ACCEPTABILITY OF THE COMBINED ONLINE INTERACTIVE MINDFULNESS AND EXERCISE PROGRAMME (MOVE-ONLINE) FOR ADULTS WITH CHRONIC PAIN - A QUALITATIVE STUDY

O. Deegan¹, B. Fullen¹, C. Hearty², C. Doody¹

¹University College Dublin, School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland, ²Mater Misericordiae University Hospital, Department of Pain Medicine, Dublin, Ireland

Background: The MOVE-Online programme is a 9-week online interactive intervention for adults with chronic pain (CP) combining mindfulness based stress reduction (MBSR) and exercise to assist in the management of CP. A feasibility study was completed to explore the acceptability and feasibility of delivering the MOVE-Online programme. Acceptability is a key consideration in the design and evaluation of novel healthcare interventions. It is recommended by the Medical Research Council (MRC) for the development of complex interventions that acceptability should be assessed in the feasibility phase of study design. A recent Theoretical Framework of Acceptability (TFA) has been developed to facilitate both quantitative and qualitative assessments of healthcare intervention acceptability.

Purpose: The aim of this qualitative study was to utilise the TFA to explore participants’ acceptability of the mindfulness and exercise interventions in the MOVE-Online programme. In addition, participants’ acceptability of the online method of delivery was investigated.

Methods: A series of online focus groups were carried out with programme participants, following completion of the MOVE-Online pain management programme (PMP). Interviews were recorded and transcribed verbatim and the data were analysed using template analysis in terms of the seven TFA constructs of acceptability [(i) Perceived Effectiveness, (ii) Affective Attitude, (iii) Self-Efficacy, (iv) Ethicality, (v) Burden, (vi) Opportunity Costs and (vii) Intervention Coherence].

Results: Twenty-one participants took part in the focus groups (female n=18, mean age 54±14 years, mean duration of symptoms 13±6 years). Five of the seven TFA constructs of acceptability were identified in the qualitative analysis; Perceived Effectiveness, Affective Attitude, Self-Efficacy, Ethicality and Burden. The participants from this programme perceived the intervention to have been largely effective at achieving the goals of a PMP (TFA construct: (i) Perceived Effectiveness), to have supported their emotional management of their condition ((ii) Affective Attitude), promoted long term self-directed engagement with the intervention ((iii) Self-Efficacy), fostered a valued group environment ((iv) Ethicality) and the online delivery of the programme reduced the physical burden normally associated with participation at an in-person PMP ((v) Burden).

Conclusions: The results of the study supports the utility of the TFA as a useful tool to understand and explore the multi-dimensional construct of acceptability of the online mindfulness and exercise interventions for the participants in the MOVE-Online programme. The TFA could be a valuable tool to use as a common framework for the exploration of acceptability in future RCTs. Further studies are required to develop a common understanding of acceptability, including outcome measures to capture its complex nature.

Implications: This investigation contributes to the understanding of acceptability as a complex multidimensional construct and emphasises the importance of considering the multiple dimensions of acceptability when evaluating participants evaluation of novel complex interventions, as recommended by the MRC guidelines. Further research exploring the synchronous delivery of online PMPs, reflecting the importance of the social dimension of the PMP highlighted in the current qualitative study, would be valuable and contribute to the development of guidelines to inform the content and delivery methods of online PMPs.

Funding acknowledgements: This work is funded by the University College Dublin, Centre for Translational Pain Research.

Keywords:
Chronic pain
eHealth
Acceptability

Topics:
Pain & pain management
Health promotion & wellbeing/healthy ageing/physical activity
Community based rehabilitation

Did this work require ethics approval? Yes

Institution: University College Dublin

Committee: Human Research Ethics Committee – Sciences

Ethics number: LS-20-76-Deegan-Doody