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. 2025 Jul 14;6(7):822-827.
doi: 10.1302/2633-1462.67.BJO-2025-0082.

From theory to practice: insights into intervention development of the NON-STOP app for children with Perthes' disease

Adam M Galloway  1   2 , Anna M Anderson  1   3 , Emma Casimir  4 , Colin Holton  2   5 , David J Keene  6   7 , Anthony C Redmond  3   8 , Heidi J Siddle  2   8 , Suzanne Richards  9 , Daniel C Perry  10   11
Affiliations

From theory to practice: insights into intervention development of the NON-STOP app for children with Perthes' disease

Adam M Galloway et al. Bone Jt Open. .

Abstract

The development of interventions in healthcare often lacks a robust theoretical basis, which may contribute to suboptimal engagement and effectiveness. This paper provides insights into and practical guidance on the development of complex interventions in healthcare, using the example of a digital self-management tool for children with Perthes' disease, called the Non-Surgical Treatment of Perthes' (NON-STOP) app. We applied the Medical Research Council framework, used psychological theory, and integrated stakeholder engagement to develop the intervention. The lessons learned and considerations for the developments of other complex interventions provide practical actions for clinicians and researchers in orthopaedics.

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Conflict of interest statement

A. M. Galloway reports funding from the National Institute for Health and Care Research (NIHR), and that this work was completed as part of a Clinical Doctoral Research Fellowship (NIHR301582). C. Holton, D. J. Keene, and H. J. Siddle are named supervisors on A. M. Galloway's fellowship. D. J. Keene is a co-applicant on the OP NON-STOP trial funded by the NIHR Health Technology Assessment programme (ref NIHR152309), and reports a grant to Alder Hey Children's NHS Foundation Trust in collaboration with the University of Exeter, unrelated to this work. D. C. Perry reports NIHR Research Professorship funding from the NIHR Academy (NIHR301655). A. Redmond reports institutional grant funding from the NIHR.

Figures

Fig. 1
Fig. 1
The Medical Research Council framework for developing and evaluating complex intervention. *Reproduced from Skivington et al (CC-BY, open access).
Fig. 2
Fig. 2
Example views of the Non-Surgical Treatment of Perthes’ app components. A and B display the ‘Learning section’ which provides text (written with input from Patient and Public Involvement Engagement (PPIE) members) and links to educational videos and resources from national guidance on physical activity levels. C and D show the ‘Activities section’, where users select and complete exercises. There are timers to countdown during the exercise as well as instructional videos to assist the user. E demonstrates the ‘Progress section’ where users can review their app use, allowing them to review how often they have completed their activities. This was needed to earn the rewards to customize the avatar. F displays an example of where users can use their rewards (stars) to customize their avatar using different styles/themes that were largely selected by children with Perthes’ disease in PPIE and user-testing sessions.
See this image and copyright information in PMC

References

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