PERSonalised Incentives for Supporting Tobacco cessation (PERSIST) among healthcare employees: a randomised controlled trial protocol

BACKGROUND: Smoking is the primary preventable risk factor for disease and premature mortality. It is highly addictive and cessation attempts are often unsuccessful. Incentive-based programmes may be an effective method to reach sustained abstinence. Individualisation of incentives based on personal characteristics yields potential to further increase the effectiveness of incentive-based programmes. METHOD: A randomised controlled trial among healthcare workers recruited through their employer and signed up for a group-based smoking cessation programme. The intervention under study is the provision of personalised incentives on validated smoking cessation at several time points after the smoking cessation programme. A total of 220 participants are required. Participants are randomised 1:1 into intervention (personalised incentives) or control (no incentives). All participants join the group-based programme. Incentives are provided on validated abstinence directly after the smoking cessation programme and after 3, 6 and 12 months.Incentives are provided according to four schemes:(1) Standard: total reward size €350, pay-out scheme: €50 (t=0), €50 (t=3 months), €50 (t=6 months) and €200 (t=12 months), (2) descending: total reward size €300, pay-out scheme: €150, €100, €50 and €0, (3) ascending: total reward size: €400, pay-out scheme: €0, €0, €50 and €350 and (4) deposit: total reward size €450, pay-out scheme: €50, €50, €150, €200; participants pay a €100 deposit, returned conditional on abstinence after 6 months.Advice on which incentive scheme suits participants best is based on willingness to provid

Perceived determinants of physical activity among women with prior severe preeclampsia: a qualitative assessment.

BackgroundThe objective of this study was to (1) qualitatively identify the perceived determinants of physical activity among women who have experienced severe preeclampsia, and (2) examine whether these determinants are consistent with the overarching processes outlined in the integrated behavior change (IBC) model, a novel model that describes physical activity as being a result of motivational, volitional, and automatic processes.MethodsPatients (n = 35) of the Follow-Up PreEClampsia (FUPEC) Outpatient Clinic, Erasmus MC, the Netherlands, participated in an anonymous online survey. The main outcomes under study were their perceived determinants of physical activity. Responses were analyzed using thematic analysis.ResultsThirteen themes emerged from the analysis. Six themes corresponded with motivational processes (future health, perceived ability, attitude, future reward or regret, physical appearance, and doing it for others), two with volitional processes (scheduling and planning), and two with automatic processes (affect and stress). Three themes were classified as environmental factors (time constraint, social support, and physical environment).ConclusionsA range of facilitating and hindering factors were described by women with prior severe preeclampsia as the determinants of their physical activity. These factors corresponded well with the overarching motivational, volitional, and automatic processes described in the IBC model. In addition, motivational and environmental factors beyond the IBC model were described. Addressing these perceived determinants could enhance the efficacy of physical activity interventions in this population.Tweetable abstractMotivational, volitional, automatic, and environmental factors drive physical activity in women with prior severe preeclampsia

Moving from intention to behaviour : a randomised controlled trial protocol for an app-based physical activity intervention (i2be)

Introduction: Efficacy tests of physical activity interventions indicate that many have limited or short-term efficacy, principally because they do not sufficiently build on theory-based processes that determine behaviour. The current study aims to address this limitation. Methods and analysis: The efficacy of the 8-week intervention will be tested using a three-condition randomised controlled trial delivered through an app, in women with a prior hypertensive pregnancy disorder. The intervention is based on the integrated behaviour change model, which outlines the motivational, volitional and automatic processes that lead to physical activity. The mechanisms by which the behaviour change techniques lead to physical activity will be tested.Following stratification on baseline factors, participants will be randomly allocated in-app to one of three conditions (1:1:1). The information condition will receive information, replicating usual care. Additionally to what the information condition receives, the motivation condition will receive content targeting motivational processes. Additionally to what the motivation condition receives, the action condition will receive content targeting volitional and automatic processes.The primary outcome is weekly minutes of moderate-to-vigorous physical activity, as measured by an activity tracker (Fitbit Inspire 2). Secondary outcomes include weekly average of Fitbit-measured daily resting heart rate, and self-reported body mass index, waist-hip ratio, cardiorespiratory fitness and subjective well-being. Tertiary outcomes include self-reported variables representing motivational, volitional, and automatic processes. Outcome measures will be assessed at baseline, immediately post-intervention, and at 3 and 12 months post-intervention. Physical activity will also be investigated at intervention midpoint. Efficacy will be determined by available case analysis. A process evaluation will be performed based on programme fidelity and acceptability measures.peerReviewe

Perceived determinants of physical activity among women with prior severe preeclampsia : a qualitative assessment

Background The objective of this study was to (1) qualitatively identify the perceived determinants of physical activity among women who have experienced severe preeclampsia, and (2) examine whether these determinants are consistent with the overarching processes outlined in the integrated behavior change (IBC) model, a novel model that describes physical activity as being a result of motivational, volitional, and automatic processes. Methods Patients (n = 35) of the Follow-Up PreEClampsia (FUPEC) Outpatient Clinic, Erasmus MC, the Netherlands, participated in an anonymous online survey. The main outcomes under study were their perceived determinants of physical activity. Responses were analyzed using thematic analysis. Results Thirteen themes emerged from the analysis. Six themes corresponded with motivational processes (future health, perceived ability, attitude, future reward or regret, physical appearance, and doing it for others), two with volitional processes (scheduling and planning), and two with automatic processes (affect and stress). Three themes were classified as environmental factors (time constraint, social support, and physical environment). Conclusions A range of facilitating and hindering factors were described by women with prior severe preeclampsia as the determinants of their physical activity. These factors corresponded well with the overarching motivational, volitional, and automatic processes described in the IBC model. In addition, motivational and environmental factors beyond the IBC model were described. Addressing these perceived determinants could enhance the efficacy of physical activity interventions in this population.peerReviewe

Needs and preferences of women with prior severe preeclampsia regarding app-based cardiovascular health promotion

Background: Women with prior severe preeclampsia are at an increased risk for cardiovascular diseases later in life compared to women who had a normotensive pregnancy. The objective of this study was to assess their needs and preferences regarding app-based cardiovascular health promotion. Methods: Patients (n = 35) of the Follow-Up PreEClampsia Outpatient Clinic (FUPEC), Erasmus MC, the Netherlands, participated in an anonymous online survey. The main outcomes under study were women’s needs for health behavior promotion, and their preferences with respect to intervention delivery. Descriptive statistics were used to evaluate needs, and thematic analysis was used to analyze preferences. Results: Women’s primary need for health behavior promotion pertained to their fat and sugar intake and physical activity; for some, to their mental health (practices), fruit and vegetable intake, salt intake, and water intake; and for a few, to their alcohol and tobacco use. Most women preferred an app-based intervention to include, in descending order: the tracking of health-related metrics, an interactive platform, the use of behavior change strategies, the provision of information, and personalization. Conclusion: Cardiovascular health promotion targeting women with prior severe preeclampsia should feel relevant to its audience. App-based interventions are likely to be well received if they target fat and sugar intake and physical activity. These interventions should preferably track health-related metrics, be interactive, contain behavior change strategies, provide information, and be personalized. Adopting these findings during intervention design could potentially increase uptake, behavior change, and behavior change maintenance in this population

Correction: Needs and preferences of women with prior severe preeclampsia regarding app-based cardiovascular health promotion

Following publication of the original article [1], the author has inserted the reference 66, and the same has been listed below: 66. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–2194. https:// doi. org/ 10. 1001/ jama. 2013. 281053. Also, the in text citation has been changed in the original article

Needs and preferences of women with prior severe preeclampsia regarding app-based cardiovascular health promotion

Background Women with prior severe preeclampsia are at an increased risk for cardiovascular diseases later in life compared to women who had a normotensive pregnancy. The objective of this study was to assess their needs and preferences regarding app-based cardiovascular health promotion. Methods Patients (n = 35) of the Follow-Up PreEClampsia Outpatient Clinic (FUPEC), Erasmus MC, the Netherlands, participated in an anonymous online survey. The main outcomes under study were women’s needs for health behavior promotion, and their preferences with respect to intervention delivery. Descriptive statistics were used to evaluate needs, and thematic analysis was used to analyze preferences. Results Women’s primary need for health behavior promotion pertained to their fat and sugar intake and physical activity; for some, to their mental health (practices), fruit and vegetable intake, salt intake, and water intake; and for a few, to their alcohol and tobacco use. Most women preferred an app-based intervention to include, in descending order: the tracking of health-related metrics, an interactive platform, the use of behavior change strategies, the provision of information, and personalization. Conclusion Cardiovascular health promotion targeting women with prior severe preeclampsia should feel relevant to its audience. App-based interventions are likely to be well received if they target fat and sugar intake and physical activity. These interventions should preferably track health-related metrics, be interactive, contain behavior change strategies, provide information, and be personalized. Adopting these findings during intervention design could potentially increase uptake, behavior change, and behavior change maintenance in this population.peerReviewe