Enhancing physical activity in patients and equipping nurses to deliver a behaviour change intervention

Abstract

Background Self-management interventions are considered effective in chronic disease patients, but trials have shown inconsistent results and it is unknown which patients benefit most. Adequate self-management often requires behaviour change. To unravel effectiveness of self-management, a nurse-led intervention was comprehensively developed using the Behaviour Change Wheel (BCW) to target one component of self-management namely physical activity. Methods Firstly, a literature review was conducted to understand which components of COM-B and Theoretical Domains Framework (TDF) needed to be targeted to increase patients’ physical activity level. Subsequently, intervention functions were identified and matching Behaviour Change Techniques (BCTs) were selected. Secondly, the BCW was applied to analyse what behaviour change is needed in nurses to adequately deliver the selected BCTs by conducting a literature review and a focus group with nurses. Findings All components of COM-B were applicable for both patients’ and nurses’ behaviours. For patients this resulted in 17 BCTs that are integrated in four nurse-led consultations: the Activate intervention. For nurses 21 BCTs were identified to adequately apply the BCTs in patients. BCTs for nurses are integrated in a one-day training and a coaching session in delivering the intervention. Discussion The Activate intervention aimed to increase physical activity in patients, however, nurses also need to change their behaviour to adequately deliver the intervention. Therefore the BCW was applied twice and resulted in an in-depth analysis in the targeted behaviour in order to increase the fidelity of delivery and effectiveness of the intervention.