Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2018

Open Access 01-12-2018 | Research article

A tailored intervention to promote uptake of retinal screening among young adults with type 2 diabetes - an intervention mapping approach

Authors: Amelia J. Lake, Jessica L. Browne, Charles Abraham, Dee Tumino, Carolyn Hines, Gwyneth Rees, Jane Speight

Published in: BMC Health Services Research | Issue 1/2018

Login to get access

Abstract

Background

Young adults (18–39 years) with type 2 diabetes are at risk of early development and rapid progression of diabetic retinopathy, a leading cause of vision loss and blindness in working-age adults. Retinal screening is key to the early detection of diabetic retinopathy, with risk of vision loss significantly reduced by timely treatment thereafter. Despite this, retinal screening rates are low among this at-risk group. The objective of this study was to develop a theoretically-grounded, evidence-based retinal screening promotion leaflet, tailored to young adults with type 2 diabetes.

Methods

Utilising the six steps of Intervention Mapping, our multidisciplinary planning team conducted a mixed-methods needs assessment (Step 1); identified modifiable behavioural determinants of screening behaviour and constructed a matrix of change objectives (Step 2); designed, reviewed and debriefed leaflet content with stakeholders (Steps 3 and 4); and developed program implementation and evaluation plans (Steps 5 and 6).

Results

Step 1 included in-depth qualitative interviews (N = 10) and an online survey that recruited a nationally-representative sample (N = 227), both informed by literature review. The needs assessment highlighted the crucial roles of knowledge (about diabetic retinopathy and screening), perception of personal risk, awareness of the approval of significant others and engagement with healthcare team, on retinal screening intentions and uptake. In Step 2, we selected five modifiable behavioural determinants to be targeted: knowledge, attitudes, normative beliefs, intention, and behavioural skills. In Steps 3 and 4, the “Who is looking after your eyes?” leaflet was developed, containing persuasive messages targeting each determinant and utilising engaging, cohort-appropriate imagery. In Steps 5 and 6, we planned Statewide implementation and designed a randomised controlled trial to evaluate the leaflet.

Conclusions

This research provides an example of a systematic, evidence-based approach to the development of a simple health intervention designed to promote uptake of screening in accordance with national guidelines. The methods and findings illustrate how Intervention Mapping can be employed to develop tailored retinal screening promotion materials for specific priority populations. This paper has implications for future program planners and is intended to assist those wishing to use Intervention Mapping to create similar theoretically-driven, tailored resources.
Appendix
Available only for authorised users
Literature
1.
Chan JC, Lau ES, Luk AO, Cheung KK, Kong AP, Yu LW, et al. Premature mortality and comorbidities in young-onset diabetes: a 7-year prospective analysis. Am J Med. 2014;127(7):616–24.CrossRefPubMed
2.
Constantino MI, Molyneaux L, Limacher-Gisler F, Al-Saeed A, Luo C, Wu T, et al. Long-term complications and mortality in young-onset diabetes: type 2 diabetes is more hazardous and lethal than type 1 diabetes. Diabetes Care. 2013;36(12):3863–9.CrossRefPubMedPubMedCentral
3.
Zimmet P, Magliano DJ, Herman W, Shaw J. Diabetes: a 21st century challenge. Lancet Diabetes & Endocrinology. 2014;2(1):56–64.CrossRef
4.
Harding J, Shaw JE, Peeters A, Davidson S, Magliano DJ. Age-specific trends from 2000–2011 in all-cause and cause-specific mortality in type 1 and type 2 diabetes: a cohort study of more than one million people. Diabetes Care. 2016;39(6):1018–26.CrossRefPubMed
5.
Tancredi M, Rosengren A, Svensson AM, Kosiborod M, Pivodic A, Gudbjornsdottir S, et al. Excess mortality among persons with type 2 diabetes. N Engl J Med. 2015;373(18):1720–32.CrossRefPubMed
6.
Song SH, Hardisty CA. Early onset type 2 diabetes mellitus: a harbinger for complications in later years—clinical observation from a secondary care cohort. QJM. 2009;102(11):799–806.CrossRefPubMed
7.
Dart AB, Martens PJ, Rigatto C, Brownell MD, Dean HJ, Sellers EA. Earlier onset of complications in youth with type 2 diabetes. Diabetes Care. 2014;37(2):436–43.CrossRefPubMed
8.
Al-Saeed AH, Constantino MI, Molyneaux L, D’Souza M, Limacher-Gisler F, Luo C, et al. An inverse relationship between age of type 2 diabetes onset and complication risk and mortality: the impact of youth-onset type 2 diabetes. Diabetes Care. 2016;39:823–9.CrossRefPubMed
9.
Leasher JL, Bourne RAA, Flaxman SR, Jonas JB, Keeffe J, Naidoo K, et al. Global estimates on the number of people blind or visually impaired by diabetic retinopathy: a meta-analysis from 1990 to 2010. Diabetes Care. 2016;39:1643–9.CrossRefPubMed
10.
Wong J, Molyneaux L, Constantino M, Twigg SM, Yue DK. Timing is everything: age of onset influences long-term retinopathy risk in type 2 diabetes, independent of traditional risk factors. Diabetes Care. 2008;31(10):1985–91.CrossRefPubMedPubMedCentral
11.
Ferris FL. How effective are treatments for diabetic retinopathy? JAMA : the journal of the American Medical Association. 1993;269(10):1290–1.CrossRefPubMed
12.
13.
American Diabetes Association. Standards of care: microvascular complications and foot care. Diabetes Care. 2017;40(Suppl 1):88–98.CrossRef
14.
15.
Scanlon PH, Stratton IM, Leese GP, Bachmann MO, Land M, Jones C, et al. Screening attendance, age group and diabetic retinopathy level at first screen. Diabet Med. 2016;33(7):904–11.CrossRefPubMed
16.
Wang SY, Andrews CA, Gardner TW, Wood M, Singer K, Stein JD. Ophthalmic screening patterns among youths with diabetes enrolled in a large US managed care network. JAMA Ophthalmology. 2017;35(5):432–8.CrossRef
17.
18.
Savage S, Dabkowski S, Dunning T. The education and information needs of young adults with type 2 diabetes: a qualitative study. J Nurs Healthcare Chronic Illn. 2009;1(4):321–30.CrossRef
19.
Forward H, Hewitt AW, Mackey DA. Missing X and Y: a review of participant ages in population-based eye studies. Clin Exp Ophthalmol. 2012;40(3):305–19.CrossRefPubMed
20.
Browne JL, Scibilia R, Speight J. The needs, concerns, and characteristics of younger Australian adults with type 2 diabetes. Diabet Med. 2013;30(5):620–6.CrossRefPubMed
21.
Song SH. Young-onset type 2 diabetes - time to realign clinical priorities. Int J Diabetes Clin Res. 2015;2:39.CrossRef
22.
MacLennan PA, McGwin G, Heckemeyer C, et al. Eye care use among a high-risk diabetic population seen in a public hospital’s clinics. JAMA Ophthalmol. 2014;132(2):162–7.CrossRefPubMedPubMedCentral
23.
Wilmot E, Idris I. Early onset type 2 diabetes: risk factors, clinical impact and management. Ther Adv in Chronic Dis. 2014;5(6):11.CrossRef
24.
Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M. Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008;337:a1655.CrossRefPubMedPubMedCentral
25.
Bartholomew Eldredge LK, Markham CM, Ruiter RAC, Fernandez ME, Kok G, Parcel GS. Planning health promotion programs : an intervention mapping approach. 4th ed. San Francisco: Jossey-Bass; 2016.
26.
27.
Ball GD, Mushquash AR, Keaschuk RA, Ambler KA, Newton AS. Using intervention mapping to develop the parents as agents of change (PAC) intervention for managing pediatric obesity. BMC Res Notes. 2017;10(1):43.CrossRefPubMedPubMedCentral
28.
Hurley DA, Murphy LC, Hayes D, Hall AM, Toomey E, McDonough SM, et al. Using intervention mapping to develop a theory-driven, group-based complex intervention to support self-management of osteoarthritis and low back pain (SOLAS). Implement Sci. 2016;11:56.CrossRefPubMedPubMedCentral
29.
Gray-Burrows KA, Day PF, Marshman Z, Aliakbari E, Prady SL, McEachan RRC. Using intervention mapping to develop a home-based parental-supervised toothbrushing intervention for young children. Implement Sci. 2016;11:61.CrossRefPubMedPubMedCentral
30.
Song M, Choi S, Kim S-a, Seo K, Lee SJ. Intervention mapping protocol for developing a theory-based diabetes self-management education program. Res Theory Nurs Pract. 2015;29(2):94–112.CrossRefPubMed
31.
Newby KV, Brown KE, Bayley J, Kehal I, Caley M, Danahay A, et al. Development of an intervention to increase sexual health service uptake by young people. Health Promot Pract. 2017;18(3):391–9.CrossRefPubMed
32.
Garba RM, Gadanya MA. The role of intervention mapping in designing disease prevention interventions: a systematic review of the literature. PLoS One. 2017;12(3):e0174438.CrossRefPubMedPubMedCentral
33.
Elliott LR, White MP, Taylor AH, Abraham C. How do brochures encourage walking in natural environments in the UK? A content analysis. Health Promot Int. 2016;33(2):299–310.
34.
Hill CA, Abraham C. School-based, randomised controlled trial of an evidence-based condom promotion leaflet. Psychol Health. 2008;23(1):41–56.CrossRefPubMed
35.
Abraham C, Southby L, Quandte S, Krahé B, ven der Sluijs W. What's in a leaflet? Identifying research-based persuasive messages in European alcohol-education leaflets. Psychol Health. 2007;22(1):31–60.CrossRef
36.
Krahé B, Abraham C, Scheinberger-Olwig R. Can safer-sex promotion leaflets change cognitive antecedents of condom use? An experimental evaluation. Br J Health Psychol. 2005;10:203–20.CrossRefPubMed
37.
Stewart D, Wilson R, Selby P, Darbyshire J. Patient and public involvement. Ann Oncol. 2011;22(Suppl 7):54–6.CrossRef
38.
Elam AR, Lee PP. High-risk populations for vision loss and eye care underutilization: a review of the literature and ideas on moving forward. Surv Ophthalmol. 2013;58(4):348–58.CrossRefPubMed
39.
Koelmeyer RL, Dharmage SC, English DR. Diabetes in young adult men: social and health-related correlates. BMC Public Health. 2016;16(S3):63–9.CrossRefPubMedCentral
40.
Browne JL, Nefs G, Pouwer F, Speight J. Depression, anxiety and self-care behaviours of young adults with type 2 diabetes: results from the international diabetes management and impact for long-term empowerment and success (MILES) study. Diabet Med. 2014;32(1):133–40.CrossRefPubMed
41.
Hessler DM, Fisher L, Mullan JT, Glasgow RE, Masharani U. Patient age: a neglected factor when considering disease management in adults with type 2 diabetes. Patient Educ Couns. 2011;85(2):154–9.CrossRefPubMed
42.
Tuomi T, Santoro N, Caprio S, Cai M, Weng J, Groop L. The many faces of diabetes: a disease with increasing heterogeneity. Lancet. 2014;383(9922):1084–94.CrossRefPubMed
43.
Reyes-Velazquez W, Sealey-Potts C. Unrealistic optimism, sex, and risk perception of type 2 diabetes onset: implications for education programs. Diabetes Spectr. 2015;28(1):5–9.CrossRefPubMedPubMedCentral
44.
Lake AJ, Browne JL, Rees G, Speight J. What factors influence uptake of retinal screening among young adults with type 2 diabetes? A qualitative study informed by the theoretical domains framework. J Diabetes Complicat. 2017;31(6):997–1006.CrossRefPubMed
45.
Owen KR. Treating young adults with type 2 diabetes or monogenic diabetes. Best Pract Res Clin Endocrinol Metab. 2016;30(3):455–67.CrossRefPubMed
46.
Zeitler P, Chou HS, Copeland KC, Geffner M. Clinical trials in youth-onset type 2 diabetes: needs, barriers, and options. Current Diabetes Reports. 2015;15(5):1–8.CrossRef
47.
Nguyen TT, Jayadeva V, Cizza G, Brown RJ, Nandagopal R, Rodriguez LM, et al. Challenging recruitment of youth with type 2 diabetes into clinical trials. J Adolesc Health. 2014;54(3):247–54.CrossRefPubMed
48.
Cane J, O'Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012;7(1):37.CrossRefPubMedPubMedCentral
49.
Fisher WA, Fisher JD, Harman J. The information–motivation–behavioral skills model: a general social psychological approach to understanding and promoting health behavior. In: Sulls J, Walston KA, editors. Social psychological foundations of health and illness. Oxford: Blackwell Publishing Ltd; 2003. p. 82–106.CrossRef
50.
Fisher J, Fisher WA, Bryan AD, Misovich SJ. Information-motivation-behavioral skills model-based HIV risk behavior change intervention for inner-city high school youth. Health Psychol. 2002;21(2):177–86.CrossRefPubMed
51.
Misovich SJ, Martinez T, Fisher JD, Bryan A, Catapano N. Predicting breast self-examination: a test of the information-motivation-behavioral skills model. J Appl Soc Psychol. 2003;33(4):775–90.CrossRef
52.
Osborn CY, Egede LE. Validation of an information-motivation-behavioral skills model of diabetes self-care (IMB-DSC). Patient Educ Couns. 2010;79(1):49–54.CrossRefPubMed
53.
Mayberry LS, Osborn CY. Empirical validation of the information-motivation-behavioral skills model of diabetes medication adherence: a framework for intervention. Diabetes Care. 2014;37(5):1246–53.CrossRefPubMedPubMedCentral
54.
Fishbein M, Ajzen I. Predicting and changing behaviour: the reasoned action approach. New York: Psychology Press; 2010.
55.
Turner KM, Percival J, Dunger DB, Olbers T, Barrett T, Shield JPH. Adolescents’ views and experiences of treatments for type 2 diabetes: a qualitative study. Diabet Med. 2015;32(2):250–6.CrossRefPubMed
56.
57.
Freijy T, Kothe EJ. Dissonance-based interventions for health behaviour change: a systematic review. Br J Health Psychol. 2013;18:310–37.CrossRefPubMed
58.
59.
Bailey SC, Brega AG, Crutchfield TM, Elasy T, Herr H, Kaphingst K, et al. Update on health literacy and diabetes. The Diabetes educator. 2014;40:581–604.CrossRefPubMedPubMedCentral
60.
Beard E, Clark M, Hurel S, Cooke D. Do people with diabetes understand their clinical marker of long-term glycemic control (HbA1c levels) and does this predict diabetes self-care behaviours and HbA1c? Patient Educ Couns. 2010;80(2):227–32.CrossRefPubMed
61.
Werrij MQ, Ruiter RAC, van't Riet J, de Vries H. Message framing. In: Abraham C, Kools M, editors. Writing health communication: an evidence based guide. London: SAGE; 2012. p. 134–43.
62.
Muller BC, Ritter SM, Glock S, Dijksterhuis A, Engels RC, van Baaren RB. Smoking-related warning messages formulated as questions positively influence short-term smoking behaviour. J Health Psychol. 2014;21(1):60–8.CrossRefPubMed
63.
Cialdini RB, Goldstein NJ. Social influence: compliance and conformity. Annu Rev Psychol. 2004;55:591–621.CrossRefPubMed
64.
Abraham C, Kools M. Writing health communication: an evidence-based guide. London: Sage; 2012.
65.
Abraham C. In: Abraham C, Kools M, editors. Mapping change mechanisms onto behaviour change techniques: a systematic approach to promoting behaviour change through text, in: writing health communication: an evidence based guide. London: SAGE; 2012.
66.
Abraham C, Michie S. A taxonomy of behavior change techniques used in interventions. Health Psychol. 2008;27(3):379–87.CrossRefPubMed
67.
Ryan L, Logsdon MC, McGill S, Stikes R, Senior B, Helinger B, et al. Evaluation of printed health education materials for use by low-education families. J Nurs Sch. 2014;46(4):218–28.CrossRef
68.
69.
Doak CC, Doak LG, Root JH. Teaching patients with low literacy skills. 2nd ed. Philadelphia: J. B. Lippincott; 1996.
70.
71.
72.
Lawrenson JG, Graham-Rowe E, Lorencatto F, Presseau J, Burr J, Ivers N, Quartilho A, Bunce C, Francis JJ, Grimshaw JM, Peto T, Rice S, Vale L. Interventions to increase attendance for diabetic retinopathy screening (Protocol). Cochrane Database of Systematic Reviews 2016, Issue 1. Art. No.: CD012054. https://​doi.​org/​10.​1002/​14651858.​CD012054.
73.
Zhang X, Norris SL, Saadine J, Chowdhury FM, Horsley T, Kanjilal S, et al. Effectiveness of interventions to promote screening for diabetic retinopathy. Am J Prev Med. 2007;33(4):318–35.CrossRefPubMed
74.
Michie S, Abraham C, editors. Health psychology in practice, vol. xiv. Malden: Blackwell Pub., British Psychological Society; 2004. p. 416.
75.
Waitzfelder B, Pihoker C, Klingensmith G, Case D, Anderson A, Bell RA, et al. Adherence to guidelines for youths with diabetes mellitus. Pediatrics. 2011;128(3):531–8.PubMedPubMedCentral
76.
Auslander WF, Sterzing PR, Zayas LE, White NH. Psychosocial resources and barriers to self-management in African American adolescents with type 2 diabetes: a qualitative analysis. Diabetes Educator. 2010;36(4):613–22.CrossRefPubMed
77.
Brouwer AM, Salamon KS, Olson KA, Fox MM, Yelich-Koth SL, Fleischman KM, et al. Adolescents and type 2 diabetes mellitus: a qualitative analysis of the experience of social support. Clin Pediatr (Phila). 2012;51(12):1130–9.CrossRef
78.
Sillars BA, Davis WA, Kamber N, Davis TME. The epidemiology and characteristics of type 2 diabetes in urban, community-based young people. Intern Med J. 2010;40(12):850–4.CrossRefPubMed
79.
Greaves CJ, Wingham J, Deighan C, Doherty P, Elliott J, Armitage W, et al. Optimising self-care support for people with heart failure and their caregivers: development of the rehabilitation enablement in chronic heart failure (REACH-HF) intervention using intervention mapping. Pilot Feasibility Stud. 2016;2:37.CrossRefPubMedPubMedCentral
80.
Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ (Clinical Research Ed). 2014;348:g1687.
81.
Speight J, Browne JL, Holmes-Truscott E, Hendrieckx C, Pouwer F. Diabetes MILES--Australia (management and impact for long-term empowerment and success): methods and sample characteristics of a national survey of the psychological aspects of living with type 1 or type 2 diabetes in Australian adults. BMC Public Health. 2012;12:120.CrossRefPubMedPubMedCentral
82.
Nadeau KJ, Anderson BJ, Berg EG, Chiang JL, Chou H, Copeland KC, et al.. Youth-onset type 2 diabetes consensus report: current status, challenges, and priorities. Diabetes Care. 2016;39(9):1635–42.
83.
Moreton RBR, Stratton IM, Chave SJ, Lipinski H, Scanlon PH. Factors determining uptake of diabetic retinopathy screening in Oxfordshire. Diabet Med. 2017;34(7):993–9.CrossRefPubMedPubMedCentral
84.
Foreman J, Keel S, Xie J, Van Wijngaarden P, Taylor HR, Dirani M. Adherence to diabetic eye examination guidelines in Australia: the National eye Health Survey. Med J Aust. 2017;206(9):402–6.CrossRefPubMed
85.
Paksin-Hall A, Dent ML, Dong F, and Ablah E. Factors contributing to diabetes patients not receiving annual dilated eye examinations. Ophthalmic Epidemiol. 2013;20(5):281–7.
86.
Shi Q, Zhao Y, Fonseca V, Krousel-Wood M, Shi L. Racial disparity of eye examinations among the U.S. working-age population with diabetes: 2002-2009. Diabetes Care. 2014;37(5):1321–8.CrossRefPubMedPubMedCentral
87.
Skinner TC, Khunti K, Carey ME, Dallosso H, Heller S, Davies MJ. Stability and predictive utility, over 3 years, of the illness beliefs of individuals recently diagnosed with type 2 diabetes mellitus. Diabet Med. 2014;31(10):1260–3.CrossRefPubMed
88.
Tryggestad JB, Willi SM. Complications and comorbidities of T2DM in adolescents: findings from the TODAY clinical trial. J Diabetes Complicat. 2015;29(2):307–12.CrossRefPubMed
89.
Highfield L, Hartman MA, Mullen PD, Rodriguez SA, Fernandez ME, Bartholomew LK. Intervention Mapping to Adapt Evidence-Based Interventions for Use in Practice: Increasing Mammography among African American Women. Biomed Res Int. 2015;2015:160103.
Metadata
Title
A tailored intervention to promote uptake of retinal screening among young adults with type 2 diabetes - an intervention mapping approach
Authors
Amelia J. Lake
Jessica L. Browne
Charles Abraham
Dee Tumino
Carolyn Hines
Gwyneth Rees
Jane Speight
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2018
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-018-3188-5

Other articles of this Issue 1/2018

BMC Health Services Research 1/2018 Go to the issue

Research article

Evidence to service gap: cardiac rehabilitation and secondary prevention in rural and remote Western Australia

Research article

Experiences of primary care physicians and staff following lean workflow redesign

Study protocol

Using NIATx strategies to implement integrated services in routine care: a study protocol

Research article

Demand for health care service and associated factors among patients in the community of Tsegedie District, Northern Ethiopia

Research article

Socio-demographic and clinical characteristics of type 1 diabetes patients associated with emergency room visits and hospitalizations in Mexico

Research article

The effectiveness of treatment for Severe Acute Malnutrition (SAM) delivered by community health workers compared to a traditional facility based model