Supporting adherence and healthy lifestyles in leg ulcer patients: systematic development of the Lively Legs program for dermatology outpatient clinics.
OBJECTIVE
The objective of our project was to develop a lifestyle program for leg ulcer patients at outpatient clinics for dermatology.


METHODS
We used the intervention-mapping (IM) framework for systematically developing theory and evidence based health promotion programs. We started with a needs-assessment. A multidisciplinary project group of health care workers and patients was involved in all five IM steps; formulating proximal program objectives, selecting methods and strategies, producing program components, planning for adoption and implementation and planning for evaluation. Several systematic literature reviews and original studies were performed to support this process.


RESULTS
Social Cognitive Theory was selected as the main theory behind the program 'Lively Legs' and was combined with elements of Goal-Setting Theory, the precaution adoption model and motivational interviewing. The program is conducted through health counseling by dermatology nurses and was successfully pre-tested. Also, an implementation and evaluation plan were made.


CONCLUSIONS
Intervention mapping helped us to succeed in developing a lifestyle program with clear goals and methods, operational strategies and materials and clear procedures.


CONCLUSIONS
Coaching leg ulcer patients towards adherence with compression therapy and healthy lifestyles should be taken on without delay. Systematic development of lifestyle programs for other patient groups should be encouraged.
Heinen
Maud M
MM
Centre for Quality of Care Research, Radboud University Nijmegen Medical Centre, Kwazo 229, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. m.heinen@kwazo.umcn.nl
Bartholomew
L Kay
LK
Wensing
Michel
M
van de Kerkhof
Peter
P
van Achterberg
Theo
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000458:organization & administration* / Q000523:psychology; D001458:Bandages; D003376:Counseling / Q000458:organization & administration*; D005081:Exercise Therapy / Q000458:organization & administration; D005240:Feasibility Studies; D005260:Female; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007871:Leg Ulcer / Q000517:prevention & control* / Q000523:psychology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009042:Motivation; D020380:Needs Assessment; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D010349:Patient Compliance / Q000523:psychology*; D016730:Program Development; D015397:Program Evaluation; D011582:Psychological Theory; D011788:Quality of Life