title: Combining users' needs with health behavior models in designing an internet- and mobile-based intervention for physical activity in cardiac rehabilitation.
abstract: BACKGROUND
  Internet-based physical activity interventions have great potential in supporting patients in cardiac rehabilitation. Health behavior change theories and user input are identified as important contributors in the effectiveness of the interventions, but they are rarely combined in a systematic way in the design of the interventions.
  
  
  OBJECTIVE
  The aim of this study is to identify the appropriate theoretical framework, along with the needs of the users of a physical activity intervention for cardiac rehabilitation, and to combine them into an effective Internet- and mobile-based intervention.
  
  
  METHODS
  We explain the theoretical framework of the intervention in a narrative overview of the existing health behavior change literature as it applies to physical activity. We also conducted a focus group with 11 participants of a cardiac rehabilitation program and used thematic analysis to identify and analyze patterns of meaning in the transcribed data.
  
  
  RESULTS
  We chose stage-based approaches, specifically the transtheoretical model and the health action process approach as our main framework for tailoring, supplemented with other theoretical concepts such as regulatory focus within the appropriate stages. From the thematic analysis of the focus group data, we identified seven themes: (1) social, (2) motivation, (3) integration into everyday life, (4) information, (5) planning, (6) monitoring and feedback, and (7) concerns and potential problems. The final design of the intervention was based on both the theoretical review and the user input, and it is explained in detail.
  
  
  CONCLUSIONS
  We applied a combination of health behavioral theory and user input in designing our intervention. We think this is a promising design approach with the potential to combine the high efficacy of theory-based interventions with the higher perceived usefulness of interventions designed according to user input.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT01223170; http://clinicaltrials.gov/show/NCT01223170 (Archived by WebCite at http://www.webcitation.org/6M5FqT9Q2).
authors.affiliation: Norwegian Center for Integrated Care and Telemedicine, University Hospital of North Norway, Tromsø, Norway. konstantinos.antypas@telemed.no.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Antypas
authors.forename: Silje C
authors.initials: SC
authors.lastname: Wangberg
keywords: Internet; SMS; cardiac rehabilitation; design methodology; focus group; health behavior models; physical activity; smoking cessation; tailoring; user involvement; user needs