Home » Self-Care Promotion » Guideline on how to promote self-care: Urinary tract infection (UTI) » 4. Select and implement self-care promotion intervention(s)

4. Select and implement self-care promotion intervention(s)

Select and implement self-care promotion intervention(s)

  • Linking intervention(s) with the hindering/facilitating mechanisms
  • Selecting intervention(s)
  • Piloting intervention(s)
  • Implementing intervention(s)

4.1. Linking intervention(s) with the hindering/facilitating mechanisms

Once the hindering or facilitating mechanisms have been identified a key next step can be to link interventions to those mechanisms.

There are numerous interventions that could potentially contribute to the promotion of self-care in urinary tract infection for the selected target issues (reduce incidence; reduce severity of cases; increase the adherence and reduce inappropriate use of antibiotics in asymptomatic bacteriuria).

The table presented in point 4.2 highlights types of interventions that could target those issues addressing the detected hindering or facilitating mechanisms, with special attention three key areas of hindering or facilitating mechanisms highlighted before: the patients’/general population knowledge and skills, organizational factors and the specific most vulnerable groups in the general population.

4.2. Selecting intervention(s)

As it was highlighted in the evaluation of mechanisms there are key areas to consider.

The following tables illustrate types of self-care promotion interventions that could address those mechanisms with the final goal of improving the key drivers for self-care promotion in ITU.

Suggested interventions by key issues
Reduce incidence
Reducing recurrence rate
Reduce severity
Improve adherence to treatment
Key characteristics of the issue
General/specific issue
Level to address the issue
Key focus that the self-care promotion strategy requires or should include
  • Structural interventions
  • Staff-oriented interventions
  • Financial interventions
  • Financial incentives to patients
  • Financial incentives to Primary Care Centers
Patient-focused interventions
  • Skill development
  • Behaviour change
  • Family support
  • Information provision
Professional-focused interventions
  • Educational interventions
  • Educational materials
  • Large-scale educational meetings
  • Small-scale educational meetings
  • Outreach visits
  • Use of opinion leaders
  • Feedbacks and reminders
  • Feedback
  • Reminders
  • Local consensus processes

From this analysis the following type of interventions could be recommended:

It is important to bear in mind that most interventions are multifaceted so include more than one area, however to facilitate the analytical line the interventions have been divided in information strategies and organizational strategies.

  • Information strategies: Information, with a special focus on symptom recognition and evaluation.

One of the identified potentially hindering mechanisms related to urinary tract infection was the lack of knowledge regarding the prevention behaviours and techniques.

Information strategies can have some beneficial results to tackle this issue. Some examples of those initiatives are:

Examples of similar practices in:

  • UK: NHS Choices – Urinary tract infection [10]
  • France: Améli.Santé – Infection urinaire [11]
  • Netherlands: Zelfzorg.nl [12]
  • Sweden: 1177 Vårdguiden – Urinvägsinfektion [13]

In those cases the challenge would be how to reach the susceptible population (particularly young women) prior to experiencing a UTI. For more tips on how to communicate check the Communication Guideline.

Information based strategies should pay special attention to health literacy barriers, for tips on how to address this in communication strategies see the health literacy checklist in the Communication Guidelines.

Note: An information campaign should be tailored to the needs of the population, so depending on the ethnic composition of the implementing context, the material of the interventions might have to be translated to multiple languages and be adapted to some cultural traits (see implementing intervention sub-section).

Given the high recurrence rate of UTI, there are also opportunities for communication directly between GPs and patients in the occurrence of an episode of UTI. Focusing on prevention strategies in this moment can be particularly effective due to the sensibilization of patients at that moment.

Consider active distribution of information or documentation illustrated with tips to follow to prevent future UTIs , mainly lifestyle and hygiene habits (for more information see table on self-care behaviours to promote).

In order to promote this communication at consultation level two essential strategies should be included: training for professionals on communication skills (if needed) and providing support elements to professionals to inform and educate patients (graphics, internet, ads, screens in consultations, etc.).

Organizational strategies:

One of the identified organization strategies to promote self-care for ITU is the self-diagnosis for telephone management.

Some studies have shown that some women who self-diagnose a UTI may be treated safely with telephone management. Women who have had acute uncomplicated cystitis previously are usually accurate in determining when they are having another episode. [5]

Remember that before implementing a piloting of the interventions is recommended. For tips regarding Implementation of interventions see the section in the general guideline