Development of a Theoretically Informed Web-Based Mind-Body Wellness Intervention for Patients With Primary Biliary Cholangitis: Formative Study.

John C Spence,Puneeta Tandon,Makayla Watt

doi:10.2196/29064

Abstract

BackgroundMind-body interventions have the potential to positively impact the symptom burden associated with primary biliary cholangitis (PBC). Interventions are more likely to be effective if they are informed by a theoretical framework. The Behaviour Change Wheel (BCW) and the behaviour change technique taxonomy version 1 (BCTv1) provide frameworks for intervention development.ObjectiveThis study describes how theory has guided the development of a 12-week multicomponent mind-body wellness intervention for PBC.MethodsThe steps involved in developing the BCW intervention included specifying the target behavior; explaining barriers and facilitators using the Capability, Opportunity, Motivation, and Behaviour and the theoretical domains framework; identifying intervention functions to target explanatory domains; and selecting relevant behavior change techniques to address intervention functions. Qualitative data from patients with inflammatory bowel disease using an earlier version of the program and feedback from a PBC patient advisory team were used to guide intervention development.ResultsBarriers and facilitators to intervention participation associated with capability, opportunity, and motivation were identified. Intervention functions and behavior change techniques were identified to target each barrier and facilitator.ConclusionsThe Peace Power Pack PBC intervention was developed to help individuals with PBC manage their symptom burden. The theoretical frameworks employed in this intervention provide direction on targeting antecedents of behavior and allow standardized reporting of intervention components.Trial RegistrationClinicalTrials.gov NCT04791527; https://clinicaltrials.gov/ct2/show/NCT04791527

Highlights

Primary biliary cholangitis (PBC) is a female predominant chronic liver disease estimated to affect between 9000 and 11,000 Canadians [1]
This paper describes how theory has guided the development of a 12-week multicomponent mind-body wellness intervention for primary biliary cholangitis (PBC) (ClinicalTrials.gov NCT04791527) using several theoretical constructs: Behaviour Change Wheel (BCW) guidelines [16], the COM-B model [16], the theoretical domains framework (TDF) [20], and the behaviour change technique taxonomy version 1 (BCTv1) [19]
The Peace Power Pack PBC (PPPPBC) intervention was co-developed with a patient advisory team from the Canadian PBC society

Summary

Introduction

Primary biliary cholangitis (PBC) is a female predominant chronic liver disease estimated to affect between 9000 and 11,000 Canadians [1]. Individuals with PBC commonly experience a low health-related quality of life (HRQOL), with 1 study concluding that 35% of individuals with PBC had an https://formative.jmir.org/2021/10/e29064 XSLFO RenderX. Current medical therapies are ineffective at improving PBC-related symptoms or impacting quality of life [5,6,8]. Mind-body wellness interventions have never been trialed in PBC, interventions of this nature have been found to improve fatigue and HRQOL in other chronic diseases [10,11,12]. Mind-body interventions have the potential to positively impact the symptom burden associated with primary biliary cholangitis (PBC). The Behaviour Change Wheel (BCW) and the behaviour change technique taxonomy version 1 (BCTv1) provide frameworks for intervention development

Methods

Results

Discussion

Conclusion