Using the Behaviour Change Wheel framework to develop an integrated intervention for diabetes and hypertension...

Area of Science:

• Public Health
• Behavioral Science
• Geriatric Medicine

Background:

• China faces significant health system challenges due to rising multimorbidity and an aging population.
• Co-management of hypertension and type 2 diabetes is a national health policy priority, but implementation faces barriers in primary care.
• Existing interventions often lack explicit links between behavioral influences and intervention design.

Purpose of the Study:

• To apply the Behaviour Change Wheel (BCW) framework to develop a tailored intervention for hypertension and type 2 diabetes co-management.
• To address implementation challenges in primary healthcare settings in China.
• To highlight the potential of behavioral science in managing complex multimorbidity.

Main Methods:

• Case report detailing the application of the Behaviour Change Wheel (BCW) framework.
• Development of the evidence-based, people-centred, integrated care (EPIC) intervention.
• Focus on personalized lifestyle prescriptions, digital tool assistance, and caregiver engagement.

Main Results:

• The BCW framework facilitated the rapid development and integration of intervention components.
• The resulting EPIC intervention is designed for routine implementation in primary care for older adults.
• The intervention restructures standard care to address hypertension and diabetes co-management.

Conclusions:

• Behavioral science frameworks, like the BCW, offer a promising approach to tackle multimorbidity implementation challenges.
• The EPIC intervention demonstrates a people-centered, integrated care model for hypertension and diabetes.
• Further empirical research is needed to link behavioral mechanisms with outcomes in theory-informed interventions.