title: Lifting the lid of the "black intervention box" - the systematic development of an action competence programme for people with screen-detected dysglycaemia.
abstract: BACKGROUND
  The evidence gained from effective self-management interventions is often criticised for the ambiguity of its active components, and consequently the obstruction of their implementation into daily practice.Our aim is to report how an intervention development model aids the careful selection of active components in an intervention for people with dysglycaemia.
  
  
  METHODS
  The first three phases of the UK Medical Research Council's model for developing complex interventions in primary care were used to develop a self-management intervention targeting people with screen-detected dysglycaemia. In the preclinical phase, the expected needs of the target group were assessed by review of empirical literature and theories. In phase I, a preliminary intervention was modelled and in phase II, the preliminary intervention was pilot tested.
  
  
  RESULTS
  In the preclinical phase the achievement of health-related action competence was defined as the overall intervention goal and four learning objectives were identified: motivation, informed decision-making, action experience and social involvement. In Phase I, the educational activities were defined and the pedagogical tools tested. In phase II, the intervention was tested in two different primary healthcare settings and adjusted accordingly. The 18-hour intervention "Ready to Act" ran for 3 months and consisted of two motivational one-to-one sessions conducted by nurses and eight group meetings conducted by multidisciplinary teams.
  
  
  CONCLUSIONS
  An intervention aimed at health-related action competence was successfully developed for people with screen-detected dysglycaemia. The systematic and transparent developmental process is expected to facilitate future clinical research. The MRC model provides the necessary steps to inform intervention development but should be prioritised according to existing evidence in order to save time.
authors.affiliation: Department of General Practice, School of Public Health, Aarhus University, Aarhus, Denmark. htm@alm.au.dk
authors.forename: Helle Terkildsen
authors.initials: HT
authors.lastname: Maindal
authors.forename: Marit
authors.initials: M
authors.lastname: Kirkevold
authors.forename: Annelli
authors.initials: A
authors.lastname: Sandbaek
authors.forename: Torsten
authors.initials: T
authors.lastname: Lauritzen
mesh_terms: D000328:Adult; D015190:Blood Glucose Self-Monitoring; D044882:Glucose Metabolism Disorders / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D008403:Mass Screening; D010353:Patient Education as Topic; D011320:Primary Health Care / Q000379:methods; D016730:Program Development / Q000379:methods*; D012107:Research Design; D012648:Self Care; D006113:United Kingdom
references.citation: Diabetes Care. 2004 May;27(5):1047-53
references.pmid: 15111519
references.citation: Diabet Med. 2004 Oct;21(10):1075-81
references.pmid: 15384953
references.citation: Am J Manag Care. 2006 May;12(5):261-6
references.pmid: 16686583
references.citation: Diabetes Educ. 1999 Nov-Dec;25(6 Suppl):7-15
references.pmid: 10711080
references.citation: Health Educ Behav. 2004 Apr;31(2):143-64
references.pmid: 15090118
references.citation: Eval Health Prof. 2006 Mar;29(1):126-53
references.pmid: 16510882
references.citation: Patient Educ Couns. 2008 Jul;72(1):88-93
references.pmid: 18367365
references.citation: Ann Intern Med. 1997 Dec 15;127(12):1097-102
references.pmid: 9412313
references.citation: Diabetes Care. 2001 Mar;24(3):561-87
references.pmid: 11289485
references.citation: Prim Care Diabetes. 2007 Feb;1(1):5-11
references.pmid: 18632013
references.citation: Diabetes Care. 1998 Sep;21(9):1414-31
references.pmid: 9727886
references.citation: Diabetes Educ. 2005 Jan-Feb;31(1):53, 55-6, 61
references.pmid: 15779247
references.citation: BMJ. 2008 Sep 29;337:a1655
references.pmid: 18824488
references.citation: Patient Educ Couns. 2004 Jun;53(3):269-75
references.pmid: 15186863
references.citation: Clin Rehabil. 2005 Aug;19(5):560-71
references.pmid: 16119413
references.citation: J Adv Nurs. 2006 May;54(3):293-303
references.pmid: 16629914
references.citation: Lancet. 1998 Sep 12;352(9131):837-53
references.pmid: 9742976
references.citation: J Adv Nurs. 2004 Jul;47(2):174-82
references.pmid: 15196191
references.citation: Ann Behav Med. 2003 Aug;26(1):1-7
references.pmid: 12867348
references.citation: Patient Educ Couns. 2001 Mar;42(3):257-70
references.pmid: 11164325
references.citation: Cochrane Database Syst Rev. 2005 Apr 18;(2):CD003417
references.pmid: 15846663
references.citation: Diabet Med. 2005 Sep;22(9):1246-51
references.pmid: 16108856
references.citation: Int J Obes Relat Metab Disord. 2000 Sep;24 Suppl 3:S6-11
references.pmid: 11063279
references.citation: Cerebrovasc Dis. 2005;20(2):85-91
references.pmid: 15976500
references.citation: Patient Educ Couns. 1996 Oct;29(1):13-23
references.pmid: 9006218
references.citation: Patient Educ Couns. 2006 Dec;64(1-3):369-77
references.pmid: 17011154
references.citation: BMC Health Serv Res. 2007 Aug 31;7:136
references.pmid: 17764549
references.citation: Nurse Educ Today. 2004 Feb;24(2):105-12
references.pmid: 14769454
references.citation: Soc Sci Med. 2005 Apr;60(7):1423-35
references.pmid: 15652676
references.citation: Diabetes Care. 1998 Oct;21(10):1644-51
references.pmid: 9773724
references.citation: N Engl J Med. 2002 Feb 7;346(6):393-403
references.pmid: 11832527
references.citation: Eff Clin Pract. 2001 Nov-Dec;4(6):256-62
references.pmid: 11769298
references.citation: Diabet Med. 2007 Jul;24(7):770-7
references.pmid: 17403125
references.citation: BMJ. 2000 Sep 16;321(7262):694-6
references.pmid: 10987780
references.citation: Patient Educ Couns. 2004 Jan;52(1):97-105
references.pmid: 14729296
references.citation: Cochrane Database Syst Rev. 2005 Apr 18;(2):CD003638
references.pmid: 15846672
references.citation: Diabetologia. 2008 Jul;51(7):1127-34
references.pmid: 18443762
references.citation: Diabet Med. 2002 May;19(5):406-11
references.pmid: 12027929