Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Mar 24, 2020
Date Accepted: Oct 28, 2020
“It’s worked for me.” Exploring attitudes and experiences of people with knee OA toward a self-directed eHealth intervention to support exercise: a qualitative study
ABSTRACT
Background:
Knee osteoarthritis (OA) is a highly prevalent and debilitating condition. Exercise is a recommended treatment with known pain and function benefits. However, exercise is underutilised in OA management. Difficulty accessing healthcare has been identified as a key barrier to exercise uptake. Innovative and scalable methods of delivering exercise treatments to people with knee OA are needed. We developed a self-directed eHealth intervention to enable and encourage exercise participation. The effectiveness of this intervention, on pain and function in people with knee OA, is being evaluated in a randomised clinical trial.
Objective:
To explore the attitudes and experiences of people with knee OA who accessed the self-directed eHealth intervention designed to encourage exercise.
Methods:
Qualitative study embedded within a randomised controlled trial. Individual, semi-structured phone interviews were conducted with 16 people with knee OA who had accessed a 6-month eHealth intervention (a website and a behaviour change short message system program) designed to support exercise participation. Interviews were audio recorded, transcribed verbatim and thematically analysed using an inductive approach.
Results:
Five themes arose: 1: Technology easy to use and follow (website ease of use; SMS ease of use); 2: Exercise autonomy and flexibility (useful features; credible OA and exercise information; prescribed exercises simple to do unsupervised; freedom to adapt exercise to suit needs; prescribed exercise issues); 3: Support and accountability (SMS good reminder and prompt; accountable; SMS tone and automation could trigger negative emotions (e.g. guilt); influence of other healthcare experiences; inability to contact someone when needed); 4: ‘It’s helped me’ (knee symptom improvements; confidence to self-manage; encouraged active living); 5: Real world application (provided by a healthcare professional preferred; should be provided at subsidised or low out-of-pocket cost).
Conclusions:
People with knee OA had mostly positive experiences with, and attitudes towards, an eHealth intervention designed to encourage and support exercise participation independent of a healthcare professional. A human connection associated with the eHealth program appeared important. Clinical Trial: Not Applicable
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