dme.14548 (1).pdf (199.71 kB)
Download file

The DAFNEplus programme for sustained type 1 diabetes self management: Intervention development using the Behaviour Change Wheel

Download (199.71 kB)
journal contribution
posted on 11.05.2021, 10:36 by SH Stanton-Fay, K Hamilton, PM Chadwick, F Lorencatto, C Gianfrancesco, N de Zoysa, E Coates, D Cooke, H McBain, SR Heller, S Michie, DAFNEplus study group
Aims
Self‐management programmes for type 1 diabetes, such as the UK’s Dose Adjustment for Normal Eating (DAFNE), improve short‐term clinical outcomes but difficulties maintaining behavioural changes attenuate long‐term impact. This study used the Behaviour Change Wheel (BCW) framework to revise the DAFNE intervention to support sustained behaviour change.

Methods
A four‐step method was based on the BCW intervention development approach: (1) Identifying self‐management behaviours and barriers/enablers to maintain them via stakeholder consultation and evidence synthesis, and mapping barriers/enablers to the Capability, Opportunity, Motivation‐Behaviour (COM‐B) model. (2) Specifying behaviour change techniques (BCTs) in the existing DAFNE intervention using the Behaviour Change Techniques Taxonomy (BCTTv1). (3) Identifying additional BCTs to target the barriers/enablers using the BCW and BCTTv1. (4) Parallel stakeholder consultation to generate recommendations for intervention revision. Revised materials were co‐designed by stakeholders (diabetologists, psychologists, specialist nurses and dieticians).

Results
In all, 34 barriers and 5 enablers to sustaining self‐management post‐DAFNE were identified. The existing DAFNE intervention contained 24 BCTs, which partially addressed the enablers. In all, 27 BCTs were added, including ‘Habit formation’, ‘Credible source’ and ‘Conserving mental resources’. In total, 15 stakeholder‐agreed recommendations for content and delivery were incorporated into the final DAFNEplus intervention, comprising three co‐designed components: (1) face‐to‐face group learning course, (2) individual structured follow‐up sessions and (3) technological support, including blood glucose data management.

Conclusions
This method provided a systematic approach to specifying and revising a behaviour change intervention incorporating stakeholder input. The revised DAFNEplus intervention aims to support the maintenance of behavioural changes by targeting barriers and enablers to sustaining self‐management behaviours.

Funding

Programme Grants for Applied Research. Grant Number: RP‐PG‐0514‐20013

History

Citation

Diabetic Medicine, Volume 38, Issue 5, May 2021, e14548

Author affiliation

Diabetes Research Centre, College of Life Sciences

Version

VoR (Version of Record)

Published in

Diabetic Medicine

Volume

38

Issue

5

Pagination

e14548

Publisher

Wiley

issn

0742-3071

eissn

1464-5491

Acceptance date

02/02/2021

Copyright date

2021

Available date

11/05/2021

Spatial coverage

England

Language

eng