Development of Motivate4Change: Interactive Physical Activity and Medication Adherence Promotion for Heart Failure Patients.

It is important that heart failure (HF) patients adhere to their medication regimen and engage in physical activity to optimally self-manage their condition. Evidence shows that adherence to these HF self-management behaviors can be improved with appropriate interventions. To further promote medication adherence and physical activity among HF patients, we developed an interactive -ICT supported- intervention for hospitalized HF patients. In a paper just published in JMIR Research Protocols, -with Rony Oosterom-Calo as first author- we describe how this intervention was developed.
The intervention mapping protocol was applied in the development of the intervention. This entailed performing a needs assessment (on which another paper was published in the same journal), defining change objectives, selecting determinants and strategies, and developing the materials. The resulting intervention, called 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.