Background & Aims

The multi-phase DAHLIA project (Bartels et al., 2022) aims to develop, evaluate, and implement a digital behavioral intervention for chronic pain. User involvement is considered essential, especially in the development phase of a treatment, and allows to improve accessibility (Skivington et al., 2021). Therefore, this study aims to (i) identify the needs of people with chronic pain and therapists and (ii) tailor the content and design of the digital behavioral intervention accordingly.

Methods

A qualitative study was conducted with two patient focus groups and three therapist (i.e., psychologists/ psychotherapists) focus groups. A semi-structured interview guide was followed during the 2-hour online focus groups, and the recorded discussions were transcribed verbatim subsequently. A qualitative framework analysis was performed using a combination of inductive and deductive coding and the Consolidated Framework for Implementation Research (CFIR), specifically the domains ‘Innovation’ and ‘Individuals’.

Results

Five people with chronic pain (n=3 in the first focus group, n=2 in the second focus group) and 12 therapists (n=4 per focus group) participated in the study. Patients were on average 43.6 years old, n=1 identified as man, n=4 identified as women, and had an average current pain level of 5.8 (SD: 1.48, range: 4-8, scale 0-10) prior to the focus groups. Therapists (n=3 identified as men, n=9 identified as women) were licensed psychologists with on average 12.29 years of experience (SD: 9.41 range: 2-31) providing psychotherapy and were on average 42.76 years old. Intertwined biopsychosocial needs were identified, including adapting and learning to self-manage life with pain, dealing with uncertainty, pressure to fulfil social roles, and changes in self-image and identity. Valuable input for the intervention design and content was obtained (e.g., text-to-audio function, flexibility in forms of communication).

Conclusions

Complex biopsychosocial health needs of people with chronic pain need to be considered in the context of providing a digital behavioural intervention. Input and preferences from the prospective of end-users are helpful for enhancing the content and structure of the treatment. The CFIR is an adaptable and comprehensive framework that proves a valuable structure during the development phase of a digital behavioural intervention.

References

-Bartels, S. L., Johnsson, S. I., Boersma, K., Flink, I., McCracken, L. M., Petersson, S., Christie, H. L., Feldman, I., Simons, L. E., Onghena, P., Vlaeyen, J. W. S., & Wicksell, R. K. (2022). Development, evaluation and implementation of a digital behavioural health treatment for chronic pain: study protocol of the multiphase DAHLIA project. BMJ open, 12(4), e059152. https://doi.org/10.1136/bmjopen-2021-059152

-Skivington, K., Matthews, L., Simpson, S. A., Craig, P., Baird, J., Blazeby, J. M., Boyd, K. A., Craig, N., French, D. P., McIntosh, E., Petticrew, M., Rycroft-Malone, J., White, M., & Moore, L. (2021). A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance. BMJ (Clinical research ed.), 374, n2061. https://doi.org/10.1136/bmj.n2061

Presenting Author

Afra S. Taygar

Poster Authors

Afra Selma Taygar

Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Institute of Social

Lead Author

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Sara Laureen Bartels

Karolinska Institutet

Lead Author

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Rocío De la Vega

Ph.D.

University of Málaga

Lead Author

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Ida Flink

Karlstad University

Lead Author

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Linnéa Engman

Ph.D.

Karolinska Institute

Lead Author

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Suzanne Petersson

Ph.D.

Department of Medicine and Optometry, Linnaeus University, Kalmar & Region Kalmar County, Sweden

Lead Author

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Sophie Johnsson

Lead Author

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Katja Boersma

PhD

School of Behavioral, Social and Legal Sciences, Örebro University

Lead Author

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Lance McCracken

Uppsala University

Lead Author

E-mail

Topics

  • Treatment/Management: Interventional Therapies – Other