Development of Motivate4Change Using the Intervention Mapping Protocol: An Interactive Technology Physical Activity and Medication Adherence Promotion Program for Hospitalized Heart Failure Patients

Abstract

Background: It is important that heart failure (HF) patients adhere to their medication regimen and engage in physical activity. Evidence shows that adherence to these HF self-management behaviors can be improved with appropriate interventions.

Objective: To further promote medication adherence and physical activity among HF patients, we developed an intervention for hospitalized HF patients.

Methods: The intervention mapping protocol was applied in the development of the intervention. This entailed performing a needs assessment, defining change objectives, selecting determinants and strategies, and developing the materials.

Results: The resulting intervention, Motivate4Change, makes use of interactive technology and provides HF patients with personalized feedback and advice. Specific change objectives were defined. The relevant behavioral determinants for the physical activity program were practical knowledge on physical activity performance and self-efficacy for, and perceived benefits of, physical activity. For medication-taking, the selected determinants were practical knowledge on medication-taking, perceived barriers to medication-taking, beliefs about the necessity and harm regarding the medication prescribed, and beliefs about overprescribing and harm of medication in general. The change objectives and behavior change determinants were translated in feedback and advice strategies in an interactive technology program that included tailored feedback and advice, and role models in videos in which the behaviors and overcoming barriers were demonstrated. Relevant stakeholders were involved in the interventions development process. The intervention was pretested among HF patients and adjustments were made accordingly.

Conclusions: The interactive technology physical activity and medication adherence promotion program for hospitalized HF patients was systematically developed using the intervention mapping protocol and was based on the available theory and evidence regarding HF self-management behavior change. The intervention's efficacy is yet to be determined in evaluation research.

Keywords: computer tailoring; heart failure; hospital; interactive technology; intervention mapping; medication adherence; physical activity; self-care; self-management.

Figure 1

The intervention mapping protocol. Source: Bartholomew et al (2001) [21].

Figure 2

The iterative process of the intervention content development.

Figure 3

The Motivate4Change intervention structure.

Figure 4

The Motivate4Change program menu.

Figure 5

A medication knowledge item from Motivate4Change.