Developing a Web-Based Version of An Exercise-Based Rehabilitation Program for People With Chronic Knee and Hip Pain: A Mixed Methods Study

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Pearson, Jennifer ; Walsh, Nicola ; Carter, Desmond ; Koskela, Sian ; Hurley, Michael (2016)
  • Publisher: JMIR Publications
  • Journal: JMIR Research Protocols, volume 5, issue 2 (eissn: 1929-0748)
  • Related identifiers: doi: 10.2196/resprot.5446, pmc: PMC4891573
  • Subject: alliedhealth | web-based program | osteoarthritis | behavioral change | exercise | qualitative research | quantitative research | Original Paper | self-care

BACKGROUND: \ud \ud Osteoarthritis is highly prevalent and has enormous personal and socioeconomic impact. Enabling Self-management and Coping with Arthritic Pain through Exercise (ESCAPE-pain) is an integrated rehabilitation program that helps people understand how exercise can improve physical and psychosocial well-being. Unfortunately, its availability is limited. A Web-based version of the program could increase access for more people. Many Web-based resources are developed without end-user input and result in over-complex, unwanted, ineffective products with limited uptake.\ud \ud OBJECTIVE: \ud \ud The objective of this study was to codesign a Web-based version of ESCAPE-pain that people with chronic joint pain find engaging, informative, and useful.\ud \ud METHODS: \ud \ud To establish older persons' Internet use we conducted a postal survey of 200 people. To establish their opinions, likes or dislikes, and requirements for a Web-based version of the ESCAPE-pain program, we conducted two focus groups with 11 people who had participated in a program based on ESCAPE-pain and two with 13 people who had not. Information from the postal survey and focus groups was used to develop an online prototype website. People's opinions of the prototype website were gauged from thematic analysis of eight semistructured "think aloud" interviews.\ud \ud RESULTS: \ud \ud The survey response rate was 42% (83/200), of whom 67% (56/83) were female and mean age was 67 years. Eighty-three percent of the people had used the Internet, 69% described themselves as either very confident or confident Internet users, and 77% had looked online for health information. With regard to participating online, 34% had read a commentary or watched a video of someone else's experience of a health problem and 23% had tracked a health issue. Key qualitative themes emerged that included engagement, acceptability and usability, and structure and content of the program.\ud \ud CONCLUSIONS: \ud \ud Older people use the Internet as a source of health information but have concerns about safe use and quality of information. Users require a credible website that provides personalized information, support, monitoring, and feedback.
  • References (36)
    36 references, page 1 of 4

    1. Vos T, Barber R, Bell B, Bertozzi-Villa A, Biryukov S, Bolliger I, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet Aug 22 2015;386(9995):743-800.

    2. Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ 2003;81(9):646-656 [FREE Full text] [Medline: 14710506]

    3. Lee I, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT, Lancet Physical Activity Series Working Group. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet 2012 Jul 21;380(9838):219-229 [FREE Full text] [doi: 10.1016/S0140-6736(12)61031-9] [Medline: 22818936]

    4. Dawson J, Linsell L, Zondervan K, Rose P, Carr A, Randall T, et al. Impact of persistent hip or knee pain on overall health status in elderly people: a longitudinal population study. Arthritis Rheum 2005 Jun 15;53(3):368-374. [doi: 10.1002/art.21180] [Medline: 15934104]

    5. Dawson J, Linsell L, Zondervan K, Rose P, Randall T, Carr A, et al. Epidemiology of hip and knee pain and its impact on overall health status in older adults. Rheumatology (Oxford) 2004 Apr;43(4):497-504 [FREE Full text] [doi: 10.1093/rheumatology/keh086] [Medline: 14762225]

    6. Losina E, Walensky RP, Reichmann WM, Holt HL, Gerlovin H, Solomon DH, et al. Impact of obesity and knee osteoarthritis on morbidity and mortality in older Americans. Ann Intern Med 2011 Feb 15;154(4):217-226 [FREE Full text] [doi: 10.7326/0003-4819-154-4-201102150-00001] [Medline: 21320937]

    7. Underwood MR. Community management of knee pain in older people: is knee pain the new back pain? Rheumatology (Oxford) 2004 Jan;43(1):2-3 [FREE Full text] [doi: 10.1093/rheumatology/keg439] [Medline: 12923284]

    8. National Institute for Health and Clinical Excellence. NICE Guide to the Methods of Technology Appraisal. PharmacoEconomics 2008 Sep;26(9):725-727.

    9. Zhang W, Doherty M, Arden N, Bannwarth B, Bijlsma J, Gunther K, EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 2005 May;64(5):669-681 [FREE Full text] [doi: 10.1136/ard.2004.028886] [Medline: 15471891]

    10. Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, American College of Rheumatology. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken) 2012 Apr;64(4):465-474. [Medline: 22563589]

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