider.

Design: Provided the ‘positive’ case for change; there are things that could work better. Articulated the core conditions for care planning in practice.

Adult education; self-efficacy [52, 42, 48, 53]

Learning is best if grounded in the person’s experience, built up from where people start; supports active learning, recognises importance of building self-efficacy.

Design: Informed the consultation model and all training and train the trainers modules.

Chronic care model (CCM) [21]

The 6 components required to work together in the community to enable ‘the engaged empowered patient and the organised proactive system to work in partnership’.

Validation and articulation: Components of CSP and The House.

Implementation of evidence-based practice [23, 54]

Identifies 3 components for successful implementation as

• Quality of ‘evidence’

• Context for delivery

• Method of facilitation

Design: Key theoretical driver for YOCP team before and during CSP

Importance and meaning of ‘purpose’ [55, 56]

Importance of:

• Being explicit about purpose

• Reframing the practitioner role from supporting individual to ‘manage condition well’ towards ‘managing life with your condition’

Articulation and validation: Better articulation of purpose of CSP and the language to debate tensions around roles and goal setting with practitioners.

Normalisation Process Theory (NPT) [57,58,59]

Implementation as work within a social context.

Core domains involved in collaboratively implementing complex interventions in complex environments.

Transformation: Mapping YOCP success criteria against NPT constructs. Reframing facilitation model, new training exercises, use of NPT tools, redesign NOMAD [60] tool for YOCP.

Importance of context for spread of innovation [61, 62]

Recognising the value of ‘practical wisdom’ to translate core elements of an innovation into a local context to achieve spread.

Validation, Articulation and Transformation: Reframing the facilitation challenge as: ‘holding the flame’ vs ‘local tailoring [63]