The development and codesign of the PATHway intervention: a theory-driven eHealth platform for the self-management of cardiovascular disease

Abstract

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.

eHealth and mHealth Interventions for Ethnic Minority and Historically Underserved Populations in Developed Countries: an Umbrella Review

“…Future research could be benefited by the adoption of theory-driven, person-centred approaches. Such approaches should follow co-design processes in the development of relevant and feasible eHealth interventions (Yardley et al 2015;Walsh et al 2019).…”

Understanding mobile application development and implementation to monitor Posyandu data in Indonesia: a 3-years hybrid action research to build “a bridge” from the community to national use

“…It can be in the form of a knowledge bias in the sense of a gap between the intervention maker or expert-driven method (which is a top-down maker) and the end-user of the intervention (32,33). Creativity in creating mobile health intervention should begin not only through a theory-driven process but also by exploring information from the enduser in terms of the targeted community (34). Then, the intervention designer should build details of the intervention design based on the explored information from the users (35).…”

Understanding mobile application development and implementation to monitor Posyandu data in Indonesia: a 3-years hybrid action research to build "a bridge" from community to national use

“…The bias can be in the form of a knowledge bias in the sense of gap between the intervention maker or expert-driven method (which is a top-down maker) and the end-user of the intervention (20,21). Creativity in creating mobile health intervention should begin not only with a theory-driven process but also by exploring information from the end-user in terms of the targeted community (22). Then, the intervention designer should build the details of the intervention design based on the explored information.…”