Pot Mirjam, Ruiter Robert A C, Paulussen Theo W G M, Heuvelink Annerieke, de Melker Hester E, van Vliet Hans J A, van Keulen Hilde M
Child Health, Netherlands Organization for Applied Scientific Research (TNO), Leiden, Netherlands.
Department of Work & Social Psychology, Maastricht University, Maastricht, Netherlands.
Front Public Health. 2018 Sep 28;6:226. doi: 10.3389/fpubh.2018.00226. eCollection 2018.
Currently, the eHealth field calls for detailed descriptions of theory-based interventions in order to support improved design of such interventions. This article aims to provide a systematic description of the design rationale behind an interactive web-based tailored intervention promoting HPV-vaccination acceptability. The 6-step Intervention Mapping (IM) protocol was used to describe the design rationale. After the needs assessment in Step 1, intervention objectives were formulated in Step 2. In Step 3, we translated theoretical methods into practical applications, which were integrated into a coherent intervention in Step 4. In Step 5, we anticipated future implementation and adoption, and finally, an evaluation plan was generated in Step 6. Walking through the various steps of IM resulted in a detailed description of the intervention. The needs assessment indicated HPV-vaccination uptake remaining lower than expected. Mothers play the most important role in decision-making about their daughter's immunization. However, they generally feel ambivalent after they made their decisions, and their decisions are based on rather unstable grounds. Therefore, intervention objectives were to improve HPV-vaccination uptake and informed decision-making, and to decrease decisional conflict among mothers of invited girls. Computer-tailoring was chosen as the main method; virtual assistants were chosen as a practical application to deliver interactive tailored feedback. To maximize compatibility with the needs of the target group, a user-centered design strategy by means of focus groups and online experiments was applied. In these, prototypes were tested and sequentially refined. Finally, efficacy, effectiveness, and acceptability of the intervention were tested in a randomized controlled trial. Results showed a significant positive effect of the intervention on informed decision-making, decisional conflict, and nearly all determinants of HPV-vaccination uptake ( < 0.001). Mothers evaluated the intervention as highly positive. Using IM led to an innovative effective intervention for promoting HPV-vaccination acceptability. The intervention maps will aid in interpreting the results of our evaluation studies. Moreover, it will ease the comparison of design rationales across interventions, and may provide leads for the development of other eHealth interventions. This paper adds to the plea for systematic reporting of design rationales constituting the process of developing interventions.
目前,电子健康领域需要对基于理论的干预措施进行详细描述,以支持改进此类干预措施的设计。本文旨在系统描述一种基于网络的交互式定制干预措施背后的设计原理,该措施旨在提高人乳头瘤病毒(HPV)疫苗接种的可接受性。采用六步干预映射(IM)方案来描述设计原理。在第1步进行需求评估后,第2步制定了干预目标。在第3步中,我们将理论方法转化为实际应用,并在第4步将其整合为一个连贯的干预措施。在第5步中,我们对未来的实施和采用情况进行了预期,最后在第6步生成了评估计划。贯穿IM的各个步骤,得出了对该干预措施的详细描述。需求评估表明,HPV疫苗接种率仍低于预期。母亲在女儿免疫接种决策中起着最重要的作用。然而,她们在做出决定后通常会感到矛盾,而且她们的决定基于相当不稳定的依据。因此,干预目标是提高HPV疫苗接种率和知情决策水平,并减少受邀女孩母亲之间的决策冲突。选择计算机定制作为主要方法;选择虚拟助手作为提供交互式定制反馈的实际应用。为了最大限度地与目标群体的需求相兼容,采用了通过焦点小组和在线实验的以用户为中心的设计策略。在这些过程中,对原型进行了测试并依次改进。最后,在一项随机对照试验中测试了该干预措施的疗效、有效性和可接受性。结果显示,该干预措施对知情决策、决策冲突以及几乎所有HPV疫苗接种率的决定因素都有显著的积极影响(<0.001)。母亲们对该干预措施给予了高度评价。使用IM导致了一种创新的有效干预措施,以提高HPV疫苗接种的可接受性。干预映射将有助于解释我们评估研究的结果。此外,它将便于比较不同干预措施的设计原理,并可能为其他电子健康干预措施的开发提供线索。本文进一步呼吁对构成干预措施开发过程的设计原理进行系统报告。