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

Greenwell, K and Ghio, D and Sivyer, K and Steele, M and Teasdale, Emma and Ridd, M.J and Roberts, A and Chalmers, J and Lawton, Sandra and Langan, Sinead M and Cowdell, Fiona and Le Roux, Emma and Wilczynska, Sylvia and Jones, Hannah and Whittaker, Emilia and Williams, HC and Thomas, Kim Suzanne and Yardely, Lucy and 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. ISSN 2044-6055

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Objectives: To describe the development of Eczema Care Online (ECO), an online behaviour change intervention for young people with eczema (Phase 1); and explore and optimise the acceptability of ECO among this target group using think-aloud interviews (Phase 2).
Methods: Theory-, evidence-, and person-based approaches to intervention development were used. In Phase 1, 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 needs of this target group to maximise user engagement. Behavioural analysis and logic modelling developed ECO’s hypothesised programme theory. In Phase 2, 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 and 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.

Item Type: Article
Identification Number: bmjopen-2021-056867
4 April 2022Accepted
20 April 2022Published Online
Subjects: CAH00 - multidisciplinary > CAH00-00 - multidisciplinary > CAH00-00-00 - multidisciplinary
CAH02 - subjects allied to medicine > CAH02-04 - nursing and midwifery > CAH02-04-05 - children's nursing
Divisions: Faculty of Health, Education and Life Sciences > School of Nursing and Midwifery
Depositing User: Fiona Cowdell
Date Deposited: 04 Apr 2022 15:43
Last Modified: 29 Apr 2022 09:43

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