BACKGROUND Familial hypercholesterolaemia (FH) is a genetic condition characterised by elevated levels of low-density lipoprotein cholesterol (LDL-C) and an increased risk of cardiovascular disease (CVD). Following dietary and physical activity guidelines could help minimise this risk but adherence is low. Interventions to target these behaviours are therefore required. A comprehensive understanding of the target behaviours and behaviour change theory should drive the process of intervention development to increase intervention effectiveness and scalability. This paper describes the application of a theoretical framework to the findings of a qualitative evidence synthesis (QES) to inform the content and delivery of an intervention to improve adherence to dietary and physical activity guidelines in individuals with FH. METHODS The Behaviour Change Wheel (BCW) was used to guide intervention development. Factors influencing dietary and physical activity behaviours were identified from an earlier QES and mapped onto factors within the BCW. A comprehensive behavioural diagnosis of these factors was conducted through application of the theoretical domains framework (TDF). Using these data, the most appropriate intervention functions and behaviour change techniques (BCTs) for inclusion in the intervention were identified. Decision making was guided by evaluation criteria recommended by BCW guidance and feedback from individuals with FH. RESULTS Factors influencing dietary and physical activity behaviours mapped onto twelve of the fourteen TDF domains, with seven intervention functions deemed suitable to target the domains' theoretical constructs. Twenty-six BCTs were identified as being appropriate for delivery within these functions and were included in the intervention. For instance, within the enablement intervention function, the BCT problem solving was incorporated by inclusion of a 'barriers and solutions' section. Guided by evaluation criteria and feedback from individuals with FH, the intervention will be delivered as an hour-long family-based appointment, followed up with four telephone calls. CONCLUSIONS The novel application of the BCW and TDF to the results of a QES has enabled the development of a theory and evidence informed behaviour change intervention. This systematic approach facilitates evaluation of the intervention as part of an ongoing feasibility trial. The transparent approach taken can be used to guide intervention development by researchers in other fields.

中文翻译：

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开发一种理论指导的行为改变干预措施，以提高家族性高胆固醇血症 (FH) 患者对饮食和身体活动治疗指南的依从性。


背景技术家族性高胆固醇血症(FH)是一种遗传性疾病，其特征是低密度脂蛋白胆固醇(LDL-C)水平升高和心血管疾病(CVD)风险增加。遵循饮食和身体活动指南可能有助于最大限度地降低这种风险，但依从性较低。因此需要针对这些行为进行干预。对目标行为和行为改变理论的全面理解应该推动干预的发展过程，以提高干预的有效性和可扩展性。本文描述了理论框架在定性证据综合（QES）结果中的应用，以告知干预措施的内容和实施，以提高 FH 个体对饮食和身体活动指南的依从性。方法 行为改变轮（BCW）用于指导干预措施的制定。影响饮食和身体活动行为的因素是从早期的 QES 中确定的，并映射到 BCW 中的因素。通过应用理论领域框架（TDF）对这些因素进行了全面的行为诊断。利用这些数据，确定了纳入干预的最合适的干预功能和行为改变技术（BCT）。决策制定以 BCW 指南推荐的评估标准和 FH 患者的反馈为指导。结果影响饮食和身体活动行为的因素映射到 14 个 TDF 领域中的 12 个，其中 7 个干预功能被认为适合针对这些领域的理论结构。 26 个 BCT 被认为适合在这些职能范围内实施，并被纳入干预措施中。 例如，在支持干预功能中，通过纳入“障碍和解决方案”部分，将 BCT 问题解决纳入其中。在评估标准和 FH 患者反馈的指导下，干预措施将通过为期一小时的家庭预约进行，随后会打四次电话。结论 BCW 和 TDF 对 QES 结果的新颖应用促进了基于理论和证据的行为改变干预措施的发展。这种系统方法有助于对干预措施进行评估，作为正在进行的可行性试验的一部分。所采取的透明方法可用于指导其他领域的研究人员开发干预措施。