Promoting health behaviour change in the preconception period: An Intervention Mapping approach (Preprint)

2021 ◽  
Author(s):  
Jodie Scott ◽  
Melissa Oxlad ◽  
Jodie Dodd ◽  
Claudia Szabo ◽  
Andrea Deussen ◽  
...  
Keyword(s):  
Weight Management ◽  
Behaviour Change ◽  
Intervention Mapping ◽  
Idea Generation ◽  
Systems Design ◽  
Behaviour Change Techniques ◽  
Healthy Weight ◽  
Weight Range ◽  
Mapping Approach ◽  
Ehealth Intervention

BACKGROUND Half of women begin pregnancy above the healthy weight range, increasing the risk of complications and adversely affecting the lifelong health of their baby. Maternal obesity remains the strongest risk factor for offspring obesity across childhood, adolescence and adulthood. Previous research suggests that women should be encouraged to be within a healthy weight range before conception in order to improve health outcomes. OBJECTIVE We outline the application of the Intervention Mapping (IM) approach in developing an evidence-informed eHealth intervention to promote weight management. The intervention, based on psychological theories and behaviour change techniques, was developed for women with overweight or obesity who intend to become pregnant. The “Begin Better” eHealth intervention is part of an integrated program being evaluated in a clinical trial to assess if weight management before pregnancy can influence clinical outcomes for mother and baby. METHODS The current study documents steps 2 to 5 of a 6-step iterative intervention mapping approach informed by the Information-Motivation-Behavioural Skills (IMB) model and the findings of a previous interview study. We defined behaviour change objectives for each of the IMB behavioural determinants as well as theory-based behaviour change techniques (BCT) and practical strategies. We also utilised Persuasive Systems Design (PSD) principles to assist in translating these strategies to a digital environment. RESULTS The resultant intervention comprises nutrition and physical activity content, along with psychological strategies, which are notably absent from mainstream weight management programs. Strategies to increase motivation, garner social support and promote self-care are integral to maintaining engagement with the intervention, which aims to improve lifestyle behaviours and enhance wellbeing. Important elements include: tracking mechanisms for percentage progress towards goals to enable feedback on behaviours and outcomes; in-app messages of praise on entry of goals or habits; strategies to prompt habit formation and action planning via small, easily achievable steps toward positive change. CONCLUSIONS Design decisions and processes for idea generation about intervention content, format and delivery are often not reported. This study we respond to this gap in the literature and outline a process that is potentially transferable to the development of other 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

scholarly journals Nutrition Concepts for the Treatment of Obesity in Adults

Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 169
Author(s):  
Meike Wiechert ◽  
Christina Holzapfel
Keyword(s):  
Weight Management ◽  
Behaviour Change ◽  
Heart Diseases ◽  
Positive Energy ◽  
Behaviour Change Techniques ◽  
Behaviour Change Technique ◽  
Self Monitoring ◽  
Treatment Approaches ◽  
Coronary Heart Diseases ◽  
Treatment Of Obesity

Obesity caused by a positive energy balance is a serious health burden. Studies have shown that obesity is the major risk factor for many diseases like type 2 diabetes mellitus, coronary heart diseases, or various types of cancer. Therefore, the prevention and treatment of increased body weight are key. Different evidence-based treatment approaches considering weight history, body mass index (BMI) category, and co-morbidities are available: lifestyle intervention, formula diet, drugs, and bariatric surgery. For all treatment approaches, behaviour change techniques, reduction in energy intake, and increasing energy expenditure are required. Self-monitoring of diet and physical activity provides an effective behaviour change technique for weight management. Digital tools increase engagement rates for self-monitoring and have the potential to improve weight management. The objective of this narrative review is to summarize current available treatment approaches for obesity, to provide a selective overview of nutrition trends, and to give a scientific viewpoint for various nutrition concepts for weight loss.

Evidencing the logic model of behaviour change underpinning a personalised and tailored app for the self-management of musculoskeletal conditions (Preprint)

2021 ◽  
Author(s):  
Alice Berry ◽  
Carey McClellan ◽  
Ben Wanless ◽  
Nicola Walsh
Keyword(s):  
Behaviour Change ◽  
Digital Health ◽  
Systems Design ◽  
Logic Model ◽  
Self Management ◽  
Behaviour Change Techniques ◽  
Design Framework ◽  
Management Tools ◽  
Change Models ◽  
The Uk

BACKGROUND Musculoskeletal (MSK) conditions such as back and joint pain are a growing problem, affecting 18.8 million people in the UK. Digital health interventions (DHIs) are a potentially effective way to deliver information and to support self-management. It is vital that the development of such interventions is transparent, can illustrate how individual components work, how they link back to the theoretical constructs they are attempting to change, and how this might influence outcomes. getUBetter is a DHI developed to address the lack of personalised supported self-management tools available to patients with MSK conditions, by providing knowledge, skills and confidence to navigate through a self-management journey. OBJECTIVE The aim of this project was to map a logic model of behaviour change for getUBetter, to illustrate how content and functionality of the DHI is aligned with recognised behavioural theory, effective behaviour change techniques (BCTs), and clinical guidelines. METHODS A range of behaviour change models and frameworks were used including the behaviour change wheel and persuasive systems design framework to map the logic model of behaviour change underpinning getUBetter. Three main stages included: 1) understanding the behaviour the intervention is attempting to change, 2) identifying which elements of the intervention might bring about the desired change in behaviour, and 3) describing intervention content and how this can be optimally implemented. RESULTS The content mapped to 25 BCTs, including: information about health consequences, instruction on how to perform a behaviour, reducing negative emotions, and verbal persuasion about capability. Mapping to the persuasive system design framework illustrated the use of a number of persuasive design principles, including: tailoring, personalisation, simulation, and reminders. CONCLUSIONS This process enabled the proposed mechanisms of action and theoretical foundations of getUBetter to be comprehensively described, highlighting the key techniques utilised to support patients to self-manage their condition. These findings provide guidance for the on-going evaluation of effectiveness (including quality of engagement) of the intervention, and highlight areas which might be strengthened in future iterations.

scholarly journals Optimisation of the ActWELL lifestyle intervention programme for women attending routine NHS breast screening clinics.

2020 ◽  
Author(s):  
Annie Anderson ◽  
Angela M. Craigie ◽  
Stephanie Gallant ◽  
Chloe McAdam ◽  
E. Jane Macaskill ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Physical Activity ◽  
Weight Loss ◽  
Weight Management ◽  
Behaviour Change ◽  
Breast Screening ◽  
Feasibility Trial ◽  
Behaviour Change Techniques ◽  
Peer Reviewers ◽  
Post Menopausal

Abstract Background Around 30% of post-menopausal breast cancer is related to excess body fat, alcohol intake and low levels of physical activity. Current estimates suggest that there is a 12% increased risk in post-menopausal breast cancer for every 5kg/m 2 increase in Body Mass Index (BMI). Despite this evidence there are few lifestyle programmes directed towards breast cancer risk reduction. This paper describes the process of optimising of the ActWELL programme which aims to support weight management in women invited to attend routine NHS breast screening clinics. Methods A feasibility study of a prototype programme aiming to change lifestyle behaviours was successfully undertaken. The programme used educational approaches and behaviour change techniques delivered by lifestyle coaches using individual face to face meetings and telephone sessions. To optimise the intervention for a definitive randomised controlled trial of weight management, data from the feasibility trial, focus group discussions conducted with the target population, feedback from the trial public advisory group and comments from peer reviewers were obtained. Concepts from implementation research provided further guidance to assist in the refinement of the intervention which was then discussed and agreed by all investigators and the trial steering group. Results The results from the feasibility trial were considered appropriate for moving on to a full trial with 70% of participants finding the programme acceptable. The primary outcomes (weight loss and physical activity) provided an important focus for design input from the target group. The contributions highlighted the need to review programme duration, coach contact time, content and use of behaviour change techniques as well as communications generally (e.g. science and evidence, non-judgemental approaches and avoiding guilt). In addition, the need for emphasis on support rather than education became apparent. The recommendations from peer reviewers focussed on the magnitude of effort required to achieve the intended weight loss and weight loss maintenance. Implementation science supported the use of the capability/opportunity/motivation (COM- B)model in overall design. Conclusions The optimisation process has facilitated the development and evaluation of a programme which enables the delivery of a promising intervention to achieve weight management in post-menopausal women.

scholarly journals A taxonomy of behaviour change methods: an Intervention Mapping approach

2015 ◽  
Vol 10 (3) ◽  
pp. 297-312 ◽  
Author(s):  
Gerjo Kok ◽  
Nell H. Gottlieb ◽  
Gjalt-Jorn Y. Peters ◽  
Patricia Dolan Mullen ◽  
Guy S. Parcel ◽  
...  
Keyword(s):  
Behaviour Change ◽  
Intervention Mapping ◽  
Mapping Approach

scholarly journals NoHoW Toolkit Development

2020 ◽  
Author(s):  
Marta M Marques ◽  
Marcela Matos ◽  
Elina Mattila ◽  
Jorge Encantado ◽  
Cristiana Duarte ◽  
...  
Keyword(s):  
Weight Loss ◽  
Emotion Regulation ◽  
Weight Management ◽  
Behaviour Change ◽  
Systematic Approach ◽  
Self Regulation ◽  
Weight Loss Maintenance ◽  
Behaviour Change Techniques ◽  
Web Based ◽  
Logic Models

Background: Many weight loss programs show short-term effectiveness, but subsequent weight loss maintenance is difficult to achieve. Digital technologies offer promising means to delivering behaviour change approaches at low cost and on a wide scale. The NoHoW project was a European Commission H2020-funded project aimed to develop, test, and evaluate a digital Toolkit designed to promote successful long-term weight management. The Toolkit was tested in an 18-month large-scale international 2 x 2 factorial (motivation and self-regulation versus emotion regulation) randomised controlled trial, conducted in overweight/obese adults who lost ≥5% of their body weight in the preceding twelve months before enrolment into the intervention. Objective: This paper describes the development of the NoHoW Toolkit focusing on the logic models, content and specifications, and results from user testing.Methods: The Toolkit was developed using a systematic approach including (1) development of the theory-based logic models, (2) selection of behaviour change techniques, (3) translation of these techniques into a digital web-based app (NoHoW Toolkit components), (4) technical development, (5) user evaluation and refinement of the Toolkit.Results: The Toolkit included a set of web-based tools and inputs from digital tracking devices (smart scales and activity trackers), with modules targeting weight, physical activity, and dietary behaviours. The final Toolkit was comprised of 34 sessions, distributed through 15 modules, providing active content over a 4-month period. The motivation and self-regulation arm consisted of 8 modules (17 sessions), the emotion regulation arm was presented with 7 modules (17 sessions), and the combined arm received the full Toolkit (15 modules, 34 sessions). The sessions included a range of implementations, such as videos, testimonies, and questionnaires. Further, the Toolkit contained 5 specific data tiles for monitoring weight, steps, healthy eating, mood and sleep. Conclusions: A systematic approach to the development of digital solutions based on theory, evidence, and user testing, may significantly contribute to the advancement of the science of behaviour change and improve current solutions for sustained weight management. Testing the Toolkit using a 2x2 design provided a unique opportunity to examine the effect of motivation and self-regulation and emotion regulation separately, as well as the effect of their interaction in weight loss maintenance.

scholarly journals An Analysis of Behaviour Change Techniques Used in a Sample of Gestational Weight Management Trials

2016 ◽  
Vol 2016 ◽  
pp. 1-15 ◽  
Author(s):  
H. Soltani ◽  
M. A. Arden ◽  
A. M. S. Duxbury ◽  
F. J. Fair
Keyword(s):  
Weight Gain ◽  
Weight Management ◽  
Gestational Weight Gain ◽  
Behaviour Change ◽  
Maternal Obesity ◽  
Adverse Outcomes ◽  
Behaviour Change Techniques ◽  
Lifestyle Interventions ◽  
Maternal Weight ◽  
Gestational Weight

Introduction. Maternal obesity and excessive gestational weight gain are associated with multiple adverse outcomes. There is a lack of clarity on the specific components of effective interventions to support pregnant women with gestational weight management.Method. All 44 studies within a preexisting review of lifestyle interventions, with a potential to impact on maternal weight outcomes, were considered for content analysis. Interventions were classified using Behaviour Change Technique (BCT) taxonomy clusters to explore which categories of BCT were used in interventions and their effectiveness in managing gestational weight gain.Results. The most commonly used BCTs were within the categories of “feedback and monitoring,” “shaping knowledge,” “goals and planning,” “repetition and substitution,” “antecedents,” and “comparison of behaviours.” For diet and mixed interventions “feedback and monitoring,” “shaping knowledge,” and “goals and planning” appeared the most successful BCT categories.Conclusions. Poor reporting within studies in defining the BCTs used, in clarifying the differences in processes between intervention and control groups, and in differentiating between the intervention and research processes made BCT classification difficult. Future studies should elaborate more clearly on the behaviour change techniques used and report them accurately to allow a better understanding of the effective ingredients for lifestyle interventions during pregnancy.

From Theory to Intervention: Mapping Theoretically Derived Behavioural Determinants to Behaviour Change Techniques

2008 ◽  
Vol 57 (4) ◽  
pp. 660-680 ◽  
Author(s):  
Susan Michie ◽  
Marie Johnston ◽  
Jill Francis ◽  
Wendy Hardeman ◽  
Martin Eccles
Keyword(s):  
Behaviour Change ◽  
Intervention Mapping ◽  
Behaviour Change Techniques ◽  
Behavioural Determinants

scholarly journals Undergraduate UK nutrition education might not adequately address weight management

2015 ◽  
Vol 19 (2) ◽  
pp. 371-381 ◽  
Author(s):  
David Rogerson ◽  
Hora Soltani ◽  
Robert Copeland
Keyword(s):  
Social Support ◽  
Weight Management ◽  
Nutrition Education ◽  
Behaviour Change ◽  
Weight Maintenance ◽  
Core Competency ◽  
Behaviour Change Techniques ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Psychological Constructs

AbstractObjectiveWeight management appears to be multidimensional and complex, and registered nutritionists might work to educate, promote and provide weight-management services to communities, groups and individuals. However, nutrition education might not adequately reflect the weight-management requirements of individuals and groups. The aim of the present study was to investigate if the Association for Nutrition’s undergraduate core competency framework for accredited Nutrition degrees sufficiently reflects the weight-management needs and experiences of individuals.DesignA qualitative investigation, conducted within critical realist ontology, was performed to understand the weight-management experiences of dieters and compare these with the Association for Nutrition’s accreditation criteria for undergraduate Nutrition degrees.SettingFramework analysis was used to identify and explain participants’ experiences thematically and to compare these with the Association for Nutrition’s core competency criteria.SubjectsParticipants (n 8) with weight-loss (n 4) and weight-maintenance experiences (n 4) were interviewed using semi-structured interviews to understand weight management at the agential level.ResultsParticipants described knowledge, exercise, planning, psychological constructs and behaviour-change techniques, determinants of eating and social support as features of weight management. The competency criteria provided clear guidance on all aspects discussed by the group, apart from psychological constructs and behaviour-change techniques and social support.ConclusionsAccredited Nutrition courses might not fully reflect the weight-management needs and experiences of individuals. Nutritionists might require greater knowledge of psychology and behaviour change to better understand and accommodate their clients’ weight-management needs.

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