Table 4 Plans for addressing the challenges faced by practitioners

A few practitioners wanted to see the information which was given to patients on the POWeR+ website.

This information will be made available to HCPs. Since many practitioners have limited time, viewing these patient pages will be considered optional. Practitioners will not need to know the content of the patient website in order to provide support.

Some practitioners found it challenging not to give specific advice as they were concerned that some patients might expect this.

In future, our online training for POWeR+ will present practitioners the evidence that the CARE approach with no advice from the practitioner is effective (based on our trial evidence; [9]), and that patients like it (data triangulated from patient interviews; [Manuscript in preparation: Smith, Mowbary, Bradbury, Little, Yardley. Patients’ perceptions of POWeR+: A qualitative interview study]), to persuade practitioners that they are not doing patients a disservice by not providing advice. We took this approach in another of our interventions and found that it reduced HCP concerns about not providing advice [Manuscript submitted: Bradbury, Morton, Band, May, McManus, Little, Yardley, understanding how primary care practitioners perceive an online intervention for the management of hypertension].

Practitioners felt it would be useful for patients to be able to leave comments for them with their weight data, to give them further information about how the patient was getting on. This contextual information might help practitioners to provide more personalised support.

Patients also commented that they would have liked to leave comments for the practitioner when entering their weight into POWeR+ [Manuscript in preparation: Smith, Mowbary, Bradbury, Little, Yardley. Patients’ perceptions of POWeR+: A qualitative interview study]. This facility will therefore be added to POWeR+.

Some practitioners had a preference for providing face-to-face rather than remote support, a few felt that this was more valuable to patients.

In our online HCP training for POWeR+, we will reassure practitioners about the value of remote support by showing them the evidence that remote support is as effective as face-to-face support (as shown in our trial; [9]) and that remote support is also acceptable to patients and preferred by some patients (data triangulated from patient interviews; [Manuscript in preparation: Smith, Mowbary, Bradbury, Little, Yardley. Patients’ perceptions of POWeR+: A qualitative interview study]).

Some practitioners found it difficult to fit the POWeR support into their busy schedules.

We will suggest to practitioners that they book time in their diaries for providing support, as other nurses found this to be an effective strategy for enabling support to fit into their schedule. As remote support is likely to take less time and is as effective as face-to-face support, then we can recommend that practitioners provide most support remotely.