125 In a previous study, in-depth interviews with CKD patients with LHL provided the main problems and recommendations. In a previous study, focus group discussions and interviews with HCPs provided the main problems and recommendations. PATIENT INTERVENTION STEPS HCP INTERVENTION 1. PROBLEM ANALYSIS • Pilot-test with patients. • Evaluation with HL tools. • Final adaptations were made. • Three pilot-workhops with HCPs. • Final adaptations were made. 5. EVALUATION • Outcomes, objectives and determinants were formulated. • Objectives were discussed with CKD patients with LHL. • New objectives were derived from interviews with patients. • We created a logic model of change. • Outcomes, objectives and determinants were formulated. • Objectives were compared with the objectives of an existing HL training. • We created a logic model of change. 2. LOGIC MODEL OF CHANGE • Theory-based strategies were selected, based on desk research. • Feedback from CKD patients led to a selection of intervention strategies and methods. • Theory-based strategies were selected, based on desk research. • A concept workshop on HL for HCPs was developed. • Educators provided feedback. 3. INTERVENTION DESIGN • A concept intervention for patients was developed. • After feedback of an advisory board the final intervention was created. • Based on step 3, a new e-learning and workshop were developed. • After feedback of students and educators the final intervention was created. 4. INTERVENTION PRODUCTION Step 3: Program design To start developing the patient intervention, we performed desk-research. This intended to find useful theories that could help to organize the objectives and determinants into intervention components, and to identify intervention methods and strategies that fitted our objectives and determinants. Next, we asked the same patients as in step 2 to comment on the identified Figure 4.1 The Intervention Mapping process to develop an intervention for both kidney patients with limited health literacy and health care professionals. CKD = chronic kidney disease, HCP = health care professional, HL = health literacy, LHL = limited health literacy.
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