Reducing patient delay in Acute Coronary Syndrome (RAPiD): research protocol for a web-based randomised controlled trial examining the effect of a behaviour change intervention

AIMS: To evaluate the efficacy of a behaviour change technique-based intervention and compare two possible modes of delivery (text+visual and text-only) with usual care.

BACKGROUND: Patient delay prevents many people from achieving optimal benefit of time-dependent treatments for Acute Coronary Syndrome. Reducing delay would reduce mortality and morbidity, but interventions to change behaviour have had mixed results. Systematic inclusion of behaviour change techniques or a visual mode of delivery might improve the efficacy of interventions.

DESIGN: A 3-arm web-based, parallel randomised controlled trial of a theory-based intervention.

METHODS: The intervention comprises 12 behaviour change techniques systematically identified following systematic review and a consensus exercise undertaken with behaviour change experts. We aim to recruit n=177 participants who have experienced Acute Coronary Syndrome in the previous 6 months from a National Health Service Hospital. Consenting participants will be randomly allocated in equal numbers to one of three study groups: i) usual care ii) usual care plus text-only behaviour change technique-based intervention or iii) usual care plus text+visual behaviour change technique-based intervention. The primary outcome will be the change in intention to phone an ambulance immediately with symptoms of Acute Coronary Syndrome ≥15 minutes duration, assessed using two randomised series of 8 scenarios representing varied symptoms before and after delivery of the interventions or control condition (usual care). Funding granted January 2014.

DISCUSSION: Positive results changing intentions would lead to a randomised controlled trial of the behaviour change intervention in clinical practice, assessing patient delay in the event of actual symptoms. This article is protected by copyright. All rights reserved.