Using the Person-Based Approach to optimise a digital intervention for the management of hypertension

Katherine Bradbury; Katherine Morton; Rebecca Band; Anne van Woezik; Rebecca Grist; Richard J. McManus; Paul Little; Lucy Yardley

doi:10.1371/journal.pone.0196868

Using the Person-Based Approach to optimise a digital intervention for the management of hypertension

Katherine Bradbury, Katherine Morton, Rebecca Band, Anne van Woezik, Rebecca Grist, Richard J. McManus, Paul Little, Lucy Yardley

University of Brighton

Research output: Contribution to journal › Article › peer-review

Abstract

For behaviour-change interventions to be successful they must be acceptable to users and overcome barriers to behaviour change. The Person-Based Approach can help to optimise interventions to maximise acceptability and engagement. This article presents a novel, efficient and systematic method that can be used as part of the Person-Based Approach to rapidly analyse data from development studies to inform intervention modifications. We describe how we used this approach to optimise a digital intervention for patients with hypertension (HOME BP), which aims to implement medication and lifestyle changes to optimise blood pressure control. Methods In study 1, hypertensive patients (N = 12) each participated in three think-aloud interviews, providing feedback on a prototype of HOME BP. In study 2 patients (N = 11) used HOME BP for three weeks and were then interviewed about their experiences. Studies 1 and 2 were used to identify detailed changes to the intervention content and potential barriers to engagement with HOME BP. In study 3 (N = 7) we interviewed hypertensive patients who were not interested in using an intervention like HOME BP to identify potential barriers to uptake, which informed modifications to our recruitment materials. Analysis in all three studies involved detailed tabulation of patient data and comparison to our modification criteria. Results Studies 1 and 2 indicated that the HOME BP procedures were generally viewed as acceptable and feasible, but also highlighted concerns about monitoring blood pressure correctly at home and making medication changes remotely. Patients in study 3 had additional concerns about the safety and security of the intervention. Modifications improved the acceptability of the intervention and recruitment materials. Conclusions This paper provides a detailed illustration of how to use the Person-Based Approach to refine a digital intervention for hypertension. The novel, efficient approach to analysis and criteria for deciding when to implement intervention modifications described here may be useful to others developing interventions

Original language	English
Article number	e0196868
Journal	PLoS ONE
Volume	13
Issue number	5
DOIs	https://doi.org/10.1371/journal.pone.0196868
Publication status	Published - 3 May 2018

Bibliographical note

© 2018 Bradbury et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Keywords

Person-Based Approach
Qualitative research
Intervention development
Hypertension
Internet

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Rebecca Grist
- R.Gristbrighton.acuk
- School of Humanities and Social Science - Senior Lecturer
Person: Academic

Cite this

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title = "Using the Person-Based Approach to optimise a digital intervention for the management of hypertension",

abstract = "For behaviour-change interventions to be successful they must be acceptable to users and overcome barriers to behaviour change. The Person-Based Approach can help to optimise interventions to maximise acceptability and engagement. This article presents a novel, efficient and systematic method that can be used as part of the Person-Based Approach to rapidly analyse data from development studies to inform intervention modifications. We describe how we used this approach to optimise a digital intervention for patients with hypertension (HOME BP), which aims to implement medication and lifestyle changes to optimise blood pressure control. Methods In study 1, hypertensive patients (N = 12) each participated in three think-aloud interviews, providing feedback on a prototype of HOME BP. In study 2 patients (N = 11) used HOME BP for three weeks and were then interviewed about their experiences. Studies 1 and 2 were used to identify detailed changes to the intervention content and potential barriers to engagement with HOME BP. In study 3 (N = 7) we interviewed hypertensive patients who were not interested in using an intervention like HOME BP to identify potential barriers to uptake, which informed modifications to our recruitment materials. Analysis in all three studies involved detailed tabulation of patient data and comparison to our modification criteria. Results Studies 1 and 2 indicated that the HOME BP procedures were generally viewed as acceptable and feasible, but also highlighted concerns about monitoring blood pressure correctly at home and making medication changes remotely. Patients in study 3 had additional concerns about the safety and security of the intervention. Modifications improved the acceptability of the intervention and recruitment materials. Conclusions This paper provides a detailed illustration of how to use the Person-Based Approach to refine a digital intervention for hypertension. The novel, efficient approach to analysis and criteria for deciding when to implement intervention modifications described here may be useful to others developing interventions",

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AU - McManus, Richard J.

AU - Little, Paul

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Using the Person-Based Approach to optimise a digital intervention for the management of hypertension

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Rebecca Grist

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