Using the Person-Based Approach to optimise a digital intervention for the management of hypertension

Bradbury, Katherine; Morton, Katherine; Band, Rebecca; Woezik, Anne Van; Grist, Rebecca; McManus, Richard J; Little, Paul; Yardley, Lucy

doi:10.1371/journal.pone.0196868

Cited by 141 publications

(143 citation statements)

References 26 publications

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“…The Person-Based Approach (PBA) is a development methodology aimed at overcoming both Information and Communications Technology (ICT)-related and humanrelated challenges to build successful interventions for people to manage their health or illness [4]. PBA is explicitly developed for mental health interventions and health management and is meant to complement evidence, and theory-based treatment approaches by capturing and incorporating user perspectives in the design process [5]. PBA draws on methods from user-centered design [6], particularly behavioral analysis, and in-depth qualitative research [5], and seeks to understand both digital and non-digital behavioral aspects of interventions [7].…”

Section: Introductionmentioning

confidence: 99%

Adaptive Systems for Internet-Delivered Psychological Treatments

et al. 2020

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Internet-Delivered Psychological Treatments (IDPT) are based on evidence-based psychological treatment models adjusted for interaction through the Internet. The use of Internet technologies has the potential to increase the availability of evidence-based mental health services for a far-reaching population with the use of fewer resources. Despite evidence that Internet Interventions can be effective means in mental health morbidities, most current IDPT systems are tunnel-based, inflexible, and non-interoperable. Hence it becomes essential to understand which elements of an Internet intervention contribute to effectiveness and treatment outcomes. By analogy, adaptation is a central aspect of successful face-to-face mental health therapy. Adaptability to patient needs can be regarded as an essential outcome factor in online systems for mental health interventions as well. While some aspects of rule-based and machine-learning-based adaptation have attracted attention in recent IDPT development, systematic reporting of core components, dimensions of adaptiveness, information architecture, and strategies for adaptation in the IDPT system are still lacking. To bridge this gap, we propose a model that shows how adaptive systems are represented in classical control theory and discuss how the model can be used to specify adaptive IDPT systems. Concerning the reference model, we outline the core components of adaptive IDPT systems, the main adaptive elements, dimensions of adaptiveness, information architecture applied to adaptive systems, and strategies used in the adaptation process. We also provide comprehensive guidelines on how to develop an adaptive IDPT system based on the Person-Based Approach.

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Section: Introductionmentioning

confidence: 99%

Adaptive Systems for Internet-Delivered Psychological Treatments

et al. 2020

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“…Clinicians' feedback was collated and organised in a 'table of changes' (online supplemental materials S3) where suggested changes were listed and given a level of priority for that change, following the Must Should Could Would (MoScoW) framework, 28 and the source of the suggested change (expert opinion, research team, clinical research team, literature review). Changes to the 'Penicillin Allergy Testing: Information for general practice' leaflet included changes to the title, to the exact doses of penicillin given to the patients during the test, information about side effects and information about which antibiotics patients with a negative test result can take safely.…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2020

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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.

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“…Clinicians' feedback was collated and organised in a 'table of changes' (see Additional Files 2) where suggested changes were listed and given a level of priority for that change, following the MoScoW framework (19), and the source of the suggested change (expert opinion, research team, clinical research team, literature review). Changes to the 'Information for general practice' included changes to the title, to the exact doses of penicillin given to the patients during the test, information about side effects and information about which antibiotics patients with a negative test result can take safely.…”

Section: Discussionmentioning

confidence: 99%

Developing a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice

Santillo¹,

Wanat²,

Davoudianfar³

et al. 2019

Preprint

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Background: To develop a behavioural intervention package to support clinicians and patients to identify and amend incorrect penicillin allergy records in English general practice. The intervention aimed to: 1) support general practice 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.Methods: Theory-based, evidence-based and person-based approaches were utilised in the intervention development. We used evidence from a rapid review, two qualitative studies, one with patients and one with general practice clinicians, and expert consultation with the clinical research team in order 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 and consultations with the clinical research team were conducted to optimise intervention materials.Results: The 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. Intervention materials were designed and developed to address these barriers. Conclusions: We 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.

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Using the Person-Based Approach to optimise a digital intervention for the management of hypertension

Cited by 141 publications

References 26 publications

Adaptive Systems for Internet-Delivered Psychological Treatments

Adaptive Systems for Internet-Delivered Psychological Treatments

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

Developing a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice

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