Stefan Elbers

156 Chapter 6 as intended (i.e. teach-back) and evaluate progress. For patients, the collection of Insight Cards provided lasting access to their most meaningful rehabilitation experiences in their personal environment. VBG consisted of a worksheet that facilitated the formulation of meaningful goals. The first part of the worksheet prompted patients to identify important personal values. The second part consisted of a prespecified algorithm to formulate desirable and feasible goals that were related to one of the identified values and could be attained within 6 months. Patients were also encouraged to set up calendar reminders and organize social support. In the third part of the worksheet, patients could plan their goal-directed activities in multiple steps, which facilitated gradual progress toward the goal. For each step, patients indicated what, when, and where as they planned the activity. Next, patients were prompted to identify potential barriers and formulate adequate strategies to overcome these barriers. When the first step was completed, patients could plan consecutive steps until the goal was attained. By continuously using the same step-by-step sequence, patients learned to set desirable and feasible goals for themselves and progress toward attainment through achievable steps, while anticipating potential barriers (Supplement 2). Supplement 3 provides an overview of the prototype intervention components and behavior change techniques (BCTs), according to the BCT taxonomy V1 of Michie and colleagues (Michie et al., 2013). Both strategies were presented in the prototype workbook. This end result of the co-design project was not only based on cocreation and user experience evaluations but also informed by behavior change theory (Hermsen et al., 2014; Michie et al., 2013). To optimize the fit between the prototype intervention and the needs of each patient, we developed three workbook versions. Two workbook versions contained either VBG or Insight Cards. The third workbook version contained both strategies. Procedure We wanted to minimize the impact of this study on existing treatment procedures to resemble a real-world situation as much as possible. Therefore, we did not prescribe when, how, or how much the workbook should be used. Rather, treatment teams were free to select the appropriate patient and time point for introducing any of the workbook versions. For each participating treatment team, a 1-hour training session was provided in which the content of the workbook and suggestions for integrating the strategies into the treatment program were explained (e.g., by encouraging patients to use an Insight Card to express a particular relevant treatment experience). Patient inclusion was permitted at any time during treatment, as long as the HCPs considered the workbook to be of potential additional