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Behaviour change strategies for reducing blood pressure-related disease burden: findings from a global implementation research programme.

GACD Hypertension Research Programme, Writing GroupPeiris D, Thompson SR, Beratarrechea A, Cárdenas MK, Diez-Canseco F, Goudge J, Gyamfi J, Kamano JH, Irazola V, Johnson C, Kengne AP, Keat NK, Miranda JJ, Mohan S, Mukasa B, Ng E, Nieuwlaat R, Ogedegbe O, Ovbiagele B, Plange-Rhule J, Praveen D, Salam A, Thorogood M, Thrift AG, Vedanthan R, Waddy SP, Webster J, Webster R, Yeates K, Yusoff K, Hypertension Research Programme membe - Implement Sci (2015)

Bottom Line: Similar policy categories were also targeted across teams particularly in the areas of guidelines, communication/marketing and service provision with few teams focussing on fiscal measures, regulation and legislation.The findings highlight the importance of contextual factors in driving success and failure of research programmes.Forthcoming outcome and process evaluations from each project will build on this exploratory work and provide a greater understanding of factors that might influence scale-up of intervention strategies.

View Article: PubMed Central - PubMed

Affiliation: The George Institute for Global Health, The University of Sydney, Sydney, Australia. dpeiris@georgeinstitute.org.

ABSTRACT

Background: The Global Alliance for Chronic Diseases comprises the majority of the world's public research funding agencies. It is focussed on implementation research to tackle the burden of chronic diseases in low- and middle-income countries and amongst vulnerable populations in high-income countries. In its inaugural research call, 15 projects were funded, focussing on lowering blood pressure-related disease burden. In this study, we describe a reflexive mapping exercise to identify the behaviour change strategies undertaken in each of these projects.

Methods: Using the Behaviour Change Wheel framework, each team rated the capability, opportunity and motivation of the various actors who were integral to each project (e.g. community members, non-physician health workers and doctors in projects focussed on service delivery). Teams then mapped the interventions they were implementing and determined the principal policy categories in which those interventions were operating. Guidance was provided on the use of Behaviour Change Wheel to support consistency in responses across teams. Ratings were iteratively discussed and refined at several group meetings.

Results: There was marked variation in the perceived capabilities, opportunities and motivation of the various actors who were being targeted for behaviour change strategies. Despite this variation, there was a high degree of synergy in interventions functions with most teams utilising complex interventions involving education, training, enablement, environmental restructuring and persuasion oriented strategies. Similar policy categories were also targeted across teams particularly in the areas of guidelines, communication/marketing and service provision with few teams focussing on fiscal measures, regulation and legislation.

Conclusions: The large variation in preparedness to change behaviour amongst the principal actors across these projects suggests that the interventions themselves will be variably taken up, despite the similarity in approaches taken. The findings highlight the importance of contextual factors in driving success and failure of research programmes. Forthcoming outcome and process evaluations from each project will build on this exploratory work and provide a greater understanding of factors that might influence scale-up of intervention strategies.

No MeSH data available.


Related in: MedlinePlus

Policy categories for the 15 research projects using the Behaviour Change Wheel framework
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Fig4: Policy categories for the 15 research projects using the Behaviour Change Wheel framework

Mentions: Figure 3 outlines the number of projects that are targeting particular intervention functions. All projects are engaging in multiple intervention functions (median = 6, range 2–8) with education, training, enablement, environmental restructuring and persuasion being the most common strategies deployed. These were particular strong elements in the projects involving task-sharing with non-physician, frontline health workers. Several projects are focussing on environmental restructuring either through different health care delivery models or through changing access to salt in the food supply. Fewer projects are using incentivisation, restrictions and modelling. No projects are using coercion strategies. Figure 4 shows the policy categories in which the proposed interventions are interacting. Again most projects are operating across multiple policy categories (median number of categories = 3, range 1–6) with guidelines, service provision and communication/marketing being the most common. Few projects are engaged in more structural policy categories such as legislation, regulation and social planning. No projects are employing fiscal measures.Fig. 3


Behaviour change strategies for reducing blood pressure-related disease burden: findings from a global implementation research programme.

GACD Hypertension Research Programme, Writing GroupPeiris D, Thompson SR, Beratarrechea A, Cárdenas MK, Diez-Canseco F, Goudge J, Gyamfi J, Kamano JH, Irazola V, Johnson C, Kengne AP, Keat NK, Miranda JJ, Mohan S, Mukasa B, Ng E, Nieuwlaat R, Ogedegbe O, Ovbiagele B, Plange-Rhule J, Praveen D, Salam A, Thorogood M, Thrift AG, Vedanthan R, Waddy SP, Webster J, Webster R, Yeates K, Yusoff K, Hypertension Research Programme membe - Implement Sci (2015)

Policy categories for the 15 research projects using the Behaviour Change Wheel framework
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4638103&req=5

Fig4: Policy categories for the 15 research projects using the Behaviour Change Wheel framework
Mentions: Figure 3 outlines the number of projects that are targeting particular intervention functions. All projects are engaging in multiple intervention functions (median = 6, range 2–8) with education, training, enablement, environmental restructuring and persuasion being the most common strategies deployed. These were particular strong elements in the projects involving task-sharing with non-physician, frontline health workers. Several projects are focussing on environmental restructuring either through different health care delivery models or through changing access to salt in the food supply. Fewer projects are using incentivisation, restrictions and modelling. No projects are using coercion strategies. Figure 4 shows the policy categories in which the proposed interventions are interacting. Again most projects are operating across multiple policy categories (median number of categories = 3, range 1–6) with guidelines, service provision and communication/marketing being the most common. Few projects are engaged in more structural policy categories such as legislation, regulation and social planning. No projects are employing fiscal measures.Fig. 3

Bottom Line: Similar policy categories were also targeted across teams particularly in the areas of guidelines, communication/marketing and service provision with few teams focussing on fiscal measures, regulation and legislation.The findings highlight the importance of contextual factors in driving success and failure of research programmes.Forthcoming outcome and process evaluations from each project will build on this exploratory work and provide a greater understanding of factors that might influence scale-up of intervention strategies.

View Article: PubMed Central - PubMed

Affiliation: The George Institute for Global Health, The University of Sydney, Sydney, Australia. dpeiris@georgeinstitute.org.

ABSTRACT

Background: The Global Alliance for Chronic Diseases comprises the majority of the world's public research funding agencies. It is focussed on implementation research to tackle the burden of chronic diseases in low- and middle-income countries and amongst vulnerable populations in high-income countries. In its inaugural research call, 15 projects were funded, focussing on lowering blood pressure-related disease burden. In this study, we describe a reflexive mapping exercise to identify the behaviour change strategies undertaken in each of these projects.

Methods: Using the Behaviour Change Wheel framework, each team rated the capability, opportunity and motivation of the various actors who were integral to each project (e.g. community members, non-physician health workers and doctors in projects focussed on service delivery). Teams then mapped the interventions they were implementing and determined the principal policy categories in which those interventions were operating. Guidance was provided on the use of Behaviour Change Wheel to support consistency in responses across teams. Ratings were iteratively discussed and refined at several group meetings.

Results: There was marked variation in the perceived capabilities, opportunities and motivation of the various actors who were being targeted for behaviour change strategies. Despite this variation, there was a high degree of synergy in interventions functions with most teams utilising complex interventions involving education, training, enablement, environmental restructuring and persuasion oriented strategies. Similar policy categories were also targeted across teams particularly in the areas of guidelines, communication/marketing and service provision with few teams focussing on fiscal measures, regulation and legislation.

Conclusions: The large variation in preparedness to change behaviour amongst the principal actors across these projects suggests that the interventions themselves will be variably taken up, despite the similarity in approaches taken. The findings highlight the importance of contextual factors in driving success and failure of research programmes. Forthcoming outcome and process evaluations from each project will build on this exploratory work and provide a greater understanding of factors that might influence scale-up of intervention strategies.

No MeSH data available.


Related in: MedlinePlus