School of Health Sciences, University of Dundee, Dundee, UK
School of Health Sciences, University of Dundee, Dundee, UK.
BMJ Open. 2022 Jun 14;12(6):e058563. doi: 10.1136/bmjopen-2021-058563.
To develop We Walk, a theoretically informed, 12-week person-centred dyadic behaviour change intervention to increase physical activity (PA) in community-dwelling people with stroke (PWS) through outdoor walking.
Three-phase intervention development study. Phase 1: we reviewed literature on barriers and facilitators to PA after stroke and mapped them to the Behaviour Change Wheel and Theoretical Domains Framework to define intervention components. The Health Action Process Approach determined intervention structure underpinned by person-centred principles. Phase 2: stakeholder focus groups involving PWS, their companions and health professionals reviewed the draft intervention, and experts in behaviour change were consulted. Phase 3: informed by phases 1 and 2, the intervention and form of delivery were refined, with final review through patient and public involvement.
Three Scottish community rehabilitation stroke services.
Twenty-three ambulatory community-dwelling PWS and their companions, thirty-seven health and exercise professionals, seven behaviour change experts.
Phase 1 determined key intervention components: information about benefits of walking; developing motivation and confidence to walk; facilitating dyadic goal setting and making plans together; monitoring walking, overcoming challenges; and maintaining walking behaviour. Phase 2 review by stakeholder focus groups and behaviour change experts endorsed intervention components and structure, emphasising dyadic relational aspects as central to potential success. In phase 3, intervention content and handbooks for PWS and buddies were finalised. Healthcare professionals proposed third-sector delivery as most appropriate for intervention delivery. A detailed delivery manual was developed. Participants preferred facilitated face-to-face and telephone delivery.
Our multilens intervention development approach ensured this novel intervention was evidence-informed, person-centred, theoretically coherent provided appropriate social support, and addressed issues of concern to PWS. This study established intervention components and structure and identified operational issues critical to future success. Future research will pilot and refine We Walk and evaluate acceptability, feasibility, effectiveness and cost-effectiveness.
ISRCTN34488928.
开发 We Walk，这是一种基于理论的、为期 12 周的以个人为中心的双元行为改变干预措施，旨在通过户外散步来增加社区中风患者（PWS）的身体活动（PA）。
三阶段干预措施开发研究。第 1 阶段：我们回顾了中风后身体活动的障碍和促进因素的文献，并将其映射到行为改变轮和理论领域框架，以确定干预措施的组成部分。健康行动过程方法确定了以个人为中心原则为基础的干预结构。第 2 阶段：包括 PWS、他们的同伴和健康专业人员的利益相关者焦点小组审查了草案干预措施，并咨询了行为改变专家。第 3 阶段：根据第 1 和第 2 阶段的情况，对干预措施和交付形式进行了改进，并通过患者和公众的参与进行了最终审查。
苏格兰三个社区康复中风服务。
23 名行动不便的社区中风患者及其同伴、37 名健康和运动专业人员、7 名行为改变专家。
第 1 阶段确定了关键的干预措施组成部分：有关散步益处的信息；发展散步的动机和信心；协助双元目标设定并共同制定计划；监测散步，克服挑战；以及保持散步行为。利益相关者焦点小组和行为改变专家的第 2 阶段审查认可了干预措施和结构组成部分，强调双元关系方面是潜在成功的关键。在第 3 阶段，PWS 和伙伴的干预内容和手册最终确定。医疗保健专业人员提出第三方交付是最适合干预措施交付的方式。详细的交付手册也已制定完成。参与者更喜欢由经过培训的人员面对面和电话进行交付。
我们的多视角干预措施开发方法确保了这种新颖的干预措施具有循证依据、以人为本、理论上一致、提供适当的社会支持，并解决了中风患者关注的问题。本研究确定了干预措施的组成部分和结构，并确定了对未来成功至关重要的操作问题。未来的研究将对 We Walk 进行试点和改进，并评估其可接受性、可行性、有效性和成本效益。
ISRCTN34488928。
