title: Reducing patient delay in Acute Coronary Syndrome (RAPiD): research protocol for a web-based randomized controlled trial examining the effect of a behaviour change intervention.
abstract: OBJECTIVE
  To evaluate the efficacy of a behaviour change technique-based intervention and compare two possible modes of delivery (text + visual and text-only) with usual care.
  
  
  BACKGROUND
  Patient delay prevents many people from achieving optimal benefit of time-dependent treatments for acute coronary syndrome. Reducing delay would reduce mortality and morbidity, but interventions to change behaviour have had mixed results. Systematic inclusion of behaviour change techniques or a visual mode of delivery might improve the efficacy of interventions.
  
  
  METHODS
  A three-arm web-based, parallel randomized controlled trial of a theory-based intervention.
  
  
  METHODS
  The intervention comprises 12 behaviour change techniques systematically identified following systematic review and a consensus exercise undertaken with behaviour change experts. We aim to recruit n = 177 participants who have experienced acute coronary syndrome in the previous 6 months from a National Health Service Hospital. Consenting participants will be randomly allocated in equal numbers to one of three study groups: i) usual care, ii) usual care plus text-only behaviour change technique-based intervention or iii) usual care plus text + visual behaviour change technique-based intervention. The primary outcome will be the change in intention to phone an ambulance immediately with symptoms of acute coronary syndrome ≥15-minute duration, assessed using two randomized series of eight scenarios representing varied symptoms before and after delivery of the interventions or control condition (usual care). Funding granted January 2014.
  
  
  CONCLUSIONS
  Positive results changing intentions would lead to a randomized controlled trial of the behaviour change intervention in clinical practice, assessing patient delay in the event of actual symptoms.
  
  
  BACKGROUND
  Registered at ClinicalTrials.gov: NCT02820103.
authors: School of Health & Social Care, Edinburgh Napier University, UK.
authors: Barbara
authors: http://orcid.org/0000-0001-9295-3156
authors: B
authors: Farquharson
authors: Institute of Applied Health Sciences, University of Aberdeen, UK.
authors: Marie
authors: M
authors: Johnston
authors: NHS Tayside, University of Dundee, UK.
authors: Karen
authors: K
authors: Smith
authors: School of Health and Social Care, Edinburgh Napier University, UK.
authors: Brian
authors: B
authors: Williams
authors: Health Services Research Unit, University of Aberdeen, UK.
authors: Shaun
authors: S
authors: Treweek
authors: Psychology, Faculty of Natural Sciences, University of Stirling, UK.
authors: Stephan U
authors: SU
authors: Dombrowski
authors: School of Health & Social Care, Edinburgh Napier University, UK.
authors: Nadine
authors: N
authors: Dougall
authors: School of Health Sciences, University of Stirling, UK.
authors: Purva
authors: P
authors: Abhyankar
authors: Nursing, Midwifery and Allied Health Professionals Research Unit (NMAHP-RU), Faculty of Health and Sports Sciences, University of Stirling, UK.
authors: Mark
authors: M
authors: Grindle
mesh_terms: D054058:Acute Coronary Syndrome / Q000523:psychology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology; D012606:Scotland; D020377:Self Efficacy; D061665:Time-to-Treatment / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult
keywords: 
  ACS
  ; 
  BCT
  ; acute coronary syndrome; behaviour; behaviour change; cardiac; delay; intervention; nursing; patient delay