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An online hand exercise intervention for adults with rheumatoid arthritis (mySARAH): design, development, and usability testing

An online hand exercise intervention for adults with rheumatoid arthritis (mySARAH): design, development, and usability testing
An online hand exercise intervention for adults with rheumatoid arthritis (mySARAH): design, development, and usability testing

BACKGROUND: The Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH) program is a tailored, progressive 12-week exercise program for people with hand problems due to rheumatoid arthritis. The program was shown to be clinically and cost-effective in a large clinical trial and is recommended by the UK National Institute for Health and Care Excellence (NICE) guidelines for rheumatoid arthritis in adults. OBJECTIVE: We have developed an online version of the SARAH program (mySARAH) to make the SARAH program widely accessible to people with rheumatoid arthritis. The purposes of this study were to develop mySARAH and to evaluate and address its usability issues. METHODS: We developed mySARAH using a three-step process and gaining feedback from patient contributors. After initial development, mySARAH was tested in two iterative usability cycles in nine participants using a simplified think-aloud protocol and self-reported questionnaires. We also evaluated if participants executed the SARAH exercises correctly after watching the exercise videos included on the website. RESULTS: A preliminary version of mySARAH consisting of six sessions over a 12-week period and delivered via text, exercise videos, images, exercise plan form, exercise calendar, and links to additional information on rheumatoid arthritis was developed. Five participants (1 male; 4 females; median age 64 years) and four participants (four females; median age 64.5 years) took part in the first and second usability testing cycles respectively. Usability issues identified from Cycle 1 such as having a navigation tutorial video and individualised feedback on pain levels were addressed prior to Cycle 2. The need for more instructions to complete the mySARAH patient forms was identified in Cycle 2 and was rectified. Self-reports from both cycles indicated that participants found the program useful and easy to use and were confident in performing the SARAH exercises themselves. Eight of the nine participants correctly demonstrated all the exercises. CONCLUSIONS: mySARAH is the first online hand exercise intervention for people with rheumatoid arthritis. We actively involved target users in the development and usability evaluation and ensured mySARAH met their needs and preferences.

exercise training, hand joints, rheumatoid arthritis, web-based
1438-8871
1-13
Srikesavan, Cynthia
9b35e197-ca5c-417c-bfb7-d0e6e8e348d7
Williamson, Esther
8adb517c-ddbc-4474-ab04-2e6108d856a5
Cranston, Tim
27536397-b5d3-44e6-b90f-27b2e260d8db
Hunter, John
ab0c9fe0-81b0-443f-b9fb-f5cb12c1c44d
Adams, Jo
6e38b8bb-9467-4585-86e4-14062b02bcba
Lamb, Sarah E.
210b9bca-47e9-4471-9fbf-6a82c35a98e2
Srikesavan, Cynthia
9b35e197-ca5c-417c-bfb7-d0e6e8e348d7
Williamson, Esther
8adb517c-ddbc-4474-ab04-2e6108d856a5
Cranston, Tim
27536397-b5d3-44e6-b90f-27b2e260d8db
Hunter, John
ab0c9fe0-81b0-443f-b9fb-f5cb12c1c44d
Adams, Jo
6e38b8bb-9467-4585-86e4-14062b02bcba
Lamb, Sarah E.
210b9bca-47e9-4471-9fbf-6a82c35a98e2

Srikesavan, Cynthia, Williamson, Esther, Cranston, Tim, Hunter, John, Adams, Jo and Lamb, Sarah E. (2019) An online hand exercise intervention for adults with rheumatoid arthritis (mySARAH): design, development, and usability testing. Journal of Medical Internet Research, 20 (6), 1-13, [e10457]. (doi:10.2196/10457).

Record type: Article

Abstract

BACKGROUND: The Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH) program is a tailored, progressive 12-week exercise program for people with hand problems due to rheumatoid arthritis. The program was shown to be clinically and cost-effective in a large clinical trial and is recommended by the UK National Institute for Health and Care Excellence (NICE) guidelines for rheumatoid arthritis in adults. OBJECTIVE: We have developed an online version of the SARAH program (mySARAH) to make the SARAH program widely accessible to people with rheumatoid arthritis. The purposes of this study were to develop mySARAH and to evaluate and address its usability issues. METHODS: We developed mySARAH using a three-step process and gaining feedback from patient contributors. After initial development, mySARAH was tested in two iterative usability cycles in nine participants using a simplified think-aloud protocol and self-reported questionnaires. We also evaluated if participants executed the SARAH exercises correctly after watching the exercise videos included on the website. RESULTS: A preliminary version of mySARAH consisting of six sessions over a 12-week period and delivered via text, exercise videos, images, exercise plan form, exercise calendar, and links to additional information on rheumatoid arthritis was developed. Five participants (1 male; 4 females; median age 64 years) and four participants (four females; median age 64.5 years) took part in the first and second usability testing cycles respectively. Usability issues identified from Cycle 1 such as having a navigation tutorial video and individualised feedback on pain levels were addressed prior to Cycle 2. The need for more instructions to complete the mySARAH patient forms was identified in Cycle 2 and was rectified. Self-reports from both cycles indicated that participants found the program useful and easy to use and were confident in performing the SARAH exercises themselves. Eight of the nine participants correctly demonstrated all the exercises. CONCLUSIONS: mySARAH is the first online hand exercise intervention for people with rheumatoid arthritis. We actively involved target users in the development and usability evaluation and ensured mySARAH met their needs and preferences.

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Accepted/In Press date: 24 April 2018
e-pub ahead of print date: 27 June 2018
Published date: June 2019
Keywords: exercise training, hand joints, rheumatoid arthritis, web-based

Identifiers

Local EPrints ID: 431469
URI: http://eprints.soton.ac.uk/id/eprint/431469
ISSN: 1438-8871
PURE UUID: cf471e5f-ef0d-4371-968c-4d255a285bce
ORCID for Jo Adams: ORCID iD orcid.org/0000-0003-1765-7060

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Date deposited: 05 Jun 2019 16:30
Last modified: 07 Oct 2020 01:38

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Contributors

Author: Cynthia Srikesavan
Author: Esther Williamson
Author: Tim Cranston
Author: John Hunter
Author: Jo Adams ORCID iD
Author: Sarah E. Lamb

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