Usability and experience testing to refine an online intervention to prevent weight gain in new kidney transplant recipients

Abstract

Objectives. Weight gain in the first year following kidney transplantation increases the risk of adverse health outcomes. Currently, there is no recognized intervention available to prevent weight gain after kidney transplantation. An online kidney transplant-specific resource, entitled Exercise in Renal Transplant Online (ExeRTiOn), has been co-created by a multi-professional team, including patients, to assist with weight prevention. This study aimed to evaluate patient and health care professional usability and experience of the ExeRTiOn online resource. Design. Qualitative study utilizing 'Think-Aloud' and semi-structured interviews. Methods. Participants (n = 17) were purposively sampled to include new kidney transplant recipients (n = 11) and transplant health care professionals (n = 6). Kidney transplant recipient participants were from a spread of physical activity levels based on scores from the General Practice Physical Activity Questionnaire (GPPAQ). 'Think-Aloud' interviews assessed the usability of ExeRTiOn. Semi-structured interviews explored participants' experience of ExeRTiOn, weight gain, and physical activity. The data set were analysed thematically. Participant characteristics, including login data and self-reported body weight, were collected. Results. Data analyses identified valued intervention content and usability aspects which were summarized by two themes. The first theme 'You need to know how to manage yourself' included subthemes: (1) the resource filled a guidance gap, (2) expert patient content resonated, and (3) the importance of goal setting and monitoring progress. The second theme 'room for improvement' included subthemes: (2) web support and (2) content and operational change suggestions.

Kidney Transplant Recipients’ Weight Change and their Behaviors and Attitudes Related to Diet and Exercise

“…Kidney transplant recipients face distinct challenges in addition to those the general population faces regarding weight gain. Future studies, building on prior work, should more closely evaluate dietary and physical activity habits through food journals and activity monitors to provide a more detailed look at patient behaviors impacting weight changes [27,28]. Prior work examining post-transplant-specific tailored exercise plans and diet guidelines has shown improvement in both patient-reported and clinical outcomes [21,28,29].…”

“…Future studies, building on prior work, should more closely evaluate dietary and physical activity habits through food journals and activity monitors to provide a more detailed look at patient behaviors impacting weight changes [27,28]. Prior work examining post-transplant-specific tailored exercise plans and diet guidelines has shown improvement in both patient-reported and clinical outcomes [21,28,29]. Further development and evaluation of a standardized counseling protocol for healthcare providers with post-transplant-specific exercise plans and diet guidelines may help to engage all patients with lifestyle counseling.…”

Do Exercise, Physical Activity, Dietetic, or Combined Interventions Improve Body Weight in New Kidney Transplant Recipients? A Narrative Systematic Review and Meta-Analysis

“…This systematic review focused on KTRs rather than all SOTs. However, KTRs have requested specific education and support [11,71], experience a unique fear avoidance pattern associated with PA [63], and experience rapid weight gain in the acute post-operative period [3]. Furthermore, this review focused on KTRs within the first year of transplant surgery.…”

Evaluating Digital Program Support for the Physical Activity 4 Everyone (PA4E1) School Program: Mixed Methods Study

“…The study was novel in its use of "think-aloud" methodology to explore teachers' experiences of using a website to support the delivery of a health-based intervention. Think-aloud methodologies have largely been used to inform the development of websites and apps for use directly with the target user of the health intervention [54][55][56][57][58] (eg, an app to support weight management among adults with diabetes [54]). By contrast, we used a think-aloud methodology with teachers (in-school champions) who have been accessing a website to support the delivery of the PA4E1 program to adolescent students.…”

“…By contrast, we used a think-aloud methodology with teachers (in-school champions) who have been accessing a website to support the delivery of the PA4E1 program to adolescent students. Previous studies using the think-aloud methodology [54][55][56][57][58] have found it to be useful for identifying usability and subjective experience issues. However, the procedure used in these studies involved the presence of a researcher, which may have affected participants' reactions.…”