Enhancing self-care adherence in patients with heart failure: a study protocol for developing a theory-based behaviour change intervention using the COM-B behaviour model (ACHIEVE study).
Enhancing self-care adherence in patients with heart failure: a study protocol for developing a theory-based behaviour change intervention using the COM-B behaviour model (ACHIEVE study).
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DOI：
10.1136/bmjopen-2018-025907
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发表时间：
2018-09-11
期刊：
影响因子：
2.9
通讯作者：
Wilm S
中科院分区：
文献类型：
--
作者：
Herber OR;Atkins L;Störk S;Wilm S
尽管国际指南建议将自我护理作为常规心力衰竭管理的一个组成部分，尽管有证据支持与自我护理相关的积极结局，但患者通常无法坚持。自我护理可以通过行为改变干预（BCI）来改变。然而，以前的自我护理干预措施在提高自我护理依从性方面取得了有限的成功，因为它们既没有理论基础，也没有明确定义，这排除了潜在因果机制的识别以及干预的可重复性。因此，我们的目标是开发一个干预手册，其中包含基于理论的脑机接口，这些脑机接口是使用八个描述符来定义的，这些描述符被提出来以标准化的方式描述脑机接口。BCI将基于通过定性荟萃总结技术和定量荟萃分析得出的结果声明。这些审查将用于提取与自我护理依从性/不依从性相关的因素（目标行为）。提取的目标行为将被映射到“能力，机会，动机和行为”（COM-B）模型，以捕捉所涉及的潜在机制。为了制定改变的方法，将使用“行为改变技术分类”，以便将目标行为有效地映射到既定的行为改变技术。然后，建议的商业行为指标将转化为当地相关的干预措施，使用规范化过程理论，以克服实施理论推导的干预措施付诸实践的困难。最后，将采用一种共识开发方法来微调干预手册的内容和可接受性，以增加在德国医疗保健系统中成功试点和实施未来BCI的可能性。本研究已获得德国杜塞尔多夫海因里希·海涅大学医学院伦理委员会的审查和批准（参考号：2018-30）。研究结果将通过同行评审的期刊出版物、会议介绍和利益攸关方参与活动传播。DRKS 00014855;预结果。
Although international guidelines recommend self-care as an integral part of routine heart failure management, and despite evidence supporting the positive outcomes related to self-care, patients are frequently unable to adhere. Self-care can be modified through behaviour change interventions (BCIs). However, previous self-care interventions have shown limited success in improving adherence to self-care, because they were neither theory-based nor well defined, which precludes the identification of underlying causal mechanisms as well as reproducibility of the intervention. Thus, our aim is to develop an intervention manual that contains theory-based BCIs that are well-defined using eight descriptors proposed to describe BCIs in a standardised way. BCIs will be based on statements of findings derived through qualitative meta-summary techniques and a quantitative meta-analysis. These reviews will be used to extract factors (target behaviours) associated with self-care adherence/non-adherence. Extracted target behaviours will be mapped onto the ‘Capability, Opportunity, Motivation and Behaviour’ (COM-B) model to capture the underlying mechanisms involved. To develop approaches for change, the ‘Taxonomy of Behaviour Change Techniques’ will be used to allow effective mapping of the target behaviours onto established behaviour change techniques. Suggested BCIs will then be translated into locally relevant interventions using the Normalisation Process Theory to overcome the difficulties of implementing theoretically derived interventions into practice. Finally, a consensus development method will be employed to fine-tune the content and acceptability of the intervention manual to increase the likelihood of successfully piloting and implementing future BCIs into the German healthcare system. This study has been reviewed and approved by the Ethics Committee of the Medical Faculty of the Heinrich Heine University Düsseldorf, Germany (Ref #: 2018-30). The results will be disseminated via peer-reviewed journal publications, conference presentations and stakeholder engagement activities. DRKS00014855; Pre-results.
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