Intervention planning for a digital intervention for self-management of hypertension: a theory-, evidence- and person-based approach.
Intervention planning for a digital intervention for self-management of hypertension: a theory-, evidence- and person-based approach.
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DOI：
10.1186/s13012-017-0553-4
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发表时间：
2017-02-23
期刊：
影响因子：
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通讯作者：
Yardley L
中科院分区：
文献类型：
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作者：
Band R;Bradbury K;Morton K;May C;Michie S;Mair FS;Murray E;McManus RJ;Little P;Yardley L
本文描述了家庭和在线血压管理和评估（HOME BP）的干预计划流程，这是一种促进高血压自我管理的数字干预措施。它说明了如何将基于人的方法与基于理论和基于证据的方法相结合。以人为本的干预措施制定方法强调使用定性研究来确保干预措施是可接受的、有说服力的、有吸引力的且易于实施。我们的干预计划流程包括两个并行、集成的工作流程，结合了理论、证据和基于人的要素。第一个工作流程涉及整理来自混合方法可行性研究的证据、系统评价和定性研究综合。对这些证据进行分析，以确定可能的障碍和促进因素，以及应纳入 HOME BP 干预措施的设计特征。第二个工作流使用了三种互补的理论建模方法：制定干预设计的简要指导原则、将干预中的行为改变技术映射到行为改变轮和规范化过程理论框架的因果建模，以及开发逻辑模型。我们的干预计划综合方法的不同要素对于如何设计干预措施以最大限度地提高患者和卫生专业人员的可接受性和易于实施性产生了重要的、互补的见解。从主要和次要证据中，我们确定了需要克服的关键障碍（例如患者和健康专业人士对逐步增加药物的副作用的担忧）和有效的干预成分（例如为改变健康行为提供面对面的支持）。我们的指导原则强调了可以解决这些问题的独特设计功能（例如在线保证和管理问题的程序）。因果模型确保所有相关的行为决定因素都得到解决，并提供了干预措施的完整描述。我们的逻辑模型将我们干预的假设作用机制与现有的心理学理论联系起来。我们的干预措施开发综合方法，结合了理论、证据和以人为本的方法，提高了我们理论模型的清晰度、全面性和信心，并使我们能够深入了解与特定干预措施和用户群体最相关的障碍和促进因素。本文的在线版本 (doi:10.1186/s13012-017-0553-4) 包含补充材料，可供授权用户使用。
This paper describes the intervention planning process for the Home and Online Management and Evaluation of Blood Pressure (HOME BP), a digital intervention to promote hypertension self-management. It illustrates how a Person-Based Approach can be integrated with theory- and evidence-based approaches. The Person-Based Approach to intervention development emphasises the use of qualitative research to ensure that the intervention is acceptable, persuasive, engaging and easy to implement. Our intervention planning process comprised two parallel, integrated work streams, which combined theory-, evidence- and person-based elements. The first work stream involved collating evidence from a mixed methods feasibility study, a systematic review and a synthesis of qualitative research. This evidence was analysed to identify likely barriers and facilitators to uptake and implementation as well as design features that should be incorporated in the HOME BP intervention. The second work stream used three complementary approaches to theoretical modelling: developing brief guiding principles for intervention design, causal modelling to map behaviour change techniques in the intervention onto the Behaviour Change Wheel and Normalisation Process Theory frameworks, and developing a logic model. The different elements of our integrated approach to intervention planning yielded important, complementary insights into how to design the intervention to maximise acceptability and ease of implementation by both patients and health professionals. From the primary and secondary evidence, we identified key barriers to overcome (such as patient and health professional concerns about side effects of escalating medication) and effective intervention ingredients (such as providing in-person support for making healthy behaviour changes). Our guiding principles highlighted unique design features that could address these issues (such as online reassurance and procedures for managing concerns). Causal modelling ensured that all relevant behavioural determinants had been addressed, and provided a complete description of the intervention. Our logic model linked the hypothesised mechanisms of action of our intervention to existing psychological theory. Our integrated approach to intervention development, combining theory-, evidence- and person-based approaches, increased the clarity, comprehensiveness and confidence of our theoretical modelling and enabled us to ground our intervention in an in-depth understanding of the barriers and facilitators most relevant to this specific intervention and user population. The online version of this article (doi:10.1186/s13012-017-0553-4) contains supplementary material, which is available to authorized users.