A Web-Based Peer-Modeling Intervention Aimed at Lifestyle Changes in Patients With Coronary Heart Disease and Chronic Back Pain: Sequential Controlled Trial

Schweier, Rebecca; Romppel, Matthias; Richter, Cynthia; Hoberg, Eike; Hahmann, Harry; I, Scherwinski; Kosmützky, Gregor; Grande, Gesine

doi:10.2196/jmir.3434

Cited by 33 publications

(26 citation statements)

References 32 publications

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“…This study builds on an emerging evidence base seeking to use digital tools to harness narrative information from peers to influence health behaviour (although not yet in the field of smoking cessation), for example studies on control of hypertension [6], attitudes to breast screening among African American women [7, 8], and lifestyle change for people with coronary heart disease and low-back pain [9]. …”

Section: Introductionmentioning

confidence: 99%

A novel experience-based internet intervention for smoking cessation: feasibility randomised controlled trial

et al. 2016

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BackgroundThe internet is frequently used to share experiences of health and illness, but this phenomenon has not been harnessed as an intervention to achieve health behaviour change. The aim of this study was to determine the feasibility of a randomised trial assessing the effects of a novel, experience-based website as a smoking cessation intervention. The secondary aim was to measure the potential impact on smoking behaviour of both the intervention and a comparator website.MethodsA feasibility randomised controlled single-blind trial assessed a novel, experience-based website containing personal accounts of quitting smoking as a cessation intervention, and a comparator website providing factual information. Feasibility measures including recruitment, and usage of the interventions were recorded, and the following participant-reported outcomes were also measured: Smoking Abstinence Self-Efficacy Questionnaire, the single-item Motivation to Stop Scale, self-reported abstinence, quit attempts and health status outcomes. Eligible smokers from two English regions were entered into the trial and given access to their allocated website for two weeks.ResultsEighty-seven smokers were randomised, 65 completed follow-up (75 %). Median usage was 15 min for the intervention, and 5 min for the comparator (range 0.5–213 min). Median logins for both sites was 2 (range 1–20). All participant-reported outcomes were similar between groups.ConclusionsIt was technically feasible to deliver a novel intervention harnessing the online sharing of personal experiences as a tool for smoking cessation, but recruitment was slow and actual use was relatively low, with attrition from the trial. Future work needs to maximize engagement and to understand how best to assess the value of such interventions in everyday use, rather than as an isolated ‘dose of information’.Trial registration ISRCTN29549695 DOI 10.1186/ISRCTN29549695. Registered 17/05/2013.

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Section: Introductionmentioning

confidence: 99%

A novel experience-based internet intervention for smoking cessation: feasibility randomised controlled trial

et al. 2016

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“…176,177 Emerging work by others is testing the value that narrative accounts could have in modifying attitudes to breast screening among African American women, 178,179 in helping people with hypertension achieve control of their blood pressure 180 and in achieving lifestyle change for people with coronary heart disease and low-back pain. 181 …”

Section: Discussionmentioning

confidence: 99%

Examining the role of patients’ experiences as a resource for choice and decision-making in health care: a creative, interdisciplinary mixed-method study in digital health

Ziébland

Powell

Briggs

et al. 2016

Programme Grants Appl Res

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BackgroundTraditional health information has been based on facts and figures and not on patient experience (PEx). Websites featuring people’s accounts of their experiences of health and illness are popular as a source of information, support and much else. However, there are concerns that experiential information on the internet might have adverse effects on health.AimsTo find out whether, when and how the NHS should incorporate PEx into online health information and elucidate the mechanisms through which PEx might influence health, develop a tool to measure the effects of online PEx, explore how PEx is used, and investigate the feasibility and acceptability of a randomised controlled trial of online PEx.MethodsMixed methods, including a conceptual literature review, qualitative secondary data analysis, the development of a new questionnaire, online ethnography, observational and experimental studies in an internet café environment, and finally feasibility trials to compare new websites based on PEx with those based on facts and figures.ResultsThe review concluded that online PEx could affect health outcomes through seven domains (information, support, affecting relationships, providing ideas on how to use health services, influencing behaviour change, learning to tell the story and visualising illness). We developed the e-Health Impact Questionnaire, which demonstrates good psychometric properties and is suitable for use across different health groups and various styles of online information. Online ethnographic studies found three types of PEx on multiple sclerosis (MS) platforms: accounts of ‘living with MS’, self-expression and creativity, and experiences of health care and treatment. Observational and laboratory-based methods included studies of how people find and use PEx to inform health choices. We developed a three-stage model (gating, the engagement loop and outcomes) which guided the development of six prototype multimedia websites featuring either experiential information (intervention) or factual information (comparator) for three exemplar health issues. We evaluated the feasibility and acceptability of a trial of the prototype PEx websites, comparing self-report and process measures with a comparator. In the three conditions we randomised 87 (smoking cessation), 148 (asthma), and 42 (caring for someone with MS) participants. At final (2-week) follow-up, retention rates were 75%, 82% and 86%, for smoking cessation, asthma and MS carers, respectively. Usage of the allocated websites was low. The median number of logins to the websites over the 2-week period was two, two and four; the median number of page views was 10, 15 and 27.5, respectively, with a median total duration on site of 9 minutes, 17 minutes and 31.5 minutes respectively. There were no reported adverse events or harms. The qualitative interviews with 30 trial participants found that the trial methods were acceptable and not burdensome and that preferences for combinations of different types of information were both idiosyncratic and dependent on timing and need.LimitationsThis programme used a pragmatic, mixed-methods approach, in which we adapted some standard approaches (e.g. realist review). The conceptual review provided a framework for the whole programme but did not draw on a single overarching theoretically informed approach. Instead, we used relevant theory and methods from the work package leads, who represented a range of disciplines.ConclusionsOnline PEx is not seen as an alternative to facts, or to care from a health professional, but is used in addition to other sources of information, support and expression. This programme of work indicates how the sharing of online PEx may benefit people, and how this can be measured. A randomised controlled trial is feasible but an allocated ‘exposure’ to a ‘dose of information’ is far from from how online experiences are shared in everyday life. Future work evaluating online health interventions which incorporate personal experiences should aim to reflect ‘natural’ use of the internet and might include online ethnography and offline interviews. Studies might explore how and why people use online sources of experience-based health information, and the effects on subsequent behaviour and health and social outcomes in different conditions. Future intervention research evaluating online health interventions should examine and explain issues of engagement and use, and seek to identify how to increase engagement.Trial registrationCurrent Controlled Trials ISRCTN29549695.FundingThis project was funded by the Programme Grants for Applied Research programme and will be published in full inProgramme Grants for Applied Research; Vol. 4, No. 17. See the NIHR Journals Library website for further project information.

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“…Successful peers are thus competent and proficient models that disseminate effective skills and schemes for managing task demands that consequently raise perceived efficacy. For example, Schweier et al (2014) have developed a webbased peer-modeling intervention to promote healthy lifestyle changes and selfmanagement ability in German patients with cardiovascular diseases and chronic back pain. Their open access and no-cost website provides more than 1000 texts, audios, and videos of people with coronary heart disease and chronic back pain reporting how they had efficiently modified their unhealthy behaviors focusing on obstacles and their successful strategies in maintaining healthy habits.…”

Section: Strategies Of Ehealth Preventionmentioning

confidence: 99%

P5 eHealth: An Agenda for the Health Technologies of the Future

Pravettoni¹,

Triberti²

2020

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A Web-Based Peer-Modeling Intervention Aimed at Lifestyle Changes in Patients With Coronary Heart Disease and Chronic Back Pain: Sequential Controlled Trial

Cited by 33 publications

References 32 publications

A novel experience-based internet intervention for smoking cessation: feasibility randomised controlled trial

A novel experience-based internet intervention for smoking cessation: feasibility randomised controlled trial

Examining the role of patients’ experiences as a resource for choice and decision-making in health care: a creative, interdisciplinary mixed-method study in digital health

P5 eHealth: An Agenda for the Health Technologies of the Future

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