Exemplar Trial Overview - ISLAND. (10-min video & 16-slide presentation)

• Summary: Dr. Noah Ivers overviews ISLAND, a pragmatic, multicentre randomized controlled trial with blinded assessment of outcome to evaluate interventions designed to improve long term adherence to recommended secondary prevention treatment after myocardial infarction.

Ivers NM, et al. Interventions supporting long term adherence and decreasing cardiovascular events after myocardial infarction (ISLAND): pragmatic randomised controlled trial. BMJ. 2020 Jun 10;369:m1731. (12-page paper)

• Summary: Publication in the BMJ describing the ISLAND pragmatic trial (Interventions Supporting Long term Adherence aNd Decreasing cardiovascular events after myocardial infarction). ISLAND tested the effects of a series of mailed educational reminders, with or without the addition of phone calls from an automated interactive voice response system and a trained lay health worker, compared with usual care for adherence to recommended secondary prevention treatments.

Exemplar Trial - ISLAND: 15-min video & 30-slide presentation.

• Summary: Dr. Noah Ivers breaks down the ISLAND trial across the sections of the curriculum wheel.

BMJ Opinion (Blog) - Author's perspective. Lessons learned from 10 years working on (an) ISLAND (June 12, 2020): 1-page website.

• Summary: Authors Drs. Noah Ivers and J-D Schwalm reflect on their experiences with running the ISLAND trial.

Ivers N, et al. Interventions Supporting Long-term Adherence aNd Decreasing cardiovascular events (ISLAND): Pragmatic randomized trial protocol. Am Heart J. 2017 Aug;190:64-75. (12-page paper) * As this is an optional resource, an institutional login (e.g., university or research institute e-mail address) is required to access this material. 

• Summary: Trial protocol describing ISLAND, a pragmatic, multicenter trial with embedded mixed-methods process evaluation that seeks to evaluate interventions that could be readily implemented by health systems or organizations wishing to improve long-term adherence to secondary prevention treatment recommendations post-myocardial infarction.

Desveaux L, et al. How and why a multifaceted intervention to improve adherence post-MI worked for some (and could work better for others): an outcome-driven qualitative process evaluation. BMJ Open. 2020 Sep 3;10(9):e036750. (10-page paper)

• Summary: A qualitative process evaluation with the following objectives: to explore (1) the extent to which a multicomponent intervention addressed determinants of the desired behaviours (i.e., adherence to cardiac rehabilitation and cardiovascular medications), (2) the associated mechanism(s) of action and (3) how future interventions might be better designed to meet the needs of this patient population.

McCleary N, et al. Interventions supporting cardiac rehabilitation completion: Process evaluation investigating theory-based mechanisms of action. Health Psychol. 2020 Dec;39(12):1048-1061. (14-page paper) * As this is an optional resource, an institutional login (e.g., university or research institute e-mail address) is required to access this material. 

• Summary: A process evaluation to help explain the ISLAND trial results, suggesting that mailouts plus telephone support increased the likelihood of completing cardiac rehabilitation by enhancing self-efficacy and action planning, and increased intention by enhancing goal priority, self-efficacy, and outcome expectancies, with an unintended consequence of a negative effect via risk perceptions.

McCleary et al. Impacts of two behavior change interventions on determinants of medication adherence: process evaluation applying the health action process approach and habit theory alongside a randomized controlled trial. J Behav Med. 2022 Oct;45(5):659-673. (15-page paper) * As this is an optional resource, an institutional login (e.g., university or research institute e-mail address) is required to access this material. 

• Summary: Describes the assessment of mechanisms of two interventions (mailouts alone, and mailouts plus telephone support, informed by the Health Action Process Approach and Habit Theory) designed to increase medication adherence after myocardial infarction.