lake-atailoredintervention-2018.pdf (2.35 MB)
A tailored intervention to promote uptake of retinal screening among young adults with type 2 diabetes - an intervention mapping approach
journal contribution
posted on 2018-05-01, 00:00 authored by Amelia Lake, J L Browne, Charles AbrahamCharles Abraham, Dee Tumino, Carolyn Hines, Gwyneth Rees, Jane SpeightJane SpeightBACKGROUND: Young adults (18-39 years) with type 2 diabetes are at risk of early development and rapid progression of diabetic retinopathy, a leading cause of vision loss and blindness in working-age adults. Retinal screening is key to the early detection of diabetic retinopathy, with risk of vision loss significantly reduced by timely treatment thereafter. Despite this, retinal screening rates are low among this at-risk group. The objective of this study was to develop a theoretically-grounded, evidence-based retinal screening promotion leaflet, tailored to young adults with type 2 diabetes. METHODS: Utilising the six steps of Intervention Mapping, our multidisciplinary planning team conducted a mixed-methods needs assessment (Step 1); identified modifiable behavioural determinants of screening behaviour and constructed a matrix of change objectives (Step 2); designed, reviewed and debriefed leaflet content with stakeholders (Steps 3 and 4); and developed program implementation and evaluation plans (Steps 5 and 6). RESULTS: Step 1 included in-depth qualitative interviews (N = 10) and an online survey that recruited a nationally-representative sample (N = 227), both informed by literature review. The needs assessment highlighted the crucial roles of knowledge (about diabetic retinopathy and screening), perception of personal risk, awareness of the approval of significant others and engagement with healthcare team, on retinal screening intentions and uptake. In Step 2, we selected five modifiable behavioural determinants to be targeted: knowledge, attitudes, normative beliefs, intention, and behavioural skills. In Steps 3 and 4, the "Who is looking after your eyes?" leaflet was developed, containing persuasive messages targeting each determinant and utilising engaging, cohort-appropriate imagery. In Steps 5 and 6, we planned Statewide implementation and designed a randomised controlled trial to evaluate the leaflet. CONCLUSIONS: This research provides an example of a systematic, evidence-based approach to the development of a simple health intervention designed to promote uptake of screening in accordance with national guidelines. The methods and findings illustrate how Intervention Mapping can be employed to develop tailored retinal screening promotion materials for specific priority populations. This paper has implications for future program planners and is intended to assist those wishing to use Intervention Mapping to create similar theoretically-driven, tailored resources.
History
Journal
BMC health services researchVolume
18Article number
396Pagination
1 - 18Publisher
BioMed CentralLocation
London, Eng.Publisher DOI
Link to full text
eISSN
1472-6963Language
engPublication classification
C1 Refereed article in a scholarly journalCopyright notice
2018, The AuthorsUsage metrics
Keywords
Diabetic retinopathyHealth behaviour changeIntervention mappingNeeds assessmentRetinal screeningType 2 diabetesYoung adultsYoung-onsetScience & TechnologyLife Sciences & BiomedicineHealth Care Sciences & ServicesSELF-CARE BEHAVIORSSKILLS MODELONSETMORTALITYAGECOMPLICATIONSADOLESCENTSYOUTHRISKRETINOPATHYLibrary and Information Studies
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