数字化2型糖尿病自我管理干预在全国推广中的变化卡塔尔世界杯8强波胆分析保真度的混合方法研究%A Benton,Jack S %A Cotterill,Sarah %A Hawkes,Rhiannon E %A Miles,Lisa M %A French,David P %+曼彻斯特大学心理与心理健康学系曼彻斯特健康心理学中心，英国曼彻斯特牛津路库普兰1号楼，M13 9PL, 44 7853986479，jack.benton@manchester.ac.uk %K 2型糖尿病%K健康生活%K数字干预%K行为改变%K自我管理%K忠诚%K实施%K混合方法%K手机%D 2022 %7 7.12.2022 %9原文% jj Med互联网Res %G英语%X“2型糖尿病患者健康生活(HeLP-Diabetes)”是一项基于理论的2型糖尿病患者数字化自我管理干预，鼓励使用行为改变技术(bct)改变行为并促进自我管理。在一项随机对照试验(RCT)中，HeLP-Diabetes可有效降低HbA1c水平。英国国民健康服务体系(NHS)委托在全国范围内推广“帮助糖尿病”的常规护理(现在称为“健康生活”)。健康生活提供了一个独特的机会来检查最初在随机对照试验中测试的干预措施在全国推广的保真度。目的:本研究旨在描述健康生活BCT和自我管理干预交付的内容和特点，比较健康生活与原来的HeLP-Diabetes干预的保真度，并通过定性访谈解释在全国推广过程中保真度漂移的原因。方法:采用新的自我管理任务评估编码框架BCT分类法v1和干预描述与复制模板3个编码框架(目标1)对健康生活进行内容分析。将bct和自我管理任务纳入健康生活的程度与已发表的HeLP-Diabetes描述进行了比较(目标2)。对参与HeLP-Diabetes或健康生活发展的9个利益相关者进行了半结构化访谈，以了解在全国推广期间发生变化的原因(目标3)。使用改进的框架方法对定性数据进行了主题分析。 Results: The content analysis identified 43 BCTs in Healthy Living. Healthy Living included all but one of the self-regulatory BCTs (“commitment”) in the original HeLP-Diabetes intervention. Healthy Living was found to address all areas of self-management (medical, emotional, and role) in line with the original HeLP-Diabetes intervention. However, 2 important changes were identified. First, facilitated access by a health care professional was not implemented; interviews revealed this was because general practices had fewer resources in comparison with the RCT. Second, Healthy Living included an additional structured web-based learning curriculum that was developed by the HeLP-Diabetes team but was not included in the original RCT; interviews revealed that this was because of changes in NHS policy that encouraged referral to structured education. Interviewees described how the service provider had to reformat the content of the original HeLP-Diabetes website to make it more usable and accessible to meet the multiple digital standards required for implementation in the NHS. Conclusions: The national rollout of Healthy Living had good fidelity to the BCT and self-management content of HeLP-Diabetes. Important changes were attributable to the challenges of scaling up a digital intervention from an RCT to a nationally implemented intervention, mainly because of fewer resources available in practice and the length of time since the RCT. This study highlights the importance of considering implementation throughout all phases of intervention development. %M 36476723 %R 10.2196/39483 %U //www.mybigtv.com/2022/12/e39483 %U https://doi.org/10.2196/39483 %U http://www.ncbi.nlm.nih.gov/pubmed/36476723