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

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.

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

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.

scholarly journals Factors influencing sedentary behaviours after stroke: findings from qualitative observations and interviews with stroke survivors and their caregivers

2020 ◽  
Author(s):  
Jennifer Hall ◽  
Sarah Morton ◽  
Claire F Fitzsimons ◽  
Jessica Faye Hall ◽  
Rekesh Corepal ◽  
...  
Keyword(s):  
Sedentary Behaviour ◽  
Behaviour Change ◽  
Intervention Development ◽  
Stroke Survivor ◽  
Stroke Survivors ◽  
Structured Interviews ◽  
Stroke Service ◽  
Service Staff ◽  
Framework Approach ◽  
The Impact

Abstract Background: Stroke survivors are more sedentary than healthy, age-matched controls, independent of functional capacity. Interventions are needed to encourage a reduction in overall sedentary time, and regular breaks in prolonged periods of sedentary behaviour. This study captured the views and experiences of stroke survivors and their caregivers related to sedentary behaviour after stroke, to inform the development of an intervention to reduce sedentary behaviour.Methods: Mixed-methods qualitative study. Non-participant observations were completed in two stroke services, inclusive of inpatient and community settings in the United Kingdom. Semi-structured interviews were conducted with stroke survivors and their caregivers (if available) at six- or nine-months post-stroke. Underpinned by the capability, opportunity and motivation (COM-B) model of behaviour change, observational data (132 hours) were analysed thematically and interview data (n=31 stroke survivors, n=12 caregivers) were analysed using the Framework approach.Findings: Observation participants differed in functional ability whereas stroke survivor interviewees were all ambulant. Six themes related to sedentary behaviour after stroke were generated: (1) sedentary behaviour levels and patterns after stroke; (2) the physical and social environment in the stroke service and in the home; (3) standing and movement capability after stroke; (4) emotion and motivation after stroke; (5) caregivers’ influence on, and role in influencing stroke survivors’ sedentary behaviour; and (6) intervening to reduce sedentary behaviour after stroke. Capability, opportunity and motivation were influenced by the impact of the stroke and caregivers’ inclination to support sedentary behaviour reduction. Stroke survivors reported being more sedentary than they were pre-stroke due to impaired balance and co-ordination, increased fatigue, and reduced confidence in mobilising. Caregivers inclination to support stroke survivors to reduce sedentary behaviour depended on factors including their willingness to withdraw from the caregiver role, and their perception of whether the stroke survivor would act on their encouragement. Conclusions: Many stroke survivors indicate being open to reducing sedentary behaviour, with appropriate support from stroke service staff and caregivers. The findings from this study have contributed to an intervention development process using the Behaviour Change Wheel (BCW) approach to develop strategies to reduce sedentary behaviour after stroke.

scholarly journals Factors influencing sedentary behaviours after stroke: findings from qualitative observations and interviews with stroke survivors and their caregivers

2019 ◽  
Author(s):  
Jennifer Hall ◽  
Sarah Morton ◽  
Claire F Fitzsimons ◽  
Jessica Faye Hall ◽  
Rekesh Corepal ◽  
...  
Keyword(s):  
Sedentary Behaviour ◽  
Behaviour Change ◽  
Intervention Development ◽  
Stroke Survivor ◽  
Stroke Survivors ◽  
Structured Interviews ◽  
Stroke Service ◽  
Service Staff ◽  
Framework Approach ◽  
The Impact

Abstract Background: Stroke survivors are highly sedentary. Interventions are needed to encourage a reduction in overall sedentary time, and regular breaks in prolonged periods of sedentary behaviour. This study captured the views and experiences of stroke survivors and their caregivers related to sedentary behaviour after stroke, to inform the development of an intervention to reduce sedentary behaviour. Methods: Mixed-methods qualitative study. Non-participant observations were completed in two stroke services, inclusive of inpatient and community settings in the United Kingdom. Semi-structured interviews were conducted with stroke survivors and their caregivers (if available) at six- or nine-months post-stroke. Underpinned by the capability, opportunity and motivation (COM-B) model of behaviour change, observational data (132 hours) were analysed thematically and interview data (n=31 stroke survivors, n=12 caregivers) were analysed using the Framework approach. Findings: Six themes related to sedentary behaviour after stroke were generated: (1) sedentary behaviour levels and patterns after stroke; (2) the physical and social environment in the stroke service and in the home; (3) standing and movement capability after stroke; (4) emotion and motivation after stroke; (5) caregivers’ influence on, and role in influencing stroke survivors’ sedentary behaviour; and (6) intervening to reduce sedentary behaviour after stroke. Capability, opportunity and motivation were influenced by the impact of the stroke and caregivers’ inclination to support sedentary behaviour reduction. Stroke survivors reported being more sedentary than they were pre-stroke due to impaired balance and co-ordination, increased fatigue, and reduced confidence in mobilising. Caregivers inclination to support stroke survivors to reduce sedentary behaviour depended on factors including their willingness to withdraw from the caregiver role, and their perception of whether the stroke survivor would act on their encouragement. Conclusions: Many stroke survivors indicate being open to reducing sedentary behaviour, with appropriate support from stroke service staff and caregivers. The findings from this study have contributed to an intervention development process using the Behaviour Change Wheel (BCW) approach [1] to develop strategies to reduce sedentary behaviour after stroke.

scholarly journals A co-production approach guided by the behaviour change wheel to develop an intervention for reducing sedentary behaviour after stroke

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Jennifer Hall ◽  
Sarah Morton ◽  
Jessica Hall ◽  
David J. Clarke ◽  
Claire F. Fitzsimons ◽  
...  
Keyword(s):  
Sedentary Behaviour ◽  
Behaviour Change ◽  
Behaviour Change Wheel ◽  
Production Approach

scholarly journals Behaviour Change for Open Science

2019 ◽  
Author(s):  
Emma Norris ◽  
Daryl Brian O'Connor
Keyword(s):  
Behaviour Change ◽  
Intervention Development ◽  
Open Science ◽  
Barriers And Facilitators ◽  
Change Strategies ◽  
Behaviour Change Wheel ◽  
Change Principles

This Editorial presents a discussion of behaviour change strategies that could be used to increase uptake of Open Science behaviours. It explores what we mean by behaviour in Open Science, barriers and facilitators of Open Science behaviours and the potential for intervention development using behaviour change principles using a case-study of the Behaviour Change Wheel.

scholarly journals Breaking Free from Smoking: A Novel Digital Smoking Cessation Intervention for Offenders in UK Prisons

2018 ◽  
Vol 13 (4) ◽  
pp. 189-200 ◽  
Author(s):  
Stephanie Dugdale ◽  
Jonathan Ward ◽  
Sarah Elison-Davies ◽  
Glyn Davies ◽  
Emma Brown
Keyword(s):  
Smoking Cessation ◽  
Behaviour Change ◽  
Behavioural Change ◽  
Intervention Development ◽  
Clinical Effectiveness ◽  
Smoking Cessation Intervention ◽  
Balance Model ◽  
Smoking Ban ◽  
Cessation Intervention ◽  
Behaviour Change Wheel

Introduction: The level of smoking cessation support across UK prisons is variable, with most offering pharmacological support, such as nicotine replacement therapy. However, with a complete smoking ban in prisons in England now imminent, additional standardised behavioural support is necessary to help offenders go smoke-free.Aims: This study used the Behaviour Change Wheel to aim to develop the content of an online smoking cessation intervention for offenders, with consideration of their capability, motivation and opportunity for behaviour change.Methods: This was an intervention development study. The Behaviour Change Wheel was used to map cognitive, behavioural, physiological and social targets for the intervention, onto appropriate intervention techniques for inclusion in the smoking cessation programme for offenders.Results: Psychological capability, social opportunity and reflective and automatic motivation were identified through deductive thematic analysis as areas of change required to achieve smoking cessation. A total of 27 behavioural change techniques were chosen for this smoking cessation intervention and were mapped onto the Lifestyle Balance Model which provided the theoretical basis on which the components of the programme are conceptualised. This included strategies around increasing motivation to quit, anticipating smoking triggers, modifying smoking-related thoughts, regulating emotions, managing cravings, replacing smoking and rewarding nicotine abstinence and adopting a healthier lifestyle.Conclusions: Through the utilisation of the Behaviour Change Wheel, the development process of this digital smoking cessation intervention was achieved. Further research is planned to evaluate the clinical effectiveness of this intervention and to explore how the programme is implemented in practice within prison settings.

scholarly journals The DAFNE plus programme for sustained type 1 diabetes self management: Intervention development using the Behaviour Change Wheel

2021 ◽  
Vol 38 (5) ◽  
Author(s):  
Stephanie H. Stanton‐Fay ◽  
Kathryn Hamilton ◽  
Paul M. Chadwick ◽  
Fabiana Lorencatto ◽  
Carla Gianfrancesco ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Behaviour Change ◽  
Intervention Development ◽  
Self Management ◽  
Management Intervention ◽  
Behaviour Change Wheel

scholarly journals Reducing drug-use harms among higher education students: MyUSE contextual-behaviour change digital intervention development using the Behaviour Change Wheel

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Vasilis S. Vasiliou ◽  
Samantha Dockray ◽  
Samantha Dick ◽  
Martin P. Davoren ◽  
Ciara Heavin ◽  
...  
Keyword(s):  
Higher Education ◽  
Drug Use ◽  
Harm Reduction ◽  
Behaviour Change ◽  
Drug Users ◽  
Behavioural Change ◽  
Intervention Development ◽  
Education Students ◽  
Behaviour Change Technique ◽  
Behaviour Change Wheel

Abstract Background Digital harm-reduction interventions typically focus on people with severe drug-use problems, yet these interventions have moderate effectiveness on drug-users with lower levels of risk of harm. The difference in effectiveness may be explained by differences in behavioural patterns between the two groupings. Harnessing behavioural theories to understand what is at the core of drug-use behaviours and mapping the content of new interventions, may improve upon the effectiveness of interventions for lower-risk drug-users. To the best of our knowledge, this is the first study to systematically apply the Behaviour Change Wheel (BCW) approach to understand the components, influencing capabilities, opportunities, and motivations (COM-B) of higher education students to change their drug-use behaviors. It is also the first study which identifies specific patterns of behaviours that are more responsive to harm reduction practices through the use of the Theoretical Domain Framework (TDF). Methods We employed an explanatory sequential mix-method design. We first conducted an on-line survey and a Delphi exercise to understand the factors influencing COM-B components of higher education students to change their drug-use. Subsequently, we mapped all evidence onto the COM-B components and the TDF domains to identify clusters of behaviours to target for change, using a pattern-based discourse analysis. Finally, a series of multidisciplinary group meetings identified the intervention functions—the means by which the intervention change targeted behaviours and the Behavioural Change Techniques (BCTs) involved using the behaviour change technique taxonomy (v.1). Results Twenty-nine BCTs relevant to harm-reduction practices were identified and mapped across five intervention functions (education, modelling, persuasion, incentivization, and training) and five policy categories (communication/marketing, guidelines, regulation, service provision, and environmental/social planning). These BCTs were distributed across eight identified saturated clusters of behaviours MyUSE intervention attempts to change. Conclusions The BCTs, identified, will inform the development of a digitally delivered behaviour change intervention that focuses on increasing mindful decision-making with respect to drug-use and promotes alternatives to drug-use activities. The findings can also inform implementation scientists in applying context-specific harm-reduction practices in higher education. We present examples of how the eight identified clusters of target behaviours are mapped across the COM-B components and the TDF, along with suggestions of implementation practices for harm reduction at student population level.

scholarly journals Developing a theory-informed complex intervention to improve nurse–patient therapeutic engagement employing Experience-based Co-design and the Behaviour Change Wheel: an acute mental health ward case study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e047114
Author(s):  
Sarah McAllister ◽  
Alan Simpson ◽  
Vicki Tsianakas ◽  
Nick Canham ◽  
Vittoria De Meo ◽  
...  
Keyword(s):  
Mental Health ◽  
Behaviour Change ◽  
Design Process ◽  
Complex Interventions ◽  
Intervention Development ◽  
Behaviour Change Techniques ◽  
Service Users ◽  
Therapeutic Engagement ◽  
Behaviour Change Wheel

ObjectivesOur objectives were threefold: (1) describe a collaborative, theoretically driven approach to co-designing complex interventions; (2) demonstrate the implementation of this approach to share learning with others; and (3) develop a toolkit to enhance therapeutic engagement on acute mental health wards.Design and participantsWe describe a theory-driven approach to co-designing an intervention by adapting and integrating Experience-based Co-design (EBCD) with the Behaviour Change Wheel (BCW). Our case study was informed by the results of a systematic integrative review and guided by this integrated approach. We undertook 80 hours of non-participant observations, and semistructured interviews with 14 service users (7 of which were filmed), 2 carers and 12 clinicians from the same acute ward. The facilitated intervention co-design process involved two feedback workshops, one joint co-design workshop and seven small co-design team meetings. Data analysis comprised the identification of touchpoints and use of the BCW and behaviour change technique taxonomy to inform intervention development.SettingThis study was conducted over 12 months at an acute mental health organisation in England.ResultsThe co-designed Let’s Talk toolkit addressed four joint service user/clinician priorities for change: (1) improve communication with withdrawn people; (2) nurses to help service users help themselves; (3) nurses to feel confident when engaging with service users; (4) improving team relations and ward culture. Intervention functions included training, education, enablement, coercion and persuasion; 14 behaviour change techniques supported these functions. We detail how we implemented our integrated co-design-behaviour change approach with service users, carers and clinicians to develop a toolkit to improve nurse–patient therapeutic engagement.ConclusionsOur theory-driven approach enhanced both EBCD and the BCW. It introduces a robust theoretical approach to guide intervention development within the co-design process and sets out how to meaningfully involve service users and other stakeholders when designing and implementing complex interventions.

scholarly journals Using Intervention Mapping to Develop and Facilitate Implementation of a Multifaceted Behavioural Intervention Targeting Physical Activity and Sedentary Behaviour in Stroke Survivors: Physical Activity Routines After Stroke (PARAS)

2021 ◽  
Author(s):  
Sarah Moore ◽  
Darren Flynn ◽  
Christopher Price ◽  
Leah Avery
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Sedentary Behaviour ◽  
Behaviour Change ◽  
Stroke Rehabilitation ◽  
Intervention Mapping ◽  
Behavioural Intervention ◽  
Behaviour Change Techniques ◽  
Stroke Survivors ◽  
Face To Face

Abstract BackgroundThe benefits of increased physical activity for stroke survivors include improved walking ability, balance and mood. However, less than 30% achieve recommended levels of physical activity, and high levels of sedentary behaviour are reported. We engaged stroke survivors, informal carers and healthcare professionals (HCPs) in a co-design process to develop an evidence-informed behavioural intervention targeting physical activity and sedentary behaviour for use by stroke rehabilitation teams. MethodsIntervention Mapping was used as a framework for intervention development. Step 1 involved a systematic review, focus group discussions and a review of existing care pathways. Step 2 involved identification of social cognitive determinants of behavioural change and behavioural outcomes of the intervention. Step 3 involved linking the determinants of behavioural outcomes with specific behaviour change techniques to target the behaviours of interest. Step 4 involved the development of the intervention informed by steps 1 to 3. Subsequently, an implementation plan was developed (Step 5) followed by an evaluation plan (Step 6). ResultsSystematic review findings informed selection of nine ‘promising’ behaviour change techniques (e.g. goal setting-behaviour; problem-solving). Focus groups with stroke survivors (n=18) and HCPs (n=24) identified the need for an intervention that could be delivered at different time points within the rehabilitation pathway, tailored to individual needs and circumstances with training for HCPs delivering the intervention. Intervention delivery was considered feasible within local community stroke services. The target behaviours for the intervention were physical activity and sedentary behaviour of stroke survivors. Assessment of acceptability and usability with 11 HCPs and 21 stroke survivors/relatives identified issues around self-monitoring tools; the need for a repository of local services for physical activity; and the need for face-to-face feedback provision to HCPs following delivery of the intervention for optimisation purposes. Face-to-face training for HCPs was delivered to support faithful delivery of the intervention within community settings. A feasibility study protocol was designed to evaluate the intervention.ConclusionsA systematic development process using intervention mapping resulted in a multi-faceted evidence- and theory-informed intervention (Physical Activity Routines After Stroke - PARAS) for delivery by community stroke rehabilitation teams. Trial registration: Trial identifier: ISRCTN35516780, date of registration: 24/10/2018, URL http://www.isrctn.com/ISRCTN35516780

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