Exploring deprescribing opportunities for community pharmacists using the Behaviour Change Wheel

An emphasis on active ageing could help to delay the onset of frailty. In Singapore, Senior Activity Centres provide free and guided group exercise sessions for older adults. However, one such centre had very low participation rates among community-dwelling older adults despite running standardised programmes. Based on a needs analysis from a prior project, this paper reports on strategies implemented to improve the daily centre-based group exercise participation rate among community-dwelling older adults. Using the behaviour change wheel model, participant motivation domains were identified as primary gaps, while the psychological capability and physical opportunity were categorised as secondary gaps. A logic model was used to design a project to respond to these identified gaps and guide the evaluation approach. Three strategies were implemented over a 4-week period and reviewed at 6 months: (1) promotion of the exercise classes, (2) delayed rewards for participation and (3) health ambassadors. Evaluation findings highlighted that more resources were needed for the training of community-dwelling older adult healthcare ambassadors in the use of motivational interviewing. The interventions were found to be efficacious in increasing daily group exercise participation rate at the centre, from an average of three to nine participants per day over the 4 weeks. Furthermore, more than 60% of these participants achieved the WHO’s weekly minimum exercise recommendation for older adults (150 min moderate-intensity physical activity). To increase the engagement of older adults in physical activity or exercise participation, we recommend the use of behaviour change wheel model and the use of community-based health ambassadors. In conclusion, the project found improved daily centre-based group physical exercise participation rates when all the domains in the behaviour change wheel model were addressed.

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An organisational participatory research study of the feasibility of the behaviour change wheel to support clinical teams implementing new models of care

BMC Health Services Research ◽

10.1186/s12913-019-3885-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Eleanor R Bull ◽

Joanne K Hart ◽

Juliette Swift ◽

Kirstie Baxter ◽

Neil McLauchlan ◽

...

Keyword(s):

Participatory Research ◽

Behaviour Change ◽

Research Study ◽

Models Of Care ◽

Behaviour Change Wheel ◽

New Models

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‘No one ever asked us’: a feasibility study assessing the co-creation of a physical activity programme with adolescent girls

Global Health Promotion ◽

10.1177/1757975919853784 ◽

2019 ◽

Vol 27 (3) ◽

pp. 34-43

Author(s):

Méabh Corr ◽

Elaine Murtagh

Keyword(s):

Physical Activity ◽

Data Collection ◽

Behaviour Change ◽

Adolescent Girls ◽

Retention Rate ◽

Controlled Trial ◽

Activity Level ◽

Health Concern ◽

Post Intervention ◽

Behaviour Change Wheel

Background: Globally, the poor activity level of adolescent girls is a public health concern. Little research has involved adolescents in the design of interventions. This study assessed the feasibility of involving girls in the co-creation of an activity programme. Methods: Thirty-one students (15–17 years old) were recruited from a post-primary school. The Behaviour Change Wheel guided intervention design, providing insights into participants’ capability, opportunity and motivation for change. Step counts and self-reported physical activity levels were recorded pre- and post-intervention. Feasibility benchmarks assessed recruitment, data collection, acceptability and adherence. Results: Activity and educational sessions were delivered for six weeks during physical education class. Average attendance was 87% (benchmark = 80%). Eligibility was 61% (benchmark = 60%). There was a 100% retention rate (benchmark = 90%). All participants ( n = 31) completed baseline measures and 71% ( n = 22) completed post-measures. 54% ( n = 17) of students completed pedometer measurements, with 32% ( n = 10) having complete data. Average daily steps were 13,121 pre-intervention and 14,128 post-intervention ( p > 0.05). Data collection was feasible, receiving a mean score > 4/5 (benchmark > 3.5/5). Conclusions: The Behaviour Change Wheel can be used to co-create an activity programme with adolescent girls. Predetermined benchmarks, except for pedometer recordings, were reached or exceeded, providing evidence for the need of a randomised controlled trial to test effectiveness.

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Using the Behaviour Change Wheel to explore potential strategies for minimising harms from non-recreational prescription medicine sharing

Research in Social and Administrative Pharmacy ◽

10.1016/j.sapharm.2018.04.001 ◽

2019 ◽

Vol 15 (2) ◽

pp. 130-144 ◽

Cited By ~ 2

Author(s):

Kebede Beyene ◽

Trudi Aspden ◽

Janie Sheridan

Keyword(s):

Behaviour Change ◽

Prescription Medicine ◽

Behaviour Change Wheel ◽

Medicine Sharing

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A co-production approach guided by the Behaviour Change Wheel to develop an intervention for reducing sedentary behaviour after stroke

10.21203/rs.3.rs-17919/v2 ◽

2020 ◽

Author(s):

Jennifer Hall ◽

Sarah Morton ◽

Jessica Hall ◽

David J Clarke ◽

Claire F Fitzsimons ◽

...

Keyword(s):

Sedentary Behaviour ◽

Behaviour Change ◽

Intervention Development ◽

Inpatient Setting ◽

Stroke Survivors ◽

Behaviour Change Wheel ◽

Target Behaviour ◽

Service Staff ◽

Stroke Services ◽

Production Approach

Abstract Background: Stroke survivors are highly sedentary; thus, breaking up long uninterrupted bouts of sedentary behaviour could have substantial health benefit. However, there are no intervention strategies specifically aimed at reducing sedentary behaviour tailored for stroke survivors. The purpose of this study was to use co-production approaches to develop an intervention to reduce sedentary behaviour after stroke.Methods: A series of five co-production workshops with stroke survivors, their caregivers, stroke service staff, exercise professionals, and researchers were conducted in parallel in two stroke services (England and Scotland). Workshop format was informed by the Behaviour Change Wheel (BCW) framework for developing interventions and incorporated systematic review and empirical evidence. Taking an iterative approach, data from activities and audio recordings were analysed following each workshop and findings used to inform subsequent workshops, to inform both the activities of the next workshop and ongoing intervention development.Findings: Co-production workshop participants (n = 43) included 17 staff, 14 stroke survivors, six caregivers, and six researchers. The target behaviour for stroke survivors is to increase standing and moving, and the target behaviour for caregivers and staff is to support and encourage stroke survivors to increase standing and moving. The developed intervention is primarily based on co-produced solutions to barriers to achieving the target behaviour. The developed intervention includes 34 behaviour change techniques. The intervention is to be delivered through stroke services, commencing in the inpatient setting and following through discharge into the community. Participants reported that taking part in intervention development was a positive experience. Conclusions: To our knowledge, this is the first study that has combined the use of co-production and the BCW to develop an intervention for use in stroke care. In-depth reporting of how a co-production approach was combined with the BCW framework, including the design of bespoke materials for workshop activities, should prove useful to other researchers and practitioners involved in intervention development in stroke.

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Use of the theoretical domains framework and behaviour change wheel to develop a novel intervention to improve the quality of multidisciplinary cancer conference decision-making

BMC Health Services Research ◽

10.1186/s12913-020-05255-w ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Christine Fahim ◽

Anita Acai ◽

Meghan M. McConnell ◽

Frances C. Wright ◽

Ranil R. Sonnadara ◽

...

Keyword(s):

Decision Making ◽

Behaviour Change ◽

Theoretical Domains Framework ◽

Behaviour Change Wheel

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Effectiveness of interventions to improve rates of intravenous thrombolysis using behaviour change wheel functions: a systematic review and meta-analysis

Implementation Science ◽

10.1186/s13012-020-01054-3 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Md Golam Hasnain ◽

John R. Attia ◽

Shahinoor Akter ◽

Tabassum Rahman ◽

Alix Hall ◽

...

Keyword(s):

Systematic Review ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Publication Bias ◽

Behaviour Change ◽

Intravenous Thrombolysis ◽

Intervention Strategies ◽

Therapeutic Window ◽

Behaviour Change Wheel ◽

Meta Analyses

Abstract Background Despite being one of the few evidence-based treatments for acute ischemic stroke, intravenous thrombolysis has low implementation rates—mainly due to a narrow therapeutic window and the health system changes required to deliver it within the recommended time. This systematic review and meta-analyses explores the differential effectiveness of intervention strategies aimed at improving the rates of intravenous thrombolysis based on the number and type of behaviour change wheel functions employed. Method The following databases were searched: MEDLINE, EMBASE, PsycINFO, CINAHL and SCOPUS. Multiple authors independently completed study selection and extraction of data. The review included studies that investigated the effects of intervention strategies aimed at improving the rates of intravenous thrombolysis and/or onset-to-needle, onset-to-door and door-to-needle time for thrombolysis in patients with acute ischemic stroke. Interventions were coded according to the behaviour change wheel nomenclature. Study quality was assessed using the QualSyst scoring system for quantitative research methodologies. Random effects meta-analyses were used to examine effectiveness of interventions based on the behaviour change wheel model in improving rates of thrombolysis, while meta-regression was used to examine the association between the number of behaviour change wheel intervention strategies and intervention effectiveness. Results Results from 77 studies were included. Five behaviour change wheel interventions, ‘Education’, ‘Persuasion’, ‘Training’, ‘Environmental restructuring’ and ‘Enablement’, were found to be employed among the included studies. Effects were similar across all intervention approaches regardless of type or number of behaviour change wheel-based strategies employed. High heterogeneity (I2 > 75%) was observed for all the pooled analyses. Publication bias was also identified. Conclusion There was no evidence for preferring one type of behaviour change intervention strategy, nor for including multiple strategies in improving thrombolysis rates. However, the study results should be interpreted with caution, as they display high heterogeneity and publication bias.

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