{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T20:00:54Z","timestamp":1780084854916,"version":"3.54.0"},"reference-count":40,"publisher":"BMJ","issue":"5","funder":[{"DOI":"10.13039\/501100007602","name":"Programme Grants for Applied Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007602","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,3,14]]},"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To develop a comprehensive intervention plan for the REDUCE maintenance intervention to support people who have had diabetic foot ulcers (DFUs) to sustain behaviours that reduce reulceration risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Theory-based, evidence-based and person-based approaches to intervention development were used. In phase I of intervention planning, evidence was collated from a scoping review of the literature and qualitative interviews with patients who have had DFUs (n=20). This was used to identify the psychosocial needs and challenges of this population and barriers and facilitators to the intervention\u2019s target behaviours: regular foot checking, rapid self-referral in the event of changes in foot health, graded and regular physical activity and emotional management. In phase II, this evidence was combined with expert consultation to develop the intervention plan. Brief \u2018guiding principles\u2019 for shaping intervention development were created. \u2018Behavioural analysis\u2019 and \u2018logic modelling\u2019 were used to map intervention content onto behaviour change theory to comprehensively describe the intervention and its hypothesised mechanisms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Key challenges to the intervention\u2019s target behaviours included patients\u2019 uncertainty regarding when to self-refer, physical limitations affecting foot checking and physical activity and, for some, difficulties managing negative emotions. Important considerations for the intervention design included a need to increase patients\u2019 confidence in making a self-referral and in using the maintenance intervention and a need to acknowledge that some intervention content might be relevant to only some patients (emotional management, physical activity). The behavioural analysis identified the following processes hypothesised to facilitate long-term behaviour maintenance including increasing patients\u2019 skills, self-efficacy, knowledge, positive outcome expectancies, sense of personal control, social support and physical opportunity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This research provides a transparent description of the intervention planning for the REDUCE maintenance intervention. It provides insights into potential barriers and facilitators to the target behaviours and potentially useful behaviour change techniques to use in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-019865","type":"journal-article","created":{"date-parts":[[2018,5,19]],"date-time":"2018-05-19T03:10:09Z","timestamp":1526699409000},"page":"e019865","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Intervention planning for the REDUCE maintenance intervention: a digital intervention to reduce reulceration risk among patients with a history of diabetic foot ulcers"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3662-1488","authenticated-orcid":false,"given":"Kate","family":"Greenwell","sequence":"first","affiliation":[{"name":"Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katy","family":"Sivyer","sequence":"additional","affiliation":[{"name":"Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kavita","family":"Vedhara","sequence":"additional","affiliation":[{"name":"Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Yardley","sequence":"additional","affiliation":[{"name":"Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Game","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Derby Teaching Hospitals NHS Foundation Trust, Derby, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trudie","family":"Chalder","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gayle","family":"Richards","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Northern Devon Healthcare NHS Trust, Barnstaple, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikki","family":"Drake","sequence":"additional","affiliation":[{"name":"Podiatry Department, Bristol Community Health, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Derby Teaching Hospitals NHS Foundation Trust, Derby, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Weinman","sequence":"additional","affiliation":[{"name":"Institute of Pharmaceutical Science, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Bradbury","sequence":"additional","affiliation":[{"name":"Centre for Clinical and Community Applications of Health Psychology, University of Southampton, Southampton, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2018,5,18]]},"reference":[{"key":"2025121602571660000_8.5.e019865.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.2.217"},{"key":"2025121602571660000_8.5.e019865.2","unstructured":"NICE. 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