Reducing patient delay in Acute Coronary Syndrome (RAPiD): research protocol for a web-based randomized controlled trial examining the effect of a behaviour change intervention

J Adv Nurs. 2017 May;73(5):1220-1234. doi: 10.1111/jan.13191. Epub 2016 Nov 18.

Abstract

Aims: To evaluate the efficacy of a behaviour change technique-based intervention and compare two possible modes of delivery (text + visual and text-only) with usual care.

Background: Patient delay prevents many people from achieving optimal benefit of time-dependent treatments for acute coronary syndrome. Reducing delay would reduce mortality and morbidity, but interventions to change behaviour have had mixed results. Systematic inclusion of behaviour change techniques or a visual mode of delivery might improve the efficacy of interventions.

Design: A three-arm web-based, parallel randomized controlled trial of a theory-based intervention.

Methods: The intervention comprises 12 behaviour change techniques systematically identified following systematic review and a consensus exercise undertaken with behaviour change experts. We aim to recruit n = 177 participants who have experienced acute coronary syndrome in the previous 6 months from a National Health Service Hospital. Consenting participants will be randomly allocated in equal numbers to one of three study groups: i) usual care, ii) usual care plus text-only behaviour change technique-based intervention or iii) usual care plus text + visual behaviour change technique-based intervention. The primary outcome will be the change in intention to phone an ambulance immediately with symptoms of acute coronary syndrome ≥15-minute duration, assessed using two randomized series of eight scenarios representing varied symptoms before and after delivery of the interventions or control condition (usual care). Funding granted January 2014.

Discussion: Positive results changing intentions would lead to a randomized controlled trial of the behaviour change intervention in clinical practice, assessing patient delay in the event of actual symptoms.

Trial registration: Registered at ClinicalTrials.gov: NCT02820103.

Keywords: ACS; BCT; acute coronary syndrome; behaviour; behaviour change; cardiac; delay; intervention; nursing; patient delay.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acute Coronary Syndrome / psychology
  • Acute Coronary Syndrome / therapy*
  • Adolescent
  • Adult
  • Aged
  • Female
  • Health Behavior
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Intention
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / psychology
  • Scotland
  • Self Efficacy
  • Time-to-Treatment / statistics & numerical data*
  • Treatment Outcome
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT02820103