DEVELOPMENT OF A TAILORED GOAL DIRECTED MOVEMENT INTERVENTION USING A MOVEMENT SENSOR FOR HOSPITALIZED PATIENTS: AN INTERVENTION MAPPING APPROACH

J. Van Grootel¹, P. Bor¹, C. Veenhof¹, K. Valkenet¹

¹University Medical Centre Utrecht, Rehabilitation, Physical Therapy Science and Sport, Utrecht, Netherlands

Background: Behavioral change is needed to decrease the time lying in bed for hospitalized patients. Goal setting and self-monitoring in combination with the use of movement sensors have proven to be effective in increasing levels of physical activity. Development of a tailored goal directed movement intervention can be supported by the use of theories and involving all stakeholders following the steps of Intervention Mapping (IM).

Purpose: To give a thorough insight in the development and evaluation parameters of a tailored goal directed movement intervention using IM, to improve physical activity in hospitalized patients.

Methods: A qualitative study was conducted on two wards at the University Medical Centre of Utrecht between February 2022 and February 2023. IM was used as a six-step framework for intervention development. A needs assessment has been carried out by focus groups with nurses, physical therapists and doctors. The Consolidated Framework for Implementation Research was used to map the focus group results. The outcomes and objectives were identified following the Theoretical Domains Framework. The intervention was systematically developed following extensive conversations with all stakeholders and its implementation was pilot tested. The taxonomy of Proctor was used to reflect on implementation- and service outcomes. The Net Promotor Score was used to reflect on patients’ satisfaction. The movement sensor PAM AM400 accelerometer is available in this study for measuring physical activity in usual care in hospitalized patients.

Results: A total of seven focus groups were conducted with a total of 50 healthcare professionals. A total of seven performance objectives were formulated. The movement intervention should consist of three main domains following the Theoretical Domains Framework; behavioral regulation, goal setting and environmental context and resources. These domains were subsequently linked to existing Behavioral Change Techniques, namely: feedback and monitoring, goals and planning and associations and antecedents. The implementation is divided in three main components; skills (and repetition), social/professional role and identity and distribution of the movement sensor.

Conclusions: A tailored goal directed movement intervention including a movement sensor to improve physical activity in hospitalized patients must among others involve changes in the hospital environment. Therefore, this intervention consists of movement posters and walking routes on the ward. All stakeholders needed to be involved, clinical instructions and protocols for healthcare professionals were developed and key users were assigned. Movement behavior was measured using a movement sensor.

Implications: Physical inactivity is frequently observed in hospitalized patients, implementation of a tailored goal directed movement intervention is likely to overcome this problem. The most important factors of a tailored goal directed movement intervention are goal setting, feedback, skills and the environment of the ward. The whole organization from patient to doctor should be taken into account. Further research should reflect on patients’ opinion about this intervention.

Funding acknowledgements: No funding

Keywords:
Physical activity
Hospitalization
Accelerometer

Topics:
Research methodology, knowledge translation & implementation science
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: University Medical Centre of Utrecht, The Netherlands

Committee: METC Utrecht

Ethics number: 22-537