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Supporting self-management among young people with acne vulgaris through a web-based behavioral intervention: development and feasibility randomized controlled trial

Supporting self-management among young people with acne vulgaris through a web-based behavioral intervention: development and feasibility randomized controlled trial
Supporting self-management among young people with acne vulgaris through a web-based behavioral intervention: development and feasibility randomized controlled trial
Background: acne is a common skin condition that is most prevalent in young people. It can have a substantial impact on the quality of life, which can be minimized with the appropriate use of topical treatments. Nonadherence to topical treatments for acne is common and often leads to treatment failure.

Objective: the aim of this study is to develop a web-based behavioral intervention to support the self-management of acne and to assess the feasibility of recruitment, retention, and engagement of users with the intervention.

Methods: the intervention was developed iteratively using the LifeGuide software and following the person-based approach for intervention development. The target behavior was appropriate use of topical treatments. Barriers and facilitators identified from the qualitative research and evidence from the wider literature were used to identify techniques to improve and promote their use. Young people with acne aged 14-25 years who had received treatment for acne in the past 6 months were invited to participate through mail-out from primary care practices in the South of England in a parallel, unblinded randomized trial. Participants were automatically randomized using a computer-generated algorithm to usual care or to usual care plus access to the web-based intervention. Usage data was collected, and a series of questionnaires, including the primary outcome measure for skin-specific quality of life (Skindex-16), were collected at baseline and at the 4- and 6-week follow-ups.

Results: a total of 1193 participants were invited, and 53 young people with acne were randomized to usual care (27/53, 51%) or usual care plus intervention (26/53, 49%). The response rate for the primary outcome measure (Skindex-16) was 87% at 4 weeks, 6 weeks, and at both time points. The estimate of mean scores between groups (with 95% CI) using linear regression showed a trend in the direction of benefit for the web-based intervention group in the primary outcome measure (Skindex-16) and secondary measures (Patient Health Questionnaire-4 and the Problematic Experiences of Therapy Scale). Intervention usage data showed high uptake of the core module in the usual care plus web-based intervention group, with 88% (23/26) of participants completing the module. Uptake of the optional modules was low, with less than half visiting each (myth-busting quiz: 27%; living with spots or acne: 42%; oral antibiotics: 19%; what are spots or acne: 27%; other treatments: 27%; talking to your general practitioner: 12%).

Conclusions: this study demonstrated the feasibility of delivering a trial of a web-based intervention to support self-management in young people with acne. Additional work is needed before a full definitive trial, including enhancing engagement with the intervention, recruitment, and follow-up rates.
2562-0959
Ip, Athena
a61d3c1f-66b6-471b-9dc8-e29aea14c449
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
Geraghty, Adam
2c6549fe-9868-4806-b65a-21881c1930af
Rumsby, Kate
dd9f1fe4-f17b-4a93-9e28-17104eab5b38
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc
Ip, Athena
a61d3c1f-66b6-471b-9dc8-e29aea14c449
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
Geraghty, Adam
2c6549fe-9868-4806-b65a-21881c1930af
Rumsby, Kate
dd9f1fe4-f17b-4a93-9e28-17104eab5b38
Stuart, Beth
626862fc-892b-4f6d-9cbb-7a8d7172b209
Little, Paul
1bf2d1f7-200c-47a5-ab16-fe5a8756a777
Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc

Ip, Athena, Muller, Ingrid, Geraghty, Adam, Rumsby, Kate, Stuart, Beth, Little, Paul and Santer, Miriam (2021) Supporting self-management among young people with acne vulgaris through a web-based behavioral intervention: development and feasibility randomized controlled trial. JMIR Dermatology, 4 (2), [2]. (doi:10.2196/25918).

Record type: Article

Abstract

Background: acne is a common skin condition that is most prevalent in young people. It can have a substantial impact on the quality of life, which can be minimized with the appropriate use of topical treatments. Nonadherence to topical treatments for acne is common and often leads to treatment failure.

Objective: the aim of this study is to develop a web-based behavioral intervention to support the self-management of acne and to assess the feasibility of recruitment, retention, and engagement of users with the intervention.

Methods: the intervention was developed iteratively using the LifeGuide software and following the person-based approach for intervention development. The target behavior was appropriate use of topical treatments. Barriers and facilitators identified from the qualitative research and evidence from the wider literature were used to identify techniques to improve and promote their use. Young people with acne aged 14-25 years who had received treatment for acne in the past 6 months were invited to participate through mail-out from primary care practices in the South of England in a parallel, unblinded randomized trial. Participants were automatically randomized using a computer-generated algorithm to usual care or to usual care plus access to the web-based intervention. Usage data was collected, and a series of questionnaires, including the primary outcome measure for skin-specific quality of life (Skindex-16), were collected at baseline and at the 4- and 6-week follow-ups.

Results: a total of 1193 participants were invited, and 53 young people with acne were randomized to usual care (27/53, 51%) or usual care plus intervention (26/53, 49%). The response rate for the primary outcome measure (Skindex-16) was 87% at 4 weeks, 6 weeks, and at both time points. The estimate of mean scores between groups (with 95% CI) using linear regression showed a trend in the direction of benefit for the web-based intervention group in the primary outcome measure (Skindex-16) and secondary measures (Patient Health Questionnaire-4 and the Problematic Experiences of Therapy Scale). Intervention usage data showed high uptake of the core module in the usual care plus web-based intervention group, with 88% (23/26) of participants completing the module. Uptake of the optional modules was low, with less than half visiting each (myth-busting quiz: 27%; living with spots or acne: 42%; oral antibiotics: 19%; what are spots or acne: 27%; other treatments: 27%; talking to your general practitioner: 12%).

Conclusions: this study demonstrated the feasibility of delivering a trial of a web-based intervention to support self-management in young people with acne. Additional work is needed before a full definitive trial, including enhancing engagement with the intervention, recruitment, and follow-up rates.

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e-pub ahead of print date: 20 November 2021

Identifiers

Local EPrints ID: 455971
URI: http://eprints.soton.ac.uk/id/eprint/455971
ISSN: 2562-0959
PURE UUID: f29d0dbf-483e-4648-8a1d-fcf9788cb7c2
ORCID for Athena Ip: ORCID iD orcid.org/0000-0002-8574-2569
ORCID for Ingrid Muller: ORCID iD orcid.org/0000-0001-9341-6133
ORCID for Adam Geraghty: ORCID iD orcid.org/0000-0001-7984-8351
ORCID for Beth Stuart: ORCID iD orcid.org/0000-0001-5432-7437
ORCID for Miriam Santer: ORCID iD orcid.org/0000-0001-7264-5260

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Date deposited: 11 Apr 2022 16:54
Last modified: 12 Apr 2022 01:42

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Contributors

Author: Athena Ip ORCID iD
Author: Ingrid Muller ORCID iD
Author: Adam Geraghty ORCID iD
Author: Kate Rumsby
Author: Beth Stuart ORCID iD
Author: Paul Little
Author: Miriam Santer ORCID iD

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