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. 2019 Sep 2:2:85.
doi: 10.1038/s41746-019-0163-4. eCollection 2019.

Developing a digital intervention for cancer survivors: an evidence-, theory- and person-based approach

Katherine Bradbury  1 , Mary Steele  1   2 , Teresa Corbett  3 , Adam W A Geraghty  4 , Adele Krusche  1 , Elena Heber  5 , Steph Easton  1 , Tara Cheetham-Blake  3 , Joanna Slodkowska-Barabasz  1 , Andre Matthias Müller  6   7 , Kirsten Smith  1 , Laura J Wilde  8 , Liz Payne  1 , Karmpaul Singh  9 , Roger Bacon  10 , Tamsin Burford  10 , Kevin Summers  10 , Lesley Turner  10 , Alison Richardson  3 , Eila Watson  11 , Claire Foster  3 , Paul Little  4 , Lucy Yardley  1   12
Affiliations

Developing a digital intervention for cancer survivors: an evidence-, theory- and person-based approach

Katherine Bradbury et al. NPJ Digit Med. .

Abstract

This paper illustrates a rigorous approach to developing digital interventions using an evidence-, theory- and person-based approach. Intervention planning included a rapid scoping review that identified cancer survivors' needs, including barriers and facilitators to intervention success. Review evidence (N = 49 papers) informed the intervention's Guiding Principles, theory-based behavioural analysis and logic model. The intervention was optimised based on feedback on a prototype intervention through interviews (N = 96) with cancer survivors and focus groups with NHS staff and cancer charity workers (N = 31). Interviews with cancer survivors highlighted barriers to engagement, such as concerns about physical activity worsening fatigue. Focus groups highlighted concerns about support appointment length and how to support distressed participants. Feedback informed intervention modifications, to maximise acceptability, feasibility and likelihood of behaviour change. Our systematic method for understanding user views enabled us to anticipate and address important barriers to engagement. This methodology may be useful to others developing digital interventions.

Keywords: Human behaviour; Quality of life.

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Conflict of interest statement

Competing interestsThe authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The logic model of the Renewed intervention. Starting on the left, the first column shows the problem with the intervention addresses. The second column shows the intervention targets, which are addressed in order to attempt to resolve the problem. The third column shows the intervention ingredients, which are used. The fourth column shows the mechanisms of action of the intervention, which will be later examined in process analysis. The final column shows the outcomes, which the intervention aims to impact on
Fig. 2
Fig. 2
The key elements of the Renewed intervention planning process, which began with a rapid scoping review of the literature (panel 1). The results of the scoping review then informed the guiding principles (panel 2), behavioural analysis (panel 3), and logic model (panel 4). In turn, these informed the prototype of renewed (panel 5), which was then refined in two qualitative optimisation studies, the first with patients (panel 6) and the second with NHS and cancer charity workers (panel 7)
Fig. 3
Fig. 3
A PRISMA flow diagram for the rapid scoping review. The first row shows the identification of potentially relevant literature, the second row describes the screening and the third row shows the number of papers assessed for eligibility and the number of full text papers read in full. The fourth row shows the number of studies included
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