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Abstract：
BACKGROUND: Chronic kidney disease (CKD) is a major public health concern. Adequate self-management skills are vital to reduce CKD burden, optimize patient health outcomes, and control health care expenditures. Using eHealth to support CKD self-management has the potential to promote healthy behaviors and improve health outcomes of patients with CKD. However, knowledge of the implementation of such interventions in general, and in China specifically, is still limited.
OBJECTIVE: This study aims to develop a tailored eHealth self-management intervention for patients with CKD in China based on the Dutch Medical Dashboard (MD) eHealth self-management intervention.
METHODS: We used an intervention mapping approach. In phase 1, a systematic review and 2 qualitative studies were conducted to examine the needs, beliefs, and perceptions of patients with CKD and health care professionals regarding CKD self-management and eHealth interventions. Afterward, key factors gathered from the aforementioned studies were categorized following the 5 domains of the Consolidated Framework for Implementation Research (CFIR). In phase 2, we specified program outcomes, performance objectives, determinants, theory-based methods, and practical strategies. Knowledge obtained from previous results was combined to complement core components of the MD self-management intervention and adapt them for Chinese patients with CKD. Additionally, the CFIR-Expert Recommendations for Implementing Change Matching Tool was pragmatically used to generate a list of potential implementation strategies to address the key factors influencing the implementation of eHealth CKD self-management interventions, and implementation strategies were discussed and finalized with the intervention monitoring group.
RESULTS: An overview of the CFIR domains showed the essential factors influencing the implementation of eHealth CKD self-management interventions in Chinese settings, including \"knowledge and beliefs\" in the domain \"individual characteristics,\" \"quality and advantage of eHealth intervention\" in the domain \"intervention characteristics,\" \"compatibility\" in the domain \"inner setting,\" and \"cultural context\" in the domain \"outer setting.\" To ensure the effectiveness of the Dutch MD-based self-management intervention, we did not change the core self-management intervention components of MD that underlie its effectiveness, such as self-monitoring. We identified surface-level cultural adaptations involving customizing intervention content, messages, and approaches to the observable cultural characteristics of the local population to enhance the intervention\'s appeal, receptivity, and feasibility, such as providing video or voice call options to support interactions with health care professionals. Furthermore, the adapted modules such as Knowledge Center and My Self-Monitoring were developed in a mobile health app.
CONCLUSIONS: Our study resulted in the delivery of a culturally tailored, standardized eHealth self-management intervention for patients with CKD in China that has the potential to optimize patients\' self-management skills and improve health status and quality of life. Moreover, our study\'s research approach and results can inform future research on the tailoring and translation of evidence-based, eHealth self-management interventions to various contexts.
BACKGROUND: ClinicalTrials.gov NCT04212923; https://classic.clinicaltrials.gov/ct2/show/NCT04212923.
OBJECTIVE: This study aims to develop a tailored eHealth self-management intervention for patients with CKD in China based on the Dutch Medical Dashboard (MD) eHealth self-management intervention.
METHODS: We used an intervention mapping approach. In phase 1, a systematic review and 2 qualitative studies were conducted to examine the needs, beliefs, and perceptions of patients with CKD and health care professionals regarding CKD self-management and eHealth interventions. Afterward, key factors gathered from the aforementioned studies were categorized following the 5 domains of the Consolidated Framework for Implementation Research (CFIR). In phase 2, we specified program outcomes, performance objectives, determinants, theory-based methods, and practical strategies. Knowledge obtained from previous results was combined to complement core components of the MD self-management intervention and adapt them for Chinese patients with CKD. Additionally, the CFIR-Expert Recommendations for Implementing Change Matching Tool was pragmatically used to generate a list of potential implementation strategies to address the key factors influencing the implementation of eHealth CKD self-management interventions, and implementation strategies were discussed and finalized with the intervention monitoring group.
RESULTS: An overview of the CFIR domains showed the essential factors influencing the implementation of eHealth CKD self-management interventions in Chinese settings, including \"knowledge and beliefs\" in the domain \"individual characteristics,\" \"quality and advantage of eHealth intervention\" in the domain \"intervention characteristics,\" \"compatibility\" in the domain \"inner setting,\" and \"cultural context\" in the domain \"outer setting.\" To ensure the effectiveness of the Dutch MD-based self-management intervention, we did not change the core self-management intervention components of MD that underlie its effectiveness, such as self-monitoring. We identified surface-level cultural adaptations involving customizing intervention content, messages, and approaches to the observable cultural characteristics of the local population to enhance the intervention\'s appeal, receptivity, and feasibility, such as providing video or voice call options to support interactions with health care professionals. Furthermore, the adapted modules such as Knowledge Center and My Self-Monitoring were developed in a mobile health app.
CONCLUSIONS: Our study resulted in the delivery of a culturally tailored, standardized eHealth self-management intervention for patients with CKD in China that has the potential to optimize patients\' self-management skills and improve health status and quality of life. Moreover, our study\'s research approach and results can inform future research on the tailoring and translation of evidence-based, eHealth self-management interventions to various contexts.
BACKGROUND: ClinicalTrials.gov NCT04212923; https://classic.clinicaltrials.gov/ct2/show/NCT04212923.
摘要：
背景：慢性肾脏病（CKD）是一个主要的公共卫生问题。足够的自我管理技能对于减轻CKD负担至关重要，优化患者健康结果，控制医疗保健支出。使用eHealth支持CKD自我管理有可能促进CKD患者的健康行为并改善其健康结果。然而,总体上了解此类干预措施的实施情况，特别是在中国，仍然有限。
目的：本研究旨在基于荷兰医疗仪表板（MD）eHealth自我管理干预措施，为中国CKD患者开发量身定制的eHealth自我管理干预措施。
方法：我们使用了干预映射方法。在第一阶段，进行了系统审查和2项定性研究，以检查需求，信仰,以及CKD患者和医疗保健专业人员对CKD自我管理和电子健康干预的看法。之后,从上述研究中收集的关键因素被归类为实施研究综合框架(CFIR)的5个领域。在第二阶段，我们指定了计划结果，绩效目标，决定因素，基于理论的方法，和实用的策略。将从先前结果中获得的知识相结合，以补充MD自我管理干预的核心组成部分，并使其适应中国CKD患者。此外,CFIR-ExpertRecommendationsforImplementingChangeMatchingToolwaspracticallyusedtogeneratealistofpotentialimplementationstrategiestoaddressthekeyfactorsimposedtheimplementationofeHealthCKDself-managementinterventions,与干预监测小组讨论并最终确定了实施策略.
结果：对CFIR领域的概述显示了影响在中国环境中实施eHealthCKD自我管理干预措施的基本因素，包括“知识和信仰”领域中的“个体特征”，“\”“电子健康干预的质量和优势\”领域\”干预特征，域内部设置中的\"兼容性\",域外部设置中的\"和\"文化上下文\"。“为了确保荷兰基于MD的自我管理干预的有效性，我们没有改变作为MD有效性基础的核心自我管理干预部分，比如自我监控。我们确定了涉及定制干预内容的表层文化适应，消息,以及对当地人口可观察到的文化特征的方法，以增强干预的吸引力，接受性,和可行性，例如提供视频或语音呼叫选项，以支持与医疗保健专业人员的互动。此外，适应的模块，如知识中心和我的自我监测是在移动健康应用程序中开发的。
结论：我们的研究导致提供了一种文化定制的，对中国CKD患者进行标准化的eHealth自我管理干预，有可能优化患者的自我管理能力，改善健康状况和生活质量。此外，我们的研究方法和结果可以为未来的研究提供基于证据的剪裁和翻译，针对各种情况的电子健康自我管理干预措施。
背景：ClinicalTrials.govNCT04212923;https://classic。clinicaltrials.gov/ct2/show/NCT04212923.
目的：本研究旨在基于荷兰医疗仪表板（MD）eHealth自我管理干预措施，为中国CKD患者开发量身定制的eHealth自我管理干预措施。
方法：我们使用了干预映射方法。在第一阶段，进行了系统审查和2项定性研究，以检查需求，信仰,以及CKD患者和医疗保健专业人员对CKD自我管理和电子健康干预的看法。之后,从上述研究中收集的关键因素被归类为实施研究综合框架(CFIR)的5个领域。在第二阶段，我们指定了计划结果，绩效目标，决定因素，基于理论的方法，和实用的策略。将从先前结果中获得的知识相结合，以补充MD自我管理干预的核心组成部分，并使其适应中国CKD患者。此外,CFIR-ExpertRecommendationsforImplementingChangeMatchingToolwaspracticallyusedtogeneratealistofpotentialimplementationstrategiestoaddressthekeyfactorsimposedtheimplementationofeHealthCKDself-managementinterventions,与干预监测小组讨论并最终确定了实施策略.
结果：对CFIR领域的概述显示了影响在中国环境中实施eHealthCKD自我管理干预措施的基本因素，包括“知识和信仰”领域中的“个体特征”，“\”“电子健康干预的质量和优势\”领域\”干预特征，域内部设置中的\"兼容性\",域外部设置中的\"和\"文化上下文\"。“为了确保荷兰基于MD的自我管理干预的有效性，我们没有改变作为MD有效性基础的核心自我管理干预部分，比如自我监控。我们确定了涉及定制干预内容的表层文化适应，消息,以及对当地人口可观察到的文化特征的方法，以增强干预的吸引力，接受性,和可行性，例如提供视频或语音呼叫选项，以支持与医疗保健专业人员的互动。此外，适应的模块，如知识中心和我的自我监测是在移动健康应用程序中开发的。
结论：我们的研究导致提供了一种文化定制的，对中国CKD患者进行标准化的eHealth自我管理干预，有可能优化患者的自我管理能力，改善健康状况和生活质量。此外，我们的研究方法和结果可以为未来的研究提供基于证据的剪裁和翻译，针对各种情况的电子健康自我管理干预措施。
背景：ClinicalTrials.govNCT04212923;https://classic。clinicaltrials.gov/ct2/show/NCT04212923.
