Development of a theory-based self-management digital intervention to promote physical activity in people living with chronic obstructive pulmonary disease: Respir’air BPCO

Aim: To describe the development of Respir'air BPCO, a theory-driven self-management digital intervention to promote physical activity in people living with chronic obstructive pulmonary disease (COPD) following pulmonary rehabilitation. Background: Physical activity is a key component of COPD self-management, yet activity levels often decline after discharge from pulmonary rehabilitation. Digital interventions may extend support beyond face-to-face care, but existing interventions are heterogeneous and frequently lack explicit theoretical grounding. Involving patients and healthcare professionals in intervention development is essential to enhance acceptability and clinical relevance. Method: Development was guided by the updated Medical Research Council framework for complex interventions and operationalized using pragmatic elements from Bleijenberg's approach. The process included evidence synthesis (umbrella review), theory selection (Middle-Range Theory of Self-Care of Chronic Illness and Self-Determination Theory), stakeholder needs assessment through focus groups with people living with COPD and healthcare professionals, contextual assessment in a Swiss pulmonary rehabilitation center, and modelling of processes and outcomes through a logic model. Content validity was assessed through a two-round modified e-Delphi with an expert panel. Results: Respir'air BPCO is a mobile application-based intervention comprising: (1) eight structured educational modules targeting physical activity, (2) daily step monitoring and personalized goal setting, and (3) motivational features including reminders and feedback. The intervention components were designed mainly to strengthen knowledge, self-management competencies, and motivation. Respir'air BPCO is expected to be feasible and acceptable, and to promote physical activity, improve disease self-management and motivation, enhance health-related quality of life, reduce symptom severity, and decrease exacerbations and hospitalizations. Conclusion: Respir'air BPCO was developed through a structured, theory-based, and stakeholder-informed design process involving patients and health professionals. Feasibility and acceptability will be evaluated in future studies. Practice implications: The intervention may help extend self-management support after rehabilitation and promote physical activity maintenance in daily life of COPD patients.