Using Intervention Mapping in the Systematic Development of a Behaviour Change Intervention to Enhance Exercise Adherence among People with Persistent Musculoskeletal Pain

This article describes the first four steps of the intervention mapping framework used to design a programme aimed at increasing adherence to prescribed exercise by people with persistent musculoskeletal pain. In Step 1, a systematic review and qualitative study was completed to inform Step 2 and the identification of the Health Action Process Approach as an appropriate theoretical framework for establishing two programme objectives: enhancing self-management and providing tailored and accessible exercise instructions. Step 3 encompassed the selection of the programme methods, and the programme is described in Step 4. The resulting programme provides virtually delivered motivational interviewing and an app-based exercise programme to support individuals' adherence to exercise. The resulting intervention was assessed in a proof-of-concept feasibility and acceptability study and was shown to be feasible and acceptable. Refinements to the programme included additional tailoring of the exercise app and modifying the motivational interviewing schedule. Using the intervention mapping approach enabled us to successfully develop an intervention aimed at supporting the development of self-management behaviours and addressing maladaptive beliefs as a means of enhancing individuals' adherence to exercise. Evaluation and implementation of the intervention should now be carried out.