The development and codesign of the PATHway intervention: a theory-driven eHealth platform for the self-management of cardiovascular disease

Background. Cardiovascular diseases (CVD) are a leading cause of premature death worldwide. International guidelines recommend routine delivery of all phases of cardiac rehabilitation (CR). Uptake of traditional cardiac rehabilitation remains suboptimal, as attendance at formal hospital-based CR programmes is low, with community-based CR rates and individual long-term exercise maintenance even lower. Home-based CR programs have been shown to be equally effective in clinical and health-related quality of life outcomes, and yet are not readily available. Purpose. The aim of the current study was to develop the PATHway intervention (Physical Activity Towards Health) for the self-management of cardiovascular disease. Increasing physical activity in individuals with CVD was the primary behaviour. Methods. The PATHway intervention was theoretically informed by the Behaviour Change Wheel (BCW) and Social Cognitive Theory (SCT). All relevant intervention functions, behaviour change techniques (BCTs) and policy categories were identified and translated into intervention content. Furthermore, a person-centred approach was adopted involving an iterative co-design process and extensive user-testing. Results. Education, enablement, modelling, persuasion, training and social restructuring were selected as appropriate intervention functions. Twenty-two BCTs, linked to the 6 intervention functions and 3 policy categories were identified for inclusion and translated into PATHway intervention content. Conclusions. This paper details the use of the BCW and SCT to develop an eHealth intervention for the self-management of CVD. The systematic and transparent development of the PATHway intervention will facilitate the evaluation of intervention effectiveness and future replication