Insight Centre for Data Analytics and School of Health & Human Performance, Dublin City University, Dublin, Ireland.
Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Transl Behav Med. 2019 Jan 1;9(1):76-98. doi: 10.1093/tbm/iby017.
Cardiovascular diseases (CVDs) are a leading cause of premature death worldwide. International guidelines recommend routine delivery of all phases of cardiac rehabilitation (CR). Uptake of traditional CR remains suboptimal, as attendance at formal hospital-based CR programs is low, with community-based CR rates and individual long-term exercise maintenance even lower. Home-based CR programs have been shown to be equally effective in clinical and health-related quality of life outcomes and yet are not readily available. The aim of the current study was to develop the PATHway intervention (physical activity toward health) for the self-management of CVD. Increasing physical activity in individuals with CVD was the primary behavior. The PATHway intervention was theoretically informed by the behavior change wheel and social cognitive theory. All relevant intervention functions, behavior change techniques, and policy categories were identified and translated into intervention content. Furthermore, a person-centered approach was adopted involving an iterative codesign process and extensive user testing. Education, enablement, modeling, persuasion, training, and social restructuring were selected as appropriate intervention functions. Twenty-two behavior change techniques, linked to the six intervention functions and three policy categories, were identified for inclusion and translated into PATHway intervention content. This paper details the use of the behavior change wheel and social cognitive theory to develop an eHealth intervention for the self-management of CVD. The systematic and transparent development of the PATHway intervention will facilitate the evaluation of intervention effectiveness and future replication.
心血管疾病（CVDs）是全球范围内导致过早死亡的主要原因。国际指南建议常规提供心脏康复（CR）的所有阶段。传统的 CR 仍然没有得到充分利用，因为正式的医院为基础的 CR 计划的参与率低，社区为基础的 CR 率和个人长期运动维持率甚至更低。家庭为基础的 CR 计划已被证明在临床和健康相关生活质量方面的效果相当，但尚未普及。本研究的目的是开发 PATHway 干预措施（促进健康的体力活动），用于 CVD 的自我管理。增加 CVD 患者的体力活动是主要的行为。PATHway 干预措施是基于行为改变轮和社会认知理论理论的。确定了所有相关的干预功能、行为改变技术和政策类别，并将其转化为干预内容。此外，还采用了以患者为中心的方法，涉及迭代共同设计过程和广泛的用户测试。教育、赋权、示范、说服、培训和社会重构被选为适当的干预功能。选择了 22 种行为改变技术，与 6 种干预功能和 3 种政策类别相关联，以纳入并转化为 PATHway 干预内容。本文详细介绍了使用行为改变轮和社会认知理论来开发用于 CVD 自我管理的电子健康干预措施。PATHway 干预措施的系统和透明的开发将有助于评估干预措施的有效性和未来的复制。
