Using co-design methods to develop new personalised support for people living with Long Covid: the ‘LISTEN’ intervention

Introduction. Many Covid-19 survivors are living with unresolved, relapsing, and remitting symptoms and no ‘one size’ of treatment is likely to be effective for everyone. Supported self-management for the varied symptoms of Long Covid (LC) is recommended by the National Institute for Health and Care Excellence in the UK. We aimed to develop a new personalised support intervention for people living with LC using a structured co-design framework to guide replication and evaluation. Methods. We used the improvement methodology, Experience-Based Co-Design (EBCD), in an accelerated form to harness the collective experiences of people with LC. Incorporating evidence from ‘Bridges Self-Management’ (Bridges) an approach in which healthcare professionals (HCPs)are trained to support knowledge, confidence and skills of individuals living with long term conditions. Co-designed resources are also central to Bridges. Adults who self-identified as living with or recovered from Long Covid, from England or Wales, aged 18 years and over were recruited, and HCPs, with experience of supporting people with LC. Participants took part in a series of small co-design group meetings and larger mixed meetings to agree priorities, core principles and generate resources and intervention content. Results. People with LC (n=28), and HCPs (n=9) supported co-design of a book (hard-copy and digital form) to be used in 1:1 support sessions with a trained HCP. Co-design stages prioritised stories about physical symptoms first and psychological and social challenges which followed, non-linear journeys, and reconceptualising stability as progress, rich descriptions of strategies, and links to reputable advice and support for navigating healthcare services. Co-design enabled formulation of eight core intervention principles which underpinned training and language used by HCPs and fidelity assessments. Conclusion. We have developed a new personalised support intervention, with core principles to be used in one-to-one sessions delivered by trained HCPs, with a new co-designed book as a prompt to build personalised strategies and plans using narratives, ideas, and solutions from other people with LC. Effectiveness and cost effectiveness of the “LISTEN’ intervention will be evaluated in a randomised controlled trial set within the context of the updated Framework for Developing and Evaluating Complex Interventions