A theory-informed approach to developing visually mediated interventions to change behaviour using an asthma and physical activity intervention exemplar

Jennifer Murray, Brian Williams, Gaylor Hoskins, Silje Skar, John McGhee, Shaun Treweek, Falko F. Sniehotta, Aziz Sheikh, Gordon Brown, Suzanne Hagen, Linda Cameron, Claire Jones, Dylan Gauld

Research output: Contribution to journalArticle

3 Citations (Scopus)
4 Downloads (Pure)

Abstract


Background

Visualisation techniques are used in a range of healthcare interventions. However, these frequently lack a coherent rationale or clear theoretical basis. This lack of definition and explicit targeting of the underlying mechanisms may impede the success of and evaluation of the intervention. We describe the theoretical development, deployment, and pilot evaluation, of a complex visually mediated behavioural intervention. The exemplar intervention focused on increasing physical activity among young people with asthma. We employed an explicit five-stage development model, which was actively supported by a consultative user group. The developmental stages involved establishing the theoretical basis, establishing a narrative structure, visual rendering, checking interpretation, and pilot testing. We conducted in-depth interviews and focus groups during early development and checking, followed by an online experiment for pilot testing. A total of 91 individuals, including young people with asthma, parents, teachers, and health professionals, were involved in development and testing.


Results

Our final intervention consisted of two components: (1) an interactive 3D computer animation to create intentions and (2) an action plan and volitional help sheet to promote the translation of intentions to behaviour. Theory was mediated throughout by visual and audio forms. The intervention was regarded as highly acceptable, engaging, and meaningful by all stakeholders. The perceived impact on asthma understanding and intentions was reported positively, with most individuals saying that the 3D computer animation had either clarified a range of issues or made them more real. Our five-stage model underpinned by extensive consultation worked well and is presented as a framework to support explicit decision-making for others developing theory informed visually mediated interventions.


Conclusions

We have demonstrated the ability to develop theory-based visually mediated behavioural interventions. However, attention needs to be paid to the potential ambiguity associated with images and thus the concept of visual literacy among patients. Our revised model may be helpful as a guide to aid development, acceptability, and ultimately effectiveness.
Original languageEnglish
Article number46
Pages (from-to)1-17
Number of pages17
JournalPilot & Feasibility Studies
Volume2
DOIs
Publication statusPublished - 15 Aug 2016

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Asthma
Exercise
Aptitude
Focus Groups
Decision Making
Referral and Consultation
Parents
Interviews
Delivery of Health Care
Health
Literacy

Keywords

  • intervention development
  • asthma
  • 3D animation
  • 3D computer animation
  • mixed-methods
  • interdisciplinary
  • visual

Cite this

A theory-informed approach to developing visually mediated interventions to change behaviour using an asthma and physical activity intervention exemplar. / Murray, Jennifer; Williams, Brian; Hoskins, Gaylor; Skar, Silje; McGhee, John; Treweek, Shaun; Sniehotta, Falko F.; Sheikh, Aziz; Brown, Gordon; Hagen, Suzanne; Cameron, Linda; Jones, Claire; Gauld, Dylan .

In: Pilot & Feasibility Studies, Vol. 2, 46, 15.08.2016, p. 1-17.

Research output: Contribution to journalArticle

Murray, J, Williams, B, Hoskins, G, Skar, S, McGhee, J, Treweek, S, Sniehotta, FF, Sheikh, A, Brown, G, Hagen, S, Cameron, L, Jones, C & Gauld, D 2016, 'A theory-informed approach to developing visually mediated interventions to change behaviour using an asthma and physical activity intervention exemplar', Pilot & Feasibility Studies, vol. 2, 46, pp. 1-17. https://doi.org/10.1186/s40814-016-0091-x
Murray, Jennifer ; Williams, Brian ; Hoskins, Gaylor ; Skar, Silje ; McGhee, John ; Treweek, Shaun ; Sniehotta, Falko F. ; Sheikh, Aziz ; Brown, Gordon ; Hagen, Suzanne ; Cameron, Linda ; Jones, Claire ; Gauld, Dylan . / A theory-informed approach to developing visually mediated interventions to change behaviour using an asthma and physical activity intervention exemplar. In: Pilot & Feasibility Studies. 2016 ; Vol. 2. pp. 1-17.
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abstract = "BackgroundVisualisation techniques are used in a range of healthcare interventions. However, these frequently lack a coherent rationale or clear theoretical basis. This lack of definition and explicit targeting of the underlying mechanisms may impede the success of and evaluation of the intervention. We describe the theoretical development, deployment, and pilot evaluation, of a complex visually mediated behavioural intervention. The exemplar intervention focused on increasing physical activity among young people with asthma. We employed an explicit five-stage development model, which was actively supported by a consultative user group. The developmental stages involved establishing the theoretical basis, establishing a narrative structure, visual rendering, checking interpretation, and pilot testing. We conducted in-depth interviews and focus groups during early development and checking, followed by an online experiment for pilot testing. A total of 91 individuals, including young people with asthma, parents, teachers, and health professionals, were involved in development and testing.ResultsOur final intervention consisted of two components: (1) an interactive 3D computer animation to create intentions and (2) an action plan and volitional help sheet to promote the translation of intentions to behaviour. Theory was mediated throughout by visual and audio forms. The intervention was regarded as highly acceptable, engaging, and meaningful by all stakeholders. The perceived impact on asthma understanding and intentions was reported positively, with most individuals saying that the 3D computer animation had either clarified a range of issues or made them more real. Our five-stage model underpinned by extensive consultation worked well and is presented as a framework to support explicit decision-making for others developing theory informed visually mediated interventions.ConclusionsWe have demonstrated the ability to develop theory-based visually mediated behavioural interventions. However, attention needs to be paid to the potential ambiguity associated with images and thus the concept of visual literacy among patients. Our revised model may be helpful as a guide to aid development, acceptability, and ultimately effectiveness.",
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note = "Funding for this study was received from the Chief Scientist Office for Scotland. We would like to thank Asthma UK and Asthma UK Scotland for facilitating the advertisement of the study pilot and consultative user group. Thanks to Dr Mark Grindle for his helpful discussions concerning narrative. Thanks also to Mr Mark Haldane who designed the characters, backgrounds, and user interface used within the 3D computer animation. Particular thanks to the participants of the consultative user group for their enthusiasm, comments, and suggestions at all stages of the intervention design.",
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AU - Murray, Jennifer

AU - Williams, Brian

AU - Hoskins, Gaylor

AU - Skar, Silje

AU - McGhee, John

AU - Treweek, Shaun

AU - Sniehotta, Falko F.

AU - Sheikh, Aziz

AU - Brown, Gordon

AU - Hagen, Suzanne

AU - Cameron, Linda

AU - Jones, Claire

AU - Gauld, Dylan

N1 - Funding for this study was received from the Chief Scientist Office for Scotland. We would like to thank Asthma UK and Asthma UK Scotland for facilitating the advertisement of the study pilot and consultative user group. Thanks to Dr Mark Grindle for his helpful discussions concerning narrative. Thanks also to Mr Mark Haldane who designed the characters, backgrounds, and user interface used within the 3D computer animation. Particular thanks to the participants of the consultative user group for their enthusiasm, comments, and suggestions at all stages of the intervention design.

PY - 2016/8/15

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N2 - BackgroundVisualisation techniques are used in a range of healthcare interventions. However, these frequently lack a coherent rationale or clear theoretical basis. This lack of definition and explicit targeting of the underlying mechanisms may impede the success of and evaluation of the intervention. We describe the theoretical development, deployment, and pilot evaluation, of a complex visually mediated behavioural intervention. The exemplar intervention focused on increasing physical activity among young people with asthma. We employed an explicit five-stage development model, which was actively supported by a consultative user group. The developmental stages involved establishing the theoretical basis, establishing a narrative structure, visual rendering, checking interpretation, and pilot testing. We conducted in-depth interviews and focus groups during early development and checking, followed by an online experiment for pilot testing. A total of 91 individuals, including young people with asthma, parents, teachers, and health professionals, were involved in development and testing.ResultsOur final intervention consisted of two components: (1) an interactive 3D computer animation to create intentions and (2) an action plan and volitional help sheet to promote the translation of intentions to behaviour. Theory was mediated throughout by visual and audio forms. The intervention was regarded as highly acceptable, engaging, and meaningful by all stakeholders. The perceived impact on asthma understanding and intentions was reported positively, with most individuals saying that the 3D computer animation had either clarified a range of issues or made them more real. Our five-stage model underpinned by extensive consultation worked well and is presented as a framework to support explicit decision-making for others developing theory informed visually mediated interventions.ConclusionsWe have demonstrated the ability to develop theory-based visually mediated behavioural interventions. However, attention needs to be paid to the potential ambiguity associated with images and thus the concept of visual literacy among patients. Our revised model may be helpful as a guide to aid development, acceptability, and ultimately effectiveness.

AB - BackgroundVisualisation techniques are used in a range of healthcare interventions. However, these frequently lack a coherent rationale or clear theoretical basis. This lack of definition and explicit targeting of the underlying mechanisms may impede the success of and evaluation of the intervention. We describe the theoretical development, deployment, and pilot evaluation, of a complex visually mediated behavioural intervention. The exemplar intervention focused on increasing physical activity among young people with asthma. We employed an explicit five-stage development model, which was actively supported by a consultative user group. The developmental stages involved establishing the theoretical basis, establishing a narrative structure, visual rendering, checking interpretation, and pilot testing. We conducted in-depth interviews and focus groups during early development and checking, followed by an online experiment for pilot testing. A total of 91 individuals, including young people with asthma, parents, teachers, and health professionals, were involved in development and testing.ResultsOur final intervention consisted of two components: (1) an interactive 3D computer animation to create intentions and (2) an action plan and volitional help sheet to promote the translation of intentions to behaviour. Theory was mediated throughout by visual and audio forms. The intervention was regarded as highly acceptable, engaging, and meaningful by all stakeholders. The perceived impact on asthma understanding and intentions was reported positively, with most individuals saying that the 3D computer animation had either clarified a range of issues or made them more real. Our five-stage model underpinned by extensive consultation worked well and is presented as a framework to support explicit decision-making for others developing theory informed visually mediated interventions.ConclusionsWe have demonstrated the ability to develop theory-based visually mediated behavioural interventions. However, attention needs to be paid to the potential ambiguity associated with images and thus the concept of visual literacy among patients. Our revised model may be helpful as a guide to aid development, acceptability, and ultimately effectiveness.

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KW - mixed-methods

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DO - 10.1186/s40814-016-0091-x

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JO - Pilot & Feasibility Studies

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