{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T18:07:24Z","timestamp":1788890844561,"version":"build-2803163510"},"reference-count":61,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":96,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Arthritis Society Doctoral Award, the Canadian Behavioural Trials"},{"name":"Interventions Network"},{"name":"Ontario Graduate Student Award and the Bone and Joint Institute Transdisciplinary"},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Canada Research Chair in Musculoskeletal Health Outcomes and Knowledge Translation"},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["#167284"],"award-info":[{"award-number":["#167284"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hand osteoarthritis (HOA) is a common and disabling condition that impairs hand function. Traditional joint protection programs (JPPs) are recommended for reducing pain and deformity and potentially slowing disease progression. While JPPs are supported by trials, programs are outdated, not co-designed and poorly implemented. Behavioral science frameworks and patient co-design methodologies may enhance relevance, adherence, effectiveness, and sustainability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to map and characterize the behavioral components of JPPs for adults with HOA and to examine the extent of patient co\u2011design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a scoping review with directed content analysis following Arksey and O\u2019Malley\u2019s framework. We used the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) reporting guidelines. Six databases and 1 clinical-trial registry were searched from inception to April 3, 2025. Eligible studies included any empirical design that included interventions described as \u201cjoint protection\u201d or clearly aligned with its core components for adults with HOA. Two reviewers independently coded intervention content using the Behavior Change Technique Taxonomy version 1 and assessed the presence of patient co-design with criteria derived from Experience-Based Co-Design frameworks. Discrepancies were resolved by consensus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 32 studies met the inclusion criteria. We identified 22 unique behavioral change techniques across 11 clusters. \u201cInstruction on how to perform the behavior\u201d was the most common item (32 studies, 100%), followed by \u201cBehavior substitution\u201d (23 studies, 72%) and \u201cRestructuring the Physical Environment\u201d (17 studies, 53%). Patient co-design was explicitly integrated in 8 studies, with varying methods and levels of engagement. In most cases, patient input was included during the intervention design stage, while only a few studies involved patients in iterative feedback and refinement. Only 1 study combined theoretically informed behavioral content with active patient co-design, highlighting a substantial gap in the development of JPPs for HOA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most JPPs for HOA incorporate behavioral change techniques but rarely systematically apply behavior change theory, clearly articulate behavioral change mechanisms or engage patients meaningfully in co-design. Integrating established behavioral frameworks with authentic patient co\u2011design could yield interventions that are both relevant and sustainable. Future programs development should embed systematic behavioral theory and genuine patient partnership from conception through refinement to support durable behavior change in people with HOA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/abm\/kaag011","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T12:35:29Z","timestamp":1773146129000},"source":"Crossref","is-referenced-by-count":2,"title":["Behavioral change techniques and patient co-design in programs for hand osteoarthritis: a scoping review with directed content analysis"],"prefix":"10.1093","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0730-0610","authenticated-orcid":false,"given":"Dimitra V","family":"Pouliopoulou","sequence":"first","affiliation":[{"name":"School of Physical Therapy, Health and Rehabilitation Sciences, Western University , London, Ontario N6A 3K7,","place":["Canada"]},{"name":"Roth | McFarlane Hand and Upper Limb Centre, St Joseph\u2019s 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