Intervention development for self-management of BP postpartum
Research type
Research Study
Full title
Optimising Self-management of Postnatal Anti-hypertensive Treatment: Qualitative research and intervention development with co-design
IRAS ID
321206
Contact name
Richard McManus
Contact email
Sponsor organisation
University of Oxford
Duration of Study in the UK
1 years, 5 months, 31 days
Research summary
This research is part of a wider programme of work to explore and evaluate a self-management intervention to better control blood pressure (BP) for women in the postnatal period following hypertensive pregnancy, with the aim of reducing both their short and long-term cardiovascular risk.
It will start by understanding usual care for women still requiring antihypertensive therapy following birth, before co-developing a new self-management intervention.
Intervention development will be based on our previously successful work which developed an app that was acceptable, feasible, and safe in supporting women to manage their hypertension following pregnancy. This study seeks to optimise the intervention to make it appropriate for a range of different care pathways, women and health care practitioners, and for the cutting-edge technology and organisational and regulatory structures needed to work in the 2020s and beyond. This development work will ensure that the intervention is useful for as wide a range of women as possible by seeking to include a broad range of views, and purposefully sampling women from ethnic minority groups and those living in more deprived areas.
The project will use a combination of qualitative research (interviews, focus groups) and co-production ('think aloud' sessions, where individuals describe out loud their experiences of using the intervention while using it) with both women and health care professionals drawn from participating NHS Trust areas and general practices in England. In 'think aloud' sessions, participants will be asked to comment on materials and the usability of the intervention.
Lay summary of study results: Study aim: To coproduce an inclusive intervention (or tool) to support for blood pressure (BP) self-management following birth.
The approach: We used the ‘person-based approach’, which involved three stages. Firstly, we developed the intervention with a diverse patient and public involvement panel and stakeholders. Secondly we optimised the intervention through think-aloud interviews with former patients and clinicians. Finally, user-testing was undertaken, followed by semi-structured interviews with current patients and their clinicians.
Who took part? Seven former patients and 11 clinicians participated in think-aloud interviews to provide their views of intervention prototypes (stage 2). Additionally, 23 patients and 9 of their clinicians participated in semi-structured interviews after using the intervention for 2 weeks (phase 3).
Intervention: An interactive patient app—My BP Care—and accompanying leaflet to support BP self-monitoring. These were linked to a clinician dashboard with alerts and an emailing system to facilitate appropriate titration of patient medication.
Results: The intervention was co-developed following these guiding principles to ensure it was accessible and inclusive: easily comprehensible, motivating, simple and quick to use. Interview findings indicated that patient using the intervention was promoted by the training conducted by the midwives, the enhanced clinical oversight they felt they received as a result of the intervention, the free BP monitor they received, reassurance they received of the medication safety for them and their baby, the intervention’s simplicity and the motivating reminders they received.
Conclusions: Through coproduction with a diverse group of patients and stakeholders, and optimisation through testing among further diverse patients and clinicians, we developed a multicomponent intervention that is accessible and engaging for diverse patients, compatible with prevailing clinical practice and adaptable to different clinical contexts.REC name
South Central - Hampshire B Research Ethics Committee
REC reference
23/SC/0033
Date of REC Opinion
10 Jan 2023
REC opinion
Favourable Opinion