Key result
The CRISP behaviour change intervention was successfully co-developed with stakeholders to address cardiovascular risk factors in patients undergoing abdominal aortic aneurysm surveillance.
Why the study?
Individuals in abdominal aortic aneurysm (AAA) surveillance have elevated cardiovascular risk that is not currently addressed sufficiently, motivating the development of a simple risk-reduction intervention embedded in surveillance pathways.
The study developed a novel behavior change intervention (CRISP) aimed at reducing cardiovascular risk in patients undergoing abdominal aortic aneurysm surveillance.
Requires prospective trials before clinical adoption in AAA surveillance; leaves open the effectiveness of co-developed behavior change interventions.
Objectives Abdominal aortic aneurysm (AAA) is an important cardiovascular health problem. Ultrasound screening is proven to reduce AAA-mortality and programmes have been implemented in some healthcare systems. Those who are identified as having a small AAA in screening enter into a surveillance programme to monitor AAA-size. Individuals in AAA-surveillance are at elevated risk of cardiovascular events, which is not currently addressed sufficiently. We aimed to develop a simple intervention to reduce cardiovascular risk, which could be embedded in AAA surveillance-pathways. Design Intervention mapping methods were used to co-develop the intervention Participants Individuals with AAA, families/carers, and healthcare staff. Setting AAA screening and surveillance programmes in the United Kingdom Outcome measures We identified “targets for change” by synthesising research evidence and international guidelines and consulting with patients, caregivers and health service providers. We conducted a series of workshops to identify barriers to and facilitators of change, and used taxonomies of behaviour change theories and techniques to match intervention strategies to each target. Further stakeholder involvement work helped refine the intervention. Results The developed intervention focusses on assessment and individually tailored discussion of risk factors, exchanging information, building motivation and action planning, followed by review of progress and problem-solving. Workbooks covering physical activity, diet, stress management, alcohol, smoking, blood pressure and mental health are provided to support behaviour change. The intervention is facilitated by trained healthcare professionals during the patient’s AAA screening appointment for the duration that they are in surveillance. Conclusions The developed intervention will now be tested to assess whether it can be integrated with the current AAA screening programme. The developed intervention is a novel approach to reducing cardiovascular disease in the AAA population, it is also the first intervention which tries to do this in this population.
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Withers et al. (2022) studied Abdominal aortic aneurysm (n=174). CRISP (Cardiovascular risk reduction in patients with aneurysms) behaviour change intervention was evaluated on Development of the intervention (identification of targets for change, barriers, facilitators, and intervention strategies). The CRISP behaviour change intervention was successfully co-developed with stakeholders to address cardiovascular risk factors in patients undergoing abdominal aortic aneurysm surveillance.
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