title: Intervention planning for a digital intervention for self-management of hypertension: a theory-, evidence- and person-based approach.
abstract: This paper describes the intervention planning process for the Home and Online Management and Evaluation of Blood Pressure (HOME BP), a digital intervention to promote hypertension self-management. It illustrates how a Person-Based Approach can be integrated with theory- and evidence-based approaches. The Person-Based Approach to intervention development emphasises the use of qualitative research to ensure that the intervention is acceptable, persuasive, engaging and easy to implement.
  
  
  
  Our intervention planning process comprised two parallel, integrated work streams, which combined theory-, evidence- and person-based elements. The first work stream involved collating evidence from a mixed methods feasibility study, a systematic review and a synthesis of qualitative research. This evidence was analysed to identify likely barriers and facilitators to uptake and implementation as well as design features that should be incorporated in the HOME BP intervention. The second work stream used three complementary approaches to theoretical modelling: developing brief guiding principles for intervention design, causal modelling to map behaviour change techniques in the intervention onto the Behaviour Change Wheel and Normalisation Process Theory frameworks, and developing a logic model.
  
  
  
  The different elements of our integrated approach to intervention planning yielded important, complementary insights into how to design the intervention to maximise acceptability and ease of implementation by both patients and health professionals. From the primary and secondary evidence, we identified key barriers to overcome (such as patient and health professional concerns about side effects of escalating medication) and effective intervention ingredients (such as providing in-person support for making healthy behaviour changes). Our guiding principles highlighted unique design features that could address these issues (such as online reassurance and procedures for managing concerns). Causal modelling ensured that all relevant behavioural determinants had been addressed, and provided a complete description of the intervention. Our logic model linked the hypothesised mechanisms of action of our intervention to existing psychological theory.
  
  
  
  Our integrated approach to intervention development, combining theory-, evidence- and person-based approaches, increased the clarity, comprehensiveness and confidence of our theoretical modelling and enabled us to ground our intervention in an in-depth understanding of the barriers and facilitators most relevant to this specific intervention and user population.
authors.affiliation: Centre for Clincial and Community Applications of Health Psychology, University of Southampton, Shackleton Building, Highfield Campus, Southampton, SO17 1BJ, UK. r.j.band@soton.ac.uk.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Band
authors.affiliation: Centre for Clincial and Community Applications of Health Psychology, University of Southampton, Shackleton Building, Highfield Campus, Southampton, SO17 1BJ, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Bradbury
authors.affiliation: Centre for Clincial and Community Applications of Health Psychology, University of Southampton, Shackleton Building, Highfield Campus, Southampton, SO17 1BJ, UK.
authors.forename: Katherine
authors.initials: K
authors.lastname: Morton
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, UK.
authors.forename: Carl
authors.initials: C
authors.lastname: May
authors.affiliation: UCL Centre for Behaviour Change, Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
authors.forename: Susan
authors.initials: S
authors.lastname: Michie
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 9LX, Scotland.
authors.forename: Frances S
authors.initials: FS
authors.lastname: Mair
authors.affiliation: Research Department of Primary Care and Population Health, University College London, Rowland Hill Street, London, NW3 2PF, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Murray
authors.affiliation: Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: McManus
authors.affiliation: Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Little
authors.affiliation: Centre for Clincial and Community Applications of Health Psychology, University of Southampton, Shackleton Building, Highfield Campus, Southampton, SO17 1BJ, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Yardley
mesh_terms: D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D019317:Evidence-Based Medicine; D005240:Feasibility Studies; D015438:Health Behavior; D006699:Home Care Services; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D000073278:Self-Management / Q000379:methods*; D012944:Social Support; D017216:Telemedicine
keywords: Blood pressure; Hypertension; Intervention planning; Methodological study; Self-management; Self-monitoring; Theoretical modelling