Etude des facteurs et des interventions basées sur le planning comportements de santé : applications à l'activité physique et à l'adhésion médicamenteuse

Health behaviours strategies promotion : cue-dependent planning interventions and factors

• Auteur / Autrice : Carine Meslot
• Direction : Benoît Allenet
• Type : Thèse de doctorat
• Discipline(s) : MBS - Modèles, méthodes et algorithmes en biologie, santé et environnement
• Date : Soutenance le 02/12/2016
• Etablissement(s) : Université Grenoble Alpes (ComUE)
• Ecole(s) doctorale(s) : École doctorale ingénierie pour la santé, la cognition, l'environnement (Grenoble, Isère, France ; 1995-....)
• Partenaire(s) de recherche : Laboratoire : Recherche translationnelle et innovation en médecine et complexité (La Tronche, Isère, France ; 1995-....)
• Jury : Président / Présidente : Martin Hagger
• Jury : Examinateurs / Examinatrices : Aurélie Gauchet, Nikos Chatzisarantis
• Jury : Rapporteurs / Rapporteuses : Olivier Desrichard, Grégory Décamps

Mots clés

Mots clés contrôlés

Analyse comportementale

Comportement humain -- Effets des médicaments

Mots clés libres

Adhésion thérapeutique

Leviers

Patients chroniques

Medication adherence

Levers

Chronic patients

Résumé

L'auteur n'a pas fourni de résumé en français

Individuals do not always enact their intentions into behaviours, which may lead to severe outcomes especially in health-related fields. Self-regulation strategies, like cuedependent plans interventions, have shown efficiency to help to counter the intentionbehaviour gap. Yet, no review has been realised recently to bring a qualitative and quantitative analyses of this effect.Firstly, we carried out a qualitative review to evaluate the effectiveness of cuedependent planning intervention to increase health-related behaviours. We included 329 studies with experimental and prospective designs that measured or evaluated the effect of cue-dependent plans (e.g. implementation intention, action planning, coping planning) on health-related behaviours, among general, clinical and student population. The qualitative analysis revealed for instance that implementation intentions were used in majority, even if the if-then format was not systematically adopted. However, we oticed confusion between the terminologies of the plans and the theories. A quantitative review will be realised to evaluate the effect size and the moderators that could magnify or diminish the effects of cuedependent planning interventions on health-related behaviours. Second, we presented two studies that tested the effectiveness of cue-dependent planning interventions on physical activity, which was the most represented health outcome in cue-dependent planning interventions, according to our review. Motivational (mental simulation) and volitional (implementation intention) interventions were combined to promote physical activity participation. The first study, adopting a cluster randomised controlled trial design among students, did not show any significant effect neither of the mental simulation plus implementation intention intervention, nor of the implementation intention intervention compared to the control condition. The second study adopted a more rigorous methodology with a full-factorial randomised controlled design, with a larger sample and objective measures of physical activity (attendance to gym centre). Nevertheless, the study revealed no statistically significant main or interactive effects of the mental simulation and implementation intention conditions on physical activity outcomes. Findings were not in line with previous research that showed effects of cue-dependent plans to promote physical activity. This adds to the necessity of identifying the moderators of these interventions in health behaviours.Thirdly, cue-dependent planning interventions are needed in illness behaviours. In chronic disease, non-adherence to medication is a public health problem that can lead to negative health outcomes. Even if the patients want to take their treatment, they may, for instance, forget it and fail to enact the behaviour. We tested the ability of an intervention adopting implementation intention and coping planning to promote medication adherence. In a randomized controlled trial, outpatients with cardiovascular diseases were randomly allocated to either an implementation intention and coping planning condition, or to a noplanning control condition. Findings revealed no significant effect of the intervention on medication adherence. However, post hoc moderator analyses showed that the beliefs moderated the effect of the intervention, which was effective in patients with lower necessity beliefs compared to those with higher necessity beliefs. The design used in the study did not enable to test the direct an interactive effect on medication adherence, so it would be necessary to replicate these findings with a full factorial design among patients with cardiovascular diseases.