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Setchell J1, Turpin M1, Costa N1, Hodges P1
1The University of Queensland, Brisbane, Australia
Background: People are increasingly using the internet to obtain health-related information, which has great potential to educate and engage patients in management of health conditions. While often beneficial, well-meaning attempts to provide comprehensive online resources can have unintended negative effects. It is challenging to present complex information in ways that will be beneficial to the variety of individuals who access sites seeking healthcare information. In an extensive research translation project, we created a consumer-focussed low back pain (LBP) online resource. The website embodies contemporary understandings of musculoskeletal pain in its key messages that focus on enhancing consumer confidence in self-management and making treatment choices; engaging patients in behaviours and attitudes to reduce the burden of pain; and providing reassurance and de-medicalisation of pain.
Purpose: We aimed to determine how key messages were taken up by individuals with LBP, and to consider any potential unintended negative effects on participants.
Methods: We employed an in-depth qualitative methodology. First, we observed the initial interaction of 15 adults with LBP with the website. The researcher asked probing questions during the observation to encourage participants to discuss their reactions to the website. Following this, we used a photo-elicitation method in which participants used a digital camera to document moments during a one-month period when they recalled the website messaging. The photographs were discussed with the researchers in a follow-up interview. The interviewer encouraged participants to discuss how the website related to their lives. Findings were analysed thematically.
Results: Analysis determined four themes relating to the study aims:
1) messages to stay active were pervasive but the site did not sufficiently address the need for pacing and rest at times;
2) the website discussed strategies to reduce/address LBP but there was little information on how to accept/live with the condition;
3) various strategies were provided, but little advice on how to choose among them;
4) the site provided information on harmful/inefficacious treatments which may distress people who have already chosen such treatments.
Conclusion(s): Our analysis highlighted that while the website presented a comprehensive overview of current evidence and created a strong sense of trust in participants, there were a number of points of tension that might have negative effects on some individuals who access the site.
Implications: Although our study only examined one website, the in-depth nature of our inquiry produced results that are likely to be applicable across many types of websites developed using academic and clinical rigour. Our study highlights that it is likely to be beneficial to consider supplementing evidenced-based information with materials that help people navigate the tensions we have outlined. These messages tend to be complex and it may be helpful to use creative approaches to delivering this information such as videos, vignettes, patient stories, artwork/images.
Keywords: Health messaging, qualitative research, on-line resources
Funding acknowledgements: This study was funded by Arthritis Australia and the National Health and Medical Research Council (NHMRC) of Australia.
Purpose: We aimed to determine how key messages were taken up by individuals with LBP, and to consider any potential unintended negative effects on participants.
Methods: We employed an in-depth qualitative methodology. First, we observed the initial interaction of 15 adults with LBP with the website. The researcher asked probing questions during the observation to encourage participants to discuss their reactions to the website. Following this, we used a photo-elicitation method in which participants used a digital camera to document moments during a one-month period when they recalled the website messaging. The photographs were discussed with the researchers in a follow-up interview. The interviewer encouraged participants to discuss how the website related to their lives. Findings were analysed thematically.
Results: Analysis determined four themes relating to the study aims:
1) messages to stay active were pervasive but the site did not sufficiently address the need for pacing and rest at times;
2) the website discussed strategies to reduce/address LBP but there was little information on how to accept/live with the condition;
3) various strategies were provided, but little advice on how to choose among them;
4) the site provided information on harmful/inefficacious treatments which may distress people who have already chosen such treatments.
Conclusion(s): Our analysis highlighted that while the website presented a comprehensive overview of current evidence and created a strong sense of trust in participants, there were a number of points of tension that might have negative effects on some individuals who access the site.
Implications: Although our study only examined one website, the in-depth nature of our inquiry produced results that are likely to be applicable across many types of websites developed using academic and clinical rigour. Our study highlights that it is likely to be beneficial to consider supplementing evidenced-based information with materials that help people navigate the tensions we have outlined. These messages tend to be complex and it may be helpful to use creative approaches to delivering this information such as videos, vignettes, patient stories, artwork/images.
Keywords: Health messaging, qualitative research, on-line resources
Funding acknowledgements: This study was funded by Arthritis Australia and the National Health and Medical Research Council (NHMRC) of Australia.
Topic: Health promotion & wellbeing/healthy ageing; Information management, technology & big data; Musculoskeletal: spine
Ethics approval required: Yes
Institution: The University of Queensland
Ethics committee: Human Ethics Committee
Ethics number: 2018000064
All authors, affiliations and abstracts have been published as submitted.
