Understanding and supporting user engagement in reablement

Main issue analysed and its relevance Existing evidence indicates that a number of person-centred factors reablement outcomes. These include service user understanding and expectations of the intervention, motivation, and acceptance of the need for help. Some person-centred factors are, potentially, amenable to change by the practitioners involved. Thus, aspects of service design and delivery are also implicated. In addition, and contributed to by both service user and practitioner, is the quality of the so-called ‘therapeutic alliance’. All these factors are components of the construct ‘intervention engagement’. However, despite reablement requiring active participation by the service user, the construct of engagement has not been investigated within this context. This paper reports findings from a study which begins to address this evidence gap. Methdology An observational study of individuals (n=186) receiving reablement in England, followed up for 6 months post-intervention. Four models of service delivery were represented. A measure of engagement, developed and evaluated by the research team, was included within a battery of measures. A nested qualitiative study investigated the views and experiences of service users, reablement staff, and senior practitioners. Together, these data have allowed us to: i) test and understand whether and how user engagement impacts on reablement outcomes; and ii) the ways that aspects of service design and delivery may moderate or mediate this association. Main findings expected from the analysis A first round of analysis of the quantitative data has found an association between user engagement and a range of outcome domains and that user engagement differed between service delivery models. Qualitative data offers some explanations for these findings. This paper will synthesise these findings and report further analyses looking at the involvement of mental health, and the association between engagement and longer-term outcomes. Finally, we will reflect on the study’s contribution to theory. We are interested in the fact that much writing on engagement is concerned with the relationship between user and worker yet, in reablement, multiple workers may be involved.