Using the Behaviour Change Wheel to co-design a sedentary behaviour intervention in individuals with spinal cord injury
Cooper, D. L.; Warland, A.; Norris, E.; Kilbride, C.; Paddison, S.; Bailey, D. P.
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PurposeThere is a lack of sedentary behaviour interventions for individuals with spinal cord injury. Interventions designed for non-disabled individuals are unlikely to be generalisable to wheelchair-users with paraplegia, meaning a tailored approach is needed. ObjectiveThis study aimed to co-design a sedentary behaviour intervention using the Behaviour Change Wheel (BCW) for manual wheelchair-users with paraplegia. MethodsAn iterative co-design approach was employed across workshops with 10 individuals with paraplegia, 13 healthcare professionals and four community caregivers. Initial workshops focused on barriers and facilitators to reducing and breaking up sedentary behaviour, and possible intervention options. This informed initial intervention concepts, which were mapped to BCW constructs and behaviour change techniques. In follow-up workshops, the acceptability, practicability, effectiveness, affordability, safety/side-effects, and equity of each intervention component was assessed to refine concepts and design an intervention protocol. Data was analysed using the framework method via inductive and deductive coding in context of the BCW. FindingsA multi-component intervention was co-designed and includes (1) a wearable activity tracker to facilitate reminders to be active and give feedback on physical activity, (2) an educational booklet to overcome lack of knowledge around sedentary behaviour, (3) goal setting, (4) one-to-one motivational support from a trained individual, (5) a peer support group and (6) activity tools, including a portable hand cycle and exercise bands. ConclusionsA novel intervention targeting sedentary behaviour has been developed for individuals with paraplegia. The combination of co-design with the BCW likely optimises the interventions acceptability and effectiveness, which now requires evaluation.
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