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

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.

Development of a self-management intervention for stroke survivors with aphasia using co-production and behaviour change theory: An outline of methods and processes

“…The BCW [ 28 ] provided a useful framework for structuring the intervention development groups; offering a set of defined stages to focus the co-production tasks. However, like others [ 37 ], we found that some stages of the BCW translated more easily in to co-production activities than others. For example, for stage one (understand the behaviour), we were able to use participants’ views and experiences to refine the target behaviours and understand the barriers to these.…”

“…We designed this study with reference to the methods used by Hall et al [ 37 ]. We ran a series of six intervention development workshops with key stakeholders (SSWA, their family members and SLTs), over a seven month period, to develop the self-management intervention.…”

Identifying the factors affecting ‘patient engagement’ in exercise rehabilitation

“…Hence, twenty articles were included in this review. Nineteen articles included patient factors in their analysis, while only five studies had clinicians as research participants [ 15 – 19 ]. Five other studies that had not involved clinicians as participants had instead included recommendations for clinicians based on their research [ 20 – 24 ].…”

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“…The BCW [28] provided a useful framework for structuring the intervention development groups; offering a set of defined stages to focus the co-production tasks. However, like others [37], we found that some stages of the BCW translated more easily in to co-production activities than others. For example, for stage one (understand the behaviour), we were able to use…”