Facilitating self-management support using the behaviour change wheel (BCW) to address healthcare professionals’ behaviour

Abstract

Background

Supporting self-management in healthcare practice is essential to improve chronic patients’ daily life experiences. Primary care professionals play an indispensable role in this. Nevertheless, supporting self-management in practice comes with many challenges. The aim of this study is to identify determinants of professionals’ supportive behaviour and develop an intervention that facilitates self-management support in primary care practice, using these determinants as building blocks.

Methods

To develop the intervention, the Behaviour Change Wheel (BCW) was used which involves eight steps in three stages: (1) Understanding the behaviour using the COM-B model, (2) Identifying intervention options, and (3) Identifying content and implementation options. The theoretical underpinnings for stage 1 included data from interviews, focus groups and brainstorm sessions, incorporated beforehand in a self-management support model. Subsequently, literature analysis, empirical research and expertise from the research group guided stages 2 and 3.

Results

We found that changes in “psychological capability”, “physical opportunity”, “reflective motivation” and “automatic motivation” are required to optimize professionals’ behaviour towards self-management support. The two key intervention functions identified were “enablement” and “education”. Therefore, a blended learning trajectory that incorporated these interventional building blocks was developed, integrating specific behaviour change techniques (BCTs) including: (1) Information about social and environmental consequences, (2) Information about health consequences, and (3) Social support (practical). The learning design was finalized by applying the Absorb-Do-Connect learning framework developed by Horton.

Conclusions

Application of the BCW framework shaped a self-management support intervention to educate and enable healthcare professionals. Future research will pilot and refine the intervention.