Development of a Fully Automated, Web-Based, Tailored Intervention Promoting Regular Physical Activity Among Insufficiently Active Adults With Type 2 Diabetes: Integrating the I-Change Model, Self-Determination Theory, and Motivational Interviewing Components

Abstract

BackgroundType 2 diabetes is a major challenge for Canadian public health authorities, and regular physical activity is a key factor in the management of this disease. Given that fewer than half of people with type 2 diabetes in Canada are sufficiently active to meet the recommendations, effective programs targeting the adoption of regular physical activity (PA) are in demand for this population. Many researchers argue that Web-based, tailored interventions targeting PA are a promising and effective avenue for sedentary populations like Canadians with type 2 diabetes, but few have described the detailed development of this kind of intervention.ObjectiveThis paper aims to describe the systematic development of the Web-based, tailored intervention, Diabète en Forme, promoting regular aerobic PA among adult Canadian francophones with type 2 diabetes. This paper can be used as a reference for health professionals interested in developing similar interventions. We also explored the integration of theoretical components derived from the I-Change Model, Self-Determination Theory, and Motivational Interviewing, which is a potential path for enhancing the effectiveness of tailored interventions on PA adoption and maintenance.MethodsThe intervention development was based on the program-planning model for tailored interventions of Kreuter et al. An additional step was added to the model to evaluate the intervention’s usability prior to the implementation phase. An 8-week intervention was developed. The key components of the intervention include a self-monitoring tool for PA behavior, a weekly action planning tool, and eight tailored motivational sessions based on attitude, self-efficacy, intention, type of motivation, PA behavior, and other constructs and techniques. Usability evaluation, a step added to the program-planning model, helped to make several improvements to the intervention prior to the implementation phase.ResultsThe intervention development cost was about CDN $59,700 and took approximately 54 full-time weeks. The intervention officially started on September 29, 2014. Out of 2300 potential participants targeted for the tailored intervention, approximately 530 people visited the website, 170 people completed the registration process, and 83 corresponded to the selection criteria and were enrolled in the intervention.ConclusionsUsability evaluation is an essential step in the development of a Web-based tailored intervention in order to make pre-implementation improvements. The effectiveness and relevance of the theoretical framework used for the intervention will be analyzed following the process and impact evaluation. Implications for future research are discussed.

User experiences from a web-based, self-management programme: struggling with what I need when stress management is about me

“…Digitalisation is a prominent field in the health care sector of many countries [1]. Several interventions that were earlier carried out as face-to-face options have now been translated into web-based formats [2][3][4]. Web-based interventions have been shown to be effective when it comes to easing different health-related problems, but the dropout rates are often high.…”

“…On average, studies show a dropout rate of 50% [5]. Many interventions aim at lifestyle-related issues, such as physical activity [4,6] and healthy eating [7], but interventions for mental health are also common [8,9]. However, programmes for mental health promotion and mental illness prevention are scarce.…”

Positive Psychological Interventions for Patients with Type 2 Diabetes: Rationale, Theoretical Model, and Intervention Development

“…Furthermore, MI itself leads to decreased ambivalence, greater intention to change, and increased feelings of control (pathway C1) [ 113 , 133 – 137 ], all of which are consistently associated with greater physical activity (pathway C2) [ 138 – 140 ]. In addition, both MI (pathway D1) [ 113 , 133 , 141 – 145 ] and the previously described effects of PP on mood, well-being, and optimism (pathway E) [ 52 , 95 , 146 ] are associated with greater self-efficacy, confidence, and motivation, which are in turn linked to physical activity (pathway D2) [ 139 , 147 – 151 ].…”

Digital Health and the Future of Diabetes Management

“…Currently, medical practitioners are in the midst of evaluating the relevance and impact of digital health interventions on the care of patients with diabetes. [9][10][11][12][13][14][15][16] Such research includes new methods of not only collecting data in real-time for therapeutic decision making, but also monitoring of concomitant disease states (e.g. hypertension), and helping patients with their medical therapy.…”