Kingshuk Pal*, Research Department of Primary Care and Population Health, London, United Kingdom Elizabeth Murray*, Research Department of Primary Care and Population Health, London, United Kingdom Sophie Eastwood, Research Department of Primary Care and Population Health, London, United Kingdom Susan Michie, Psychology and Language Sciences, University College London, London, United Kingdom Maria Barnard, Department of Diabetes, The Whittington Hospital NHS Trust, London, United Kingdom Andrew Farmer, The Health Centre, Thame, Oxfordshire, Oxford, United Kingdom Richard Peacock, Archway Healthcare Library, London, United Kingdom Track: Research Presentation Topic: 2.0 Research methodology Presentation Type: Oral presentation Submission Type: Single Presentation Building: MECC Room: Auditorium 2 Date: 2010-11-29 04:45 PM – 06:15 PM Last modified: 2010-09-22

If you are the presenter of this abstract (or if you cite this abstract in a talk or on a poster), please show the QR code in your slide or poster (QR code contains this URL).

Background: Internet based self-management programmes have been shown to be effective for a number of long term conditions, particularly where they have a strong theoretical foundation. This could be particularly important in diabetes as previous studies with face-to-face structured patient education programmes reduced the risk of diabetes-related complications four-fold. Computer based self-management interventions have the potential to provide similar benefits at lower costs in a tailored, interactive and convenient way. However there are currently significant gaps in the literature with unanswered questions about the efficacy, cost-effectiveness and essential/effective components of successful computer based self-management interventions. There are also significant challenges to systematic reviews for complex interventions, especially in the field of behavioural interventions, as interventions are often poorly defined and the theoretical basis is often not clearly stated or incorrectly applied.

Objective: The aim of this work is to devise a protocol for a Cochrane systematic review for computer-based self-management programmes for adults with type 2 diabetes using principles of evidence-based behavioural medicine to try and address these issues.

Methods: The steering group for the systematic review was multi-disciplinary and included a behavioural scientist who provided the expertise for the systematic analysis of a complex behavioural intervention. The methodology for the systematic review is based on the standard Cochrane methodology (available online).

Results: The protocol will be presented, focusing on a recently proposed method for describing the theoretical basis of complex behaviour change interventions. This is much more rigorous than the current practice which is often limited to stating 1 or more theories of behaviour change that were considered in developing the intervention. The method involves 1 or more of following stages:

1. Identify the determinants that drive the health behaviour(s) that is being targeted. The key constructs to define a health behaviour can be explored in more detail and described in terms of 12 domains defined in preceding work cited in the protocol.

2. Identify the behaviour change techniques used by the interventions to change that behaviour(s). The taxonomy used in this work describes 40 different behaviour change techniques to define the active ingredients of a complex behaviour-change intervention.

3. Analyze the interventions and map them back to the appropriate theory. It is possible to review an intervention and analyze in retrospect the theoretical basis for the intervention and assess the extent to which theory has been applied to developing and evaluating it.

The educational content of the self-management programmes will be analyzed using a previously published taxonomy for diabetes education programmes.

Conclusions: This process described above should accurately define the components used in the interventions and any behaviour change theories used in their design. This approach could be applied to complex behaviour change interventions in other fields and could provide clinicians with a more systematic approach to developing and appraising behaviour change interventions delivered through the internet or other means.