scholarly journals The development of a theory informed behaviour change intervention to improve adherence to dietary and physical activity treatment guidelines in individuals with familial hypercholesterolaemia (FH)

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
F. J. Kinnear ◽  
E. Wainwright ◽  
J. E. Bourne ◽  
F. E. Lithander ◽  
J. Hamilton-Shield ◽  
...  
Keyword(s):  
Physical Activity ◽  
Behaviour Change ◽  
Familial Hypercholesterolaemia ◽  
Evaluation Criteria ◽  
Intervention Development ◽  
Feasibility Trial ◽  
Behaviour Change Intervention ◽  
Physical Activity Guidelines ◽  
Factors Influencing ◽  
Guide Intervention

Abstract Background Familial hypercholesterolaemia (FH) is a genetic condition characterised by elevated levels of low-density lipoprotein cholesterol (LDL-C) and an increased risk of cardiovascular disease (CVD). Following dietary and physical activity guidelines could help minimise this risk but adherence is low. Interventions to target these behaviours are therefore required. A comprehensive understanding of the target behaviours and behaviour change theory should drive the process of intervention development to increase intervention effectiveness and scalability. This paper describes the application of a theoretical framework to the findings of a qualitative evidence synthesis (QES) to inform the content and delivery of an intervention to improve adherence to dietary and physical activity guidelines in individuals with FH. Methods The Behaviour Change Wheel (BCW) was used to guide intervention development. Factors influencing dietary and physical activity behaviours were identified from an earlier QES and mapped onto factors within the BCW. A comprehensive behavioural diagnosis of these factors was conducted through application of the theoretical domains framework (TDF). Using these data, the most appropriate intervention functions and behaviour change techniques (BCTs) for inclusion in the intervention were identified. Decision making was guided by evaluation criteria recommended by BCW guidance and feedback from individuals with FH. Results Factors influencing dietary and physical activity behaviours mapped onto twelve of the fourteen TDF domains, with seven intervention functions deemed suitable to target the domains’ theoretical constructs. Twenty-six BCTs were identified as being appropriate for delivery within these functions and were included in the intervention. For instance, within the enablement intervention function, the BCT problem solving was incorporated by inclusion of a ‘barriers and solutions’ section. Guided by evaluation criteria and feedback from individuals with FH, the intervention will be delivered as an hour-long family-based appointment, followed up with four telephone calls. Conclusions The novel application of the BCW and TDF to the results of a QES has enabled the development of a theory and evidence informed behaviour change intervention. This systematic approach facilitates evaluation of the intervention as part of an ongoing feasibility trial. The transparent approach taken can be used to guide intervention development by researchers in other fields.

scholarly journals Reducing cardiovascular disease risk among families with familial hypercholesterolaemia by improving diet and physical activity: a randomised controlled feasibility trial

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e044200
Author(s):  
Fiona Jane Kinnear ◽  
Fiona E Lithander ◽  
Aidan Searle ◽  
Graham Bayly ◽  
Christina Wei ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Familial Hypercholesterolaemia ◽  
Disease Risk ◽  
Pilot Trial ◽  
Feasibility Trial ◽  
Cvd Risk ◽  
Sedentary Behaviours ◽  
Diet And Physical Activity ◽  
Randomised Controlled

ObjectiveFamilial hypercholesterolaemia (FH) elevates low-density lipoprotein cholesterol (LDL-C) and increases cardiovascular disease (CVD) risk. This study aimed to provide evidence for the feasibility of conducting a randomised controlled trial to evaluate the efficacy of an intervention designed to improve diet and physical activity in families with FH.DesignA parallel, randomised, waitlist-controlled, feasibility pilot trial.SettingThree outpatient lipid clinics in the UK.ParticipantsFamilies that comprised children (aged 10–18 years) and their parent with genetically diagnosed FH.InterventionFamilies were randomised to either 12-week usual care or intervention. The behavioural change intervention aimed to improve dietary, physical activity and sedentary behaviours. It was delivered to families by dietitians initially via a single face-to-face session and then by four telephone or email follow-up sessions.Outcome measuresFeasibility was assessed via measures related to recruitment, retention and intervention fidelity. Postintervention qualitative interviews were conducted to explore intervention acceptability. Behavioural (dietary intake, physical activity and sedentary time) and clinical (blood pressure, body composition and blood lipids) outcomes were collected at baseline and endpoint assessments to evaluate the intervention’s potential benefit.ResultsTwenty-one families (38% of those approached) were recruited which comprised 22 children and 17 adults with FH, and 97% of families completed the study. The intervention was implemented with high fidelity and the qualitative data revealed it was well accepted. Between-group differences at the endpoint assessment were indicative of the intervention’s potential for improving diet in children and adults. Evidence for potential benefits on physical activity and sedentary behaviours was less apparent. However, the intervention was associated with improvements in several CVD risk factors including LDL-C, with a within-group mean decrease of 8% (children) and 10% (adults).ConclusionsThe study’s recruitment, retention, acceptability and potential efficacy support the development of a definitive trial, subject to identified refinements.Trial registration numberISRCTN24880714.

scholarly journals Improving Physical Activity mHealth Interventions: Development of a Computational Model of Self-Efficacy Theory to Define Adaptive Goals for Exercise Promotion

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Dario Baretta ◽  
Fabio Sartori ◽  
Andrea Greco ◽  
Marco D’Addario ◽  
Riccardo Melen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Computational Model ◽  
Behaviour Change ◽  
Self Efficacy ◽  
Protective Factor ◽  
Cognitive Theory ◽  
Physical Activity Promotion ◽  
Physical Activity Guidelines ◽  
Model Based ◽  
Activity Promotion

The practice of regular physical exercise is a protective factor against noncommunicable diseases and premature mortality. In spite of that, large part of the population does not meet physical activity guidelines and many individuals live a sedentary life. Recent technological progresses and the widespread adoption of mobile technology, such as smartphone and wearables, have opened the way to the development of digital behaviour change interventions targeting physical activity promotion. Such interventions would greatly benefit from the inclusion of computational models framed on behaviour change theories and model-based reasoning. However, research on these topics is still at its infancy. The current paper presents a smartphone application and wearable device system called Muoviti! that targets physical activity promotion among adults not meeting the recommended physical activity guidelines. Specifically, we propose a computational model of behaviour change, grounded on the social cognitive theory of self-efficacy. The purpose of the computational model is to dynamically integrate information referring to individuals’ self-efficacy beliefs and physical activity behaviour in order to define exercising goals that adapt to individuals’ changes over time. The paper presents (i) the theoretical constructs that informed the development of the computational model, (ii) an overview of Muoviti! describing the system dynamics, the graphical user interface, the adopted measures and the intervention design, and (iii) the computational model based on Dynamic Decision Network. We conclude by presenting early results from an experimental study.

scholarly journals Developing a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice and subsequently change antibiotic use

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e035793 ◽  
Author(s):  
Marta Santillo ◽  
Marta Wanat ◽  
Mina Davoudianfar ◽  
Emily Bongard ◽  
Sinisa Savic ◽  
...  
Keyword(s):  
General Practice ◽  
Behaviour Change ◽  
Controlled Trial ◽  
Intervention Development ◽  
Penicillin Allergy ◽  
Feasibility Trial ◽  
Rapid Review ◽  
Behavioural Intervention ◽  
Behaviour Change Techniques ◽  
Intervention Package

ObjectivesTo develop a behavioural intervention package to support clinicians and patients to amend incorrect penicillin allergy records in general practice. The intervention aimed to: (1) support clinicians to refer patients for penicillin allergy testing (PAT), (2) support patients to attend for PAT and (3) support clinicians and patients to prescribe or consume penicillin, when indicated, following a negative PAT result.MethodsTheory-based, evidence-based and person-based approaches were used in the intervention development. We used evidence from a rapid review, two qualitative studies, and expert consultations with the clinical research team to identify the intervention ‘guiding principles’ and develop an intervention plan. Barriers and facilitators to the target behaviours were mapped to behaviour change theory in order to describe the proposed mechanisms of change. In the final stage, think-aloud interviews were conducted to optimise intervention materials.ResultsThe collated evidence showed that the key barriers to referral of patients by clinicians were limited experience of referral and limited knowledge of referral criteria and PAT. Barriers for patients attending PAT were lack of knowledge of the benefits of testing and lack of motivation to get tested. The key barriers to the prescription and consumption of first-line penicillin following a negative test result were patient and clinician beliefs about the accuracy of PAT and whether taking penicillin was safe. Intervention materials were designed and developed to address these barriers.ConclusionsWe present a novel behavioural intervention package designed to address the multiple barriers to uptake of PAT in general practice by clinicians and patients. The intervention development details how behaviour change techniques have been incorporated to hypothesise how the intervention is likely to work to help amend incorrect penicillin allergy records. The intervention will go on to be tested in a feasibility trial and randomised controlled trial in England.

scholarly journals Development of Virtual Traveller: A behaviour change intervention to increase physical activity during primary school lessons

2016 ◽  
Vol 4 ◽  
Author(s):  
Norris Emma ◽  
Shelton Nicola ◽  
Dunsmuir Sandra ◽  
Duke-Williams Oliver ◽  
Stamatakis Emmanuel
Keyword(s):  
Physical Activity ◽  
Primary School ◽  
Behaviour Change ◽  
Behaviour Change Intervention

scholarly journals PARIS: protocol for a prospective single arm, theory-based, group-based feasibility intervention study to increase Physical Activity and reduce sedentary behaviouR after barIatric Surgery

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e051638
Author(s):  
Jennifer James ◽  
Wendy Hardeman ◽  
Helen Eborall ◽  
Mark Goodall ◽  
John Wilding
Keyword(s):  
Physical Activity ◽  
Bariatric Surgery ◽  
Sedentary Behaviour ◽  
Behaviour Change ◽  
Feasibility Study ◽  
Theoretical Domains Framework ◽  
Comparative Approach ◽  
Service Research ◽  
Behaviour Change Techniques ◽  
Behaviour Change Intervention

IntroductionIncreased physical activity and reduced sedentary behaviour can encourage favourable outcomes after bariatric surgery. However, there is a lack of evidence as to how to support patients with behaviour change. The aim of this study is to assess the feasibility of a physiotherapist led, online group-based behaviour change intervention to increase physical activity and reduce sedentary behaviour following bariatric surgery.Methods and analysisSingle arm feasibility study of a theory and evidence-based group behaviour change intervention based on the Behaviour Change Wheel and Theoretical Domains Framework using behaviour change techniques from the Behaviour Change Technique Taxonomy v1. The intervention has eight objectives and specifies behaviour change techniques that will be used to address each of these. Groups of up to eight participants who have had surgery within the previous 5 years will meet weekly over 6 weeks for up to 1½ hours. Groups will be held online led by a physiotherapist and supported by an intervention handbook. Feasibility study outcomes include: rate of recruitment, retention, intervention fidelity, participant engagement and acceptability. Secondary outcomes include: physical activity, sedentary behaviour, body composition, self-reported health status and will be analysed descriptively. Change in these outcomes will be used to calculate the sample size for a future evaluation study. Qualitative interviews will explore participants’ views of the intervention including its acceptability. Data will be analysed according to the constant comparative approach of grounded theory.Ethics and disseminationThis study has National Health Service Research Ethics Committee approval; Haydock 20/NW/0472. All participants will provide informed consent and can withdraw at any point. Findings will be disseminated through peer-reviewed journals, conference and clinical service presentations.Trial registration numberISRCTN31524689.

scholarly journals Self-regulation as a Mediator of Mindfulness and Physical Activity: A Narrative Review

Spectrum ◽  
2021 ◽  
Author(s):  
Aaron Boyle ◽  
Amber Mosewich
Keyword(s):  
Physical Activity ◽  
Behaviour Change ◽  
Self Regulation ◽  
Narrative Review ◽  
Activity Participation ◽  
Potential Mechanism ◽  
Review Of The Literature ◽  
Physical Activity Guidelines ◽  
Mechanisms Of Mindfulness

Mindfulness is gaining increased attention as a means of increasing physical activity (PA) participation. Given that only 15.4% of adult Canadians currently meet the Canadian Physical Activity Guidelines (Colley et al., 2011), it is imperative to find ways to increase PA among adults. One way to do this is to promote self-regulation skills as self-regulation is among the top predictors of PA participation (Teixeira et al., 2015).  The purpose of this narrative review was to further understand the role of self-regulation as a potential mechanism by which mindfulness may be related to PA participation. Initially, 160 papers were identified by title for this review. After reading abstracts, 37 papers were identified as possibly relating to the topic of interest. Following full readings, 26 papers were included in the final review. Likely due to the novelty of this topic, there is limited research on the mechanisms by which mindfulness may be related to physical activity. Review of the literature suggests that self-regulation appears to be a promising mechanism by which mindfulness could improve physical activity participation (Shapiro et al., 2006; Samdal et al., 2017), as self-regulation has been shown to play an important role in behaviour change, however, other alternative mechanisms include improved self-efficacy, as well as improved satisfaction (Neace et al., 2020; Tsafou et al., 2016). The authors conclude that more research on the mechanisms of mindfulness on PA, specifically self-regulation as a mechanism, could foster more knowledgeable intervention practices, and consequently improve mindfulness-based interventions efficacy.

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