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Table 7 Participants’ programme feedback: qualitative results

From: Healthy Parent Carers programme: development and feasibility of a novel group-based health-promotion intervention

Themes Illustrating quotes
Satisfaction with the programme and its impact
 Overall satisfaction • ‘It was really good… I learnt a lot. I’ve never heard of CLANGERS, so that was new… And obviously meeting new people was great, and [the facilitator] made it fun, and it was really informative.’ (FG) • ‘I found all of that absolutely brilliant and it’s made me think so much more. I really really really enjoyed the course.’ (FG) • There were times in my life when this [course] would have been a life saver. Coming somewhere like this would have saved my life. It would have made such a difference to me being good and not very good.’ (FG)
 Impact and changes post-programme • ‘On Friday I parked further away from school… just because in my head I’m thinking it’s better for my children to walk a little bit, and I wouldn’t have done that if hadn’t come here.’ (FG) • ‘I walked down to meet [another participant], whereas I would’ve just driven. It’s only 10 min walking but I would’ve always just driven down.’ (FG) • ‘I’m forever going up and down the stairs, but normally I just plot up, so I’ve started to run up them more cause I’m thinking ‘I might not be going for that 30 min walk but the amount of time, especially when kids are at home, I’m running up and down the stairs…” (FG) • ‘The Eat Well – I’ve gone back to planning menus for the week…’ (FG) • ‘Yesterday I was breathing, when the kids were annoying I was like [sounds of deep breath-in] and I would never have done that.’ (FG) • ‘We had two new members in [a support group] and we had to introduce ourselves and I actually, for the first time, spoke about myself as well as my children…’ (FG) • ‘… [my son] is picking up on the fact that on a Monday [after the session] I feel very good when I come back… and he’s noticing it, so it’s having an impact on how they see us as well…. I felt rot bottom coming to this course and I feel as a person my confidence has grown over the past few weeks. And kids are noticing it… I think each of us from week one we’ve grown.’ (FG)
 Impact and changes at 2-month follow-up • ‘I have actively seen my GP for a carer’s assessment; sought help with dealing with social service through Health Watch’ (FF) • ‘Looking after myself more’ (FF) • ‘I use my awareness of CLANGERS every day’ (FF) • ‘Increased resilience even when things are tough’ (FF)
Most valued elements of the programme
 Learning about CLANGERS • ‘Gives me much more appreciation of CLANGERS and how using them can improve health and wellbeing.’ (FF) • ‘Opening your eyes to how they [CLANGERS] can improve life.’ (FF) • ‘Having the CLANGERS idea.’ (FF) • ‘Taking note of elements of wellbeing and thinking about what would benefit me and my family’ (FF)
 Developing awareness, confidence and learning to focus on own health & wellbeing • ‘A lot of it is common sense but it is recognising these things and raising the awareness, and thinking about it more.’ (FG) • Participants reported that keeping the ‘CLANGERS diary’, or reviewing in the session which CLANGERS they did, helped them raise awareness and confidence; ‘Even the table to write down, trying that for a couple of weeks, write down what you’ve done and it does give you a boost of confidence because you do quite a lot, and a lot of active stuff, or I wasn’t doing so much of that so what could I do to fulfil that.’ (FG) • ‘You gain confidence with doing the course cause it emphasises that actually we are the most important people. If we don’t look after ourselves as parent carers, it can have a negative effect on the kids.’ (FG) • ‘Learning and putting emphasis on us instead of kids…’ (FG) • ‘Learning how to put yourself first.’ (FF) • The ‘CLANGERS diary’ prompted one participant to take time for herself and keep a journal; ‘It also makes doing that form each week into some sort of journal as well. So you get used to spending that 10, 20 min journaling… It’s time for you, allocated 15 min to fill in that sheet.’ (FG)
 Meeting other parent carers, sharing and peer support in non-judgmental, empathetic setting • ‘Meeting others who understand the situation instead of judgement’ (FF) • ‘I think the main benefit is actually meeting other parent carers.’ (FG) • ‘…in the group we are not alone with this, we all do this.’ (FG) • ‘Being able to gain thoughts and ideas from other parent carers who cope with similar or harder situations’ (FF) • ‘They’ve been through it and they can help you without judging.’ (FG) • ‘Ability to share experiences with others’ (FF) • ‘Peer support very helpful’ (FF) • ‘Peer support, working on being a healthy parent, confidence building, awareness.’ (FF) • ‘Being with others that are in the same boat.’ (FF) • ‘And also in the group we are not alone with this, we all do this.’ (FG)
 Positive group interaction • ‘That there was laughter’ (FF) • ‘Being able to talk openly’ (FF) • ‘Being able to participate and not just being talked to’ (FF) • ‘The active participation of group members - sharing ideas, solutions, being self-reflective’ (FF)
 Practical group activities • Participants liked practical, ‘crafty’ activities, such as making a paper box, the compliment flower, colouring, which were perceived positively and as small achievements in the sessions (FF & FG) • They also liked a group walk (FF & FG)
Ambivalent elements and main suggestions for improvements
 Goal setting • Some participants felt that they set unrealistic goals; not achieving their goals had a negative effect; e.g.: ‘I found with my goals, looking back, they were probably unrealistic. So although I was doing the CLANGERS every week, I wasn’t achieving my goal. So then I felt guilty and disheartened.’ (FG) • Some felt that setting and reviewing goals was helpful as it raised self-awareness and helped identify barriers; e.g.: ‘Just becoming more aware. It brings up things like “why haven’t I done that?” or “have I been doing that?” which has been really good. And for me just having that awareness is a good starting point because then long-term it will benefit me.’ (FG) • Others felt that there should be more focus on thinking about long-term goals; ‘I think it would have been good to think “these are all the things I want to do long-term’ so setting long-term goals, but in that particular week all goes wrong and you don’t even think about or worry about your goal setting, and you come in and you think “oh no, I’ve not done it”. • Overall, participants agreed that there should be more focus at the beginning of the programme on discussing goal setting (e.g. why and how to set goals).
 Contact time and time management in the sessions • Participants reported that they would welcome more sessions (or on-going groups) that would provide more time to discuss issues related to CLANGERS and other issues that they wanted to share in the group and for peer support; ‘It could have done with another week or two. Especially the second week when we did the Connect, that was quite a big issue for some and we could have done a lot more time on it, cause we had to park stuff but we never actually got back to the parked things cause we didn’t have the time to.’ (FG) • They also would like to have more time within the sessions for ice-breaking, goal setting, unstructured group discussions and filling in feedback forms.
 Managing group interaction • Although participants generally found the group positive and enjoyable, they also felt that sometimes the group dynamics were challenging as everyone wanted to talk about their experiences and issues in a limited time; ‘Also, if [the facilitator] would start this side of the room doing feedback and said ‘let’s just have one’, we’d start with one and by the time we got to the other end then we suddenly went onto everything.’ (FG) ‘There are going to be times where everybody is going to feel they have something else to say and they really want to expand on what they’ve said, and having that opportunity – but it’s just when everyone stops? And with some topics perhaps we could’ve done with a little bit more time to allow to just get that off, when we really needed to off load something.’ (FG) • Participants suggested that it might be helpful to better manage how much time people take talking about their own experiences and views, mixing up where people sit and who they work with, and revisiting group ground rules more regularly.
 Feedback forms and questionnaires • Participants felt there should be more time to fill them in. • They preferred feedback forms specific to each of the CLANGERS. • They would like to be able to report any other circumstances (e.g. recent health issues) affecting their health and wellbeing, and longer-term follow up.
  1. Abbreviations used in the table: FF participants’ feedback forms, FG focus group