Table 1 Application of the HAPA model and behavioral change techniques used for the SSP development
HAPA model component | Components used in the SSP | Used behavioral change techniques |
|---|---|---|
Risk awareness, outcome-expectancy, self-efficacy | - Information and education about T2DM in general and personalized to patients’ current health situation. | - Provide information on consequences of behavior in general/to the individual. |
- Model/Demonstrate the behavior. | ||
- Overview of patients’ personal clinical results. | - Prompt self-monitoring of behavioral outcome. | |
- Patients’ clinical measures are compared to norm values and GPs’ advice, showed in a table and in a graph. | - Prompt review of outcome goals. | |
- Information about the clinical measurements and information on behaviors that influence these clinical measurements. | - Provide information on consequences of behavior in general/to the individual. | |
- Provide instruction on how to perform the behavior. | ||
- Model/Demonstrate the behavior. | ||
- Patients can fill-in a motivation why they want to change their behavior. | - Motivational interviewing. | |
Goal setting | - Patients are guided to choose a goal from a list of 4 behavioral goals (diet, exercise, medication & stop smoking) | - Goal setting (behavior). |
Action planning, Self-efficacy | - Patients are guided to create a behavioral action-plan for the chosen goal. (Patients receive instructions and examples of action-planning in the SSP). | - Action planning. |
- Provide instruction on how to perform the behavior. | ||
- Facilitate social comparison. | ||
- Set graded tasks. | ||
- Intervention group only: Patients’ action-plan is send to a coach for feedback. The coach provides feedback (message in the SSP) on the process of action-planning, not on medical subjects. After receiving the feedback, patients are prompted to start the planned behavior. | - Provide feedback on performance. | |
| Â | - Patients are prompted to start the planned behavior. | - Use of follow-up prompts. |
Self-efficacy, Maintenance | - Patients receive reminders and encouragements via text-messaging and e-mail. | - Use of follow-up prompts. |
- Relapse prevention. | ||
- Patients receive a reminder to return to the ICP and evaluate their action plan. | - Set graded tasks. | |
- Barrier identification/problem solving. | ||
- Use of follow-up prompts. | ||
- Provide feedback on performance. | ||
- Patients can fill in outcome measurements in the ICP | - Prompt self-monitoring of behavior/behavioral outcome. | |
- Prompt review of behavioral goals/outcome goals. | ||
| Â | - Intervention group only: Patients can ask for feedback from a coach. | - Provide feedback on performance. |