Components and evidence for the CHEERS educational intervention
| Component | Evidence |
| A leaflet on BP control was sent to participants prior to the educational intervention to prepare them for a group discussion. | Preparatory information has been used in a previous successful group education intervention (involving one session) for predialysis patients.7 |
| A single group educational session (lasting 2.5 h) involving facilitated informal discussion, problem-solving activities and sharing of experiences to work through modules that would equip the participants with the necessary knowledge to be able to self-manage their BP. In addition, participants were introduced to the importance of goal setting as an effective self-management skill and were asked to complete an action plan setting out short-term goals. | The intervention used the principles of social cognitive theory6 as a theoretical framework that aimed to engage and empower patients by increasing self-efficacy (a patient's confidence in their own ability to self-manage their health condition) by giving patients the necessary knowledge and skills. |
| Participants were asked to write their goals in a self-addressed letter that was sent to them at 6 months as a reminder. They were also given access to support and advice from the study nurse via telephone or email. | Maintenance of behavioural change is paramount. Reminder letters have been shown to be effective in helping patients maintain positive health behaviours, and additional telephone support has been shown to maintain behavioural change in predialysis patient.8 Support is essential to help overcome any barriers or obstacles to behavioural change. The support was offered rather than enforced to fit with the philosophy of empowerment. |
BP, blood pressure.