Abstract
Background:
To assess the benefits of telehealth (TH) on decreasing exacerbations and emergency room visits with COPD, it is important to explore the Behaviour Change Techniques (BCTs) associated with TH interventions. BCTs are important strategies which could help to generate and implement effective TH interventions with COPD. This study describes the most common BCTs demonstrated to COPD invited to TH.
Methods:
Included studies were randomized controlled trials (RCTs) and observational single arm pre-post trials that evaluated TH with COPD. A systematic search was performed from the earliest records to May 2019 in CINAHL, MEDLINE (Ovid), Cochrane library, and Embase databases. The Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) guidelines was used to guide the selection process. Two independent reviewers retrieved titles, abstracts, full texts, and completed data extractions. BCTs were extracted from the description of TH found in the included studies. To categorize and summarize BCTs, we used the taxonomy of Abraham and Michie that published in 2008. This taxonomy details 26 BCTs that can be combined in interventions, ranging from the simple provision of information on consequences of one’s behavior to more complex techniques.
Results:
Among 1480 abstracts identified, 93 articles underwent full-text review, and 33 were eligible and included. Twenty-seven were RCTs, and six were pre-post studies. Overall, 16 of BCTs were used within our included studies, out of the 26 possibilities of Abraham and Michie’s taxonomy. The most commonly used technique was to provide information about the consequences. It has been reported in 30/33 studies. The lowest frequent BCTs was prompt barrier identification. It was used only in 6/33 studies. All included articles used four or more BCTs combinations. 27/33 of the studies have the combinations between four BCTs which are provide information about behavior, provide information about consequences, prompt self-monitoring, and provide feedback. All BCTs delivered using video calls, online education martials, online activities and healthcare professional supports.
Conclusions:
TH intervention with COPD used a combination of BCTs. BCTs are essential features of TH interventions with COPD. The current review suggests optimizing the design of TH studies by considering BCTs. The next step will be to evaluate if using more BCTs in TH intervention with COPD will increase the positive impact of TH interventions.
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