Table 1 Description of the intervention as per the TIDieR checklist (Hoffmann et al. 2014)

Brief name

1.

SPEECH (Safer Patients Empowered to Engage and Communicate about Health) – a patient-focused behaviour change intervention to empower older people (aged 65+) with multiple long-term conditions – multimorbidity (MLTC-M), improve their communication with staff working in general practices, and reduce risks to patient safety.

Why

2.

A theory-, evidence- and person-based approach was used to plan, design and develop the intervention.

Plan: Barriers to and enablers of communication were identified using the COM-B model of behaviour change.

Design: Key stakeholders (including patients and staff) determined which barriers and enablers were the most important to address and promote, and discussed how this might be achieved. Alongside these discussions, the Behaviour Change Wheel was used to identify relevant intervention functions (mechanisms of action) and select Behaviour Change Techniques (active ingredients).

Develop: The intervention was optimised through rounds of user feedback and modification.

A logic model for the intervention is shown in Goulding [16].

What

3.

Materials: Booklet for patients and guidance document for staff. The booklet for patients is the intervention. This has three main sections: (1) Information about staff and services, (2) Skills to prepare and explain, and (3) Confidence to speak up and ask. The guidance document for staff is designed to support the implementation of the intervention. This explains the purpose of the intervention and how practices and their staff can support the intervention.

4.

Procedures: Participating patients were given a copy of the intervention booklet. They were asked to read the booklet and make use of the suggestions and guidance within. If participating patients had any questions or queries about the booklet or its contents, they were able to contact the research team for support. The research team also contacted participating patients on one occasion after they received the booklet to ask if they needed support. Participating practices were given copies of both the intervention booklet and the implementation document. They were asked to circulate these materials to all staff who have contact with patients, and to make use of the suggestions and guidance within. If staff at participating practices had any questions or queries about the materials or their contents, they were able to contact the research team for support. The research team also contacted participating practices on one occasion after they received the materials to ask if they needed support.

Who provided

5.

The research team provided the materials to participating patients and practices, and provided support as and when needed.

How

6.

The materials were distributed by post and/or via email according to the participating patients’ and practices’ preferences. Support was provided by telephone, video-call or email according to the participating patients’ and practices’ preferences.

Where

7.

NHS General Practices in North West England.

When and how much

8.

Patients were given a copy of the intervention booklet at the start of their participation in the study, once they had provided informed consent and completed baseline questionnaires. After eight weeks, they were sent follow-up questionnaires and their participation in the study came to an end. Throughout the study period, participating patients were able to contact the research team for support. The research team also contacted participating patients two to four weeks after they received the booklet to ask if they needed support. Practices were given copies of the intervention booklet and implementation document at least two weeks before the first patient participant from their practice.

Tailoring

9.

N/A

How well

11.

At follow-up, eight weeks after being sent the intervention booklet, participating patients were asked to complete a pro forma to provide information on their engagement with the booklet, and whether or not they tried to make use of the suggestions and guidance within. At the end of the study period for all patient participants at a practice, staff were asked to complete a pro forma to provide information on their engagement with the intervention booklet and implementation document, and whether or not their practice tried to make use of the suggestions and guidance within the latter.