Sassen Barbara, Kok Gerjo, Mesters Ilse, Crutzen Rik, Cremers Anita, Vanhees Luc
Innovation in Health Care, University of Applied Sciences, Utrecht, Netherlands.
JMIR Res Protoc. 2012 Dec 14;1(2):e21. doi: 10.2196/resprot.1804.
Patients with cardiovascular risk factors can reduce their risk of cardiovascular disease by increasing their physical activity and their physical fitness. According to the guidelines for cardiovascular risk management, health professionals should encourage their patients to engage in physical activity.
In this paper, we provide insight regarding the systematic development of a Web-based intervention for both health professionals and patients with cardiovascular risk factors using the development method Intervention Mapping. The different steps of Intervention Mapping are described to open up the "black box" of Web-based intervention development and to support future Web-based intervention development.
The development of the Professional and Patient Intention and Behavior Intervention (PIB2 intervention) was initiated with a needs assessment for both health professionals (ie, physiotherapy and nursing) and their patients. We formulated performance and change objectives and, subsequently, theory- and evidence-based intervention methods and strategies were selected that were thought to affect the intention and behavior of health professionals and patients. The rationale of the intervention was based on different behavioral change methods that allowed us to describe the scope and sequence of the intervention and produced the Web-based intervention components. The Web-based intervention consisted of 5 modules, including individualized messages and self-completion forms, and charts and tables.
The systematic and planned development of the PIB2 intervention resulted in an Internet-delivered behavior change intervention. The intervention was not developed as a substitute for face-to-face contact between professionals and patients, but as an application to complement and optimize health services. The focus of the Web-based intervention was to extend professional behavior of health care professionals, as well as to improve the risk-reduction behavior of patients with cardiovascular risk factors.
The Intervention Mapping protocol provided a systematic method for developing the intervention and each intervention design choice was carefully thought-out and justified. Although it was not a rapid or an easy method for developing an intervention, the protocol guided and directed the development process. The application of evidence-based behavior change methods used in our intervention offers insight regarding how an intervention may change intention and health behavior. The Web-based intervention appeared feasible and was implemented. Further research will test the effectiveness of the PIB2 intervention.
Dutch Trial Register, Trial ID: ECP-92.
患有心血管危险因素的患者可通过增加身体活动和提高身体素质来降低患心血管疾病的风险。根据心血管风险管理指南，健康专业人员应鼓励患者进行身体活动。
在本文中，我们使用干预映射开发方法，深入探讨了针对健康专业人员和患有心血管危险因素的患者的基于网络的干预措施的系统开发。描述了干预映射的不同步骤，以打开基于网络的干预开发的“黑匣子”，并支持未来基于网络的干预开发。
专业人员和患者意图与行为干预（PIB2干预）的开发始于对健康专业人员（即物理治疗师和护士）及其患者的需求评估。我们制定了绩效和变革目标，随后选择了基于理论和证据的干预方法和策略，这些方法和策略被认为会影响健康专业人员和患者的意图和行为。干预的基本原理基于不同的行为改变方法，这些方法使我们能够描述干预的范围和顺序，并生成基于网络的干预组件。基于网络的干预包括5个模块，包括个性化信息、自我完成表格以及图表。
PIB2干预的系统和计划开发产生了一种通过互联网提供的行为改变干预措施。该干预措施并非作为专业人员与患者面对面接触的替代品而开发，而是作为一种补充和优化健康服务的应用程序。基于网络的干预的重点是扩展医疗保健专业人员的专业行为，以及改善患有心血管危险因素的患者的降低风险行为。
干预映射协议为开发干预措施提供了一种系统方法，并且每个干预设计选择都经过仔细考虑和论证。虽然这不是一种快速或简单的干预开发方法，但该协议指导并引导了开发过程。我们的干预中使用的基于证据的行为改变方法的应用，为干预如何改变意图和健康行为提供了见解。基于网络的干预似乎是可行的并且已实施。进一步的研究将测试PIB2干预的有效性。
荷兰试验注册中心，试验编号：ECP-92。
