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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
Intervention planning for a digital intervention for self-management of hypertension: a theory-, evidence- and person-based approach
Background: This paper describes the intervention planning process for 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.

Methods: 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.

Results: 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.

Conclusion: 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.
1-27
Band, Rebecca
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Bradbury, Katherine
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Morton, Kate
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May, Carl
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Michie, Susan
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Mair, Francis
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Murray, Elizabeth
cb300780-9041-44af-9ae5-e13531eb23b8
McManus, Richard
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Little, Paul
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Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Band, Rebecca
be8901bb-bb1b-4131-8e19-c1d4a3bdfb8d
Bradbury, Katherine
87fce0b9-d9c5-42b4-b041-bffeb4430863
Morton, Kate
6fa41cd3-ba4d-476c-9020-b8ef93c7ade7
May, Carl
17697f8d-98f6-40d3-9cc0-022f04009ae4
Michie, Susan
47e0a907-79cb-47d5-b5a9-82d2afe1747a
Mair, Francis
dcb02f04-1900-4d8f-910b-fb63a3e89936
Murray, Elizabeth
cb300780-9041-44af-9ae5-e13531eb23b8
McManus, Richard
eac36c17-f265-499a-aaab-03f1a3df5286
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Yardley, Lucy
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Band, Rebecca, Bradbury, Katherine, Morton, Kate, May, Carl, Michie, Susan, Mair, Francis, Murray, Elizabeth, McManus, Richard, Little, Paul and Yardley, Lucy (2017) Intervention planning for a digital intervention for self-management of hypertension: a theory-, evidence- and person-based approach. Implementation Science, 1-27. (doi:10.1186/s13012-017-0553-4).

Record type: Article

Abstract

Background: This paper describes the intervention planning process for 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.

Methods: 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.

Results: 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.

Conclusion: 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.

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More information

Accepted/In Press date: 9 February 2017
e-pub ahead of print date: 23 February 2017
Published date: 23 February 2017
Organisations: Psychology

Identifiers

Local EPrints ID: 405659
URI: https://eprints.soton.ac.uk/id/eprint/405659
PURE UUID: 1a300fc5-a10c-454f-98bb-47ed93ec5c48
ORCID for Rebecca Band: ORCID iD orcid.org/0000-0001-5403-1708
ORCID for Katherine Bradbury: ORCID iD orcid.org/0000-0001-5513-7571
ORCID for Carl May: ORCID iD orcid.org/0000-0002-0451-2690

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Date deposited: 10 Feb 2017 11:28
Last modified: 21 Nov 2018 05:01

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Contributors

Author: Rebecca Band ORCID iD
Author: Kate Morton
Author: Carl May ORCID iD
Author: Susan Michie
Author: Francis Mair
Author: Elizabeth Murray
Author: Richard McManus
Author: Paul Little
Author: Lucy Yardley

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