Improving cardiovascular health in patients with an abdominal aortic aneurysm: development of the cardiovascular risk reduction in patients with aneurysms (CRISP) behaviour change intervention

Tom M. Withers; Colin J. Greaves; Matt J. Bown; Athanasios Saratzis

doi:10.1186/s40814-024-01445-z

Improving cardiovascular health in patients with an abdominal aortic aneurysm: development of the cardiovascular risk reduction in patients with aneurysms (CRISP) behaviour change intervention

Tom M. Withers, Colin J. Greaves, Matt J. Bown, Athanasios Saratzis^*

^*Corresponding author for this work

Sport, Exercise and Rehabilitation Sciences

Research output: Contribution to journal › Article › peer-review

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Abstract

Background: Abdominal aortic aneurysm (AAA) is an important cardiovascular health problem. Ultrasound screening is proven to reduce AAA mortality and programmes have been implemented in some healthcare systems. Those who are identified as having a small AAA in screening enter into a surveillance programme to monitor AAA size. Individuals in AAA surveillance are at elevated risk of cardiovascular events, which is not currently addressed sufficiently. We aimed to develop a simple intervention to reduce cardiovascular risk, which could be embedded in AAA surveillance pathways.

Methods: Intervention mapping methods were used to co-develop the intervention with individuals with AAA, families/carers, and healthcare staff. We identified “targets for change” by synthesising research evidence and international guidelines and consulting with patients, caregivers and health service providers. We conducted a series of workshops to identify barriers to and facilitators of change and used taxonomies of behaviour change theories and techniques to match intervention strategies to each target. Further stakeholder involvement work helped refine the intervention.

Results: The developed intervention focusses on assessment and individually tailored discussion of risk factors, exchanging information, building motivation and action planning, followed by review of progress and problem-solving. Workbooks covering physical activity, diet, stress management, alcohol, smoking, blood pressure and mental health are provided to support behaviour change. The intervention is facilitated by trained healthcare professionals during the patient’s AAA screening appointment for the duration that they are in surveillance.

Discussion: The developed intervention will now be tested to assess whether it can be integrated with the current AAA screening programme. The developed intervention is a novel approach to reducing cardiovascular disease in the AAA population, it is also the first intervention which tries to do this in this population.

Trial registration: International Clinical Trial Registration: ISRCTN93993995.

Original language	English
Article number	17
Number of pages	11
Journal	Pilot and Feasibility Studies
Volume	10
Issue number	1
DOIs	https://doi.org/10.1186/s40814-024-01445-z
Publication status	Published - 29 Jan 2024

Bibliographical note

Funding:
This research was approved by the NHS Wales Research Ethics Committee 7 (NHS Wales REC 7) and the NHS Health Research Authority (HRA) in January 2020 (reference: 19/EM/0366). The research was funded by the National Institute for Health and Care Research (NIHR) Academy (reference: NIHR300059) and sponsored by the University of Leicester (reference: 0479); the funder and sponsor had no input in data collection, analysis or interpretation. Participants provided written informed consent upon recruitment.

Publisher Copyright:
© 2024, The Author(s).

Keywords

Intervention development
Intervention mapping
Abdominal aortic aneurysm

ASJC Scopus subject areas

Medicine (miscellaneous)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1186/s40814-024-01445-zLicence: Creative Commons: Attribution (CC BY)

WithersT2024ImprovingFinal published version, 2.08 MBLicence: Creative Commons: Attribution (CC BY)

Cardiovascular Risk reduction In the NHS abdominal aortic aneurysm (AAA) Screening Programme: a co-developed cardiovascular prevention intervention (the CRISP study)
Greaves, C.
NIHR
1/04/20 → 31/03/24
Project: Other Government Departments

Cite this

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title = "Improving cardiovascular health in patients with an abdominal aortic aneurysm: development of the cardiovascular risk reduction in patients with aneurysms (CRISP) behaviour change intervention",

abstract = "Background: Abdominal aortic aneurysm (AAA) is an important cardiovascular health problem. Ultrasound screening is proven to reduce AAA mortality and programmes have been implemented in some healthcare systems. Those who are identified as having a small AAA in screening enter into a surveillance programme to monitor AAA size. Individuals in AAA surveillance are at elevated risk of cardiovascular events, which is not currently addressed sufficiently. We aimed to develop a simple intervention to reduce cardiovascular risk, which could be embedded in AAA surveillance pathways. Methods: Intervention mapping methods were used to co-develop the intervention with individuals with AAA, families/carers, and healthcare staff. We identified “targets for change” by synthesising research evidence and international guidelines and consulting with patients, caregivers and health service providers. We conducted a series of workshops to identify barriers to and facilitators of change and used taxonomies of behaviour change theories and techniques to match intervention strategies to each target. Further stakeholder involvement work helped refine the intervention. Results: The developed intervention focusses on assessment and individually tailored discussion of risk factors, exchanging information, building motivation and action planning, followed by review of progress and problem-solving. Workbooks covering physical activity, diet, stress management, alcohol, smoking, blood pressure and mental health are provided to support behaviour change. The intervention is facilitated by trained healthcare professionals during the patient{\textquoteright}s AAA screening appointment for the duration that they are in surveillance. Discussion: The developed intervention will now be tested to assess whether it can be integrated with the current AAA screening programme. The developed intervention is a novel approach to reducing cardiovascular disease in the AAA population, it is also the first intervention which tries to do this in this population. Trial registration: International Clinical Trial Registration: ISRCTN93993995.",

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note = "Funding: This research was approved by the NHS Wales Research Ethics Committee 7 (NHS Wales REC 7) and the NHS Health Research Authority (HRA) in January 2020 (reference: 19/EM/0366). The research was funded by the National Institute for Health and Care Research (NIHR) Academy (reference: NIHR300059) and sponsored by the University of Leicester (reference: 0479); the funder and sponsor had no input in data collection, analysis or interpretation. Participants provided written informed consent upon recruitment. Publisher Copyright: {\textcopyright} 2024, The Author(s).",

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Improving cardiovascular health in patients with an abdominal aortic aneurysm: development of the cardiovascular risk reduction in patients with aneurysms (CRISP) behaviour change intervention. / Withers, Tom M.; Greaves, Colin J.; Bown, Matt J. et al.
In: Pilot and Feasibility Studies, Vol. 10, No. 1, 17, 29.01.2024.

Research output: Contribution to journal › Article › peer-review

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AU - Greaves, Colin J.

AU - Bown, Matt J.

AU - Saratzis, Athanasios

N1 - Funding: This research was approved by the NHS Wales Research Ethics Committee 7 (NHS Wales REC 7) and the NHS Health Research Authority (HRA) in January 2020 (reference: 19/EM/0366). The research was funded by the National Institute for Health and Care Research (NIHR) Academy (reference: NIHR300059) and sponsored by the University of Leicester (reference: 0479); the funder and sponsor had no input in data collection, analysis or interpretation. Participants provided written informed consent upon recruitment. Publisher Copyright: © 2024, The Author(s).

PY - 2024/1/29

Y1 - 2024/1/29

N2 - Background: Abdominal aortic aneurysm (AAA) is an important cardiovascular health problem. Ultrasound screening is proven to reduce AAA mortality and programmes have been implemented in some healthcare systems. Those who are identified as having a small AAA in screening enter into a surveillance programme to monitor AAA size. Individuals in AAA surveillance are at elevated risk of cardiovascular events, which is not currently addressed sufficiently. We aimed to develop a simple intervention to reduce cardiovascular risk, which could be embedded in AAA surveillance pathways. Methods: Intervention mapping methods were used to co-develop the intervention with individuals with AAA, families/carers, and healthcare staff. We identified “targets for change” by synthesising research evidence and international guidelines and consulting with patients, caregivers and health service providers. We conducted a series of workshops to identify barriers to and facilitators of change and used taxonomies of behaviour change theories and techniques to match intervention strategies to each target. Further stakeholder involvement work helped refine the intervention. Results: The developed intervention focusses on assessment and individually tailored discussion of risk factors, exchanging information, building motivation and action planning, followed by review of progress and problem-solving. Workbooks covering physical activity, diet, stress management, alcohol, smoking, blood pressure and mental health are provided to support behaviour change. The intervention is facilitated by trained healthcare professionals during the patient’s AAA screening appointment for the duration that they are in surveillance. Discussion: The developed intervention will now be tested to assess whether it can be integrated with the current AAA screening programme. The developed intervention is a novel approach to reducing cardiovascular disease in the AAA population, it is also the first intervention which tries to do this in this population. Trial registration: International Clinical Trial Registration: ISRCTN93993995.

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KW - Intervention mapping

KW - Abdominal aortic aneurysm

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Improving cardiovascular health in patients with an abdominal aortic aneurysm: development of the cardiovascular risk reduction in patients with aneurysms (CRISP) behaviour change intervention

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Fingerprint

Projects

Cardiovascular Risk reduction In the NHS abdominal aortic aneurysm (AAA) Screening Programme: a co-developed cardiovascular prevention intervention (the CRISP study)

Cite this