Background: Self-management interventions are considered effective in patients with chronic disease, but trials have shown inconsistent results, and it is unknown which patients benefit most. Adequate self-management requires behaviour change in both patients and health care providers. Therefore, the Activate intervention was developed with a focus on behaviour change in both patients and nurses. The intervention aims for change in a single self-management behaviour, namely physical activity, in primary care patients at risk for cardiovascular disease. The aim of this study is to evaluate the effectiveness of the Activate intervention. Methods/design: A two-arm cluster randomised controlled trial will be conducted to compare the Activate intervention with care as usual at 31 general practices in the Netherlands. Approximately 279 patients at risk for cardiovascular disease will participate. The Activate intervention is developed using the Behaviour Change Wheel and consists of 4 nurse-led consultations in a 3-month period, integrating 17 behaviour change techniques. The Behaviour Change Wheel was also applied to analyse what behaviour change is needed in nurses to deliver the intervention adequately. This resulted in 1-day training and coaching sessions (including 21 behaviour change techniques). The primary outcome is physical activity, measured as the number of minutes of moderate to vigorous physical activity using an accelerometer. Potential effect modifiers are age, body mass index, level of education, social support, depression, patient-provider relationship and baseline number of minutes of physical activity. Data will be collected at baseline and at 3 months and 6 months of follow-up. A process evaluation will be conducted to evaluate the training of nurses, treatment fidelity, and to identify barriers to and facilitators of implementation as well as to assess participants’ satisfaction. Discussion: To increase physical activity in patients and to support nurses in delivering the intervention, behaviour change techniques are applied to change behaviours of the patients and nurses. Evaluation of the effectiveness of the intervention, exploration of which patients benefit most, and evaluation of our theory-based training for primary care nurses will enhance understanding of what works and for whom, which is essential for further implementation of self-management in clinical practice.
Communication plays an important role in manyprofessional contexts. This is especially truefor students in the field of social work. Theaim of this study was to develop formative,self-regulated multimedia self-assessment ofsocial-communicative competencies for socialwork students. First, a pilot study wasconducted to gain insight into the students'specific characteristics. This insight was usedto design guidelines for the development of theassessment instrument in order to tune these tothe students' perceptions, instructionalpreferences, and personalities and thusenhancing the students' enthusiasm to use theself-assessment instrument. This might increasethe chance for successful implementation ofthis new form of assessment. A first version of a multimedia test wasdeveloped. A quality expert meeting wasorganised to gain insight into expertjudgements on the quality of the test and toobtain indications for improvement of theassessment. A second version of the test wasconstructed and put on the Internet. Nearly 400students completed the assessment and expressedtheir opinions on this new way of communicationassessment. We found it was possible to testsocial-communicative competence by means ofmultimedia, with the help of digital video. Theuse of Internet makes assessments available atany time to fit curriculum needs and alsoresolves time and space constraints. Ourconclusion was that the multimedia test isreasonably valid. All students reported havingliked the multimedia assessment.
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