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Healthcare 2016, 4(1), 10;

Developing a Complex Educational–Behavioural Intervention: The TREAT Intervention for Patients with Atrial Fibrillation

School of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
University of Birmingham Institute of Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, UK
Department of Psychology, University of Malta, Msida MSD 2080, Malta
Author to whom correspondence should be addressed.
Academic Editor: Sampath Parthasarathy
Received: 26 October 2015 / Revised: 4 January 2016 / Accepted: 5 January 2016 / Published: 14 January 2016
(This article belongs to the Special Issue Health Psychology in Healthcare Settings)
Full-Text   |   PDF [768 KB, uploaded 14 January 2016]   |  


This article describes the theoretical and pragmatic development of a patient-centred intervention for patients with atrial fibrillation (AF). Theoretical models (Common Sense Model, Necessity-Concerns Framework), clinical frameworks, and AF patient feedback contributed to the design of a one-off hour-long behaviour-change intervention package. Intervention materials consisted of a DVD, educational booklet, diary and worksheet, which were patient-centred and easy to administer. The intervention was evaluated within a randomised controlled trial. Several “active theoretical ingredients” were identified (for e.g., where patients believed their medication was less harmful they spent more time within the therapeutic range (TTR), with general harm scores predicting TTR at 6 months). Allowing for social comparison and adopting behaviour change techniques enabled accurate patient understanding of their condition and medication. The process of developing the intervention using theory-derived content and evaluation tools allowed a greater understanding of the mechanisms by which this intervention was successful. Alleviating concerns about treatment medication by educating patients can help to improve adherence. This process of intervention development could be adopted for a range of chronic illnesses and treatments. Critical elements should include the use of: (1) clinical guidelines; (2) appropriate theoretical models; (3) patient input; and (4) appropriate evaluation tools. View Full-Text
Keywords: common-sense model; intervention; necessity-concerns; atrial fibrillation; anticoagulation common-sense model; intervention; necessity-concerns; atrial fibrillation; anticoagulation

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Clarkesmith, D.E.; Pattison, H.M.; Borg Xuereb, C.; Lane, D.A. Developing a Complex Educational–Behavioural Intervention: The TREAT Intervention for Patients with Atrial Fibrillation. Healthcare 2016, 4, 10.

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