Development and evaluation of the keep moving support tool: Empowering self-management and patient-centred...

Supporting patients to achieve healthy physical activity (PA) levels can enhance meaningful participation. However, interventions rarely result in sustained PA. There is a need for person-centred approaches that integrate patients' unique contexts and link them with principles of behavioural science. We developed the Keep Moving Support (KMS) tool to empower patients' self-management and support healthcare professionals in promoting sustained PA.

The developed KMS tool consist of two parts: six PA stories and a flowchart. To create the PA stories, design research was carried out using context mapping sessions (n = 8; 38 patients), storytelling (12 patients, 11 professionals), and the COM-B model components. The flowchart was developed using PA stories, COM-B model, behaviour change techniques (BCTs). A scoping review of 15 systematic reviews and 22 RCTs informed the section of effective BCTs. A pilot study was conducted among 52 patients, 22 professionals and 14 graduating physiotherapy students.

Context mapping and storytelling provided a comprehensive overview of patients' experiences, tacit knowledge, latent needs and motivations related to PA. This data, combined with the COM-B components, served as the foundation for the development of the PA stories. The developed flowchart linked BCTs to the COM-B components integrated into the PA stories. Based on this information, patients and professionals co-create personalized interventions. The pilot study indicated that the first part of the KMS tool - the PA stories - effectively supports an active patient role, empowers self-management, and facilitates shared decision-making. In contrast, professionals found it challenging to use the second part of the KMS tool - the flowchart - to integrate BCTs into personalized interventions.

The KMS tool holds promise to support professionals in the provision of personalized PA counselling. However, the flowchart requires further development to enhance it practicality. Additional training may also be needed to support effective use by professionals.