Ledel Solem Ingrid Konstanse, Varsi Cecilie, Eide Hilde, Kristjansdottir Olöf Birna, Børøsund Elin, Schreurs Karlein M G, Waxenberg Lori B, Weiss Karen E, Morrison Eleshia J, Haaland-Øverby Mette, Bevan Katherine, Zangi Heidi Andersen, Stubhaug Audun, Solberg Nes Lise
Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway.
Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
J Med Internet Res. 2020 Jan 21;22(1):e15889. doi: 10.2196/15889.
Chronic pain conditions are complicated and challenging to live with. Electronic health (eHealth) interventions show promise in helping people cope with chronic illness, including pain. The success of these interventions depends not only on the technology and intervention content but also on the users' acceptance and adherence. Involving all stakeholders (eg, patients, spouses, health care providers, designers, software developers, and researchers) and exploring their input and preferences in the design and development process is an important step toward developing meaningful interventions and possibly strengthening treatment outcomes.
The aim of this study was to design and develop a user-centered, evidence-based eHealth self-management intervention for people with chronic pain.
The study employed a multidisciplinary and user-centered design approach. Overall, 20 stakeholders from the project team (ie, 7 researchers, 5 editors, 7 software developers, and 1 user representative), together with 33 external stakeholders (ie, 12 health care providers, 1 health care manger, 1 eHealth research psychologist, and 17 patients with chronic pain and 2 of their spouses) participated in a user-centered development process that included workshops, intervention content development, and usability testing. Intervention content was developed and finalized based on existing evidence, stakeholder input, and user testing. Stakeholder input was examined through qualitative analyses with rapid and in-depth analysis approaches.
Analyses from stakeholder input identified themes including a need for reliable, trustworthy, and evidence-based content, personalization, options for feedback, behavioral tracking, and self-assessment/registration as factors to include in the intervention. Evidence-based intervention content development resulted in one face-to-face introduction session and 9 app-based educational and exercise-based modules. Usability testing provided further insight into how to optimize the design of the intervention to the user group, identifying accessibility and a simple design to be essential.
The design and development process of eHealth interventions should strive to combine well-known evidence-based concepts with stakeholder input. This study, designing and developing the pain management intervention EPIO, illustrates how a stakeholder-centered design approach can provide essential input in the development of an eHealth self-management intervention for people with chronic pain.
ClinicalTrials.gov NCT03705104; https://clinicaltrials.gov/ct2/show/NCT03705104.
慢性疼痛状况复杂且难以应对。电子健康（eHealth）干预在帮助人们应对包括疼痛在内的慢性病方面显示出前景。这些干预措施的成功不仅取决于技术和干预内容，还取决于用户的接受程度和依从性。让所有利益相关者（如患者、配偶、医疗保健提供者、设计师、软件开发人员和研究人员）参与，并在设计和开发过程中探索他们的意见和偏好，是开发有意义的干预措施并可能加强治疗效果的重要一步。
本研究的目的是为慢性疼痛患者设计并开发一种以用户为中心、基于证据的电子健康自我管理干预措施。
该研究采用了多学科且以用户为中心的设计方法。总体而言，项目团队的20名利益相关者（即7名研究人员、5名编辑、7名软件开发人员和1名用户代表），以及33名外部利益相关者（即12名医疗保健提供者、1名医疗保健经理、1名电子健康研究心理学家、17名慢性疼痛患者及其2名配偶）参与了一个以用户为中心的开发过程，该过程包括研讨会、干预内容开发和可用性测试。干预内容是基于现有证据、利益相关者的意见和用户测试来制定和最终确定的。通过快速和深入分析的定性分析方法来研究利益相关者的意见。
对利益相关者意见的分析确定了一些主题，包括需要可靠、可信且基于证据的内容、个性化、反馈选项、行为跟踪以及自我评估/注册等作为干预措施应包含的因素。基于证据的干预内容开发产生了一次面对面介绍课程和9个基于应用程序的教育和运动模块。可用性测试进一步深入了解了如何针对用户群体优化干预措施的设计，确定可访问性和简单设计至关重要。
电子健康干预措施的设计和开发过程应努力将知名的基于证据的概念与利益相关者的意见相结合。本研究设计并开发疼痛管理干预措施EPIO，说明了以利益相关者为中心的设计方法如何能为慢性疼痛患者的电子健康自我管理干预措施的开发提供重要意见。
ClinicalTrials.gov NCT03705104；https://clinicaltrials.gov/ct2/show/NCT03705104 。
