The rapid development of a novel kidney-specific digital intervention for self-management of physical activity and emotional well-being during the COVID-19 pandemic and beyond: Kidney Beam

Mayes, Juliet; Billany, Roseanne E; Vadaszy, Noemi; Young, Hannah; Castle, Ellen M.; Bishop, Nicolette C.; Bramham, Kate; Nixon, Andrew; Wilkinson, Thomas J; Hamilton, Alexander; Saynor, Zoe L.; Chilcot, Joseph; Picariello, Federica; Macdonald, Jamie; Greenwood, Sharlene

doi:10.1093/ckj/sfab239

Cited by 19 publications

(26 citation statements)

References 6 publications

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“…To our knowledge, this is the first systematically developed theory- and evidence-based digital self-management program for people with nondialysis CKD in the United Kingdom. Another digital intervention for people with CKD, called Kidney Beam, has been developed in the United Kingdom to provide support for exercise, physical activity, and emotional well-being [ 93 ]. Similar to MK&M, Kidney Beam is theory informed and guided by the Behaviour Change Wheel.…”

Section: Discussionmentioning

confidence: 99%

The Codevelopment of “My Kidneys & Me”: A Digital Self-management Program for People With Chronic Kidney Disease

Lightfoot¹,

Wilkinson²,

Hadjiconstantinou³

et al. 2022

J Med Internet Res

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Background Health care self-management is important for people living with nondialysis chronic kidney disease (CKD). However, the few available resources are of variable quality. Objective This work describes the systematic codevelopment of “My Kidneys & Me” (MK&M), a theory-driven and evidence-based digital self-management resource for people with nondialysis CKD, guided by an established process used for the successful development of the diabetes education program MyDESMOND (Diabetes Education and Self-Management for Ongoing and Newly Diagnosed, DESMOND). Methods A multidisciplinary steering group comprising kidney health care professionals and researchers and specialists in the development of complex interventions and digital health provided expertise in the clinical and psychosocial aspects of CKD, self-management, digital health, and behavior change. A patient and public involvement group helped identify the needs and priorities of MK&M and co-design the resource. MK&M was developed in 2 sequential phases. Phase 1 involved the codevelopment process of the MK&M resource (content and materials), using Intervention Mapping (IM) as a framework. The first 4 IM steps guided the development process: needs assessment was conducted to describe the context of the intervention; intervention outcomes, performance objectives, and behavioral determinants were identified; theory- and evidence-based change methods and practical strategies to deliver change methods were selected; and program components were developed and refined. Phase 2 involved the adoption and adaptation of the existing MyDESMOND digital platform to suit the MK&M resource. Results The needs assessment identified that individuals with CKD have multiple differing needs and that delivering a self-management program digitally would enable accessible, tailored, and interactive information and support. The intended outcomes of MK&M were to improve and maintain effective self-management behaviors, including physical activity and lifestyle, improve knowledge, promote self-care skills, increase self-efficacy, and enhance well-being. This was achieved through the provision of content and materials designed to increase CKD knowledge and patient activation, reduce health risks, manage symptoms, and improve physical function. Theories and behavior change techniques selected include Self-Management Framework, Capability, Opportunity, Motivation Behavior model components of Behaviour Change Wheel and taxonomy of behavior change techniques, Health Action Process Approach Model, Common Sense Model, and Social Cognitive Theory. The program components developed comprised educational and behavior change sessions, health trackers (eg, monitoring blood pressure, symptoms, and exercise), goal-setting features, and forums for social support. The MyDESMOND digital platform represented an ideal existing platform to host MK&M; thus, the MyDESMOND interface and features were adopted and adapted for MK&M. Conclusions Applying the IM framework enabled the systematic application of theory, empirical evidence, and practical perspectives in the codevelopment of MK&M content and materials. Adopting and adapting a preexisting platform provided a cost- and time-efficient approach for developing our digital intervention. In the next stage of work, the efficacy of MK&M in increasing patient activation will be tested in a randomized controlled trial.

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Section: Discussionmentioning

confidence: 99%

The Codevelopment of “My Kidneys & Me”: A Digital Self-management Program for People With Chronic Kidney Disease

Lightfoot¹,

Wilkinson²,

Hadjiconstantinou³

et al. 2022

J Med Internet Res

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“…Similarly, Gibson et al ( 73 ) reported KTRs participants would value the opportunity to play-back the videos to increase flexibility. Further studies would benefit from exploring delivery of educational videos to include both live and on-demand content such as kidney beam ( 22 ).…”

Section: Discussionmentioning

confidence: 99%

“…Despite national clinical practice ( 18 ) and workforce practice guidelines ( 19 ) that recommend access to both kidney physiotherapists and dietitians, these healthcare professionals (HCPs) are not routinely represented in all transplant centers ( 20 ). Whilst COVID-19 has seen an increase in virtual kidney services ( 21 ), and the creation of online PA and well-being interventions for people living with chronic kidney disease ( 22 ), there remains no recognized intervention to prevent weight gain in new KTRs ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

The Feasibility and User-Experience of a Digital Health Intervention Designed to Prevent Weight Gain in New Kidney Transplant Recipients—The ExeRTiOn2 Trial

et al. 2022

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Half of kidney transplant recipients (KTRs) gain more than 5% of their body weight in the first year following transplantation. KTRs have requested support with physical activity (PA) and weight gain prevention, but there is no routine care offered. There are few high-quality studies investigating the clinical value of diet, PA or combined interventions to prevent weight gain. The development and evaluation of theoretically informed complex-interventions to mitigate weight gain are warranted. The aims of this mixed-methods randomized controlled trial (RCT) were to explore the feasibility, acceptability and user-experience of a digital healthcare intervention (DHI) designed to prevent post-transplant weight gain, in preparation for a large multi-center trial. New KTRs (<3 months) with access to an internet compatible device were recruited from a London transplant center. The usual care (UC) group received standard dietary and PA advice. The intervention group (IG) received access to a 12-week DHI designed to prevent post-transplant weight gain. Primary feasibility outcomes included screening, recruitment, retention, adherence, safety and hospitalizations and engagement and experience with the DHI. Secondary outcomes (anthropometrics, bioimpedance, arterial stiffness, 6-minute walk distance and questionnaires) were measured at baseline, 3- and 12-months. 38 KTRs were screened, of which 32 (84.2%) were eligible, and of those 20 (62.5%) consented, with 17 participants (85%) completing baseline assessment (Median 49 years, 58.8% male, Median 62 days post-transplant). Participants were randomized using a computer-generated list (n = 9 IG, n = 8 UC). Retention at 12-months was 13 (76.4%) (n = 6 IG, n = 7 UC). All a priori progression criteria were achieved. There were no associated adverse events. Reflexive thematic analysis revealed four themes regarding trial participation and experience whilst using the DHI. Halting recruitment due to COVID-19 resulted in the recruitment of 40% of the target sample size. Mixed-methods data provided important insights for future trial design. A definitive RCT is warranted and welcomed by KTRs.Clinical Trial Registrationwww.clinicalTrials.gov, identifier: NCT03996551.

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“…A newly established online platform, which aims to enhance physical activity and emotional wellbeing in people with CKD, 'Kidney Beam', may prove beneficial for people with frailty and CKD [138]. Indeed, a 6-month clinical pilot demonstrated an increase in the number of participants self-reporting that they were meeting national physical activity guidelines, as well as demonstrating an increase in perceived energy levels [139]. A multi-centre, randomised, controlled trial is currently underway to evaluate the clinical effectiveness of this digital platform for individuals living with CKD.…”

Section: Digital Health Interventionsmentioning

confidence: 99%

Targeted Non-Pharmacological Interventions for People Living with Frailty and Chronic Kidney Disease

Mayes

Young

Blacklock

et al. 2022

Kidney and Dialysis

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Frailty is highly prevalent within people living with chronic kidney disease (CKD) and is associated with the increased risk of falls, hospitalisation, and mortality. Alongside this, individuals with CKD report a high incidence of depression and reduced quality of life. The identification of frailty within nephrology clinics is needed to establish comprehensive management plans to improve clinical outcomes and quality of life for people with CKD. Current research exploring the role of non-pharmacological management has primarily focussed on exercise and physical activity interventions in the frail CKD population. However, there is a growing evidence base and interest in this area. This review provides an up-to-date overview of the literature into frailty assessment in CKD and subsequent non-pharmacological treatment approaches.

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The rapid development of a novel kidney-specific digital intervention for self-management of physical activity and emotional well-being during the COVID-19 pandemic and beyond: Kidney Beam

Cited by 19 publications

References 6 publications

The Codevelopment of “My Kidneys & Me”: A Digital Self-management Program for People With Chronic Kidney Disease

The Codevelopment of “My Kidneys & Me”: A Digital Self-management Program for People With Chronic Kidney Disease

The Feasibility and User-Experience of a Digital Health Intervention Designed to Prevent Weight Gain in New Kidney Transplant Recipients—The ExeRTiOn2 Trial

Targeted Non-Pharmacological Interventions for People Living with Frailty and Chronic Kidney Disease

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