Introduction: SPUR, a Valuable Tool for Research
SPUR is a dynamic and predictive self-assessment questionnaire. Over the past 4 years, several tens of thousands of patients have tested SPUR, and our international research protocol validated the tool with the input of 2,500 patients globally. SPUR reliably detects a patient's risk of non-adherence and accurately articulates the reasons for his/her health behavior along four over-arching dimensions: Social, Psychological, Usage and Rational (the initials form the name SPUR).
SPUR is unique insofar as it allows researchers to:
- Understand chronic patients’ behavior holistically,
- Accurately detect the risk of non-adherence, even for naïve patients,
- Limit bias through usage of Likert scale and non-judgmental question phrasing, and
- Adapt suggestions for patient support.
Theoretical Frameworks behind SPUR
SPUR™ aggregates and distills decades of proven theories and models in behavioral science into a single validated digital tool. SPUR’s building blocks were informed by the following theories and models,
- the Health Model Belief, established in the 1950s, which posits that a patient's beliefs in both the threat represented by the illness and the efficacy of the recommended treatment will determine his/her adherence to the recommended behavior,
- the Theory of Planned Behavior, developed in the 1980s, which posits that behavior change requires active decision and planning, and that intentions to perform behaviors of different kinds can be predicted accurately from attitudes toward the behavior, subjective norms, and perceived behavioral control,
- the COM-B model, developed in early 2000s, which identifies three factors that need to be present for any behavior to occur: capability, opportunity and motivation, and
- the Transtheoretical Model of Change, developed in the 1970s, which lays out six stages of intentional change within health behavior change.
Various profiling approaches have built on the successes and addressed the shortcomings of their predecessors. One of the innovations of SPUR is its focus on the motivational dimension, through the evaluation of psychological drivers with demonstrated influence on adherence in chronic patients: rejection of identity as a patient, reactance and discounting of future benefits.
Health Behavior in Four Dimensions
Within the four over-arching dimensions of health behavior, SPUR calculates a score for 13 individual drivers: