Abstract
BackgroundJoint pain caused by osteoarthritis (OA) is highly prevalent and can be extremely debilitating. Programs to support self-management of joint pain can be effective; however, most programs are designed to build self-efficacy and rarely engage social networks. Digital interventions are considered acceptable by people with joint pain. However, many existing resources are not accessible for or developed alongside people with lower health literacy, which disproportionately affects people with OA.ObjectiveThis study aims to design and develop an accessible digital self-management tool for people with joint pain and integrate this with an existing social network activation tool (Generating Engagement in Network Involvement [GENIE]) and to explore the feasibility of these linked tools for supporting the management of joint pain.MethodsThe study was conducted in 2 phases: a design and development stage and a small-scale evaluation. The first phase followed the person-based approach to establish guiding principles for the development of a new site (Managing joint Pain On the Web and through Resources [EMPOWER]) and its integration with GENIE. People with joint pain were recruited from libraries, a community café, and an exercise scheme to take part in 3 focus groups. EMPOWER was tested and refined using think-aloud interviews (n=6). In the second phase, participants were recruited through the web via libraries to participate in a small-scale evaluation using the LifeGuide platform to record use over a 1-month period. Participants (n=6) were asked to complete evaluation questionnaires on their experiences. The NASSS (nonadoption, abandonment, scale-up, spread, and sustainability) framework was used to explore the feasibility of the sites.ResultsThe focus groups established guiding principles for the development of the tool. These included ensuring accessibility and relevance for people with OA-related joint pain and recognizing that joint pain is the reason for seeking support, trust, social facilitation, and goal setting. Think-aloud interviews identified issues with user experience and site navigation and the need for professional input for referral and goal setting, confusion, and tensions over the role of GENIE and site connectivity. Participants expected the sites to be specific to their pain-related needs. EMPOWER was accessed 18 times; 6 users registered with the site during the evaluation study. Participants mostly explored information pages on being active and being a healthy weight. Only one participant undertook goal setting and 4 participants visited the GENIE website.ConclusionsUsing the NASSS framework, we identified the complexity associated with integrating EMPOWER and GENIE. The value proposition domain highlighted the technical and conceptual complexity associated with integrating approaches. Although identified as theoretically achievable, the integration of differing propositions may have caused cognitive and practical burdens for users. Nevertheless, we believe that both approaches have a distinct role in the self-management of joint pain.
Highlights
BackgroundJoint pain secondary to osteoarthritis (OA) causes disability for many people and can be associated with a loss of independence [1,2]
Using the NASSS framework, we identified the complexity associated with integrating EMPOWER and Generating Engagement in Network Involvement (GENIE)
This study has demonstrated the complexity associated with developing an accessible digital tool that combines self-efficacy and social network activation to support the variety of needs of people with joint pain
Summary
Joint pain secondary to osteoarthritis (OA) causes disability for many people and can be associated with a loss of independence [1,2]. The prevalence of OA increases with age, with substantial associated human and economic costs [4]. OA disproportionately affects lower socioeconomic groups [6]. Such groups have been found to have low levels of health literacy, which is associated with poorer health outcomes [7]. Joint pain caused by osteoarthritis (OA) is highly prevalent and can be extremely debilitating. Many existing resources are not accessible for or developed alongside people with lower health literacy, which disproportionately affects people with OA
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