Using The Behavior Change Wheel For Intervention Development For Chronic Ankle Instability

PURPOSE: The aim of this study was to develop, implement, and assess a performative developmental evaluation survey to assess patient-perceived determinants of non-traditional, psychologically-based interventions for future applications in Chronic Ankle Instability (CAI) patients. Methods: The Behavior Change Wheel (BCW) was used for survey construction by mapping BCW components to potential intervention barrier/enabler questions to discern participants’ preferences to how an at-home intervention is structured and may impact patient engagement and adherence to home-based interventions. Psychologically-based interventions investigated were: Mindfulness-Based Stress Reduction (MBSR), Acceptance and Commitment Therapy (ACT), Traumatic/Tension Releasing Exercises (TRE), Diaphragmatic Breathing Exercises (DBE), and Stress Inoculation Training (SIT). Data collection was performed using REDCap. Means and standard deviations or prevalence (sample total, percentages) will be discussed. RESULTS: 34 individuals volunteered (female: n = 17, 50%; age: 25.6 ± 6.7 years). The majority of participants were interested in trying TRE (n = 21, 62%), with the least interested in trying ACT (n = 14, 42%). The vast majority were open to receiving an electronic reminder to complete an intervention (n = 29, 85%), with text messages being the most preferred condition (n = 23, 68%). A majority of participants rated a visual reminder for home or the workplace as helpful (n = 26, 76%). A video tutorial was the most preferred method for home practice across all interventions (MBSR: 13/18, 72%; ACT: 5/10, 50%; TRE: 17/21, 81%; DBE: 15/16, 94%; SIT: 10/14, 72%) compared to static pictures or written instructions. Of those who reported perceived barriers (n = 13), most (9/13) were related to the time commitment of an intervention. Other perceived barriers were a lack of (1) a workout space, (2) a quiet environment, and (3) motivation. Overall, participants reported that 1 session lasting 20-30 minutes per week as more feasible than longer or more frequent sessions. CONCLUSION: Participants were most interested in using TRE, frequently reported time as a barrier, and rated the use of visual and electronic reminders as helpful. These factors should be considered when designing such interventions for the CAI population. Supported by: This study was funded by the Endowed University Professor in Health Sciences Fund.