healthcare Article Person-Centered Health Promotion: Learning from 10 Years of Practice within Long Term Conditions John Downey * , Saul Bloxham, Ben Jane, Joseph D. Layden and Sam Vaughan   Citation: Downey, J.; Bloxham, S.; Jane, B.; Layden, J.D.; Vaughan, S. Person-Centered Health Promotion: Learning from 10 Years of Practice within Long Term Conditions. Healthcare 2021, 9, 439. https:// doi.org/10.3390/healthcare9040439 Academic Editor: Eric Sobolewski Received: 3 March 2021 Accepted: 7 April 2021 Published: 8 April 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). School of Sport, Health and Wellbeing, Plymouth Marjon University, Plymouth PL6 8BH, UK; sbloxham@marjon.ac.uk (S.B.); bjane@marjon.ac.uk (B.J.); Jlayden@marjon.ac.uk (J.D.L.); Svaughan@marjon.ac.uk (S.V.) * Correspondence: jdowney@marjon.ac.uk Abstract: The utilization of person-centered care is highlighted as essential for health promotion, yet implementation has been inconsistent and multiple issues remain. There is a dearth of applied research exploring the facets of successful implementation. In this paper, a person-centered wellbeing program spanning various groups is discussed, outlining the central principles that have allowed for successful outcomes. Ten years of pragmatic pre–post service evaluation have shown consistent improvement in measures of functional capacity and wellbeing. The method for this paper is a reflective exploration of the theory and practices that can explain the continual improvement the clinics have achieved over 10 years. Core principles relate to connecting with people, connecting through groups, and connecting with self. The operationalization and theoretical explanation of these principles is outlined. The discussion of these principles posits essential factors to prioritize to advance the implementation of person-centered care in health promotion for long-term conditions. Keywords: person-centered care; health promotion; implementation; behavior change; primary care 1. Introduction Non-communicable diseases (NCDs) are diseases that are not acquired through trans- mission. NCDs represent the largest threat to global mortality and an unsustainable demand on health services worldwide [1]. The dominant NCDs are chronic, develop over time, require self-management and include cancer, diabetes, cardiovascular disease, and respiratory disease [2]. There is substantial overlap in the label “NCDs” and “long-term conditions”, as both define disorders which are ongoing, worsen over time, and are typi- cally mediated through poor lifestyle choices. The label “long-term conditions”, however, also captures interrelated disorders that are not defined as NCDs, for example, chronic pain. Moreover, and in line with our approach below, the term “long-term conditions” provides a more appropriate lexicon for these populations. Long-term conditions and unhealthy lifestyle behaviors tend to cluster in low socioeconomic groups. The term NCDs conflates the role of socioeconomic determinants of health. The risk-taking behaviors associated with long-term conditions are arguably communicable as they are passed across generations, which challenges the term NCDs [3]. Long-term conditions are a pressing challenge for contemporary healthcare. Long- term conditions are responsible for half of the global deaths in those over 40 years of age [4]. By the age of 50 years, half the United Kingdom will have one long-term condition. Worryingly, long-term conditions demonstrate a progressive trend and there is now a high prevalence of people with three or more long-term conditions. This multimorbid status leads to a decreased quality of life, increased risk of premature death and an unsustainable demand on health and social care systems [5]. Long-term conditions also lead to an expanding proportion of people who are less functionally capable, have lower health literacy, and respond poorly to usual care [6,7]. Healthcare 2021, 9, 439. https://doi.org/10.3390/healthcare9040439 https://www.mdpi.com/journal/healthcare