www.fimdm.org

BESI

Aim

This project has three aims. 

1. Develop a ‘meta’ theory for interventions that would help patients adapt to living with a chronic condition and to realise their preferred aims using a literature search and synthesis.
2. Compare and contrast BESIs produced by a range of providers, analyzing their fit to a proposed meta theory of behaviour support intervention design. 
3. Exploring the boundary between shared decision making and motivational interviewing, addressing where the overlap and distinction lies in the two approaches to the patient-professional encounter. 

Background

The interest in creating interventions which help patients to make decisions about treatments or tests and other choices in health care has led to substantial debate in how these tools should be developed, designed and implemented. There is increasing realization that the goals of a behaviour support intervention (BESI) are different from the goals of a decision support intervention (DESI). Whereas a DESI seeks to inform patients of the options when equipoise exists to assist in making a choice, a BESI, to be effective, has to motivate and assist the patient to adopt new behaviour(s) or make behaviour changes that are known to improve health outcomes. A body of theoretical and empirical work is devoted to conceptualizing and testing the determinants of behaviour and behaviour  change. The failure to build on existing theory is often cited as one the major sources for lack of effectiveness of interventions in the healthcare context. A major challenge for developers of BESIs is which among the many different theories to draw on in developing interventions and how to translate theory into intervention components that can be operationalised and implemented successfully.

About the study

The overall purpose of the study is to bridge the gap between theories of behaviour and the development of behaviour support interventions for patients who have chronic diseases so as to guide the future development of a suite of programmes that can be used by a wide range of patients who need to adapt their lives to cope with both increased monitoring activities or adherence to medication and other regimes. We will do this by identifying the determinants of these behaviours; identify how the components of the Foundation’s programmes (and a selection of others) map onto a meta theory of behaviour change techniques. In so doing we will suggest specific modifications that would strengthen the theoretical grounding / component design of the programmes, thereby increasing the likelihood that they will effective at motivating patients to change or adopt a new behaviour.