title: Development of Motivate4Change Using the Intervention Mapping Protocol: An Interactive Technology Physical Activity and Medication Adherence Promotion Program for Hospitalized Heart Failure Patients.
abstract: BACKGROUND
  It is important that heart failure (HF) patients adhere to their medication regimen and engage in physical activity. Evidence shows that adherence to these HF self-management behaviors can be improved with appropriate interventions.
  
  
  OBJECTIVE
  To further promote medication adherence and physical activity among HF patients, we developed an intervention for hospitalized HF patients.
  
  
  METHODS
  The intervention mapping protocol was applied in the development of the intervention. This entailed performing a needs assessment, defining change objectives, selecting determinants and strategies, and developing the materials.
  
  
  RESULTS
  The resulting intervention, Motivate4Change, makes use of interactive technology and provides HF patients with personalized feedback and advice. Specific change objectives were defined. The relevant behavioral determinants for the physical activity program were practical knowledge on physical activity performance and self-efficacy for, and perceived benefits of, physical activity. For medication-taking, the selected determinants were practical knowledge on medication-taking, perceived barriers to medication-taking, beliefs about the necessity and harm regarding the medication prescribed, and beliefs about overprescribing and harm of medication in general. The change objectives and behavior change determinants were translated in feedback and advice strategies in an interactive technology program that included tailored feedback and advice, and role models in videos in which the behaviors and overcoming barriers were demonstrated. Relevant stakeholders were involved in the interventions development process. The intervention was pretested among HF patients and adjustments were made accordingly.
  
  
  CONCLUSIONS
  The interactive technology physical activity and medication adherence promotion program for hospitalized HF patients was systematically developed using the intervention mapping protocol and was based on the available theory and evidence regarding HF self-management behavior change. The intervention's efficacy is yet to be determined in evaluation research.
authors.affiliation: Philips Research, Briarcliff Manor, NY, United States. rony.calo@philips.com.
authors.forename: Rony
authors.identifier: http://orcid.org/0000-0002-6097-091X
authors.initials: R
authors.lastname: Oosterom-Calo
authors.forename: Saskia J
authors.identifier: http://orcid.org/0000-0002-4674-8052
authors.initials: SJ
authors.lastname: Te Velde
authors.forename: Wim
authors.identifier: http://orcid.org/0000-0002-0468-2315
authors.initials: W
authors.lastname: Stut
authors.forename: Johannes
authors.identifier: http://orcid.org/0000-0002-1904-7349
authors.initials: J
authors.lastname: Brug
keywords: computer tailoring; heart failure; hospital; interactive technology; intervention mapping; medication adherence; physical activity; self-care; self-management