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Volkmer B, Sekhon M, Bieles J, Fisher G, Galea Holmes MN, Quirke-McFarlane S, Modarai B, Peacock J, Sackley C, Weinman J, Bearne LM. Participants' experiences and acceptability of a home-based walking exercise behaviour-change intervention (MOtivating Structure walking Activity in people with Intermittent Claudication (MOSAIC)). Physiotherapy 2024; 122:70-79. [PMID: 38266395 DOI: 10.1016/j.physio.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 06/12/2023] [Accepted: 09/20/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES This study explored the experiences and acceptability of a novel, home-based, walking exercise behaviour-change intervention (MOtivating Structured walking Activity in people with Intermittent Claudication (MOSAIC)) in adults with Peripheral Arterial Disease (PAD). DESIGN AND SETTING Individual semi-structured audio-recorded interviews were conducted with adults with Peripheral Arterial Disease who had completed the MOSAIC intervention as part of a randomised clinical trial. Data were analysed using inductive reflexive thematic analysis and interpreted using the seven-construct theoretical framework of acceptability of healthcare interventions (TFA). PARTICIPANTS Twenty participants (mean age (range) 67(54-80) years, 70% male, 55% White British) were interviewed. RESULTS One central theme was identified: Acceptability of walking exercise as a treatment. This theme was explained by four linked themes: Exploring walking exercise with a knowledgeable professional, Building confidence with each step, Towards self-management-learning strategies to continue walking and The impact of walking exercise. These themes were interpreted using six of the seven TFA constructs: affective attitude, burden, perceived effectiveness, intervention coherence, opportunity costs, and self-efficacy. CONCLUSIONS Participants perceived MOSAIC as an effective, acceptable, and low burden intervention. Physiotherapists were regarded as knowledgeable and supportive professionals who helped participants understand PAD and walking exercise as a treatment. Participants developed confidence to self-manage their condition and their symptoms. As participants confidence and walking capacity improved, they expanded their activities and gained a more positive outlook on their future. MOSAIC is an acceptable intervention that may facilitate adoption of and access to exercise for people with PAD. IMPLICATIONS FOR PRACTICE
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Affiliation(s)
- Brittannia Volkmer
- Department of Population Health Sciences, King's College London, United Kingdom
| | - Mandeep Sekhon
- Department of Population Health Sciences, King's College London, United Kingdom; Population Health Research Institute, St George's, University of London, United Kingdom
| | - Julie Bieles
- Department of Population Health Sciences, King's College London, United Kingdom
| | - Graham Fisher
- Department of Population Health Sciences, King's College London, United Kingdom
| | - Melissa N Galea Holmes
- Department of Population Health Sciences, King's College London, United Kingdom; NIHR ARC North Thames, Department of Applied Health Research, University College London, United Kingdom
| | | | - Bijan Modarai
- Department of Vascular Surgery, Guy's and St Thomas NHS Foundation Trust, London, United Kingdom
| | - Janet Peacock
- Department of Population Health Sciences, King's College London, United Kingdom; Department of Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth College, NH, USA
| | - Catherine Sackley
- Department of Population Health Sciences, King's College London, United Kingdom; Faculty of Medicine & Health Sciences, University of Nottingham, United Kingdom
| | - John Weinman
- Institute of Pharmaceutical Sciences, Kings College London, London, United Kingdom
| | - Lindsay M Bearne
- Department of Population Health Sciences, King's College London, United Kingdom; Population Health Research Institute, St George's, University of London, United Kingdom.
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Agung FH, Sekartini R, Sudarsono NC, Hendarto A, Werdhani RA, Pudjiati SR, Hanum L, Naufal A, Sawyer SM. Development and validation of the adolescent behavioural change Counselling Assessment Tool in Indonesia. BMC Health Serv Res 2024; 24:257. [PMID: 38419005 PMCID: PMC10900824 DOI: 10.1186/s12913-024-10582-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 01/09/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Primary care provides an important context to engage adolescents and their families in healthy lifestyles with the goal of reducing future behaviour-related health problems. Developing a valid tool to assess health professionals' skills in behavioural change counselling is integral to improving the quality of clinical care provided to adolescents in Indonesia. METHODS This work was nested within a project to develop a training program to enhance the behaviour-change counselling of adolescents and their parents by Indonesian primary care professionals. Initial item development was based on the content of the training module and the domain structure of the Behavioral Change Counselling Index (BECCI), a commonly used tool to assess counselling quality in healthcare settings. Expert panels were used to test content validity, while face validity was assessed by a group of trained psychologists. Inter-rater agreement was calculated prior to tests of construct validity and reliability, which involved psychologists rating 125 audio-taped counselling sessions between the health professional and adolescent patients, together with a parent. RESULTS An initial 13-item tool was developed using a 1-5 Likert scale. Validity and reliability testing resulted in the decision to use a 14-item tool with a 0-3 Likert scale. The scale was found to have a Cronbach's α coefficient of 0.839 (internal consistency), and there was strong inter-rater agreement (0.931). CONCLUSION The assessment tool known as the Adolescent Behavioural Change Counselling Assessment Tool, is a valid and reliable instrument to measure Indonesian health professionals' behavioural-change counselling skills with adolescent patients. The tool provides an evaluation framework for future interventions that aim to improve health professionals' skills in addressing adolescent behaviour-related health problems.
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Affiliation(s)
- Fransisca Handy Agung
- Faculty of Medicine, Universitas Pelita Harapan, Jl. Jend. Sudirman No.20, Bencongan, Kelapa Dua, 15810, Tangerang, Banten, Indonesia.
| | - Rini Sekartini
- Department of Child Health, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jl. Salemba Raya No.6 Jakarta Pusat, 10430, Jakarta, Indonesia
| | - Nani Cahyani Sudarsono
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No.6 Jakarta Pusat, 10430, Jakarta, Indonesia
| | - Aryono Hendarto
- Department of Child Health, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jl. Salemba Raya No.6 Jakarta Pusat, 10430, Jakarta, Indonesia
| | - Retno Asti Werdhani
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jl. Salemba Raya No.6 Jakarta Pusat, 10430, Jakarta, Indonesia
| | - Sri Retno Pudjiati
- Faculty of Psychology, Universitas Indonesia, Kampus UI, Depok, West Java, Indonesia
| | - Lathifah Hanum
- Faculty of Psychology, Universitas Indonesia, Kampus UI, Depok, West Java, Indonesia
| | - Affan Naufal
- Balaraja Distric Hospital, Jl. Rumah Sakit No 88, Balaraja, Tangerang, Banten, Indonesia
| | - Susan M Sawyer
- Centre for Adolescent Health, Royal Children's Hospital and Murdoch Children's Research Institute, Department of Paediatrics, The University of Melbourne, 50 Flemington Rd, 3052, Parkville, VIC, Australia
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Essery R, Pollet S, Smith KA, Mowbray F, Slodkowska-Barabasz J, Denison-Day J, Hayter V, Bradbury K, Grey E, Western MJ, Milton A, Hunter C, Ferrey AE, Müller AM, Stuart B, Mutrie N, Griffin S, Kendrick T, Brooker H, Gudgin B, Phillips R, Stokes T, Niven J, Little P, Yardley L. Planning and optimising a digital intervention to protect older adults' cognitive health. Pilot Feasibility Stud 2021; 7:158. [PMID: 34407886 PMCID: PMC8371874 DOI: 10.1186/s40814-021-00884-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND By 2050, worldwide dementia prevalence is expected to triple. Affordable, scalable interventions are required to support protective behaviours such as physical activity, cognitive training and healthy eating. This paper outlines the theory-, evidence- and person-based development of 'Active Brains': a multi-domain digital behaviour change intervention to reduce cognitive decline amongst older adults. METHODS During the initial planning phase, scoping reviews, consultation with PPI contributors and expert co-investigators and behavioural analysis collated and recorded evidence that was triangulated to inform provisional 'guiding principles' and an intervention logic model. The following optimisation phase involved qualitative think aloud and semi-structured interviews with 52 older adults with higher and lower cognitive performance scores. Data were analysed thematically and informed changes and additions to guiding principles, the behavioural analysis and the logic model which, in turn, informed changes to intervention content. RESULTS Scoping reviews and qualitative interviews suggested that the same intervention content may be suitable for individuals with higher and lower cognitive performance. Qualitative findings revealed that maintaining independence and enjoyment motivated engagement in intervention-targeted behaviours, whereas managing ill health was a potential barrier. Social support for engaging in such activities could provide motivation, but was not desirable for all. These findings informed development of intervention content and functionality that appeared highly acceptable amongst a sample of target users. CONCLUSIONS A digitally delivered intervention with minimal support appears acceptable and potentially engaging to older adults with higher and lower levels of cognitive performance. As well as informing our own intervention development, insights obtained through this process may be useful for others working with, and developing interventions for, older adults and/or those with cognitive impairment.
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Affiliation(s)
- Rosie Essery
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK.
| | - Sebastien Pollet
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Kirsten A Smith
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Fiona Mowbray
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Joanna Slodkowska-Barabasz
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - James Denison-Day
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Victoria Hayter
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | - Katherine Bradbury
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK
| | | | | | - Alexander Milton
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Cheryl Hunter
- University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Anne E Ferrey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Andre Matthias Müller
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, 117549, Singapore.,Centre for Sport & Exercise Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Beth Stuart
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
| | - Simon Griffin
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Tony Kendrick
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | | | - Bernard Gudgin
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - Rosemary Phillips
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - Tom Stokes
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - John Niven
- Public and Patient Involvement (PPI) representative, Southampton, UK
| | - Paul Little
- Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK
| | - Lucy Yardley
- Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK. .,School of Psychological Science, University of Bristol, Bristol, UK.
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