ArticleBMC primary care2026
Destress II: using the Behaviour Change Wheel and preliminary testing to co-develop a complex intervention to improve the quality of primary care responses to people experiencing poverty-related mental distress.
Article in BMC primary care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUK policy recommends non-pharmacological interventions as a first-line response to depression, yet antidepressant prescribing continues to rise, particularly in low income communities. Structural barriers, including short consultation times and long waiting lists for talking therapies, often lead to prescribing as a pragmatic but limited response to social suffering, costing the NHS approximately £230 million annually. While clinicians and patients seek more holistic approaches, there is a lack of actionable guidance on how to implement these alternatives within primary care service pressures. The aim of this study was to co-develop a theory-informed intervention to help primary care staff improve their understanding of how poverty and social determinants impact mental health. The intervention seeks to build empathy and trust within short consultations, promote more prudent antidepressant prescribing, and encourage the use of non-pharmacological support through enhanced team working.
methodsThe Behaviour Change Wheel was used to co-develop a complex intervention (Destress-II) aimed at primary care staff. A group of GPs (n = 19) and members of low-income communities (n = 17) followed BCW stages to create the intervention. In 2022-3, Phase 1 piloted an in-person iteration with 53 practices; qualitative data from trainers and participants were analysed using descriptive thematic analysis. Refined into a practice-delivered web-resource, the intervention was tested in a further 30 practices in Phase 2 and re-evaluated using interviews.
resultsBoth phases identified three main themes: content, delivery, and acceptability within time-pressured services. Participants valued the content and the team-discussion aspect, finding the brief duration appropriate for existing training meetings. Many appreciated the intervention for reinforcing holistic approaches rather than introducing entirely new concepts.
conclusionThe study successfully co-developed an acceptable and feasible intervention to improve clinical responses to mental distress exacerbated by poverty and wider social circumstances. The co-development approach to complex interventions is transferable to other clinical areas.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.