Abahussin Asma A, West Robert M, Wong David C, Ziegler Lucy E, Allsop Matthew J
Department of Biomedical Technology, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, United Kingdom.
JMIR Cancer. 2023 Oct 9;9:e49471. doi: 10.2196/49471.
To inform the development of an intervention, it is essential to have a well-developed theoretical understanding of how an intervention causes change, as stated in the UK Medical Research Council guidelines for developing complex interventions. Theoretical foundations are often ignored in the development of mobile health apps intended to support pain self-management for patients with cancer.
This study aims to systematically set a theory- and evidence-driven design for a pain self-management app and specify the app's active features.
The Behavior Change Wheel (BCW) framework, a step-by-step theoretical approach to the development of interventions, was adopted to achieve the aim of this study. This started by understanding and identifying sources of behavior that could be targeted to support better pain management. Ultimately, the application of the BCW framework guided the identification of the active contents of the app, which were characterized using the Behavior Change Technique Taxonomy version 1.
The theoretical analysis revealed that patients may have deficits in their capability, opportunity, and motivation that prevent them from performing pain self-management. The app needs to use education, persuasion, training, and enablement intervention functions because, based on the analysis, they were found the most likely to address the specified factors. Eighteen behavior change techniques were selected to describe precisely how the intervention functions can be presented to induce the desired change regarding the intervention context. In other words, they were selected to form the active contents of the app, potentially reducing barriers and serving to support patients in the self-management of pain while using the app.
This study fully reports the design and development of a pain self-management app underpinned by theory and evidence and intended for patients with cancer. It provides a model example of the BCW framework application for health app development. The work presented in this study is the first systematic theory- and evidence-driven design for a pain app for patients with cancer. This systematic approach can support clarity in evaluating the intervention's underlying mechanisms and support future replication.
如英国医学研究理事会制定复杂干预措施的指南所述，为了指导干预措施的开发，必须对干预措施如何引起变化有深入的理论理解。在旨在支持癌症患者疼痛自我管理的移动健康应用程序开发中，理论基础常常被忽视。
本研究旨在系统地为一款疼痛自我管理应用程序设定基于理论和证据的设计，并明确该应用程序的有效功能。
采用行为改变轮（BCW）框架，这是一种开发干预措施的逐步理论方法，以实现本研究的目的。首先要理解和识别可作为目标以支持更好疼痛管理的行为来源。最终，BCW框架的应用指导了应用程序有效内容的识别，这些内容使用行为改变技术分类法第1版进行了描述。
理论分析表明，患者在能力、机会和动机方面可能存在不足，这阻碍了他们进行疼痛自我管理。该应用程序需要使用教育、劝说、培训和赋能干预功能，因为根据分析，发现这些功能最有可能解决特定因素。选择了18种行为改变技术来精确描述干预功能如何呈现，以在干预背景下引发期望的改变。换句话说，选择它们来构成应用程序的有效内容，可能减少障碍，并在患者使用应用程序时支持他们进行疼痛自我管理。
本研究全面报告了一款基于理论和证据、面向癌症患者的疼痛自我管理应用程序的设计与开发。它提供了一个将BCW框架应用于健康应用程序开发的典型示例。本研究中呈现的工作是首个针对癌症患者疼痛应用程序的系统的基于理论和证据的设计。这种系统方法有助于清晰评估干预的潜在机制，并支持未来的复制。
