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Shen H, van der Kleij R, van der Boog PJM, Chavannes NH. Developing a Tailored eHealth Self-Management Intervention for Patients With Chronic Kidney Disease in China: Intervention Mapping Approach. JMIR Form Res 2024; 8:e48605. [PMID: 38869943 DOI: 10.2196/48605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 09/24/2023] [Accepted: 04/03/2024] [Indexed: 06/14/2024] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) is a major public health concern. Adequate self-management skills are vital to reduce CKD burden, optimize patient health outcomes, and control health care expenditures. Using eHealth to support CKD self-management has the potential to promote healthy behaviors and improve health outcomes of patients with CKD. However, knowledge of the implementation of such interventions in general, and in China specifically, is still limited. OBJECTIVE This study aims to develop a tailored eHealth self-management intervention for patients with CKD in China based on the Dutch Medical Dashboard (MD) eHealth self-management intervention. METHODS We used an intervention mapping approach. In phase 1, a systematic review and 2 qualitative studies were conducted to examine the needs, beliefs, and perceptions of patients with CKD and health care professionals regarding CKD self-management and eHealth interventions. Afterward, key factors gathered from the aforementioned studies were categorized following the 5 domains of the Consolidated Framework for Implementation Research (CFIR). In phase 2, we specified program outcomes, performance objectives, determinants, theory-based methods, and practical strategies. Knowledge obtained from previous results was combined to complement core components of the MD self-management intervention and adapt them for Chinese patients with CKD. Additionally, the CFIR-Expert Recommendations for Implementing Change Matching Tool was pragmatically used to generate a list of potential implementation strategies to address the key factors influencing the implementation of eHealth CKD self-management interventions, and implementation strategies were discussed and finalized with the intervention monitoring group. RESULTS An overview of the CFIR domains showed the essential factors influencing the implementation of eHealth CKD self-management interventions in Chinese settings, including "knowledge and beliefs" in the domain "individual characteristics," "quality and advantage of eHealth intervention" in the domain "intervention characteristics," "compatibility" in the domain "inner setting," and "cultural context" in the domain "outer setting." To ensure the effectiveness of the Dutch MD-based self-management intervention, we did not change the core self-management intervention components of MD that underlie its effectiveness, such as self-monitoring. We identified surface-level cultural adaptations involving customizing intervention content, messages, and approaches to the observable cultural characteristics of the local population to enhance the intervention's appeal, receptivity, and feasibility, such as providing video or voice call options to support interactions with health care professionals. Furthermore, the adapted modules such as Knowledge Center and My Self-Monitoring were developed in a mobile health app. CONCLUSIONS Our study resulted in the delivery of a culturally tailored, standardized eHealth self-management intervention for patients with CKD in China that has the potential to optimize patients' self-management skills and improve health status and quality of life. Moreover, our study's research approach and results can inform future research on the tailoring and translation of evidence-based, eHealth self-management interventions to various contexts. TRIAL REGISTRATION ClinicalTrials.gov NCT04212923; https://classic.clinicaltrials.gov/ct2/show/NCT04212923.
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Affiliation(s)
- Hongxia Shen
- School of Nursing, Guangzhou Medical University, Guangzhou, China
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
| | - Rianne van der Kleij
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
| | | | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
- National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
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Humphries D, Marotta P, Hu Y, Wang V, Gross G, Rucker D, Jones J, Alam F, Brown T, Carter CR, Spiegelman D. St. Louis Enhancing Engagement and Retention in HIV/AIDS Care (STEER): a participatory intersectional needs assessment for intervention and implementation planning. RESEARCH SQUARE 2024:rs.3.rs-4225131. [PMID: 38746123 PMCID: PMC11092814 DOI: 10.21203/rs.3.rs-4225131/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Background Missouri is one of seven priority states identified by the Ending the HIV Epidemic Initiative, and St. Louis contains almost half of the people living with HIV (PLWH) in Missouri. As St. Louis has a marked history of structural racism and economic inequities, we utilized the Intersectionality Based Policy Analysis (IBPA) framework to guide a participatory needs assessment for planning and program development. Methods The planning team included researchers, the lead implementer from our community partner, and two community representatives, and had biweekly 60-90 minute meetings for 18 months. The planning team discussed and approved all research materials, reviewed and interpreted results, and made decisions about outreach, recruitment, conduct of the needs assessment and development of the planned intervention. The needs assessment integrated information from existing data, (1) interviews with (a) PLWH (n=12), (b) community leaders (n=5), (c) clinical leaders (n=4), and (d) community health workers (CHWs) (n=3) and (e) CHW supervisors (n=3) who participated in a Boston University-led demonstration project on CHWs in the context of HIV and (2) focus groups (2 FG, 12 participants) with front line health workers such as peer specialists, health coaches and outreach workers. A rapid qualitative analysis approach was used for all interviews and focus groups. Results The IBPA was used to guide team discussions of team values, definition and framing of the problem, questions and topics in the key informant interviews, and implementation strategies. Applying the IBPA framework contributed to a focus on intersectional drivers of inequities in HIV services. The effective management of HIV faces significant challenges from high provider turnover, insufficient integration of CHWs into care teams, and organizational limitations in tailoring treatment plans. Increasing use of CHWs for HIV treatment and prevention also faces challenges. People living with HIV (PLWH) encounter multiple barriers such as stigma, lack of social support, co-morbidities, medication side effects and difficulties in meeting basic needs. Conclusions Addressing intersectional drivers of health inequities may require multi-level, structural approaches. We see the IBPA as a valuable tool for participatory planning while integrating community engagement principles in program and implementation design for improving HIV outcomes.
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Affiliation(s)
| | - Phillip Marotta
- Washington University In St Louis: Washington University in St Louis
| | | | | | - Greg Gross
- Washington University In St Louis: Washington University in St Louis
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Chang H, Do YJ. A spark of change: developing an innovative gerontological nursing intervention mapping initiative for training and education (IGNITE). BMC MEDICAL EDUCATION 2024; 24:266. [PMID: 38459465 PMCID: PMC10924358 DOI: 10.1186/s12909-024-05240-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 02/28/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND With an aging global population and advancements in medical technology, there is an urgent need for innovative gerontological nursing education programs. This study aimed to develop and evaluate the Innovative Gerontological Nursing Intervention Mapping Initiative for Training and Education (IGNITE) program. This program is a digital platform-based postgraduate nursing curriculum that employs the Intervention Mapping Approach (IMA) and Transformative Learning Theory to address the evolving needs of gerontological nursing. METHODS The IGNITE program's development process encompassed a comprehensive approach, including needs assessment, mapping of course objectives, integration of theory-based methods and strategies, course design, implementation, and rigorous evaluation. The pilot evaluation study involved pre- and post-tests focused on ageism, attitudes towards elder care, knowledge about older adults, transformative behavior change, and program satisfaction. The findings revealed significant improvements across all these dimensions, affirming the effectiveness of the program. RESULTS The program leveraged experiential learning, critical reflection, and rational discourse to facilitate transformative educational experiences. Notably, pre- and post-test comparisons showed marked improvements in attitudes towards older adult care and dementia care knowledge. Participants expressed high satisfaction with the program, with significant reported changes in transformative behaviors. The study also illuminated the initial negative attitudes of clinical nurses towards older adults and underscored the importance of transformative learning experiences in fostering empathy and understanding. CONCLUSIONS The IGNITE program lays a foundational framework for developing educational materials that promote transformative learning and self-reflection among healthcare professionals. This approach can lead to innovative nursing practices and personal growth. The application of the IMA and Transformative Learning Theory in gerontological nursing education shows significant promise. Future research should focus on exploring the long-term impacts of such programs and their applicability in diverse healthcare settings.
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Affiliation(s)
- HeeKyung Chang
- College of Nursing, Gerontological Health Research Center in Institute of Health Sciences, Gyeongsang National University, 52727, 816-15, Jinju-daero, Jinju, South Korea
| | - Young Joo Do
- College of Nursing, Gyeongsang National University, 52727, 816-15, Jinju-daero, Jinju, Gyeongnam, South Korea.
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Eekholm S, Samuelson K, Ahlström G, Lindhardt T. Development of an Implementation Strategy Tailored to Deliver Evidence-Based and Person-Centred Nursing Care for Patients with Community-Acquired Pneumonia: An Intervention Mapping Approach. Healthcare (Basel) 2023; 12:32. [PMID: 38200938 PMCID: PMC10779328 DOI: 10.3390/healthcare12010032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Community-acquired pneumonia is a serious public health problem, and more so in older patients, leading to high morbidity and mortality. However, this problem can be reduced by optimising in-hospital nursing care. Accordingly, this study describes a systematic process of designing and developing a tailored theory- and research-based implementation strategy that supports registered nurses (RNs) in delivering evidence-based and person-centred care for this patient population in a hospital setting. The implementation strategy was developed by completing the six steps of the Intervention Mapping framework: (1) developing a logic model of the problem and (2) a logic model of change by defining performance and change objectives, (3) designing implementation strategy interventions by selecting theory-based change methods, (4) planning the interventions and producing materials through a co-design approach, (5) developing a structured plan for adoption, maintenance and implementation and (6) developing an evaluation plan. This method can serve as a guide to (1) target behavioural and environmental barriers hindering the delivery of nursing care in local clinical practice, (2) support evidence uptake, (3) support RNs in the delivery of nursing care according to individual patient needs and thereby (4) optimise health-related patient outcomes.
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Affiliation(s)
- Signe Eekholm
- Department of Health Sciences, Faculty of Medicine, Lund University, Sölvegatan 19, P.O. Box 117, SE-221 00 Lund, Sweden; (K.S.); (G.A.)
- Department of Internal Medicine, Copenhagen University Hospital Herlev and Gentofte, Gentofte Hospitalsvej 4, 2nd. Floor, DK-2900 Hellerup, Denmark;
| | - Karin Samuelson
- Department of Health Sciences, Faculty of Medicine, Lund University, Sölvegatan 19, P.O. Box 117, SE-221 00 Lund, Sweden; (K.S.); (G.A.)
| | - Gerd Ahlström
- Department of Health Sciences, Faculty of Medicine, Lund University, Sölvegatan 19, P.O. Box 117, SE-221 00 Lund, Sweden; (K.S.); (G.A.)
| | - Tove Lindhardt
- Department of Internal Medicine, Copenhagen University Hospital Herlev and Gentofte, Gentofte Hospitalsvej 4, 2nd. Floor, DK-2900 Hellerup, Denmark;
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DANIELS KURTJOHN, PHARAOH HAMILTON. The prevalence of health risk behavior engagement among grade 4 to 7 learners in primary schools: A phase one needs analysis. J Public Health Afr 2023; 14:2328. [PMID: 38162335 PMCID: PMC10755514 DOI: 10.4081/jphia.2023.2328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 12/19/2022] [Indexed: 01/03/2024] Open
Abstract
Health risk behaviour, as it pertains to adolescent behaviour, poses a massive challenge for many fields of medicine, not only due to developmental and psychological concerns but also its inevitable contribution to the burden of disease through trauma and non-communicable diseases resulting from risky behavioural choices. The objective study is to explore the prevalence of health risk behavior engagement among grade 4-7 learners at four primary schools in the Western Cape, South Africa, as well as establish a need for a prevention program starting at primary school level. An observational, descriptive, quantitative design was used to conduct this study. Non-probability, heterogenous, purposive sampling was used to select the study population. A needs analysis assessment using a modified self-administered Child Health Risk Behaviour survey was conducted using 7-inch electronic tablets. Four primary schools agreed to participate yielding a total sample size of n=1147 learners in grades 4 to 7. Learners' age ranged from nine years old to fourteen years old with a mean age of 11.45 (SD 1.271). Riding a bicycle without a helmet, physical fight (86.1 and 64.1% among boys and girls respectively), ever smoked a cigarette (boys 36.3%; girls 28.3%) and consuming alcohol without permission (boys 28.7%; girls 23.8%) had the most engagement. Sexual curiosity questions had by far the most positive engagement and consistency of engagement among both boys and girls. This evidence reaffirms the need that early, bespoke and scientific intervention/prevention programs are needed to combat health risk behaviour and subsequently reduce the burden of disease.
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Affiliation(s)
- KURT JOHN DANIELS
- Department of Physiotherapy, University of Kwazulu-Natal, School of Health Sciences, Westville, South Africa
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Isehunwa OO, Hill SV, Menninger AT, Hubner B, Krakower D, Long DM, Pratt MC, Clement ME, Wagoner NV, Lanzi RG, Simpson T, Elopre L, Matthews LT. A Multicomponent Intervention to Train and Support Family Medicine Providers to Promote Pre-exposure Prophylaxis (PrEP) for Adolescent Girls and Young Women in the Deep South: Protocol for the PrEP-Pro Study. JMIR Res Protoc 2023; 12:e44908. [PMID: 36943364 PMCID: PMC10131664 DOI: 10.2196/44908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Pre-exposure prophylaxis (PrEP) is a highly effective biomedical prevention intervention and a major strategy for reducing the HIV burden in the United States. However, PrEP provision and uptake remain lower than estimated needs, and in ways that may exacerbate HIV disparities among Black adolescent girls and young women in the southern United States. Data suggest that gaps in provider knowledge of HIV epidemiology and PrEP and skills assessing sexual health practices are important barriers to provision and uptake, with limited evidence-based interventions to address these gaps. OBJECTIVE This paper describes the "PrEP-Pro" intervention, a multicomponent intervention to train and support family medicine (FM) trainees to promote PrEP for adolescent girls and young women in Alabama. METHODS The PrEP-Pro intervention comprises 3 main components guided by the Capability-Opportunity-Motivation-Behavior (COM-B) model for behavioral change and the Consolidated Framework for Implementation Research (CFIR): (1) provider HIV epidemiology and PrEP education, (2) sexual history taking, and (3) PrEP Champions. In phase 1, we will work with community advisory boards (providers and clients) and then conduct focus groups with FM trainees to adapt content to train FM residents on HIV epidemiology and PrEP and develop implementation strategies, including provider-facing tools and client-facing educational materials. In phase 2, we will pretest and then pilot-test the initially adapted PrEP-Pro intervention with FM trainees. FM trainees will complete baseline, 3-, and 6-month questionnaires post PrEP-Pro intervention. We will also conduct in-depth interviews (IDIs) with FM pilot participants, adolescent girls and young women who accessed care after the PrEP-Pro pilot, and key stakeholders. The primary outcomes are PrEP-Pro acceptability and feasibility, which would be assessed using validated instruments at months 3 (among pretest participants) and 6 (among pilot participants). Secondary outcomes will also be assessed, including PrEP knowledge, sexual history-taking attitudes and practices, PrEP prescriptions among adolescent girls and young women encounters, and sexually transmitted infections (STIs) and HIV testing among adolescent girls and young women encounters in 6 months. RESULTS Study results will be disseminated to practices, state health officials, and other key stakeholders to solicit feedback on implementation opportunities and challenges to inform a hybrid effectiveness implementation trial. Our results will also be presented at local and national conferences and submitted to peer-reviewed journals. CONCLUSIONS As PrEP grows, there is a pressing need to train FM providers and develop appropriate, contextually relevant tools to support PrEP implementation. The PrEP-Pro intervention is a multicomponent intervention to train FM residents across Alabama on sexual history-taking, PrEP provision for adolescent girls and young women, and supporting practice-based PrEP Champions. The PrEP-Pro intervention is anticipated to increase PrEP prescriptions for adolescent girls and young women and expand comprehensive sexual and reproductive health care for adolescent girls and young women in rural and urban Alabama. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/44908.
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Affiliation(s)
- Oluwaseyi O Isehunwa
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Samantha V Hill
- Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Alex Tobias Menninger
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
- School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Brook Hubner
- Department of Medical Education, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Douglas Krakower
- Division of Infectious Diseases, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Dustin M Long
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Madeline C Pratt
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Meredith E Clement
- Section of Infectious Diseases, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, United States
| | - Nicholas Van Wagoner
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Robin Gaines Lanzi
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Tina Simpson
- Tulane University School of Medicine, New Orleans, LA, United States
| | - Latesha Elopre
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Lynn T Matthews
- Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
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Terp R, Lindhardt T, Kayser L. Theory-driven development of an educative nutritional intervention (ENI) supporting older hospital patients to eat sufficiently, assisted by an eHealth solution: an intervention mapping approach. BMC Health Serv Res 2022; 22:1435. [DOI: 10.1186/s12913-022-08679-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 10/14/2022] [Indexed: 11/29/2022] Open
Abstract
Abstract
Background:
Insufficient protein and energy intake is a prevalent and serious problem in older hospital patients. Here, we describe the development of a program consisting of 1) an educative nutritional intervention (ENI) to support older hospital patients to participate in their own nutritional care using the eHealth solution Food’n’Go, and 2) a plan for education and support of healthcare professionals, enabling them to conduct the ENI. Further, we describe the evaluation of the acceptability of the program as perceived by nursing staff and dieticians.
Methods:
The Intervention Mapping (IM) framework was used to design and develop the ENI through six steps: 1) a logic model of the problem was developed; 2) performance objectives and related change objectives were defined for patients, relatives, and healthcare professionals; 3) the intervention was designed using relevant theory-based change methods; 4) program materials were produced; and finally, 5) implementation and maintenance were planned and 6) evaluation of the program was planned. End users (patients, relatives, and healthcare professionals) were involved in the design and development of the ENI.
Results:
Based on the logic model, the personal determinants (knowledge, skills, self-efficacy, outcome expectation, social support, attitude, and awareness) related to the patients and their relatives were addressed in the ENI, and those related to the healthcare professionals were addressed in the plan for their education and support. Theories of behavioral change, technology acceptance, and nutritional management for older persons were applied. A plan for evaluation of the effectiveness (intake of energy and protein) and feasibility of the ENI was conducted. The feasibility measurements were the behaviors and determinants related to the intervention outcome that were identified in the logic model of change. The ENI was perceived as acceptable by the nursing staff and dieticians.
Conclusion:
We developed a theory- and evidence-based intervention guided by the IM framework and a sociotechnical approach, which was perceived as acceptable and ready for use to support older hospital patients to eat sufficiently assisted by eHealth.
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Passero L, Srinivasan S, Grewe ME, Leeman J, Berg J, Reuland D, Roberts MC. Development and initial testing of a multi-stakeholder intervention for Lynch syndrome cascade screening: an intervention mapping approach. BMC Health Serv Res 2022; 22:1411. [PMID: 36434579 PMCID: PMC9694070 DOI: 10.1186/s12913-022-08732-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 10/25/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Lynch syndrome is an underdiagnosed hereditary condition carrying an increased lifetime risk for colorectal and endometrial cancer and affecting nearly 1 million people in the United States. Cascade screening, systematic screening through family members of affected patients, could improve identification of Lynch syndrome, but this strategy is underused due to multi-level barriers including low knowledge about Lynch syndrome, low access to genetics services, and challenging family dynamics. METHODS We used intervention mapping, a 6-step methodology to create stakeholder-driven interventions that meet the needs of a target population, to develop an intervention to improve cascade screening for Lynch syndrome. The intervention development process was guided by input from key stakeholders in Lynch syndrome care and patients. We conducted usability testing on the intervention with Lynch syndrome patients using qualitative semi-structured interviewing and rapid qualitative analysis. RESULTS We developed a workbook intervention named Let's Talk that addresses gaps in knowledge, skills, self-efficacy, outcome expectancy and other perceived barriers to cascade screening for Lynch syndrome. Let's Talk contained educational content, goal setting activities, communication planning prompts and supplemental resources for patients to plan family communication. Evidence-based methods used in the workbook included information chunking, guided practice, goal setting and gain-framing. We conducted usability testing focused on the complexity and relative advantage of the intervention through 45-min virtual interviews with 10 adult patients with Lynch syndrome recruited from a national advocacy organization in the United States. Usability testing results suggested the intervention was acceptable in terms of complexity and relative advantage to other available resources, but additional information for communication with young or distant family members and a web-based platform could enhance the intervention's usability. CONCLUSIONS Intervention mapping provided a framework for intervention development that addressed the unique needs of Lynch syndrome patients in overcoming barriers to cascade screening. Future work is needed to transform Let's Talk into a web-based tool and evaluate the effectiveness of the intervention in clinical practice with patients and genetic counselors. Intervention mapping can be useful to researchers as an evidence-based technique to develop stakeholder-centered interventions for addressing the needs of other unique populations.
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Affiliation(s)
- Lauren Passero
- grid.10698.360000000122483208Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, NC Chapel Hill, US
| | - Swetha Srinivasan
- grid.10698.360000000122483208Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, NC Chapel Hill, US
| | - Mary E. Grewe
- grid.10698.360000000122483208North Carolina Translational and Clinical Sciences Institute, University of North Carolina at Chapel Hill, NC Chapel Hill, US
| | - Jennifer Leeman
- grid.10698.360000000122483208School of Nursing, University of North Carolina at Chapel Hill, NC Chapel Hill, US
| | - Jonathan Berg
- grid.10698.360000000122483208School of Medicine, University of North Carolina at Chapel Hill, NC Chapel Hill, US
| | - Daniel Reuland
- grid.10698.360000000122483208School of Medicine, University of North Carolina at Chapel Hill, NC Chapel Hill, US
| | - Megan C. Roberts
- grid.10698.360000000122483208Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, NC Chapel Hill, US
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Sun Y, Gao Y, Yu S, Wang A, Ou X, Tao D, Baker JS. Promoting Physical Activity among Workers: A Review of Literature and Future Directions on Developing Theory-Based Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13594. [PMID: 36294174 PMCID: PMC9602512 DOI: 10.3390/ijerph192013594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/15/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
Insufficient physical activity (PA) has been identified as a leading risk factor for premature and all-cause death, as well as non-communicable diseases. Employees, especially those with low occupational PA, are more vulnerable to physical inactivity, and studies in this population are scarce. However, employees may receive benefits for both health and work productivity from PA. Therefore, well-designed behavior change studies to promote PA in employees are urgently needed, especially during the COVID-19 pandemic. Literature was searched before 30 July 2022, and updated evidence was summarized. This review elaborates on the evidence related to insufficient PA and further provides an overview of theory-based interventions for promoting PA. Evidence indicates that intervention mapping (IM) was a useful tool to develop, implement, and evaluate behavior change interventions. Based on the IM framework, reviewing the theory- and evidence-based change methods and delivery modes, and further identifying the research gaps and limitations of existing interventions could provide promising suggestions and directions for development of well-founded interventions promoting PA among employees. The updated knowledge base for developing future interventions may boost efficacy and provide firm conclusions for researchers in this area.
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Affiliation(s)
- Yan Sun
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong 999077, China
| | - Yang Gao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong 999077, China
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong 999077, China
| | - Siyue Yu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong 999077, China
| | - Aiwei Wang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong 999077, China
- College of Physical Education, Yangzhou University, Yangzhou 225012, China
| | - Xiaoting Ou
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong 999077, China
| | - Dan Tao
- Department of Government and International Studies, Hong Kong Baptist University, Hong Kong 999077, China
| | - Julien S. Baker
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong 999077, China
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong 999077, China
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Bravington A, Chen H, Dyson J, Jones L, Dalgliesh C, Bryan A, Patnick J, Macleod U. Translating qualitative data into intervention content using the Theoretical Domains Framework and stakeholder co-design: a worked example from a study of cervical screening attendance in older women. BMC Health Serv Res 2022; 22:610. [PMID: 35524217 PMCID: PMC9074234 DOI: 10.1186/s12913-022-07926-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 04/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Previous screening interventions have demonstrated a series of features related to social determinants which have increased uptake in targeted populations, including the assessment of health beliefs and barriers to screening attendance as part of intervention development. Many studies cite the use of theory to identify methods of behaviour change, but fail to describe in detail how theoretical constructs are transformed into intervention content. The aim of this study was to use data from a qualitative exploration of cervical screening in women over 50 in the UK as the basis of intervention co-design with stakeholders using behavioural change frameworks. We describe the identification of behavioural mechanisms from qualitative data, and how these were used to develop content for a service-user leaflet and a video animation for practitioner training. The interventions aimed to encourage sustained commitment to cervical screening among women over 50, and to increase sensitivity to age-related problems in screening among primary care practitioners. Methods Secondary coding of a qualitative data set to extract barriers and facilitators of cervical screening attendance. Barrier and facilitator statements were categorised using the Theoretical Domains Framework (TDF) to identify relevant behaviour change techniques (BCTs). Key TDF domains and associated BCTs were presented in stakeholder focus groups to guide the design of intervention content and mode of delivery. Results Behavioural determinants relating to attendance clustered under three domains: beliefs about consequences, emotion and social influences, which mapped to three BCTs respectively: (1) persuasive communication/information provision; (2) stress management; (3) role modelling and encouragement. Service-user stakeholders translated these into three pragmatic intervention components: (i) addressing unanswered questions, (ii) problem-solving practitioner challenges and (iii) peer group communication. Based on (ii), practitioner stakeholders developed a call to action in three areas – clinical networking, history-taking, and flexibility in screening processes. APEASE informed modes of delivery (a service-user leaflet and a cartoon animation for practitioners). Conclusion The application of the TDF to qualitative data can provide an auditable protocol for the translation of qualitative data into intervention content. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07926-2.
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Affiliation(s)
- Alison Bravington
- Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK.
| | - Hong Chen
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Judith Dyson
- Centre for Social Care, Health and Related Research, Birmingham City University, Birmingham, UK
| | - Lesley Jones
- Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK
| | | | | | - Julietta Patnick
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Una Macleod
- Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK
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Using an Intervention Mapping Approach to Develop a Program for Preventing High Blood Pressure in a Marginalized Afro-Colombian Population: A Community-Based Participatory Research. JOURNAL OF PREVENTION 2022; 43:209-224. [PMID: 35445375 PMCID: PMC8800401 DOI: 10.1007/s10935-022-00668-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/11/2022] [Indexed: 11/04/2022]
Abstract
The prevention of high blood pressure (HBP) is an important public health initiative worldwide, since HBP is the main risk factor for cardiovascular diseases and increases the damage caused by coronavirus disease 2019 (COVID-19). We designed, implemented, and evaluated a program to identify effective and sustainable interventions for preventing HBP in a marginalized black population. Our study was conducted in Quibdó, a city in Colombia with the highest poverty rate and located in the Pacific coast, a subregion in Colombia with the highest prevalence of HBP. We followed an intervention mapping framework using a community-based participatory research approach. Focus groups, photovoice, literature reviews, and cross-sectional quantitative surveys were used for data collection. The community chose the time, place, and type of physical activity; led the physical activities; and strengthened their skills in seeking resources in their community to sustain the program. The evaluation was aimed at determining whether the interventions were able to achieve the program’s primary aim. We used a before (September 2016) and after (December 2017) design for the evaluation. To decrease the selection bias and allow comparisons between homogeneous groups, we used a propensity score matching technique. The steps required to create a self-sustaining physical activity program were provided in detail. The pre-post test showed a decrease of the HBP (systolic, 13.4% points; p = 0.018; diastolic, 6.5% points; p = 0.002). The program may be an effective and self-sustaining intervention, and it can be replicated by policymakers and implemented in other population groups.
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12
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Park J, Ten Hoor GA, Baek S, Chung S, Kim YH, Hwang G. The Let's Eat Healthy and Move at School program for adolescents in South Korea: Program design, implementation, and evaluation plan using intervention mapping. CHILD HEALTH NURSING RESEARCH 2022; 27:225-242. [PMID: 35004512 PMCID: PMC8650854 DOI: 10.4094/chnr.2021.27.3.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/07/2021] [Accepted: 07/14/2021] [Indexed: 11/11/2022] Open
Abstract
Purpose This study aimed to systematically develop an obesity prevention program for adolescents to promote healthy eating and physical activity in schools. Methods The development of the Let's Eat Healthy and Move at School program for adolescents followed the six steps of intervention mapping (IM). IM is a widely used protocol for developing systematic and effective interventions based on theories and evidence. Results To better understand the problem and identify the needs of adolescents, interviews were conducted with teachers, school nurses, and students (step 1). In step 2, the desired behaviors and their determinants were established and combined into a matrix comprising 16 change objectives. In step 3, theoretical methods such as persuasive communication and consciousness-raising were chosen. The program was segmented into three educational activity sessions in step 4. In step 5, an implementation manual was developed for program instructors to ensure effective and accurate implementation. Finally, practices for evaluating the program's effectiveness and procedures were designed in step 6. Conclusion The Let’s Eat Healthy and Move at School program will provide adolescents with guidelines to promote healthy living and prevent obesity in everyday life using strategies for sustainable adolescent obesity prevention and management.
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Affiliation(s)
- Jiyoung Park
- Assistant Professor, College of Nursing, Institute for Health Science Research, Inje University, Busan, Korea
| | - Gill A Ten Hoor
- Assistant Professor, Department of Work and Social Psychology, Maastricht University, Maastricht, Netherlands
| | - Seolhyang Baek
- Professor, College of Nursing, Dongguk University, Gyeongju, Korea
| | - Sochung Chung
- Professor, Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
| | - Yang-Hyun Kim
- Associate Professor, Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea
| | - Gahui Hwang
- Graduate Student, College of Nursing, Yonsei University, Seoul, Korea
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13
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García Bengoechea E, Clifford AM, Gallagher S, O' Regan A, O'Sullivan N, Casey M, Glynn L, Macken P, Sweeney J, Donnelly A, Murphy A, Woods CB. Juggling with theory, evidence, practice, and real-world circumstances: Development of a complex community intervention to increase physical activity in inactive adults aged 50 years and older - The Move for Life Study. EVALUATION AND PROGRAM PLANNING 2021; 89:101983. [PMID: 34404011 DOI: 10.1016/j.evalprogplan.2021.101983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 06/03/2021] [Accepted: 06/06/2021] [Indexed: 06/13/2023]
Abstract
Despite well-known benefits of physical activity, in Ireland only 38 % of older adults are sufficiently active. Behavioural interventions are rarely developed systematically and, when reported, inadequate description often becomes a barrier for subsequent replication and scalability. In this article, we describe the development and characteristics of Move for Life, an intervention to reach and help inactive adults aged 50 years and older increase their physical activity. It was designed to fit within existing group-based structured physical activity programmes run by Local Sports Partnerships, thus maximising the likelihood of translation into policy and practice. Constructs from social cognitive theory, self-determination theory, and the conceptual model of group cohesion in exercise informed the conceptual model and the development of behavioural skills, social support, and group cohesion intervention strategies. Physical activity instructors supported by peer mentors, who also contributed to sustaining the intervention, implemented these strategies. Moving away from accounts of intervention development as a relatively simple linear process, we illustrate the complex interplay of theory, evidence, practice, and real-world contextual circumstances that shaped the development of Move for Life. Against this backdrop, we discuss issues relevant to the planning and reporting of behavioural and physical activity interventions in public health.
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Affiliation(s)
- Enrique García Bengoechea
- University of Limerick Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, Ireland
| | | | | | - Andrew O' Regan
- University of Limerick School of Medicine and Health Research Institute, Ireland
| | - Nollaig O'Sullivan
- University of Limerick Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, Ireland
| | - Monica Casey
- University of Limerick School of Medicine and Health Research Institute, Ireland
| | - Liam Glynn
- University of Limerick School of Medicine and Health Research Institute, Ireland; HRB Primary Care Clinical Trial Network Ireland, Ireland
| | | | | | - Alan Donnelly
- University of Limerick Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, Ireland
| | - Andrew Murphy
- HRB Primary Care Clinical Trial Network Ireland, Ireland; NUI Galway Department of General Practice, Ireland
| | - Catherine B Woods
- University of Limerick Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, Ireland.
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14
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Muniswamy P, Gorhe V, Parashivakumar L, Chandrasekaran B. Short-term effects of a social media-based intervention on the physical and mental health of remotely working young software professionals: A randomised controlled trial. Appl Psychol Health Well Being 2021; 14:537-554. [PMID: 34750975 DOI: 10.1111/aphw.12318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/09/2021] [Indexed: 11/28/2022]
Abstract
The present study aimed to explore the short term effects of a social media-based intervention on the physical and mental health of the software professionals working remotely during the pandemic. Sixty software professionals with poor physical and mental health were randomised to Facebook-based intervention (FIIT) and a control (CONT) group for 2 months. Forty-six remote workers (26.25 ± 3.49 years) completed the study (FIIT = 22; CONT = 26). All the respondents had the median sitting time (7.07 ± 2.30 h/day) during office hours on workdays. We found a significant difference in the sitting time during office hours in workday within the subjects (F1,46 = 4.66; p < .004; ηp 2 = .048) and between the subjects (F1,46 = 3.81; p < .004; ηp 2 = .040). Post hoc analysis revealed participants in the FIIT group reduced their sitting time by 58 min during office hours during a typical workday compared with the control group. Nevertheless, we found a significant difference in the scores of stress, anxiety and depression within and between the groups. Short-term social media-based physical and mental health intervention may improve physical and mental health scores in the desk-based office workers working remotely.
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Affiliation(s)
- Prabhu Muniswamy
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Varadayini Gorhe
- Sports & Performance Psychology, MindFirst Performance, Pune, India
| | | | - Baskaran Chandrasekaran
- Department of Exercise and Sports Sciences, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
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15
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van Agteren J, Iasiello M, Ali K, Fassnacht DB, Furber G, Woodyatt L, Howard A, Kyrios M. Using the Intervention Mapping Approach to Develop a Mental Health Intervention: A Case Study on Improving the Reporting Standards for Developing Psychological Interventions. Front Psychol 2021; 12:648678. [PMID: 34675833 PMCID: PMC8524131 DOI: 10.3389/fpsyg.2021.648678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 08/09/2021] [Indexed: 01/02/2023] Open
Abstract
Replicating or distilling information from psychological interventions reported in the scientific literature is hindered by inadequate reporting, despite the existence of various methodologies to guide study reporting and intervention development. This article provides an in-depth explanation of the scientific development process for a mental health intervention, and by doing so illustrates how intervention development methodologies can be used to improve development reporting standards of interventions. Intervention development was guided by the Intervention Mapping approach and the Theoretical Domains Framework. It relied on an extensive literature review, input from a multi-disciplinary group of stakeholders and the learnings from projects on similar psychological interventions. The developed programme, called the “Be Well Plan”, focuses on self-exploration to determine key motivators, resources and challenges to improve mental health outcomes. The programme contains an online assessment to build awareness about one’s mental health status. In combination with the exploration of different evidence-based mental health activities from various therapeutic backgrounds, the programme teaches individuals to create a personalised mental health and wellbeing plan. The use of best-practice intervention development frameworks and evidence-based behavioural change techniques aims to ensure optimal intervention impact, while reporting on the development process provides researchers and other stakeholders with an ability to scientifically interrogate and replicate similar psychological interventions.
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Affiliation(s)
- Joep van Agteren
- Wellbeing and Resilience Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,Órama Institute for Mental Health and Wellbeing, Adelaide, SA, Australia
| | - Matthew Iasiello
- Wellbeing and Resilience Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.,College of Nursing and Health Science, Flinders University, Adelaide, SA, Australia
| | - Kathina Ali
- Órama Institute for Mental Health and Wellbeing, Adelaide, SA, Australia.,College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia
| | - Daniel B Fassnacht
- Órama Institute for Mental Health and Wellbeing, Adelaide, SA, Australia.,College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia
| | - Gareth Furber
- Health Counselling and Disability Services, Flinders University, Adelaide, SA, Australia
| | - Lydia Woodyatt
- College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia
| | - Alexis Howard
- College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia
| | - Michael Kyrios
- Órama Institute for Mental Health and Wellbeing, Adelaide, SA, Australia.,College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia
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16
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Halliday JA, Speight J, Russell-Green S, O E, Hagger V, Morris A, Sturt J, Hendrieckx C. Developing a novel diabetes distress e-learning program for diabetes educators: an intervention mapping approach. Transl Behav Med 2021; 11:1264-1273. [PMID: 33677509 DOI: 10.1093/tbm/ibaa144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Diabetes distress is a common negative emotional response to the ongoing burden of living with diabetes. Elevated diabetes distress is associated with impaired diabetes self-management and quality of life yet rarely identified and addressed in clinical practice. Health professionals report numerous barriers to the provision of care for diabetes distress, including lack of skills and confidence, but few diabetes distress training opportunities exist. The purpose of this paper is to describe how we utilized Intervention Mapping to plan the development, implementation, and evaluation of a novel diabetes distress e-learning program for diabetes educators, to meet a well-documented need and significant gap in diabetes care. A multidisciplinary team (combining expertise in research, health and clinical psychology, diabetes education, nursing, tertiary education, and website architecture) developed a diabetes distress e-learning program. We followed a six-step process (logic model of the problem, program outcomes and objectives, program design, program production, program implementation plan, and evaluation plan) known as Intervention Mapping. The program is underpinned by educational and psychological theory, including Bloom's Taxonomy of Educational Objectives and social cognitive theory. We developed a short (estimated 4 h) e-learning program for diabetes educators, which draws on the content of the Diabetes and Emotional Health handbook and toolkit. It integrates a 7As model, which provides a stepwise approach to identifying and addressing diabetes distress. Our diabetes distress e-learning program has been developed systematically, guided by an Intervention Mapping approach. In the next phase of the project, we will trial the e-learning.
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Affiliation(s)
- Jennifer A Halliday
- School of Psychology, Deakin University, Geelong, Australia.,The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, Australia.,The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - Sienna Russell-Green
- School of Psychology, Deakin University, Geelong, Australia.,The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - Eric O
- Faculty of Health, Deakin University, Geelong, Australia
| | | | - Ann Morris
- AMCON Diabetes Management Service, Warrnambool, Australia
| | - Jackie Sturt
- Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, Kings College London, London, UK
| | - Christel Hendrieckx
- School of Psychology, Deakin University, Geelong, Australia.,The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
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17
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Daniels KJ, Pharaoh H. Developing a children's health risk behaviour prevention program targeting grade 4-7 learners in the western cape, South Africa: a study protocol. BMC Public Health 2021; 21:1021. [PMID: 34053443 PMCID: PMC8166084 DOI: 10.1186/s12889-021-10968-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background Health risk behaviour among South African youth is a significant public health concern. Despite a societal mind shift to educating the public on the prevention of health risk behaviour, behavioural change is not progressing at the rate needed to influence health risk behaviour positively. The project aims to explore behavioural trends and willingness to engage in risky behaviour among senior primary school children. Secondly, to design a health risk behaviour prevention program which adequately equips senior primary school children with the necessary life skills to alter risk behaviour engagement. Methods The study will make use of an intervention mapping framework and a sequential, explanatory mixed methods design. Stratified random probability sampling will be used to select three primary schools in the region. Nonprobability purposive sampling will be used to select the stakeholders participating in the focus group sessions. Data collection consists of five phases with the results of each stage informing the structure and application of the next. Phase 1 - baseline data collection (needs analysis) using the child health risk behaviour survey. Phase 2 - focus group interviews. Phase 3 - a systematic review of the literature for result analysis triangulation. Phase 4 – the development of the child risk behaviour prevention program based on the outcomes of phases 1,2 and 3. Phase 5 - implementation of the program. Descriptive statistics will be used to analyse the quantitative data. Chi-square, ANOVA and multiple regression analyses will be used to predict health risk behaviour engagement. Thematic analysis will be used to analyse qualitative data. Discussion To our knowledge, this is the first study that would attempt to establish a health risk behaviour prevention program in youth and young people in South Africa. Overwhelming evidence exists that adolescents engage in risky health behaviour which may potentially negatively impact their lives. This study provides an opportunity to address a gap in the current strategy by developing a prevention program for young people which could later be supported by further booster programs through their adolescents. This project would serve as a baseline prevention program that could assist in the reduction of risky health behaviour among various communities. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10968-6.
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Affiliation(s)
- Kurt John Daniels
- Department of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, University Drive, Durban, 4001, South Africa.
| | - Hamilton Pharaoh
- Department of Physiotherapy, School of Health Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, University Drive, Durban, 4001, South Africa
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18
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Brewster S, Holt R, Price H. Introduction to the development of complex interventions. Postgrad Med J 2021; 98:895-899. [PMID: 34039699 DOI: 10.1136/postgradmedj-2021-139766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 05/02/2021] [Accepted: 05/06/2021] [Indexed: 11/04/2022]
Abstract
Healthcare interventions are complex, but have the potential to deliver more efficient, cost-effective care and improved health outcomes. Careful attention must be paid to their early planning and development to minimise research waste or interventions that fail to deliver what they set out to achieve. The Medical Research Council provides guidance to help intervention developers, encouraging an explicit and iterative approach. This article describes the Medical Research Council's guidance and introduces two frequently used tools that further support the process of intervention design.
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Affiliation(s)
- Sarah Brewster
- Research and Development, Southern Health NHS Foundation Trust, Southampton, UK
| | - Richard Holt
- Faculty of Medicine, University of Southampton Division of Human Development and Health, Southampton, UK
| | - Hermione Price
- West Hampshire Community Diabetes Service, Southern Health NHS Foundation Trust, Southampton, UK
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19
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Leenen J, Hoebe CJPA, Bos AER, Wolffs PFG, van Loo IHM, de Wit JBF, Jonas KJ, Dukers-Muijrers NHTM. Systematic Development of an Intervention to Promote Self-Sampling for HIV and Sexually Transmitted Infections for Men Who Have Sex With Men: An Intervention Mapping Approach. FRONTIERS IN REPRODUCTIVE HEALTH 2021; 3:634032. [DOI: 10.3389/frph.2021.634032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/17/2021] [Indexed: 11/13/2022] Open
Abstract
Sexual healthcare aims to reduce HIV and sexually transmitted infections (STIs) by promoting testing and prevention. To better reach men who have sex with men (MSM), additional strategies are needed. Here, we describe development of an intervention, which is part of a broader HIV/STI home-care program, targeted to reach MSM and motivate them to use self-sampling tests. Self-sampling includes blood sampling (finger prick) for HIV, hepatitis B, and syphilis, and a urine sample and oral and anorectal swab samples for chlamydia and gonorrhea. Intervention mapping, a systematic six-step approach, was used to guide the development process: (1) needs assessment including interviews with MSM, (2) create a matrix of change, (3) selection of theory-based methods and practical strategies, (4) intervention development, (5) implementation plan, and (6) evaluation (not included in this paper). Stakeholders were involved to increase program support and feasibility. The needs assessment revealed that testing barriers among MSM related to stigma, time, and privacy concerns. Barriers among healthcare providers related to time, competing priorities, lack of expertise, and guideline restrictions. Included intervention components are designed to overcome these barriers, e.g., engaging role models, with a website with a role model story, and providing tailored information. Methods to reach MSM were a variety of information channels (posters, flyers, and audio-visual displays) and delivery modes, such as advertisements on websites and invitational cards (online and paper) distributed by healthcare providers and MSM themselves (social network testing/peer testing). Our intervention aims to encourage MSM to engage in testing, re-testing, and providing a test to peer MSM. Evidence-based methods to overcome barriers were included to reach and motivate an increased number of MSM. Using intervention mapping stimulated systematic evidence-based decision making and adapting the intervention to the target audience and setting. The next step (step 6) is to implement and evaluate the intervention.
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20
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Ravicz M, Muhongayire B, Kamagaju S, Klabbers RE, Faustin Z, Kambugu A, Bassett I, O'Laughlin K. Using Intervention Mapping methodology to design an HIV linkage intervention in a refugee settlement in rural Uganda. AIDS Care 2021; 34:446-458. [PMID: 33749418 PMCID: PMC8452793 DOI: 10.1080/09540121.2021.1900532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Nearly 80 million people have been forcibly displaced by persecution, violence, and disaster. Displaced populations, including refugees, face health challenges such as resource shortages, food and housing insecurity, violence, and disrupted social support. People living with HIV in refugee settings have decreased engagement with HIV services compared to non-refugee populations, and interventions are needed to enhance linkage to care. However, designing health interventions in humanitarian settings is challenging. We used Intervention Mapping (IM), a six-step method for developing theory- and evidence-based health interventions, to design a program to increase linkage to HIV care for refugees and Ugandan nationals in Nakivale Refugee Settlement in Uganda. We engaged a diverse group of stakeholders (N = 14) in Nakivale, including community members and humanitarian actors, in an interactive workshop focusing on IM steps 1–4. We developed a chronic care program that would integrate HIV care with services for hypertension and diabetes at accessible community sites, thereby decreasing stigma around HIV treatment and improving access to care. IM provided an inclusive, efficient method for integrating community members and program implementers in the intervention planning process, and can be used as a method-driven approach to intervention design in humanitarian settings.
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Affiliation(s)
- Miranda Ravicz
- Departments of Internal Medicine and Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Robin E Klabbers
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | | | - Andrew Kambugu
- Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda
| | - Ingrid Bassett
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Kelli O'Laughlin
- Departments of Emergency Medicine and Global Health, University of Washington, Seattle, WA, USA
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21
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Bakhuys Roozeboom MC, Wiezer NM, Boot CRL, Bongers PM, Schelvis RMC. Use of Intervention Mapping for Occupational Risk Prevention and Health Promotion: A Systematic Review of Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041775. [PMID: 33670376 PMCID: PMC7918071 DOI: 10.3390/ijerph18041775] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 11/19/2022]
Abstract
Aim: Intervention mapping (IM) is a method to systematically design interventions that is applied regularly within the public health domain. This study investigates whether IM is effectively used within the occupational safety and health domain as well. Specifically, this study explores the relation between the fidelity regarding the use of the IM protocol for intervention development, the implementation process and the effectiveness of the occupational risk prevention and health promotion interventions. Methods: A systematic review was conducted including articles on development, implementation, and effects of occupational risk prevention and health promotion interventions that were developed according to the IM-protocol. By means of a checklist, two authors reviewed the articles and rated them on several indicators regarding the fidelity of the IM-protocol, the implementation process, and the intervention effect. Results: A literature search resulted in a total of 12 interventions as described in 38 articles. The fidelity to the IM-protocol was relatively low for participation throughout the development process and implementation planning. No relationship was found between fidelity of the IM-protocol and the intervention effect. A theory-based approach (as one of the core elements of IM) appears to be positively related to a successful implementation process. Conclusion: Results of the review suggest that organizing a participative approach and implementation planning is difficult in practice. In addition, results imply that conducting matrices of change objectives as part of the intervention development, although challenging and time-consuming, may ultimately pay off, resulting in a tailored intervention that matches the target group.
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Affiliation(s)
- Maartje C. Bakhuys Roozeboom
- Department of Healthy Living, Netherlands Organisation for Applied Scientific Research (TNO), Schipholweg 77, 2316 ZL Leiden, The Netherlands; (N.M.W.); (P.M.B.)
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University, Amsterdam UMC, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands;
- Correspondence:
| | - Noortje M. Wiezer
- Department of Healthy Living, Netherlands Organisation for Applied Scientific Research (TNO), Schipholweg 77, 2316 ZL Leiden, The Netherlands; (N.M.W.); (P.M.B.)
| | - Cécile R. L. Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University, Amsterdam UMC, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands;
| | - Paulien M. Bongers
- Department of Healthy Living, Netherlands Organisation for Applied Scientific Research (TNO), Schipholweg 77, 2316 ZL Leiden, The Netherlands; (N.M.W.); (P.M.B.)
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University, Amsterdam UMC, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands;
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Shegog R, Armistead L, Markham C, Dube S, Song HY, Chaudhary P, Spencer A, Peskin M, Santa Maria D, Wilkerson JM, Addy R, Tortolero Emery S, McLaughlin J. A Web-Based Game for Young Adolescents to Improve Parental Communication and Prevent Unintended Pregnancy and Sexually Transmitted Infections (The Secret of Seven Stones): Development and Feasibility Study. JMIR Serious Games 2021; 9:e23088. [PMID: 33502323 PMCID: PMC7875699 DOI: 10.2196/23088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/03/2020] [Accepted: 11/26/2020] [Indexed: 12/02/2022] Open
Abstract
Background Early adolescent unintended pregnancy and sexually transmitted infection prevention are significant public health challenges in the United States. Parental influence can help adolescents make responsible and informed sexual health decisions toward delayed sexual debut; yet parents often feel ill equipped to communicate about sex-related topics. Intergenerational games offer a potential strategy to provide life skills training to young adolescents (aged 11-14 years) while engaging them and their parents in communication about sexual health. Objective This study aims to describe the development of a web-based online sexual health intergenerational adventure game, the Secret of Seven Stones (SSS), using an intervention mapping (IM) approach for developing theory- and evidence-based interventions. Methods We followed the IM development steps to describe a theoretical and empirical model for young adolescent sexual health behavior, define target behaviors and change objectives, identify theory-based methods and practical applications to inform design and function, develop and test a prototype of 2 game levels to assess feasibility before developing the complete 18-level game, draft an implementation plan that includes a commercial dissemination strategy, and draft an evaluation plan including a study design for a randomized controlled trial efficacy trial of SSS. Results SSS comprised an adventure game for young adolescent skills training delivered via a desktop computer, a text-based notification system to provide progress updates for parents and cues to initiate dialogue with their 11- to 14-year-old child, and a website for parent skills training and progress monitoring. Formative prototype testing demonstrated feasibility for in-home use and positive usability ratings. Conclusions The SSS intergenerational game provides a unique addition to the limited cadre of home-based programs that facilitate parent involvement in influencing young adolescent behaviors and reducing adolescent sexual risk taking. The IM framework provided a logical and thorough approach to development and testing, attentive to the need for theoretical and empirical foundations in serious games for health.
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Affiliation(s)
- Ross Shegog
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
| | | | - Christine Markham
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Sara Dube
- The Widen Lab, University of Texas at Austin, Austin, TX, United States
| | - Hsing-Yi Song
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Pooja Chaudhary
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Angela Spencer
- Special Supplemental Nutrition Program for Women, Infants and Children (WIC), Washington, DC, United States
| | - Melissa Peskin
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Diane Santa Maria
- School of Nursing, University of Texas Health Science Center Houston, Houston, TX, United States
| | - J Michael Wilkerson
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Robert Addy
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
| | - Susan Tortolero Emery
- Department of Health Promotion and Behavioral Sciences, School of Public Health, University of Texas Health Science Center Houston, Houston, TX, United States
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Shen H, van der Kleij R, van der Boog PJM, Song X, Wang W, Zhang T, Li Z, Lou X, Chavannes N. Development and evaluation of an eHealth self-management intervention for patients with chronic kidney disease in China: protocol for a mixed-method hybrid type 2 trial. BMC Nephrol 2020; 21:495. [PMID: 33213398 PMCID: PMC7678219 DOI: 10.1186/s12882-020-02160-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 11/10/2020] [Indexed: 12/13/2022] Open
Abstract
Background Chronic kidney disease (CKD) is a significant public health concern. In patients with CKD, interventions that support disease self-management have shown to improve health status and quality of life. At the moment, the use of electronic health (eHealth) technology in self-management interventions is becoming more and more popular. Evidence suggests that eHealth-based self-management interventions can improve health-related outcomes of patients with CKD. However, knowledge of the implementation and effectiveness of such interventions in general, and in China in specific, is still limited. This study protocol aims to develop and tailor the evidence-based Dutch ‘Medical Dashboard’ eHealth self-management intervention for patients suffering from CKD in China and evaluate its implementation process and effectiveness. Methods To develop and tailor a Medical Dashboard intervention for the Chinese context, we will use an Intervention Mapping (IM) approach. A literature review and mixed-method study will first be conducted to examine the needs, beliefs, perceptions of patients with CKD and care providers towards disease (self-management) and eHealth (self-management) interventions (IM step 1). Based on the results of step 1, we will specify outcomes, performance objectives, and determinants, select theory-based methods and practical strategies. Knowledge obtained from prior results and insights from stakeholders will be combined to tailor the core interventions components of the ‘Medical Dashboard’ self-management intervention to the Chinese context (IM step 2–5). Then, an intervention and implementation plan will be developed. Finally, a 9-month hybrid type 2 trial design will be employed to investigate the effectiveness of the intervention using a cluster randomized controlled trial with two parallel arms, and the implementation integrity (fidelity) and determinants of implementation (IM step 6). Discussion Our study will result in the delivery of a culturally tailored, standardized eHealth self-management intervention for patients with CKD in China, which has the potential to optimize patients’ self-management skills and improve health status and quality of life. Moreover, it will inform future research on the tailoring and translation of evidence-based eHealth self-management interventions in various contexts. Trial registration Clinicaltrials.gov NCT04212923; Registered December 30, 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-020-02160-6.
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Affiliation(s)
- Hongxia Shen
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands. .,Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China.
| | - Rianne van der Kleij
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands.,Department of Obstetrics and Gynaecology, Erasmus Medical Center, Rotterdam, Netherlands
| | | | - Xiaoyue Song
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands.,School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Wenjiao Wang
- Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Tongtong Zhang
- Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Zhengyan Li
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Xiaoping Lou
- Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Niels Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
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24
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Lakhanpaul M, Culley L, Robertson N, Alexander EC, Bird D, Hudson N, Johal N, McFeeters M, Hamlyn-Williams C, Manikam L, Boo YY, Lakhanpaul M, Johnson MRD. A structured collaborative approach to intervention design using a modified intervention mapping approach: a case study using the Management and Interventions for Asthma (MIA) project for South Asian children. BMC Med Res Methodol 2020; 20:271. [PMID: 33138784 PMCID: PMC7607819 DOI: 10.1186/s12874-020-01148-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 10/14/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND To describe how using a combined approach of community-based participatory research and intervention mapping principles could inform the development of a tailored complex intervention to improve management of asthma for South Asian (SA) children; Management and Interventions for Asthma (MIA) study. METHODS A qualitative study using interviews, focus groups, workshops, and modified intervention mapping procedures to develop an intervention planning framework in an urban community setting in Leicester, UK. The modified form of intervention mapping (IM) included: systematic evidence synthesis; community study; families and healthcare professionals study; and development of potential collaborative intervention strategies. Participants in the community study were 63 SA community members and 12 key informants; in-depth semi-structured interviews involved 30 SA families, 14 White British (WB) families and 37 Healthcare Professionals (HCPs) treating SA children living with asthma; prioritisation workshops involved 145 SA, 6 WB and 37 HCP participants; 30 participants in finalisation workshops. RESULTS Two key principles were utilised throughout the development of the intervention; community-based participatory research (CBPR) principles and intervention mapping (IM) procedures. The CBPR approach allowed close engagement with stakeholders and generated valuable knowledge to inform intervention development. It accounted for diverse perceptions and experiences with regard to asthma and recognised the priorities of patients and their families/caregivers for service improvement. The 'ACT on Asthma' programme was devised, comprising four arms of an intervention strategy: education and training, clinical support, advice centre and raising awareness, to be co-ordinated by a central team. CONCLUSIONS The modified IM principles utilised in this study were systematic and informed by theory. The combined IM and participatory approach could be considered when tailoring interventions for other clinical problems within diverse communities. The IM approach to intervention development was however resource intensive. Working in meaningful collaboration with minority communities requires specific resources and a culturally competent methodology.
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Affiliation(s)
- Monica Lakhanpaul
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, 30 Guildford Street, London, WC1N 1EH, UK. .,Whittington Health NHS Trust, London, UK.
| | - Lorraine Culley
- School of Applied Social Sciences, De Montfort University, The Gateway, Leicester, LE1 9BH, UK
| | - Noelle Robertson
- Clinical Psychology, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Lancaster Road, Leicester, LE1 7HA, UK
| | - Emma C Alexander
- Paediatric Liver, GI and Nutrition Centre and Mowatlabs, King's College Hospital, London, SE5 9RS, UK.,Aceso Global Health Consultants Ltd., 3 Abbey Terrace, London, SE2 9EY, UK
| | - Deborah Bird
- Child Development Team, Ealing Services for Children with Additional Needs, West London NHS Trust, Carmelita House, 21-22 The Mall, Ealing, W5 2PJ, UK
| | - Nicky Hudson
- School of Applied Social Sciences, De Montfort University, The Gateway, Leicester, LE1 9BH, UK
| | | | - Melanie McFeeters
- Specialised Commissioning, NHS England and NHS Improvement, Midlands Region, Fosse House, 6 Smith Way, Grove Park, Enderby, Leicester, LE19 1SX, UK
| | - Charlotte Hamlyn-Williams
- Center for Health Services and Clinical Research, University of Hertfordshire, College Lane Campus, Hatfield, AL10 9AB, UK
| | - Logan Manikam
- Aceso Global Health Consultants Ltd., 3 Abbey Terrace, London, SE2 9EY, UK.,UCL Institute of Epidemiology & Healthcare, 1 - 19 Torrington Place, London, WC1E 7HB, UK
| | - Yebeen Ysabelle Boo
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, 30 Guildford Street, London, WC1N 1EH, UK.,Aceso Global Health Consultants Ltd., 3 Abbey Terrace, London, SE2 9EY, UK.,Nuffield Department of Population Health, University of Oxford Richard Doll Building, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Maya Lakhanpaul
- Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Mark R D Johnson
- Faculty of Health and Life Sciences, Mary Seacole Research Centre, De Montfort University, The Gateway, Leicester, LE1 9BH, UK
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Dober M, Mikocka-Walus A, Evans S, Beswick L, Emerson C, Olive L. Perspectives on an Acceptance and Commitment Therapy (ACT) based program for patients with inflammatory bowel disease and comorbid anxiety and/or depressive symptoms. Psychother Res 2020; 31:668-681. [PMID: 32892715 DOI: 10.1080/10503307.2020.1813915] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background and aim: Individuals with inflammatory bowel disease (IBD) suffer higher rates of anxiety and depression than the general population, however, few psychological interventions are designed for this population. Acceptance and Commitment Therapy (ACT), aimed to increase psychological flexibility, may be useful to address the unique concerns of IBD sufferers. This study aimed to explore stakeholder perspectives on an ACT-based intervention prototype tailored to people with IBD and comorbid anxiety and/or depressive symptoms.Methods: An Intervention Mapping methodology guided intervention design. A qualitative exploratory design was used to investigate the perspectives of stakeholders. Focus groups or interviews obtained feedback from IBD patients of a major regional hospital, and health providers to IBD patients Australia-wide.Results: Findings were analysed using template analysis. Data saturation was reached at 19 participants (11 patients and 8 health professionals). Participants' perspectives on the ACT-based intervention were distributed across four themes: (1) Barriers to access and participation; (2) Timing in the illness trajectory; (3) ACT is useful for IBD; and (4) The more support, the better.Conclusion: The findings suggest that an ACT modality and blended delivery design is well received by patients and health professionals, providing recommendations to future researchers and clinicians on intervention design.
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Affiliation(s)
- Madeleine Dober
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
| | | | - Subhadra Evans
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
| | - Lauren Beswick
- Department of Gastroenterology, Barwon Health, Geelong, Australia
| | - Catherine Emerson
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
| | - Lisa Olive
- School of Psychology, Faculty of Health, Deakin University, Burwood, Australia
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Sun Y, Wang A, Yu S, Hagger MS, Chen X, Fong SSM, Zhang C, Huang WY, Baker JS, Dutheil F, Gao Y. A blended intervention to promote physical activity, health and work productivity among office employees using intervention mapping: a study protocol for a cluster-randomized controlled trial. BMC Public Health 2020; 20:994. [PMID: 32586293 PMCID: PMC7315542 DOI: 10.1186/s12889-020-09128-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 06/16/2020] [Indexed: 12/11/2022] Open
Abstract
Background Regular participation in moderate-to-vigorous physical activity (MVPA) is related to decreased risk of morbidity and mortality. Among working populations, lack of MVPA may also be a risk factor for absenteeism and presenteeism. Both traditional workplace-based and web-based interventions have been suggested as being effective in promoting participation MVPA, health-related outcomes, and work-related productivity. However, several challenges limit their application in real world contexts. A ‘blended’ intervention approach combining the two intervention strategies is proposed to overcome these limitations. The proposed intervention aims to utilize the blended approach to increase participation in MVPA, health-related outcomes, and work productivity among inactive workers. Methods The study will comprise of a three-group cluster randomized controlled trial (cluster-RCT), comprising a three-month actual intervention and a nine-month behavioral follow-up period. The three groups will be: a web-based intervention group, a blended intervention group combining the web-based components with face-to-face workshops and posters, and a control group. Physically inactive office employees (N = 495) from 33 companies (i.e., clusters) will be recruited and randomly assigned to the three groups by cluster randomization. The intervention mapping (IM) framework will be used for selecting and applying effective health behavioral theories and behavioral change techniques (BCTs) to the development, implementation and assessment of the intervention, which will be personally tailored. The primary outcome variable will be objectively-measured MVPA using an accelerometer. Secondary outcomes will consist of indices of health including adiposity, blood pressure, blood sugar, blood lipids, self-reported depression, anxiety, stress, health-related quality of life and work-related variables including absenteeism and presenteeism. Discussion The proposed study adopts a robust blended intervention approach that is expected to overcome challenges in applying workplace-based and web-based interventions separately and yield larger effects in promoting MVPA participation, health-related outcomes and work productivity. Improvements in work productivity outcomes will be of particular interest to employers. If more effective, the new blended intervention has the potential to be implemented on a larger scale to benefit workplace populations. Trial registration The trial is prospectively registered at the ClinicalTrials.gov PRS (Trial ID: NCT04391270; Date of First Posted: May 18, 2020).
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Affiliation(s)
- Yan Sun
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Aiwei Wang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Siyue Yu
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Martin S Hagger
- Psychological Sciences, University of California, Merced, CA, USA
| | - Xiangyan Chen
- Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hong Kong, China
| | - Shirley Siu Ming Fong
- Department of Health and Physical Education, Education University of Hong Kong, Hong Kong, China.,School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Chunqing Zhang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Wendy Yajun Huang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Julien S Baker
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Frédéric Dutheil
- LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Preventive and Occupational Medicine, Witty Fit, University Hospital of Clermont-Ferrand, F-63000, Clermont-Ferrand, France
| | - Yang Gao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China.
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Wu F, Drevenhorn E, Carlsson G. Nurses' Experiences of Promoting Healthy Aging in the Municipality: A Qualitative Study. Healthcare (Basel) 2020; 8:healthcare8020131. [PMID: 32397532 PMCID: PMC7349578 DOI: 10.3390/healthcare8020131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/29/2020] [Accepted: 05/06/2020] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to describe nurses’ experiences of promoting healthy aging in municipalities. A descriptive qualitative research design based on semi-structured interviews with 13 nurses was employed. The nurses described the importance of giving older adults the possibility to live as individuals, but also that the organization matters as too does the nurses’ own desire to work professionally and with passion. Nurses in the municipality noticed that in today’s world, there is a changing perspective of older adults. They more often want to continue their previous life and care greatly about quality of life and because of this, they also expect more service from their health care. Our study suggests that nurses should be supported to specialize in elderly care and measures should be taken to reduce the gap between vision and reality when it comes to team work.
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Affiliation(s)
- Fan Wu
- School of Nursing, Peking Union Medical College, Beijing 100144, China;
| | - Eva Drevenhorn
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden;
| | - Gunilla Carlsson
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden;
- Correspondence:
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Development of a community pharmacy-based intervention to enhance adherence to adjuvant endocrine therapy among breast cancer survivors guided by the Intervention Mapping approach. Res Social Adm Pharm 2020; 16:1724-1736. [PMID: 32205070 DOI: 10.1016/j.sapharm.2020.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 01/31/2020] [Accepted: 02/09/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Adjuvant endocrine therapy (AET) is prescribed for 5 or 10 years to women with non-metastatic breast cancer to reduce recurrence and mortality risks. However, AET adherence is suboptimal for many women. The few interventions specifically designed to enhance AET adherence and evaluated to date have provided inconclusive results. None of these interventions was offered in the community pharmacy setting. OBJECTIVE To describe the development of the PAcHA program, a community pharmacy-based intervention aiming to enhance AET adherence. METHODS The development of the intervention was guided by the six-step Intervention Mapping approach: needs assessment (Step 1); development of objectives matrices (Step 2); selection of theory-based intervention methods and practical applications (Step 3); development of the intervention program (Step 4); development of the adoption and implementation plan (Step 5); and evaluation plan (Step 6). Researchers, pharmacists and women prescribed AET were consulted at key steps. RESULTS The logic model was developed based on women's needs identified through a literature review and a qualitative study (Step 1). Optimal use of treatment for each woman with a new AET prescription was considered the behavioral outcome of the intervention. A woman is expected to: acquire knowledge about AET; make an informed decision about AET initiation and persistence; respect administration modalities and cope with side effects (Step 2). Motivational interviewing principles serve to guide the pharmacist intervention (Step 3). The intervention is brief and tailored to AET initiation and follow-up visits. Standardized intervention tools are available as support for pharmacists in their counseling (Step 4). An implementation plan was established, and web-based training was designed to train the pharmacists (Step 5). A cluster-randomized controlled trial was designed to evaluate the intervention (Step 6). CONCLUSION The systematic approach used for developing the intervention may increase its potential for being efficiently implemented and effective.
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Anselma M, Altenburg TM, Emke H, van Nassau F, Jurg M, Ruiter RAC, Jurkowski JM, Chinapaw MJM. Co-designing obesity prevention interventions together with children: intervention mapping meets youth-led participatory action research. Int J Behav Nutr Phys Act 2019; 16:130. [PMID: 31831006 PMCID: PMC6909512 DOI: 10.1186/s12966-019-0891-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 11/25/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Youth-led Participatory Action Research (YPAR) involves children throughout the process of developing and implementing interventions. Combining YPAR with a structural approach for designing and planning interventions, such as Intervention Mapping (IM), may further improve implementation and effectiveness of interventions. This paper describes how YPAR and IM were combined in the Kids in Action study. METHODS The Kids in Action study aims to improve health behaviors of 9-12-year old children living in a low socioeconomic neighborhood in Amsterdam, by co-designing interventions with these children. At each of four schools 6-8 children (N = 18-24 total per year) and two academic researchers formed participatory groups that met weekly or every fortnight during two school years. An IM expert panel advised the participatory groups on the application of IM. RESULTS Following the IM protocol, we conducted a participatory needs assessment with children, parents and professionals, in IM-step 1. In IM-step 2, the IM expert panel constructed matrices of program objectives, and the children provided feedback. In collaboration with children programs were designed and produced using an iterative process during IM-steps 3-4. In IM-step 5, the participatory groups and professional community partners designed the implementation plan. Finally, in IM-step 6, the protocol of the process and effect evaluation - executed by academic researchers with input from children - was developed. CONCLUSIONS By combining YPAR and IM, several interventions have been developed and implemented, varying from a school water policy to extracurricular sports activities. Sharing responsibility with children was challenging when combining IM with YPAR. In YPAR children are given as much autonomy as possible, while traditional IM development work is primarily done by academic researchers. Strengths in combining IM and YPAR include the involvement of the end-users - children - throughout the process while at the same time developing interventions based on existing evidence. Time-management, a multidisciplinary team, and flexibility are important conditions when combining IM with YPAR. A strong community project group, with professionals who were willing to help children develop and execute their ideas, was an important success factor. This study can serve as an example to other YPAR studies developing interventions using the IM protocol.
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Affiliation(s)
- Manou Anselma
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands
| | - Teatske M. Altenburg
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands
| | - Helga Emke
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands
| | - Femke van Nassau
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands
| | - Merlin Jurg
- InReturn, Sustainable employability and vitality, Koog aan de Zaan, The Netherlands
| | - Robert A. C. Ruiter
- Department of Work and Social Psychology, Maastricht University, P.O. Box 616, NL-6200 MD Maastricht, the Netherlands
| | - Janine M. Jurkowski
- Department of Health Policy, Management, & Behavior, University at Albany School of Public Health, State University of New York, Albany, New York USA
| | - Mai J. M. Chinapaw
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, NL-1081 BT Amsterdam, The Netherlands
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de Lijster GPA, Kok G, Kocken PL. Preventing adolescent sexual harassment: evaluating the planning process in two school-based interventions using the Intervention Mapping framework. BMC Public Health 2019; 19:1455. [PMID: 31694590 PMCID: PMC6833192 DOI: 10.1186/s12889-019-7808-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 10/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The development of school-based programs for preventing adolescent sexual harassment often lacks an evidence-based approach and use of proper theories. Appropriate stakeholders are often not involved in the development process. To help improve this process, we used the Intervention Mapping framework to retrospectively evaluate the development of two school-based programs, Benzies & Batchies and Boys, each of which was intended to prevent sexual harassment among adolescent students of a lower educational level in the Netherlands. The two interventions were among the first school-based programs targeting sexual harassment, and were implemented in Dutch secondary schools. METHODS As well as doing desk research into the context and content of the interventions, we used semi-structured focused interviews with the initial developers to gather their opinions on and experiences with the development process, whereby the topics were based on the six steps of the IM framework. To better suit the needs of the respondents, we had adapted the language of our topics and had used open-ended questions The data we had gathered from the desk research and face-to-face consultations were checked against a planning tool that was based on 19 tasks within the six steps of IM. RESULTS Although both programs had been developed in practice and lacked a thorough theoretical foundation, the methods and materials used represented aspects of behavior-change theories. The developers of Benzies & Batchies completed slightly more planning criteria within the six steps of the planning process, and used more change methods than the developers of Boys did. CONCLUSIONS We recommend that parents should also be involved in the development of sex and relationship education programs, and should be allowed to participate in the program itself. To meet the needs of intervention developers, greater insight is needed into the importance of the individual steps in the Intervention Mapping framework. In our view, the development of practice-based interventions will improve if future intervention developers combine evidence-based theories with their practice-based experience. This will increase the success and effectiveness of their interventions.
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Affiliation(s)
- Gaby P A de Lijster
- TNO, PO Box 3005, Leiden, 2301 DA, the Netherlands. .,Maastricht University, PO Box 616, Maastricht, 6200 MD, the Netherlands.
| | - Gerjo Kok
- Maastricht University, PO Box 616, Maastricht, 6200 MD, the Netherlands
| | - Paul L Kocken
- TNO, PO Box 3005, Leiden, 2301 DA, the Netherlands.,Department of Public Health and Primary Care, Leiden University Medical Centre (LUMC), PO Box 9600, Leiden, 2300 RC, the Netherlands
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Kienen N, Wiltenburg TD, Bittencourt L, Scarinci IC. Development of a gender-relevant tobacco cessation intervention for women in Brazil-an intervention mapping approach to planning. HEALTH EDUCATION RESEARCH 2019; 34:505-520. [PMID: 31495883 PMCID: PMC7962721 DOI: 10.1093/her/cyz025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 08/13/2019] [Indexed: 06/10/2023]
Abstract
The purpose of this article is to describe the development of a theory-based, culturally and gender-relevant Community Health Worker (CWH)-led tobacco cessation intervention for low-income Brazilian women who augments the tobacco cessation program offered through the public health system using Intervention Mapping (IM). We began with the establishment of a network of representatives from different segments of society followed by comprehensive needs assessments. We then established a logical planning process that was guided by a theoretical framework (Social Cognitive Theory) and existing evidence-based tobacco cessation programs, taking into account socio-political context of a universal health care system. Given the gender-relevance of our intervention and the importance of social support in tobacco cessation among women, we chose an intervention that would be delivered within the public health system but augmented by CHWs that would be trained in behavior change by researchers. One of major advantages of utilizing IM was that decisions were made in a transparent and supportive manner with involvement of all stakeholders throughout the process. Despite the fact that this process is very taxing on researchers and the health care system as it takes time, resources and negotiation skills, it builds trust and promotes ownership which can assure sustainability.
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Affiliation(s)
- Nádia Kienen
- Department of Psychology and Behavior Analysis, Universidade Estadual de Londrina, Rodovia Celso Garcia Cid, PR 445 Km 380, Londrina, PR, Brazil
| | - Thaís Distéfano Wiltenburg
- Department of Psychology and Behavior Analysis, Universidade Estadual de Londrina, Rodovia Celso Garcia Cid, PR 445 Km 380, Londrina, PR, Brazil
| | - Lorna Bittencourt
- Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, MT 609, Birmingham, AL, USA
| | - Isabel C Scarinci
- Division of Preventive Medicine, University of Alabama at Birmingham, 1717 11th Avenue South, MT 609, Birmingham, AL, USA
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O'Cathain A, Croot L, Duncan E, Rousseau N, Sworn K, Turner KM, Yardley L, Hoddinott P. Guidance on how to develop complex interventions to improve health and healthcare. BMJ Open 2019; 9:e029954. [PMID: 31420394 PMCID: PMC6701588 DOI: 10.1136/bmjopen-2019-029954] [Citation(s) in RCA: 581] [Impact Index Per Article: 116.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To provide researchers with guidance on actions to take during intervention development. SUMMARY OF KEY POINTS Based on a consensus exercise informed by reviews and qualitative interviews, we present key principles and actions for consideration when developing interventions to improve health. These include seeing intervention development as a dynamic iterative process, involving stakeholders, reviewing published research evidence, drawing on existing theories, articulating programme theory, undertaking primary data collection, understanding context, paying attention to future implementation in the real world and designing and refining an intervention using iterative cycles of development with stakeholder input throughout. CONCLUSION Researchers should consider each action by addressing its relevance to a specific intervention in a specific context, both at the start and throughout the development process.
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Affiliation(s)
- Alicia O'Cathain
- Medical Care Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Liz Croot
- Medical Care Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Edward Duncan
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Stirling, UK
| | - Nikki Rousseau
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Stirling, UK
| | - Katie Sworn
- Medical Care Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Katrina M Turner
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Lucy Yardley
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- Psychology, University of Southampton, Southampton, UK
| | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Stirling, UK
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Reducing growth and developmental problems in children: Development of an innovative postnatal risk assessment. PLoS One 2019; 14:e0217261. [PMID: 31166964 PMCID: PMC6550373 DOI: 10.1371/journal.pone.0217261] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 05/09/2019] [Indexed: 12/18/2022] Open
Abstract
Introduction Globally, awareness of the relevance of both medical and non-medical risk factors influencing growth and development of children has been increasing. The aim of our study was to develop an innovative postnatal risk assessment to be used by the Preventive Child Healthcare (PCHC) to identify at an early stage children at risk for growth (catch-up growth, overweight and obesity) and developmental problems (such as motor, cognitive, psychosocial and language/ speech problems). Methods We used the first four steps of the Intervention Mapping process. Step 1: Review of the literature and focus group discussions. Step 2: Identification of program objectives on how to develop and implement a risk assessment in PCHC daily practice. Step 3: Application of the ASE model to initiate behavioral change in the target group. Step 4: Development of the postnatal R4U and a program plan for the implementation in PCHC organizations. Results Subsequently in 2015, the 41 item postnatal R4U (the postnatal Rotterdam Reproduction Risk Reduction checklist) was developed according to steps one until four of the Intervention Mapping process and was implemented in four PCHC organizations. Conclusions It was feasible to design and implement a postnatal risk assessment identifying both medical and non-medical risks for growth and developmental problems, using the Intervention Mapping process.
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Turner KM, Rousseau N, Croot L, Duncan E, Yardley L, O’Cathain A, Hoddinott P. Understanding successful development of complex health and healthcare interventions and its drivers from the perspective of developers and wider stakeholders: an international qualitative interview study. BMJ Open 2019; 9:e028756. [PMID: 31152042 PMCID: PMC6549621 DOI: 10.1136/bmjopen-2018-028756] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Identify how individuals involved in developing complex health and healthcare interventions (developers), and wider stakeholders in the endeavour, such as funders, define successful intervention development and what factors influence how interventions are developed. DESIGN In-depth interviews with developers and wider stakeholders to explore their views and experiences of developing complex health and healthcare interventions. SETTING Interviews conducted with individuals in the UK, Europe and North America. PARTICIPANTS Twenty-one individuals were interviewed: 15 developers and 6 wider stakeholders. Seventeen participants were UK based. RESULTS Most participants defined successful intervention development as a process that resulted in effective interventions that were relevant, acceptable and could be implemented in real-world contexts. Accounts also indicated that participants aimed to develop interventions that end users wanted, and to undertake a development process that was methodologically rigorous and provided research evidence for journal publications and future grant applications. Participants' ambitions to develop interventions that had real-world impact drove them to consider the intervention's feasibility and long-term sustainability early in the development process. However, this process was also driven by other factors: the realities of resource-limited health contexts; prespecified research funder priorities; a reluctance to deviate from grant application protocols to incorporate evidence and knowledge acquired during the development process; limited funding to develop interventions and the need for future randomised controlled trials (RCTs) to prove effectiveness. Participants expressed concern that these drivers discouraged long-term thinking and the development of innovative interventions, and prioritised evaluation over development and future implementation. CONCLUSIONS Tensions exist between developers' goal of developing interventions that improve health in the real world, current funding structures, the limited resources within healthcare contexts, and the dominance of the RCT for evaluation of these interventions. There is a need to review funding processes and expectations of gold standard evaluation.
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Affiliation(s)
| | - Nikki Rousseau
- Newcastle University Faculty of Medical Sciences, Newcastle upon Tyne, Newcastle upon Tyne, UK
| | - Liz Croot
- MCRU, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | - Lucy Yardley
- Psychology, University of Southampton, Southampton, UK
- School of Health Sciences, University of Bristol, Bristol, UK
| | - Alicia O’Cathain
- School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - Pat Hoddinott
- Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Stirling, UK
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Manyeh AK, Ibisomi L, Baiden F, Chirwa T, Ramaswamy R. Using intervention mapping to design and implement quality improvement strategies towards elimination of lymphatic filariasis in Northern Ghana. PLoS Negl Trop Dis 2019; 13:e0007267. [PMID: 30908495 PMCID: PMC6448919 DOI: 10.1371/journal.pntd.0007267] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 04/04/2019] [Accepted: 02/26/2019] [Indexed: 11/18/2022] Open
Abstract
Introduction The Global Strategy to Eliminate Lymphatic Filiariasis (GFELF) through Mass Drug Administration (MDA) has been implemented in Ghana since the year 2000 and transmission has been interrupted in 76 of 98 endemic districts. To improve the MDA in the remaining districts with microfilaria (MF) prevalence above the 1% threshold for the interruption of transmission, there is a need to identify and implement appropriate quality improvement (QI) strategies. This paper describes the use of intervention mapping to select QI strategies to improve an existing evidence-based MDA program in Northern Ghana. Methods Due to the complexities associated with implementing evidence-based programs (EBP) such as the lymphatic filariasis MDA and variability in the context, an initial assessment to identify implementation bottlenecks associated with the quality of implementation of lymphatic filariasis MDA in the Bole District of Ghana was conducted using a mixed methods approach. Based on the findings of the initial assessment, a context specific QI strategy was designed and operationalized using intervention mapping strategy in terms of seven domains: actor, the action, action targets, temporality, dose, implementation outcomes addressed, and theoretical justification. Results The initial needs assessment shows that the persistent transmission of lymphatic filariasis in the Bole District is characterized by high levels of refusal to ingest the drug, high levels of reported adverse drug reactions, low MDA coverage at community level, poor adherence to the MDA protocol and non-participants’ responsiveness. Conclusion This study has shown that it is feasible to develop a context specific QI strategy for an existing evidence-based intervention based on an initial needs assessment through stakeholder participation using the IM approach. However, working (towards) QI requires more time than is usually available in public health service. Sufficient theoretical knowledge of implementation research and experience with technical IM experts must be available. Lymphatic Filariasis is a significant health problem threatening 1.1 billion people in 55 countries globally. After 18 years of implementing MDA in Ghana, LF transmission still persist in some districts with microfilaria prevalence level high above the threshold needed for the interruption of transmission of the disease. For Ghana to meet the 2020 NTDs deadline, it is important to identify context specific need-based QI strategies to make the drug accessible to all eligible individuals in the endemic communities. Hence, this study has demonstrated the feasibility of using IM to develop and implement a context specific QI strategy for an existing evidence-based intervention (LF MDA) towards elimination of lymphatic filariasis as a public health challenge in Bole District of Northern Ghana.
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Affiliation(s)
- Alfred Kwesi Manyeh
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Parktown, Johannesburg, South Africa
- Dodowa Health Research Centre, Dodowa, Ghana
- * E-mail:
| | - Latifat Ibisomi
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Parktown, Johannesburg, South Africa
- Nigerian Institute of Medical Research, Lagos, Nigeria
| | - Frank Baiden
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tobias Chirwa
- Division of Epidemiology and Biostatistics, School of Public Health, University of the Witwatersrand, Parktown, Johannesburg, South Africa
| | - Rohit Ramaswamy
- Public Health Leadership Program, Gillings School of Global Public Health, University of North Carolina, McGavran-Greenberg Hall, Chapel Hill, North Carolina, United State of America
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den Bakker CM, Schaafsma FG, van der Meij E, Meijerink WJ, van den Heuvel B, Baan AH, Davids PH, Scholten PC, van der Meij S, van Baal WM, van Dalsen AD, Lips DJ, van der Steeg JW, Leclercq WK, Geomini PM, Consten EC, Schraffordt Koops SE, de Castro SM, van Kesteren PJ, Cense HA, Stockmann HB, Ten Cate AD, Bonjer HJ, Huirne JA, Anema JR. Electronic Health Program to Empower Patients in Returning to Normal Activities After General Surgical and Gynecological Procedures: Intervention Mapping as a Useful Method for Further Development. J Med Internet Res 2019; 21:e9938. [PMID: 30724740 PMCID: PMC6381532 DOI: 10.2196/jmir.9938] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 07/16/2018] [Accepted: 08/30/2018] [Indexed: 12/13/2022] Open
Abstract
Background Support for guiding and monitoring postoperative recovery and resumption of activities is usually not provided to patients after discharge from the hospital. Therefore, a perioperative electronic health (eHealth) intervention (“ikherstel” intervention or “I recover” intervention) was developed to empower gynecological patients during the perioperative period. This eHealth intervention requires a need for further development for patients who will undergo various types of general surgical and gynecological procedures. Objective This study aimed to further develop the “ikherstel” eHealth intervention using Intervention Mapping (IM) to fit a broader patient population. Methods The IM protocol was used to guide further development of the “ikherstel” intervention. First, patients’ needs were identified using (1) the information of a process evaluation of the earlier performed “ikherstel” study, (2) a review of the literature, (3) a survey study, and (4) focus group discussions (FGDs) among stakeholders. Next, program outcomes and change objectives were defined. Third, behavior change theories and practical tools were selected for the intervention program. Finally, an implementation and evaluation plan was developed. Results The outcome for an eHealth intervention tool for patients recovering from abdominal general surgical and gynecological procedures was redefined as “achieving earlier recovery including return to normal activities and work.” The Attitude-Social Influence-Self-Efficacy model was used as a theoretical framework to transform personal and external determinants into change objectives of personal behavior. The knowledge gathered by needs assessment and using the theoretical framework in the preparatory steps of the IM protocol resulted in additional tools. A mobile app, an activity tracker, and an electronic consultation (eConsult) will be incorporated in the further developed eHealth intervention. This intervention will be evaluated in a multicenter, single-blinded randomized controlled trial with 18 departments in 11 participating hospitals in the Netherlands. Conclusions The intervention is extended to patients undergoing general surgical procedures and for malignant indications. New intervention tools such as a mobile app, an activity tracker, and an eConsult were developed. Trial Registration Netherlands Trial Registry NTR5686; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5686
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Affiliation(s)
- Chantal M den Bakker
- Amsterdam Public Health Research Institute, Department of Occupational and Public Health, VU University Medical Center, Amsterdam, Netherlands.,Department of Surgery, VU University Medical Center, Amsterdam, Netherlands
| | - Frederieke G Schaafsma
- Amsterdam Public Health Research Institute, Department of Occupational and Public Health, VU University Medical Center, Amsterdam, Netherlands
| | - Eva van der Meij
- Amsterdam Public Health Research Institute, Department of Occupational and Public Health, VU University Medical Center, Amsterdam, Netherlands.,Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, Netherlands
| | | | - Baukje van den Heuvel
- Department of Operation Rooms, Radboud University Medical Center, Nijmegen, Netherlands
| | - Astrid H Baan
- Department of Surgery, Amstelland Ziekenhuis, Amstelveen, Netherlands
| | - Paul Hp Davids
- Department of Surgery, Diakonessenhuis, Utrecht, Netherlands
| | - Petrus C Scholten
- Department of Obstetrics and Gynaecology, Diakonessenhuis, Utrecht, Netherlands
| | | | - W Marchien van Baal
- Department of Obstetrics and Gynaecology, Flevoziekenhuis, Almere, Netherlands
| | | | - Daniel J Lips
- Department of Surgery, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, Netherlands
| | - Jan Willem van der Steeg
- Department of Obstetrics and Gynaecology, Jeroen Bosch Ziekenhuis, 's-Hertogenbosch, Netherlands
| | | | - Peggy Maj Geomini
- Department of Obstetrics and Gynaecology, Máxima Medisch Centrum, Veldhoven, Netherlands
| | - Esther Cj Consten
- Department of Surgery, Meander Medisch Centrum, Amersfoort, Netherlands
| | | | - Steve Mm de Castro
- Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Paul Jm van Kesteren
- Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Huib A Cense
- Department of Surgery, Rode Kruis Ziekenhuis, Beverwijk, Netherlands
| | | | - A Dorien Ten Cate
- Department of Obstetrics and Gynaecology, Spaarne Gasthuis, Haarlem, Netherlands
| | - Hendrik J Bonjer
- Department of Surgery, VU University Medical Center, Amsterdam, Netherlands
| | - Judith Af Huirne
- Department of Obstetrics and Gynaecology, VU University Medical Center, Amsterdam, Netherlands
| | - Johannes R Anema
- Amsterdam Public Health Research Institute, Department of Occupational and Public Health, VU University Medical Center, Amsterdam, Netherlands
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Using Intervention Mapping to Develop an Efficacious Multicomponent Systems-Based Intervention to Increase Human Papillomavirus (HPV) Vaccination in a Large Urban Pediatric Clinic Network. THE JOURNAL OF APPLIED RESEARCH ON CHILDREN : INFORMING POLICY FOR CHILDREN AT RISK 2019; 10:9. [PMID: 32724705 PMCID: PMC7386427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Walklet E, Mahoney B, Bradley E, OʼHickey S. Application of Health Psychology: Development of a Practitioner Training Intervention in Anaphylaxis. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2019; 39:130-135. [PMID: 31045987 DOI: 10.1097/ceh.0000000000000254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Adrenaline autoinjectors (AAIs) improve outcomes and reduce fatalities in patients with anaphylaxis, but many patients neither carry them nor know how to use them. Practitioner training in evidence-based strategies designed to increase patient adherence could improve the likelihood of AAI adherence and increase confidence among practitioners to initiate discussions about practical and perceptual barriers to AAI adherence. This article reports the development of a new practitioner training intervention, grounded in health psychology theory and evidence designed for practitioners in contact with patients with anaphylaxis to encourage adherence to AAIs. Potential implications for the design, implementation, and evaluation of future practitioner training in strategies they can use to encourage anaphylaxis patients' AAI adherence are discussed. Although designed for those working with anaphylaxis patients, this step-by-step process to encouraging adherence could be adapted for practitioners working with patients living with other long-term conditions.
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Affiliation(s)
- Elaine Walklet
- Ms. Walklet: Senior Lecturer, School of Psychology, University of Worcester, Worcester, United Kingdom. Dr. Mahoney: Senior Lecturer, School of Psychology, University of Worcester, Worcester, United Kingdom. Dr. Bradley: Professor, University of Worcester, Worcester, United Kingdom. Mr. O'Hickey: Professor, University of Worcester, Worcester, United Kingdom and Professor, Worcestershire Acute Hospitals NHS Trust, Worcester, United Kingdom
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Majid U, Kim C, Cako A, Gagliardi AR. Engaging stakeholders in the co-development of programs or interventions using Intervention Mapping: A scoping review. PLoS One 2018; 13:e0209826. [PMID: 30586425 PMCID: PMC6306258 DOI: 10.1371/journal.pone.0209826] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 12/12/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Health care innovations tailored to stakeholder context are more readily adopted. This study aimed to describe how Intervention Mapping (IM) was used to design health care innovations and how stakeholders were involved. METHODS A scoping review was conducted. MEDLINE, EMBASE, Cochrane Library, Scopus and Science Citation Index were searched from 2008 to November 2017. English language studies that used or cited Intervention Mapping were eligible. Screening and data extraction were done in triplicate. Summary statistics were used to describe study characteristics, IM steps employed, and stakeholder involvement. RESULTS A total of 852 studies were identified, 449 were unique, and 333 were excluded based on title and abstracts, 116 full-text articles were considered and 61 articles representing 60 studies from 13 countries for a variety of clinical issues were included. The number of studies published per year increased since 2008 and doubled in 2016 and 2017. The majority of studies employed multiple research methods (76.7%) and all 6 IM steps (73.3%). Resulting programs/interventions were single (55.4%) or multifaceted (46.4%), and 60.7% were pilot-tested. Programs or interventions were largely educational material or meetings, and were targeted to patients (70.2%), clinicians (14.0%) or both (15.8%). Studies provided few details about current or planned evaluation. Of the 4 (9.3%) studies that reported impact or outcomes, 3 achieved positive improvements in patient or professional behaviour or patient outcomes. Many studies (28.3%) did not involve stakeholders. Those that did (71.7%) often involved a combination of patients, clinicians, and community organizations. However, less than half (48.8%) described how they were engaged. Most often stakeholders were committee members and provide feedback on program or intervention content or format. CONCLUSIONS It is unclear if use of IM or stakeholder engagement in IM consistently results in effective programs or interventions. Those employing IM should report how stakeholders were involved in each IM step and how involvement influenced program or intervention design. They should also report the details or absence of planned evaluation. Future research should investigate how to optimize stakeholder engagement in IM, and whether use of IM itself or stakeholder engagement in IM are positively associated with effective programs or interventions.
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Affiliation(s)
- Umair Majid
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Claire Kim
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Albina Cako
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Anna R. Gagliardi
- Toronto General Hospital Research Institute, University Health Network, Toronto, Ontario, Canada
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Scheerman JFM, van Empelen P, van Loveren C, van Meijel B. A Mobile App (WhiteTeeth) to Promote Good Oral Health Behavior Among Dutch Adolescents with Fixed Orthodontic Appliances: Intervention Mapping Approach. JMIR Mhealth Uhealth 2018; 6:e163. [PMID: 30120085 PMCID: PMC6119215 DOI: 10.2196/mhealth.9626] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/26/2018] [Accepted: 05/15/2018] [Indexed: 12/23/2022] Open
Abstract
Background The insertion of fixed orthodontic appliances increases the risk of dental caries, particularly in adolescents. Caries can be prevented through good oral health behavior. To support adolescents with fixed orthodontic appliances and for promoting oral health behavior, we developed a theory- and evidence-based mHealth program, the WhiteTeeth app. Objective The objective of our paper was to describe the systematic development and content of the WhiteTeeth app. Methods For systematic development of the program, we used the intervention mapping (IM) approach. In this paper, we present the results of applying the first 5 steps of IM to the design of an mHealth program: (1) identifying target behaviors and determinants through problem analysis, including a literature search, a survey study, and semistructured interviews, to explore adolescent oral health behavior during orthodontic therapy; (2) defining program outcomes and objectives; (3) selecting theoretical methods and translating them into practical strategies for the program design; (4) producing the program, including a pilot test with 28 adolescents testing the acceptability and usability of the WhiteTeeth app; and (5) planning implementation and adoption. Results On the basis of our literature search, we identified fluoride use and control of dental plaque levels (eg, tooth brushing and proxy brush usage) as target behaviors for preventing caries. Next, we identified important and changeable determinants of oral health behavior that fitted the theoretical concepts of the Health Action Process Approach (HAPA) theory. The HAPA theory, the self-regulation theory, and the results of the semistructured interviews were used to define the program objectives, that is, the performance and change objectives. After defining the objectives, we identified multiple behavior change techniques that could be used to achieve these objectives, such as providing oral health information and feedback, prompting self-monitoring, coaching of set actions and coping plans, and sending reminders. We translated these methods into practical strategies, such as videos and a brushing timer. Next, we combined these strategies into a single program resulting in the WhiteTeeth app (which is available on both iTunes and Google Play stores as “Witgebit”). Adolescents with fixed orthodontic appliances and dental professionals were included in the development process to increase the success of implementation. The pilot test revealed that the app users appreciated and liked the app. The WhiteTeeth app can be integrated into current orthodontic care. Conclusions IM allowed us to identify multiple techniques that have been shown to be the most effective in initiating behavior change, but have not yet been incorporated into existing orthodontic apps. The WhiteTeeth app contains all these techniques, which makes it a unique and promising home-based app for promoting oral health in adolescents with fixed orthodontic appliances.
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Affiliation(s)
- Janneke Francisca Maria Scheerman
- Department of Preventive Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Cluster Oral Hygiene, Department of Health, Sports & Welfare, Inholland University, Amsterdam, Netherlands.,Department of Child Health, Netherlands Organization for Applied Scientific Research, Leiden, Netherlands
| | - Pepijn van Empelen
- Department of Child Health, Netherlands Organization for Applied Scientific Research, Leiden, Netherlands
| | - Cor van Loveren
- Department of Preventive Dentistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Berno van Meijel
- Cluster Nursing, Department of Health, Sports & Welfare, Inholland University, Amsterdam, Netherlands.,Department of Psychiatry, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam Medical Center, Amsterdam, Netherlands.,Parnassia Psychiatric Institute, The Hague, Netherlands
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Lake AJ, Browne JL, Abraham C, Tumino D, Hines C, Rees G, Speight J. A tailored intervention to promote uptake of retinal screening among young adults with type 2 diabetes - an intervention mapping approach. BMC Health Serv Res 2018; 18:396. [PMID: 29855307 PMCID: PMC5984467 DOI: 10.1186/s12913-018-3188-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 05/04/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Young adults (18-39 years) with type 2 diabetes are at risk of early development and rapid progression of diabetic retinopathy, a leading cause of vision loss and blindness in working-age adults. Retinal screening is key to the early detection of diabetic retinopathy, with risk of vision loss significantly reduced by timely treatment thereafter. Despite this, retinal screening rates are low among this at-risk group. The objective of this study was to develop a theoretically-grounded, evidence-based retinal screening promotion leaflet, tailored to young adults with type 2 diabetes. METHODS Utilising the six steps of Intervention Mapping, our multidisciplinary planning team conducted a mixed-methods needs assessment (Step 1); identified modifiable behavioural determinants of screening behaviour and constructed a matrix of change objectives (Step 2); designed, reviewed and debriefed leaflet content with stakeholders (Steps 3 and 4); and developed program implementation and evaluation plans (Steps 5 and 6). RESULTS Step 1 included in-depth qualitative interviews (N = 10) and an online survey that recruited a nationally-representative sample (N = 227), both informed by literature review. The needs assessment highlighted the crucial roles of knowledge (about diabetic retinopathy and screening), perception of personal risk, awareness of the approval of significant others and engagement with healthcare team, on retinal screening intentions and uptake. In Step 2, we selected five modifiable behavioural determinants to be targeted: knowledge, attitudes, normative beliefs, intention, and behavioural skills. In Steps 3 and 4, the "Who is looking after your eyes?" leaflet was developed, containing persuasive messages targeting each determinant and utilising engaging, cohort-appropriate imagery. In Steps 5 and 6, we planned Statewide implementation and designed a randomised controlled trial to evaluate the leaflet. CONCLUSIONS This research provides an example of a systematic, evidence-based approach to the development of a simple health intervention designed to promote uptake of screening in accordance with national guidelines. The methods and findings illustrate how Intervention Mapping can be employed to develop tailored retinal screening promotion materials for specific priority populations. This paper has implications for future program planners and is intended to assist those wishing to use Intervention Mapping to create similar theoretically-driven, tailored resources.
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Affiliation(s)
- Amelia J. Lake
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - Jessica L. Browne
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
| | - Charles Abraham
- Institute of Health Research, University of Exeter Medical School, Exeter, UK
| | - Dee Tumino
- Vision 2020 Australia, Melbourne, Australia
| | | | - Gwyneth Rees
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, 3002 Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, 3010 Australia
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, Australia
- The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia
- AHP Research, Hornchurch, UK
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Santina T, Lauzier S, Gagnon H, Villeneuve D, Moisan J, Grégoire JP, Guillaumie L. The Development of a Community Pharmacy-Based Intervention to Optimize Patients' Use of and Experience with Antidepressants: A Step-by-Step Demonstration of the Intervention Mapping Process. PHARMACY 2018; 6:pharmacy6020039. [PMID: 30720782 PMCID: PMC6025435 DOI: 10.3390/pharmacy6020039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 04/18/2018] [Accepted: 04/23/2018] [Indexed: 11/16/2022] Open
Abstract
Objective: To describe the development of a community pharmacy-based intervention aimed at optimizing experience and use of antidepressants (ADs) for patients with mood and anxiety disorders. Methods: Intervention Mapping (IM) was used for conducting needs assessment, formulating intervention objectives, selecting change methods and practical applications, designing the intervention, and planning intervention implementation. IM is based on a qualitative participatory approach and each step of the intervention development process was conducted through consultations with a pharmacists' committee. Results: A needs assessment was informed by qualitative and quantitative studies conducted with leaders, pharmacists, and patients. Intervention objectives and change methods were selected to target factors influencing patients' experience with and use of ADs. The intervention includes four brief consultations between the pharmacist and the patient: (1) provision of information (first AD claim); (2) management of side effects (15 days after first claim); (3) monitoring treatment efficacy (30-day renewal); (4) assessment of treatment persistence (2-month renewal, repeated every 6 months). A detailed implementation plan was also developed. Conclusion: IM provided a systematic and rigorous approach to the development of an intervention directly tied to empirical data on patients' and pharmacists' experiences and recommendations. The thorough description of this intervention may facilitate the development of new pharmacy-based interventions or the adaptation of this intervention to other illnesses and settings.
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Affiliation(s)
- Tania Santina
- Faculty of Nursing, Université Laval, Pavillon Ferdinand-Vandry, 1050, Avenue de la Médecine, Quebec City, QC G1V 0A6, Canada.
| | - Sophie Lauzier
- Faculty of Pharmacy and Centre de Recherche du CHU de Québec-Université Laval, Hôpital Saint-Sacrement, 1050 Chemin Ste-Foy, Quebec City, QC G1S 4L8, Canada.
| | | | | | - Jocelyne Moisan
- Faculty of Pharmacy and Centre de Recherche du CHU de Québec-Université Laval, Hôpital Saint-Sacrement, 1050 Chemin Ste-Foy, Quebec City, QC G1S 4L8, Canada.
| | - Jean-Pierre Grégoire
- Faculty of Pharmacy and Centre de Recherche du CHU de Québec-Université Laval, Hôpital Saint-Sacrement, 1050 Chemin Ste-Foy, Quebec City, QC G1S 4L8, Canada.
| | - Laurence Guillaumie
- Faculty of Nursing, Université Laval, Pavillon Ferdinand-Vandry, 1050, Avenue de la Médecine, Quebec City, QC G1V 0A6, Canada.
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Shegog R, Begley CE. Clinic-Based Mobile Health Decision Support to Enhance Adult Epilepsy Self-Management: An Intervention Mapping Approach. Front Public Health 2017; 5:256. [PMID: 29043247 PMCID: PMC5632356 DOI: 10.3389/fpubh.2017.00256] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 09/08/2017] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Epilepsy is a neurological disorder involving recurrent seizures. It affects approximately 5 million people in the U.S. To optimize their quality of life people with epilepsy are encouraged to engage in self-management (S-M) behaviors. These include managing their treatment (e.g., adhering to anti-seizure medication and clinical visit schedules), managing their seizures (e.g., responding to seizure episodes), managing their safety (e.g., monitoring and avoiding environmental seizure triggers), and managing their co-morbid conditions (e.g., anxiety, depression). The clinic-based Management Information Decision Support Epilepsy Tool (MINDSET) is a decision-support system founded on theory and empirical evidence. It is designed to increase awareness by adult patients (≥18 years) and their health-care provider regarding the patient's epilepsy S-M behaviors, facilitate communication during the clinic visit to prioritize S-M goals and strategies commensurate with the patient's needs, and increase the patient's self-efficacy to achieve those goals. METHODS The purpose of this paper is to describe the application of intervention mapping (IM) to develop, implement, and formatively evaluate the clinic-based MINDSET prototype and in developing implementation and evaluation plans. Deliverables comprised a logic model of the problem (IM Step 1); matrices of program objectives (IM Step 2); a program planning document comprising scope, sequence, theory-based methods, and practical strategies (IM Step 3); a functional MINDSET program prototype (IM Step 4); plans for implementation (IM Step 5); and evaluation (IM Step 6). IM provided a logical and systematic approach to developing and evaluating clinic-based decision support toward epilepsy S-M.
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Affiliation(s)
- Ross Shegog
- School of Public Health, University of Texas Health Science Center, Houston, TX, United States
| | - Charles E. Begley
- School of Public Health, University of Texas Health Science Center, Houston, TX, United States
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Besharati F, Karimi-Shahanjarini A, Hazavehei SMM, Bashirian S, Bagheri F, Faradmal J. Development of a Colorectal Cancer Screening Intervention for Iranian Adults: Appling Intervention Mapping. Asian Pac J Cancer Prev 2017; 18:2193-2199. [PMID: 28843255 PMCID: PMC5697480 DOI: 10.22034/apjcp.2017.18.8.2193] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: While the incidence rate of the colorectal cancer (CRC) has been increasing over the last three
decades in Iran, very limited interventions to increase CRC screening have been developed for Iranian population.
The purpose of this study was to describe the use of Intervention Mapping (IM) for applying theory and evidence and
considering local contexts to develop a CRC screening program among adults in Iran. Materials and Methods: From
April 2014 to July 2016 following the IM process, six steps were formulated and implemented. First a need assessment
was conducted involving relevant stakeholders and using focus groups discussions (n=10), individual interviews
(n=20), and a household survey (n= 480). Then a matrix of change objectives was developed for each behavioral
outcome and theoretical methods and their practical applications were identified to guide intervention development and
implementation. A multi-component intervention was developed and piloted. Decision on suitable parts of intervention
was made based on feedback of pilot study. Finally, evaluation plan including process and outcome evaluation was
generated and conducted to inform future scale up. Results: The needs assessment highlighted factors affecting CRC
screening including knowledge, self efficacy, social support and perceived benefit and barriers (financial problems,
fear of detection of cancer and etc). Results of needs assessment were used to develop next steps IM. The program
utilized methods like information delivery, modeling, and persuasion. Practical applications included video presentation,
group discussion, role playing and postcards.This program was assessed through a cluster-randomized controlled
trial. Results showed that there were significant differences in CRC screening uptake between intervention groups and
control (P<0.001). Conclusions: IM is a useful process in the design of a theory-based intervention addressing CRC
screening among Iranian population.
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Affiliation(s)
- Fereshteh Besharati
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
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