Bildungshaus Mariatrost offenes Forum für Weiterbildung und Dialog der Diözese Graz-Seckau

Basilika Mariatrost und Bildungshaus Mariatros

Investigating and evaluating evidence of the behavioural determinants of adherence to social distancing measures – A protocol for a scoping review of COVID-19 research

Background: The WHO has declared the outbreak of coronavirus disease 2019 (COVID-19) as a pandemic. With no vaccine currently available, using behavioural measures to reduce the spread of the virus within the population is an important tool in mitigating the effects of this pandemic. As such, social distancing measures are being implemented globally and have proven an effective tool in slowing the large-scale spread of the virus. Aim: This scoping review will focus on answering key questions about the state of the evidence on the behavioural determinants of adherence to social distancing measures in research on COVID-19. Methods: A scoping review will be conducted in accordance with guidelines for best practice. Literature searches will be conducted using online databases and grey literature sources. Databases will include Medline, Web of Science, Embase and PsycInfo, alongside relevant pre-print servers. Grey literature will be searched on Google Scholar. Screening, data extraction and quality appraisal will be conducted by members of the research team, with any discrepancies resolved by consensus discussion. Quality appraisal will be conducted using the Cochrane’s ROBINS-I tool, the Cochrane Risk of Bias tool, and the JBI Critical Appraisal Checklist where appropriate. Results will be analysed by mapping findings onto the Theoretical Domains Framework and visualising characteristics of the included studies using EviAtlas. This scoping review is pre-registered with Open Science Framework. Conclusions: The results of this study may facilitate the systematic development of behavioural interventions to increase adherence to social distancing measures

Supporting General Practitioners and people withhypertension to maximise medication use to control bloodpressure: the contribution of Collective Intelligence to thedevelopment of the ‘Maximising Adherence, MinimisingInertia’ (MIAMI) intervention

Background: Hypertension remains one of the most important modifiable risk factors for stroke and heart disease. Anti-hypertensive medications are effective, but are often not used to maximum benefit. Sub-optimal dosing by prescribers and challenges with medication-taking for patients remain barriers to effective blood pressure control. Objectives: We aimed to systematically develop a theory-based complex intervention to support General Practitioners (GPs) and people with hypertension to maximise medication use to control blood pressure. Methods: We used the three-phase Behaviour Change Wheel (BCW) as the overarching intervention development framework. Collective Intelligence methodology was used to operationalise the stakeholder input to Phases 2 and 3 of the BCW. This took the form of a Collective Intelligence workshop with 19 stakeholders from diverse backgrounds including lived experience, general practice, nursing, pharmacy and health psychology. Techniques such as barrier identification, idea-writing and scenario-based design were used to generate possible intervention options. Intervention options were then selected and refined using the Acceptability, Practicability, Effectiveness, Affordability, Side-effects and Equity (APEASE) criteria and guidance from the MIAMI Public and Patient Involvement Panel. Results: The finalised MIAMI intervention consists of both GP and patient supports. GP supports include a 30-minute online training, information booklet and consultation guide (drop-down menu) embedded within the patient electronic health system. Patient supports include a pre-consultation plan, website, and a structured GP consultation with results from an Ambulatory Blood Pressure Monitor and urine chemical adherence test. The intervention components have been mapped to the intervention functions of the BCW and Behaviour Change Technique Ontology. Conclusion: Collective Intelligence offered a novel method to operationalise stakeholder input to Phases 2 and 3 of the BCW. The MIAMI intervention is now at pilot evaluation stage.Additional author: Gerard J Mollo

Supporting General Practitioners and people withhypertension to maximise medication use to control bloodpressure: the contribution of Collective Intelligence to thedevelopment of the ‘Maximising Adherence, MinimisingInertia’ (MIAMI) intervention

Background: Hypertension remains one of the most important modifiable risk factors for stroke and heart disease. Anti-hypertensive medications are effective, but are often not used to maximum benefit. Sub-optimal dosing by prescribers and challenges with medication-taking for patients remain barriers to effective blood pressure control. Objectives: We aimed to systematically develop a theory-based complex intervention to support General Practitioners (GPs) and people with hypertension to maximise medication use to control blood pressure. Methods: We used the three-phase Behaviour Change Wheel (BCW) as the overarching intervention development framework. Collective Intelligence methodology was used to operationalise the stakeholder input to Phases 2 and 3 of the BCW. This took the form of a Collective Intelligence workshop with 19 stakeholders from diverse backgrounds including lived experience, general practice, nursing, pharmacy and health psychology. Techniques such as barrier identification, idea-writing and scenario-based design were used to generate possible intervention options. Intervention options were then selected and refined using the Acceptability, Practicability, Effectiveness, Affordability, Side-effects and Equity (APEASE) criteria and guidance from the MIAMI Public and Patient Involvement Panel. Results: The finalised MIAMI intervention consists of both GP and patient supports. GP supports include a 30-minute online training, information booklet and consultation guide (drop-down menu) embedded within the patient electronic health system. Patient supports include a pre-consultation plan, website, and a structured GP consultation with results from an Ambulatory Blood Pressure Monitor and urine chemical adherence test. The intervention components have been mapped to the intervention functions of the BCW and Behaviour Change Technique Ontology. Conclusion: Collective Intelligence offered a novel method to operationalise stakeholder input to Phases 2 and 3 of the BCW. The MIAMI intervention is now at pilot evaluation stage

Developing the evidence base for a digital intervention to enhance adherence to medication in people with hypertension

Background. Hypertension is a chronic condition in which the blood vessels have persistently raised pressure. It is a major modifiable risk factor for both cardiovascular and cerebrovascular disease. Hypertension is estimated to affect one billion people worldwide and is therefore a global health challenge. The pharmacological treatment of hypertension has led to substantial benefits in the prevention of morbidity and mortality from cardiovascular and cerebrovascular disease. However, despite their established efficacy, there is a significant problem of non-adherence to anti-hypertensive medications in those diagnosed and prescribed this treatment; therefore the effectiveness of current medications is sub-optimal. Traditionally, intervention to enhance adherence to anti-hypertension have been delivered face to face or over the telephone. Digital interventions, such as those delivered via smartphone apps, offer a new, scalable and potentially cost-effective way to improve adherence to anti-hypertensive medications. However as the growth of these platforms has been relatively recent, little is known about the development, acceptability, usability and feasibility of these type of interventions. Aim. The aim of this research is to develop the evidence base for a digital intervention to enhance medication adherence in people living with hypertension. Methods. The studies conducted in this research were based on the development phase of the UK Medical Research Council Framework for developing complex interventions. In the first study a systematic review and meta-analysis was conducted to identify evidence base related to interventions to enhance adherence in hypertension. In order to characterise the technology base, the second study was a content analysis of smartphone apps to enhance medication adherence. Two qualitative studies were then conducted, the first with GPs and the second with patients with hypertension in order to explore their thoughts and views around using a smartphone app to manage their medication adherence. Thematic analysis was conducted in both these studies. Findings. The systematic review found tentative evidence to suggest that medication adherence interventions significantly lower blood pressure values. However, there was substantial heterogeneity amongst the included RCTs and many potential biases as the number of low risk of bias studies was limited. The content analysis of existing mobile phone applications highlighted a lack of behavioural theory and evidence integrated into commercially available medication adherence apps. Participants in both qualitative studies (GPs and patients with hypertension) could see benefit as well as expressing concern about a digital intervention such as a smartphone app. Both parties felt it could be empowering but also had reservations about the possible anxiety inducing nature of excessive engagement with the intervention. Conclusion. The findings of this research contribute to insights in relation to the development of a digital intervention to enhance medication adherence in hypertension. The use of theory, systematic review and qualitative work means that this research was an appropriate enhancement of the evidence base and provides a platform for future intervention development

Exploring Patient Acceptability of an Online Hypertension Self-Management Education Programme Using the Theoretical Framework of Acceptability: A Qualitative Study

Hypertension (high blood pressure) is a critical risk factor for cardiovascular disease (CVD), but it is often poorly managed. Self-management support programmes such as the ‘My Blood Pressure’ (My BP) programme developed by Croí Heart and Stroke Charity have been implemented to support patient self-management. There is an international gap in the literature for patient acceptability of digitally delivered education-based hypertension self-management supports. This study aimed to explore patient acceptability of the ‘My BP’ programme

Getting started with Network Meta-analysis in Health Psychology

Supplementary material for Noone et al. (2018