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Eczema Care Online: development and qualitative optimisation of an online behavioural intervention to support self-management in young people with eczema

Eczema Care Online: development and qualitative optimisation of an online behavioural intervention to support self-management in young people with eczema
Eczema Care Online: development and qualitative optimisation of an online behavioural intervention to support self-management in young people with eczema
Objectives To describe the development of Eczema Care Online (ECO), an online behaviour change intervention for young people with eczema (phase I); and explore and optimise the acceptability of ECO among this target group using think-aloud interviews (phase II).

Methods Theory-based, evidence-based and person-based approaches to intervention development were used. In phase I, a qualitative systematic review and qualitative interviews developed an in-depth understanding of the needs and challenges of young people with eczema. Guiding principles highlighted key intervention design objectives and features to address the needs of this target group to maximise user engagement. Behavioural analysis and logic modelling developed ECO’s hypothesised programme theory. In phase II, qualitative think-aloud interviews were carried out with 28 young people with eczema and the intervention was optimised based on their feedback.

Results The final intervention aimed to reduce eczema severity by supporting treatment use (emollients, topical corticosteroids/topical calcineurin inhibitors), management of irritants/triggers, emotional management and reducing scratching. Generally, young people expressed positive views of intervention content and design in think-aloud interviews. Quotes and stories from other young people with eczema and ECO’s focus on living with eczema (not just topical treatments) were valuable for normalising eczema. Young people believed ECO addressed knowledge gaps they had from childhood and the safety information about topical corticosteroids was reassuring. Negative feedback was used to modify ECO.

Conclusions A prototype of the ECO intervention was developed using rigorous and complementary intervention development approaches. Subsequent think-aloud interviews helped optimise the intervention, demonstrated ECO is likely to be acceptable to this target group, and provided support for our guiding principles including key design objectives and features to consider when developing interventions for this population. A randomised controlled trial and process evaluation of the intervention is underway to assess effectiveness and explore user engagement with the intervention’s behavioural goals.
eczema, paediatric dermatology, primary care, qualitative research
2044-6055
Greenwell, Kate
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Ghio, Daniela
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Sivyer, Katy
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Steele, Mary
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Teasdale, Emma
158b9b56-bff0-4309-8ffc-f2583695a70e
Ridd, Matthew J.
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Roberts, Amanda
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Chalmers, Joanne R.
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Lawton, Sandra
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Langan, Sinéad
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Cowdell, Fiona
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Le Roux, Emma
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Wilczynska, Sylvia
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Jones, Hannah
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Whittaker, Emilia
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Williams, H.C.
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Thomas, Kim Suzanne
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Yardley, Lucy
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Santer, Miriam
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Muller, Ingrid
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Greenwell, Kate
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Ghio, Daniela
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Sivyer, Katy
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Steele, Mary
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Teasdale, Emma
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Ridd, Matthew J.
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Roberts, Amanda
e6039287-3653-43e2-84ce-22b27db8640d
Chalmers, Joanne R.
94e08e98-5c93-405d-9278-97acfe4985a0
Lawton, Sandra
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Langan, Sinéad
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Cowdell, Fiona
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Le Roux, Emma
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Wilczynska, Sylvia
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Jones, Hannah
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Whittaker, Emilia
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Williams, H.C.
41a47f08-d65d-4c83-ba87-139a31125483
Thomas, Kim Suzanne
8c6a245a-af7a-4d25-8a16-ad9d5ab1cc72
Yardley, Lucy
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Santer, Miriam
3ce7e832-31eb-4d27-9876-3a1cd7f381dc
Muller, Ingrid
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Greenwell, Kate, Ghio, Daniela, Sivyer, Katy, Steele, Mary, Teasdale, Emma, Ridd, Matthew J., Roberts, Amanda, Chalmers, Joanne R., Lawton, Sandra, Langan, Sinéad, Cowdell, Fiona, Le Roux, Emma, Wilczynska, Sylvia, Jones, Hannah, Whittaker, Emilia, Williams, H.C., Thomas, Kim Suzanne, Yardley, Lucy, Santer, Miriam and Muller, Ingrid (2022) Eczema Care Online: development and qualitative optimisation of an online behavioural intervention to support self-management in young people with eczema. BMJ Open, 12 (4), [12:e056867]. (doi:10.1136/bmjopen-2021-056867).

Record type: Article

Abstract

Objectives To describe the development of Eczema Care Online (ECO), an online behaviour change intervention for young people with eczema (phase I); and explore and optimise the acceptability of ECO among this target group using think-aloud interviews (phase II).

Methods Theory-based, evidence-based and person-based approaches to intervention development were used. In phase I, a qualitative systematic review and qualitative interviews developed an in-depth understanding of the needs and challenges of young people with eczema. Guiding principles highlighted key intervention design objectives and features to address the needs of this target group to maximise user engagement. Behavioural analysis and logic modelling developed ECO’s hypothesised programme theory. In phase II, qualitative think-aloud interviews were carried out with 28 young people with eczema and the intervention was optimised based on their feedback.

Results The final intervention aimed to reduce eczema severity by supporting treatment use (emollients, topical corticosteroids/topical calcineurin inhibitors), management of irritants/triggers, emotional management and reducing scratching. Generally, young people expressed positive views of intervention content and design in think-aloud interviews. Quotes and stories from other young people with eczema and ECO’s focus on living with eczema (not just topical treatments) were valuable for normalising eczema. Young people believed ECO addressed knowledge gaps they had from childhood and the safety information about topical corticosteroids was reassuring. Negative feedback was used to modify ECO.

Conclusions A prototype of the ECO intervention was developed using rigorous and complementary intervention development approaches. Subsequent think-aloud interviews helped optimise the intervention, demonstrated ECO is likely to be acceptable to this target group, and provided support for our guiding principles including key design objectives and features to consider when developing interventions for this population. A randomised controlled trial and process evaluation of the intervention is underway to assess effectiveness and explore user engagement with the intervention’s behavioural goals.

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Accepted/In Press date: 3 April 2022
e-pub ahead of print date: 20 April 2022
Keywords: eczema, paediatric dermatology, primary care, qualitative research

Identifiers

Local EPrints ID: 456970
URI: http://eprints.soton.ac.uk/id/eprint/456970
ISSN: 2044-6055
PURE UUID: 4da3e825-2b15-4bc3-9b59-bc02d939e8b3
ORCID for Kate Greenwell: ORCID iD orcid.org/0000-0002-3662-1488
ORCID for Katy Sivyer: ORCID iD orcid.org/0000-0003-4349-0102
ORCID for Mary Steele: ORCID iD orcid.org/0000-0003-2595-3855
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X
ORCID for Miriam Santer: ORCID iD orcid.org/0000-0001-7264-5260
ORCID for Ingrid Muller: ORCID iD orcid.org/0000-0001-9341-6133

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Date deposited: 18 May 2022 17:04
Last modified: 10 Jun 2022 01:47

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Contributors

Author: Kate Greenwell ORCID iD
Author: Daniela Ghio
Author: Katy Sivyer ORCID iD
Author: Mary Steele ORCID iD
Author: Emma Teasdale
Author: Matthew J. Ridd
Author: Amanda Roberts
Author: Joanne R. Chalmers
Author: Sandra Lawton
Author: Sinéad Langan
Author: Fiona Cowdell
Author: Emma Le Roux
Author: Sylvia Wilczynska
Author: Hannah Jones
Author: Emilia Whittaker
Author: H.C. Williams
Author: Kim Suzanne Thomas
Author: Lucy Yardley ORCID iD
Author: Miriam Santer ORCID iD
Author: Ingrid Muller ORCID iD

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