Understanding User Reactions and Interactions With an Internet-Based Intervention for Tinnitus Self-Management: Mixed-Methods Process Evaluation Protocol

Abstract

BackgroundTinnitus is a common medical symptom that can affect an individual’s emotional and functional quality of life. Psychological therapies are acknowledged as beneficial to people with tinnitus; however, such therapies are not always readily accessible. With their global reach, automated Internet-based interventions have the potential to reduce the disparity in access to psychological support that people with tinnitus currently experience. However, the evidence on the acceptability and efficacy of these interventions is lacking. Process evaluations that develop an in-depth understanding of how users experience these interventions provide an essential first step when evaluating complex psychological interventions.ObjectiveTo describe the protocol for a study that will explore past, current, and new users’ reactions to and interactions with the Tinnitus E-Programme, an Internet-based intervention for the self-management of tinnitus.MethodsTwo parallel mixed-methods studies will be carried out with 2 different populations. Study 1 will use an online survey to gather past and current users’ views of the program. Study 2 will recruit new program users to take part in an interview and complete a relaxation log to explore how well they were able to implement the skills they learned during the program in their everyday lives. The findings from both studies will be triangulated to develop an in-depth understanding of the program’s mechanisms of impact and identify any implementation or contextual factors that strengthen or impede its delivery and functioning.ResultsStudy 1 is open for recruitment with a projected completion in June 2016 and Study 2 was completed November 2015. At the time of submission, 36 participants have been recruited to Study 1 and 12 participants have taken part in Study 2.ConclusionsFindings will inform the optimization of the Tinnitus E-Programme and guide future evaluation work to assess the program’s effectiveness as a therapy for people with tinnitus.

Development and technical functionality of an Internet-based intervention for tinnitus in the UK

“…It consists of education, psychoeducation, relaxation and attentional-focus exercises running over 6 weeks, followed by a 4 week maintenance period ( Greenwell et al, 2015 ). Since its inception in 2009, it has not been widely used, which may be linked to the fact that this intervention has never been formally evaluated, although a protocol to evaluate this intervention has been proposed ( Greenwell et al, 2016 ).…”

Understanding User Reactions and Interactions with an Internet-Based Intervention for Tinnitus Self-Management: Mixed-Methods Process Evaluation (Preprint)

“…Users who did not provide data on their intervention usage, or indicated that they had not used the intervention but intended to do so in the future were excluded. Answers to open questions were analyzed using inductive thematic analysis [25] and QSR's NVivo v10 qualitative data analysis software (see [17] for details). Quantitative findings that did not fit under the identified qualitative themes were reported as additional themes.…”

“…The protocol for this research [17] is summarized here. Two parallel mixed-methods studies were carried out with two different populations.…”

“…It was improved with feedback from a public and patient involvement (PPI) panel and tested for acceptability and face validity with past users [17]. It became clear that some participants were reaching the survey before they had made the decision to engage with the intervention, which was not anticipated.…”

“…The interview guide (Multimedia Appendix 3) was reviewed by the PPI panel and piloted with a previous user of the intervention [17]. Participants were sent sample interview questions to encourage transparency with the interview process and improve recall [28].…”