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The Space From Heart Disease Intervention for People With Cardiovascular Disease and Distress: A Mixed-Methods Study.

Barley EA, Clifton A, Lee G, Norman IJ, O'Callaghan D, Tierney K, Richards D - JMIR Res Protoc (2015)

Bottom Line: The use of multiple evaluation tests informed improvements to content and usability.Preliminary acceptability and feasibility has been demonstrated.The Space from Heart Disease intervention is now ready to be tested for effectiveness.

View Article: PubMed Central - HTML - PubMed

Affiliation: Post Graduate Research Department, Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, United Kingdom. elizabeth.barley@kcl.ac.uk.

ABSTRACT

Background: Poor self-management of symptoms and psychological distress leads to worse outcomes and excess health service use in cardiovascular disease (CVD). Online-delivered therapy is effective, but generic interventions lack relevance for people with specific long-term conditions, such as cardiovascular disease.

Objective: To develop a comprehensive online CVD-specific intervention to improve both self-management and well-being, and to test acceptability and feasibility.

Methods: Informed by the Medical Research Council (MRC) guidance for the development of complex interventions, we adapted an existing evidence-based generic intervention for depression and anxiety for people with CVD. Content was informed by a literature review of existing resources and trial evidence, and the findings of a focus group study. Think-aloud usability testing was conducted to identify improvements to design and content. Acceptability and feasibility were tested in a cross-sectional study.

Results: Focus group participants (n=10) agreed that no existing resource met all their needs. Improvements such as "collapse and expand" features were added based on findings that participants' information needs varied, and specific information, such as detecting heart attacks and when to seek help, was added. Think-aloud testing (n=2) led to changes in font size and design changes around navigation. All participants of the cross-sectional study (10/10, 100%) were able to access and use the intervention. Reported satisfaction was good, although the intervention was perceived to lack relevance for people without comorbid psychological distress.

Conclusions: We have developed an evidence-based, theory-informed, user-led online intervention for improving self-management and well-being in CVD. The use of multiple evaluation tests informed improvements to content and usability. Preliminary acceptability and feasibility has been demonstrated. The Space from Heart Disease intervention is now ready to be tested for effectiveness. This work has also identified that people with CVD symptoms and comorbid distress would be the most appropriate sample for a future randomized controlled trial to evaluate its effectiveness.

No MeSH data available.


Related in: MedlinePlus

Screenshot of Space from Heart Disease home page.
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figure2: Screenshot of Space from Heart Disease home page.

Mentions: Space from Heart Disease is an online psychoeducational and therapeutic intervention designed to support self-management of symptoms and to promote the well-being of people with CVD. A modular design (see Table 1) was used to increase engagement by allowing users to select content relevant to them. The existing SilverCloud intervention for distress delivers cognitive behavioral therapy; we adapted this to include CBT for coping with chest pain, fatigue, and breathlessness. Our literature review also identified specific behavior change techniques—see, for example, the Coventry, Aberdeen and London Refined (CALO-RE) taxonomy [40]—which are effective for CVD-related self-management. For instance, users are helped to apply outcome goal setting (ie, “I will drink no more than one glass of wine on week days") and action planning (ie, deciding in advance what steps to take when faced with a health-related choice, including what to do, where to do it, when to do it, and who will help) to help them to make healthy choices. A summary of module content is shown in Table 1. A tracker app allows users to record their daily activities as part of the therapy, for instance, as a homework task, and a journal function allows users to record free-text thoughts and comments. Standardized outcome measures can also be collected and results displayed graphically; quizzes are used to consolidate learning. Figure 2 shows a screenshot of the home page. Patient stories are used across the modules to provide context. The platform facilitates users to share their work, information, tasks, homework activities, etc, with a supporter, although a supporter was not provided during this development stage.


The Space From Heart Disease Intervention for People With Cardiovascular Disease and Distress: A Mixed-Methods Study.

Barley EA, Clifton A, Lee G, Norman IJ, O'Callaghan D, Tierney K, Richards D - JMIR Res Protoc (2015)

Screenshot of Space from Heart Disease home page.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4526970&req=5

figure2: Screenshot of Space from Heart Disease home page.
Mentions: Space from Heart Disease is an online psychoeducational and therapeutic intervention designed to support self-management of symptoms and to promote the well-being of people with CVD. A modular design (see Table 1) was used to increase engagement by allowing users to select content relevant to them. The existing SilverCloud intervention for distress delivers cognitive behavioral therapy; we adapted this to include CBT for coping with chest pain, fatigue, and breathlessness. Our literature review also identified specific behavior change techniques—see, for example, the Coventry, Aberdeen and London Refined (CALO-RE) taxonomy [40]—which are effective for CVD-related self-management. For instance, users are helped to apply outcome goal setting (ie, “I will drink no more than one glass of wine on week days") and action planning (ie, deciding in advance what steps to take when faced with a health-related choice, including what to do, where to do it, when to do it, and who will help) to help them to make healthy choices. A summary of module content is shown in Table 1. A tracker app allows users to record their daily activities as part of the therapy, for instance, as a homework task, and a journal function allows users to record free-text thoughts and comments. Standardized outcome measures can also be collected and results displayed graphically; quizzes are used to consolidate learning. Figure 2 shows a screenshot of the home page. Patient stories are used across the modules to provide context. The platform facilitates users to share their work, information, tasks, homework activities, etc, with a supporter, although a supporter was not provided during this development stage.

Bottom Line: The use of multiple evaluation tests informed improvements to content and usability.Preliminary acceptability and feasibility has been demonstrated.The Space from Heart Disease intervention is now ready to be tested for effectiveness.

View Article: PubMed Central - HTML - PubMed

Affiliation: Post Graduate Research Department, Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, United Kingdom. elizabeth.barley@kcl.ac.uk.

ABSTRACT

Background: Poor self-management of symptoms and psychological distress leads to worse outcomes and excess health service use in cardiovascular disease (CVD). Online-delivered therapy is effective, but generic interventions lack relevance for people with specific long-term conditions, such as cardiovascular disease.

Objective: To develop a comprehensive online CVD-specific intervention to improve both self-management and well-being, and to test acceptability and feasibility.

Methods: Informed by the Medical Research Council (MRC) guidance for the development of complex interventions, we adapted an existing evidence-based generic intervention for depression and anxiety for people with CVD. Content was informed by a literature review of existing resources and trial evidence, and the findings of a focus group study. Think-aloud usability testing was conducted to identify improvements to design and content. Acceptability and feasibility were tested in a cross-sectional study.

Results: Focus group participants (n=10) agreed that no existing resource met all their needs. Improvements such as "collapse and expand" features were added based on findings that participants' information needs varied, and specific information, such as detecting heart attacks and when to seek help, was added. Think-aloud testing (n=2) led to changes in font size and design changes around navigation. All participants of the cross-sectional study (10/10, 100%) were able to access and use the intervention. Reported satisfaction was good, although the intervention was perceived to lack relevance for people without comorbid psychological distress.

Conclusions: We have developed an evidence-based, theory-informed, user-led online intervention for improving self-management and well-being in CVD. The use of multiple evaluation tests informed improvements to content and usability. Preliminary acceptability and feasibility has been demonstrated. The Space from Heart Disease intervention is now ready to be tested for effectiveness. This work has also identified that people with CVD symptoms and comorbid distress would be the most appropriate sample for a future randomized controlled trial to evaluate its effectiveness.

No MeSH data available.


Related in: MedlinePlus