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AB1092-HPR Developing An Online Self-Management Program for Rheumatoid Arthritis Patients, Using Behavioral Change Techniques and Patients' Input
  1. R. Zuidema1,2,
  2. H. Repping1,3,
  3. R. Nijhuis1,2,
  4. S. van Dulmen1,4,
  5. B. van Gaal2
  1. 1Radboudumc, Nijmegen, Netherlands
  2. 2IQ healthcare
  3. 3Rheumatology
  4. 4Primary and community care, Radboudumc, Nijmegen, Netherlands

Abstract

Background To support individual behavioral change by self-management interventions, behavioral change techniques (BCT) may be helpful to induce behavior change [1]. Conditions for effectivity of BCT's are that they fit to experienced problems in self-management and that the conditions under which they work (parameters) are taken into account. So important steps in the development of self-management programs are 1) identifying the self-management behavioral problems and factors (determinants) affecting these problems in patients, 2) link BCT techniques to these behavioral problems and determinants, 3) identifying parameters of the BCT's and 4) implement BCT techniques into the intervention [2].

Objectives Development of an online self-management program for Rheumatoid Arthritis (RA) patients.

Methods A panel of 5 RA patients and 5 health professionals identified self-management behavioral problems and prioritized them. Determinants of these behavioral problems were identified in literature and confirmed by patients. Two independent researchers coded techniques from a list of BCT's linked to the determinants of the identified problems with the panel and discussed, which led to consensus [3]. Afterwards, parameters of BCT's where identified from literature. Lastly, RA patients' input during a meeting was used to implement the techniques into the intervention.

Results In total 9 behavioral problems related to self-management were mentioned, namely: balancing rest and activity, setting boundaries in daily life, asking for help and supportuse of medicines, communication with health professionals, use of assistive devices, performing physical exercises, coping with worries, and coping with RA. Determinants of these problems were: knowledge, awareness, risk perception, social influence, attitude, self-efficacy, and habits. To change patients' self-management behavior, 15 BCT's were identified, for example persuasive communication, guided practice and self-monitoring. After identifying, the BCT's were linked to the determinants of behavioral problems and parameters where identified.An example of the BCT modeling, linked to a low self-efficacy an parameters, is presented in table 1.

Conclusions Although the BCT taxonomy was helpful as a starting point to induce behavioral change in self-management, firstly the problems related to self-management and their determinants must be clear. Afterwards, the parameters of the BCTs and patients' preferences need to be taken into account when translating these techniques into the self-management program.

  1. Abraham, C., & Michie, S. (2008). A taxonomy of behavior change techniques used in interventions. Health Psychol, 27(3), 379–387. doi: 10.1037/0278-6133.27.3.379.

  2. Kok, G., Schaalma, H., Ruiter, R. A. C., Van Empelen, P., & Brug, J. (2004). Intervention mapping: A protocol for applying health psychology theory to prevention programmes. Journal of Health Psychology, 9(1), 85–98. doi: 10.1177/1359105304038379.

  3. De Bruin, M., Kok. G., Schaalma, H., Hospers, H. (2007). Coding manual for behavioral change techniques http://www.biomedcentral.com/content/supplementary/1748-5908-7-92-S2.pdf.

Disclosure of Interest None declared

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