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Intervention planning and modification of the BUMP intervention: a digital intervention for the early detection of raised blood pressure in pregnancy

Intervention planning and modification of the BUMP intervention: a digital intervention for the early detection of raised blood pressure in pregnancy
Intervention planning and modification of the BUMP intervention: a digital intervention for the early detection of raised blood pressure in pregnancy
Background: Hypertensive disorders in pregnancy, particularly pre-eclampsia, pose a substantial health risk for both maternal and fetal outcomes. The BUMP (Blood Pressure Self-Monitoring in Pregnancy) interventions are being tested in a trial. They aim to facilitate the early detection of raised blood pressure through self-monitoring. This article outlines how the self-monitoring interventions in the BUMP trial were developed and modified using the person-based approach to promote engagement and adherence.

Methods: Key behavioural challenges associated with blood pressure self-monitoring in pregnancy were identified through synthesising qualitative pilot data and existing evidence, which informed guiding principles for the development process. Social Cognitive Theory was identified as an appropriate theoretical framework. A testable logic model was developed to illustrate the hypothesized processes of change associated with the intervention. Iterative qualitative feedback from women and staff informed modifications to the participant materials.

Results: The evidence synthesis suggested women face challenges integrating self-monitoring into their lives, and that adherence is challenging at certain time points in pregnancy (for example, starting maternity leave). Intervention modification included strategies to address adherence, but also focussed on modifying outcome expectancies, by providing messages explaining pre-eclampsia and outlining the potential benefits of self-monitoring.

Conclusions: With an in-depth understanding of the target population, several methods and approaches to plan and develop interventions specifically relevant to pregnant women were successfully integrated, to address barriers to behaviour change while ensuring they are easy to engage with, persuasive and acceptable.
hypertension; pregnancy; pre-eclampsia; digital intervention; intervention planning; person-based approach.
2055-5784
Band, Rebecca
be8901bb-bb1b-4131-8e19-c1d4a3bdfb8d
Hinton, Lisa
177e60b0-f34c-4c40-b3b4-c130eea37f93
Tucker, Katherine
c8929efe-384c-45b2-be09-4726bd1c5393
Chappell, Lucy
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Crawford, Carole
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Franssen, Marloes
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Greenfield, Sheila
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Hodgkinson, James
43cc80f2-c05e-4d03-8a3f-ecd532b392ff
McCourt, Christine
e48c7f85-876d-4c8e-94f1-fbe009e6123b
McManus, Richard
d7f90873-d802-4aaf-9f19-abc08804e95d
Sandall, Jane
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Dala Santos, Mauro
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Velardo, Carmelo
72fd5835-64d8-4094-8822-6da3cea85815
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Band, Rebecca
be8901bb-bb1b-4131-8e19-c1d4a3bdfb8d
Hinton, Lisa
177e60b0-f34c-4c40-b3b4-c130eea37f93
Tucker, Katherine
c8929efe-384c-45b2-be09-4726bd1c5393
Chappell, Lucy
6d93b760-d510-4c5f-a557-b27b64ce8456
Crawford, Carole
2d782db3-375d-469a-9505-56ba8dde9cee
Franssen, Marloes
281af067-8e31-4d45-906f-af540e3b7323
Greenfield, Sheila
f4b76a2b-4a73-4381-81a7-f49e655f9f64
Hodgkinson, James
43cc80f2-c05e-4d03-8a3f-ecd532b392ff
McCourt, Christine
e48c7f85-876d-4c8e-94f1-fbe009e6123b
McManus, Richard
d7f90873-d802-4aaf-9f19-abc08804e95d
Sandall, Jane
77437928-6256-49db-ba7d-13722d6917d7
Dala Santos, Mauro
15ec0fd0-b680-4b5a-8587-d1434fd20f11
Velardo, Carmelo
72fd5835-64d8-4094-8822-6da3cea85815
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e

Band, Rebecca, Hinton, Lisa, Tucker, Katherine, Chappell, Lucy, Crawford, Carole, Franssen, Marloes, Greenfield, Sheila, Hodgkinson, James, McCourt, Christine, McManus, Richard, Sandall, Jane, Dala Santos, Mauro, Velardo, Carmelo and Yardley, Lucy (2019) Intervention planning and modification of the BUMP intervention: a digital intervention for the early detection of raised blood pressure in pregnancy. Pilot and Feasibility Studies, 5, [153]. (doi:10.1186/s40814-019-0537-z).

Record type: Article

Abstract

Background: Hypertensive disorders in pregnancy, particularly pre-eclampsia, pose a substantial health risk for both maternal and fetal outcomes. The BUMP (Blood Pressure Self-Monitoring in Pregnancy) interventions are being tested in a trial. They aim to facilitate the early detection of raised blood pressure through self-monitoring. This article outlines how the self-monitoring interventions in the BUMP trial were developed and modified using the person-based approach to promote engagement and adherence.

Methods: Key behavioural challenges associated with blood pressure self-monitoring in pregnancy were identified through synthesising qualitative pilot data and existing evidence, which informed guiding principles for the development process. Social Cognitive Theory was identified as an appropriate theoretical framework. A testable logic model was developed to illustrate the hypothesized processes of change associated with the intervention. Iterative qualitative feedback from women and staff informed modifications to the participant materials.

Results: The evidence synthesis suggested women face challenges integrating self-monitoring into their lives, and that adherence is challenging at certain time points in pregnancy (for example, starting maternity leave). Intervention modification included strategies to address adherence, but also focussed on modifying outcome expectancies, by providing messages explaining pre-eclampsia and outlining the potential benefits of self-monitoring.

Conclusions: With an in-depth understanding of the target population, several methods and approaches to plan and develop interventions specifically relevant to pregnant women were successfully integrated, to address barriers to behaviour change while ensuring they are easy to engage with, persuasive and acceptable.

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Intervention_planning_BUMP_manuscript_R1_Nov_2019_clean - Accepted Manuscript
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More information

Accepted/In Press date: 25 November 2019
e-pub ahead of print date: 20 December 2019
Keywords: hypertension; pregnancy; pre-eclampsia; digital intervention; intervention planning; person-based approach.

Identifiers

Local EPrints ID: 436410
URI: http://eprints.soton.ac.uk/id/eprint/436410
ISSN: 2055-5784
PURE UUID: eb2000ae-2d4b-40b5-8ed7-8c3c4e3e0eb9
ORCID for Rebecca Band: ORCID iD orcid.org/0000-0001-5403-1708
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 10 Dec 2019 17:30
Last modified: 07 Oct 2020 04:33

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Contributors

Author: Rebecca Band ORCID iD
Author: Lisa Hinton
Author: Katherine Tucker
Author: Lucy Chappell
Author: Carole Crawford
Author: Marloes Franssen
Author: Sheila Greenfield
Author: James Hodgkinson
Author: Christine McCourt
Author: Richard McManus
Author: Jane Sandall
Author: Mauro Dala Santos
Author: Carmelo Velardo
Author: Lucy Yardley ORCID iD

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