Abstract
This paper illustrates a rigorous approach to developing digital interventions using an evidence-, theory- and person-based approach. Intervention planning included a rapid scoping review that identified cancer survivors’ needs, including barriers and facilitators to intervention success. Review evidence (N = 49 papers) informed the intervention’s Guiding Principles, theory-based behavioural analysis and logic model. The intervention was optimised based on feedback on a prototype intervention through interviews (N = 96) with cancer survivors and focus groups with NHS staff and cancer charity workers (N = 31). Interviews with cancer survivors highlighted barriers to engagement, such as concerns about physical activity worsening fatigue. Focus groups highlighted concerns about support appointment length and how to support distressed participants. Feedback informed intervention modifications, to maximise acceptability, feasibility and likelihood of behaviour change. Our systematic method for understanding user views enabled us to anticipate and address important barriers to engagement. This methodology may be useful to others developing digital interventions.
Highlights
The UK has one of the lowest cancer survival rates among highincome countries[1] and quality of life (QoL) in some cancer survivors is poor, equivalent to chronic diseases.[2,3] Problems faced include fatigue,[4] pain,[5] weight gain,[6] depression and anxiety[7,8] and fear of recurrence.[9]
A number of barriers to engagement with the Renewed digital intervention and offline behaviour changes were identified
This paper demonstrates a methodological approach, which could be useful to others developing digital interventions
Summary
The UK has one of the lowest cancer survival rates among highincome countries[1] and quality of life (QoL) in some cancer survivors is poor, equivalent to chronic diseases.[2,3] Problems faced include fatigue,[4] pain,[5] weight gain,[6] depression and anxiety[7,8] and fear of recurrence.[9]. Failure to address barriers in a healthcare environment is linked The Guiding Principles aimed to ensure the intervention with failed digital interventions for cancer survivors, whereas addressed all of these challenges Those that do take the implementation setting into account (e.g. through eliciting staff views) have proven successful.[22] Reviews have highlighted that only a minority of studies incorporate the views of stakeholders who might be crucial to implementation[22,23] or use implementation theory that considers the environment in which an intervention will be set[22] when developing digital interventions for cancer survivors. The current paper attempts to overcome the limitations of development methodologies highlighted in reviews of digital interventions for cancer survivors It provides a detailed report of the development process of Renewed, which used an evidence-, theory- and person-based approach to intervention planning and optimisation.[24,25,26] The approach combined Patient and Public. Participants made many positive comments about Renewed, in particular participants often liked the look of Renewed, found the majority of the website easy to navigate and some noted that they trusted the website as it was designed by experts and found the
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