Developing digital interventions: a methodological guide.

Digital interventions are becoming an increasingly popular method of delivering healthcare as they enable and promote patient self-management. This paper provides a methodological guide to the processes involved in developing effective digital interventions, detailing how to plan and develop such interventions to avoid common pitfalls. It demonstrates the need for mixed qualitative and quantitative methods in order to develop digital interventions which are effective, feasible, and acceptable to users and stakeholders

Be Quiet and Man Up: A Qualitative Questionnaire Study into Fathers Who Witnessed Their Partner’s Birth Trauma

Background: Research focusing on paternal mental health is limited, especially regarding the impact of the experience of poor mental health in the perinatal period. For example, little is known about the experiences of fathers who witness their partner’s traumatic birth and the subsequent impact on their mental health. Therefore, the aim of this study was to explore fathers’ experiences of witnessing a traumatic birth, how these experiences impacted their wellbeing, and what support they received during and following the traumatic birth. Methods: Sixty-one fathers were recruited via targeted social media to complete an anonymous online qualitative questionnaire regarding their birth trauma experience. Eligible participants were fathers aged eighteen or over, resided in the UK and had witnessed their partner’s traumatic birth (that did not result in loss of life). Thematic analysis was used to analyse the questionnaire data. Results: Three main themes were identified: ‘fathers’ understanding of the experience’ (subthemes: nothing can prepare you for it; merely a passenger; mixed experiences with staff; not about me); ‘life after birth trauma’ (subthemes: manhood after birth; inability to be happy; impact on relationships); and ‘the support fathers received vs what they wanted’ (subthemes: prenatal support; birth support; and postnatal support). Conclusions: Fathers reported that witnessing their partner’s traumatic birth had a significant impact on them. They felt this affected their mental health and relationships long into the postnatal period. However, there is no nationally recognised support in place for fathers to use as a result of their experiences. The participants attributed this to being perceived as less important than women in the postnatal period, and maternity services’ perceptions of the father more generally. Implications include ensuring support is available for both the mother and father following a traumatic birth, with additional staff training geared towards the father’s role

Health behaviour change interventions for couples: A systematic review.

OBJECTIVES: Partners are a significant influence on individuals' health, and concordance in health behaviours increases over time in couples. Several theories suggest that couple-focused interventions for health behaviour change may therefore be more effective than individual interventions. DESIGN: A systematic review of health behaviour change interventions for couples was conducted. METHODS: Systematic search methods identified randomized controlled trials (RCTs) and non-randomized interventions of health behaviour change for couples with at least one member at risk of a chronic physical illness, published from 1990-2014. RESULTS: We identified 14 studies, targeting the following health behaviours: cancer prevention (6), obesity (1), diet (2), smoking in pregnancy (2), physical activity (1) and multiple health behaviours (2). In four out of seven trials couple-focused interventions were more effective than usual care. Of four RCTs comparing a couple-focused intervention to an individual intervention, two found that the couple-focused intervention was more effective. CONCLUSIONS: The studies were heterogeneous, and included participants at risk of a variety of illnesses. In many cases the intervention was compared to usual care for an individual or an individual-focused intervention, which meant the impact of the couplebased content could not be isolated. Three arm studies could determine whether any added benefits of couple-focused interventions are due to adding the partner or specific content of couple-focused interventions. Statement of contribution What is already known on this subject? Health behaviours and health behaviour change are more often concordant across couples than between individuals in the general population. Couple-focused interventions for chronic conditions are more effective than individual interventions or usual care (Martire, Schulz, Helgeson, Small, & Saghafi, ). What does this study add? Identified studies targeted a variety of health behaviours, with few studies in any one area. Further assessment of the effectiveness of couple-focused versus individual interventions for those at risk is needed. Three-arm study designs are needed to determine benefits of targeting couples versus couple-focused intervention content

Supporting women who develop poor postnatal mental health: what support do fathers receive to support their partner and their own mental health?

Background: Research regarding support provided for poor maternal postnatal mental health (such as depression, anxiety disorders, and postpartum psychosis) is relatively common. Fathers appear to play an important role supporting partners but many feel alienated within maternity services. Research focusing on fathers is less common. Methods: The current qualitative study aimed to investigate fathers’ experience of support provided to fathers, to help support their partner should she experience poor postnatal mental health. Results: Twenty-five fathers participated in an online questionnaire regarding their experience of their partner’s poor postnatal mental health and the support provided to fathers to help her. Thematic analysis revealed three main themes and seven sub-themes. The themes were: ‘Support received to help support their partner’, ‘Support fathers wanted that was not received’ and ‘Father’s mental health’. The results highlight an overall lack of support for many fathers, despite many wanting support on how to help their partner, information on their own mental health and the services available. Fathers specifically wanted healthcare professionals to sign-post them to someone they can talk to for emotional support, and to be taught coping strategies which would help them to support both their partner and baby. Conclusions: The findings from this study suggest that health professionals and perinatal mental health services need a better understanding about what resources fathers need to support the mental health of themselves and their partner

Wellbeing in Addiction Recovery: Does It Differ across Addictions?

Limited research has been conducted on the experiences of individuals in long-term recovery from addiction, and addictions are usually studied in isolation. However, no theories of addiction differentiate between addictions or assume that individuals will experience only one addiction. This study aimed to compare affect between individuals with addictions to drugs and alcohol and to explore how QoL changes in long-term recovery from addiction. Individuals in recovery from addiction (n = 115; 52.2% male) were recruited via snowball sampling on social media signposted by an addiction rehabilitation charity. Participants completed questionnaires about QoL (WHOQOL-Bref) and positive and negative affect (PANAS-X). The main primary addictions were drugs (76.5%) and alcohol (21.7%), with 69.7% reporting multiple addictions including food, sex, internet, and gambling. Affect and coping strategies did not differ by addiction. QoL appeared to improve with time in recovery. The high percentage of multiple addictions and greater similarities than differences between individuals with drug and alcohol addictions suggest that addictions should not be studied in isolation when studying psychological health during long-term recovery

The impact of Behçet's disease on intimate relationships in women: A qualitative study.

OBJECTIVE: Behçet's disease is a rare and incurable condition where the body's immune system attacks healthy tissue. Behçet's can cause blood clots and ulcerations to form in every organ and system in the body, including deep and painful genital ulceration. The psychological impact of the disease on intimacy and relationships is unexplored. This study aimed to explore how the disease impacts on female patients' intimate partner relationships. METHODS: Participants were seven female, UK patients with Behçet's disease who were in committed relationships. In depth, semi-structured interviews lasting approximately 80 minutes were conducted via video conferencing about participants' sexual functioning and intimate relationships. Data was analysed using Interpretative Phenomenological Analysis. RESULTS: Patients' sexual relationships and intimacy were impacted by issues due to lack of knowledge of symptoms (misdiagnosis of herpes), issues due to symptoms (genital manifestations, painful sex, exhaustion), difficulties communicating with medical professionals, medication, partner support, and support from fellow Behçet's patients. DISCUSSION: Female Behçet's patients are at risk of developing psychological problems with intimacy due to symptoms, lack of knowledge of symptoms, and negative impacts of medication. Intimacy needs to be discussed in medical consultations so these issues can be addressed before a lack of intimacy negatively impacts relationships

‘Trapped under a tonne of rubble’: Using LEGO® to explore conceptual metaphors of psychological stress

Qualitative research methods have recently gained substantial ground in psychology. However, creative methods of data collection are still underused. Here we share our experiences of using LEGO® as a visual qualitative methodology to elicit metaphors of psychological stress. We highlight the value of this method through showcasing some examples of a research project that used LEGO® in a workshop to enable in-depth exploration about the lay conceptualisation of stress. LEGO® is an excellent tool for externalising and communicating thoughts about abstract concepts such as stress and coping. It is easy to use, attractive to participants and provides opportunities for sharing experiences and having fun. From the researcher’s perspective, LEGO® enables collection of enriched data which can shed new light on the research topic. It can be a useful visual methodological tool for enhancing and empowering qualitative researchers in many areas of psycholog

Explainable persuasion for interactive design: The case of online gambling.

Persuasive technology refers to digital means that influence attitude behaviour, and decisions. While the professional design of persuasive interfaces considers user interests and freedom of choice a primary requirement, principles and methods to achieve it are yet to be introduced. In the design of persuasive interfaces, fulfilling conditions of informed consent can help establish transparency and address such ethical issues. This paper defined explainable persuasion, its potential form, and benefits and explored whether explainable persuasion is a user requirement on demand. This paper further examined explainable persuasion design from the user’s perspective and reported on acceptance and rejection factors, as well as possible design tensions and solutions. In this study, we took online gambling as a case study. A total of 250 UK-based users of gambling platforms (age range 18 – 75, 18–75, 127 female) completed our online survey based on principles of persuasion and explainability. Findings showed that players were aware of the use, persuasive intent, and potential harm of various persuasive design techniques used in online gambling platforms (e.g., the use of in-game rewards, reminders, and praise to encourage further gambling). Despite this awareness, they agreed that explainable persuasion can still help users stay in control of their online experience, increase their positive attitude towards the online system, and keep them reminded of the potential side effects of persuasive interfaces. Future research is required to enhance the design and implementation of explainable persuasion in persuasive interfaces

"What kind of man gets depressed after having a baby?" Fathers' experiences of mental health during the perinatal period.

BACKGROUND: To date, information and support has been focused on mothers, with evidence that healthcare professionals overlook fathers' mental health, and that fathers receive little or no support for themselves during the perinatal period. However, recently, fathers' mental health has become an area of interest. METHODS: This study explored the support fathers receive for their own mental health during the perinatal period. A qualitative questionnaire was distributed on social media networks and completed by twenty-nine fathers. RESULTS: Thematic analysis produced three main themes: Factors Influencing Fathers' Mental Health, Consequences of Poor Mental Health in Fathers and Solutions to Improve Fathers' Mental Health. CONCLUSIONS: The findings from this study highlighted important implications about fathers' mental health and the need to support them more effectively. Fathers' reluctance to seek support and the limited support available need to be addressed. Fathers in this study perceived that perinatal health professionals view 'mothers as the priority'. It is clear that health professionals need more training on how to recognise that fathers are also important and need support for their mental health

Perceptions of Interactive, Real-Time Persuasive Technology for Managing Online Gambling

Background: Interactive persuasive techniques, supported by the ability to retrieve real-time behaviour and other contextual data, offer an unprecedented opportunity to manage online activity. An example is Responsible Gambling (RG) tools. Currently, despite vast potential, they do not make use of real time gambling behaviour data, whether captured by operators (device, location, bets, limits set) or self-reported (finance, emotion, online browsing history). To design useful interactive persuasive tools, it is important to understand users’ perceptions to ensure maximum acceptance. Aims: Explore gamblers’ perceptions of the potential of future online platforms in providing data-driven, real-time, persuasive interventions for supporting responsible online gambling. Method: Qualitative semi-structured interviews conducted with 22 gamblers (80% men; 15 ex-problem, 7 current), regarding perceptions of the potential of persuasive techniques. Results: Thematic analysis showed participants were positive about data-driven, real-time, interactive technology for (i) providing information (educational, personal and comparative), (ii) limiting gambling (time and money spent, access to gambling operators) and (iii) providing support to gamblers (advice, feedback and context sensing). The technology was identified as most appropriate for low to moderate gamblers. Conclusions: Participants were positive about the new data access, techniques and modalities of interactions for supporting responsible online gambling. To ensure maximum reach and acceptability, such technology should be customised to fit individual profiles. Personalisation and tailoring of content, interactivity, framing and timing are necessary to enhance acceptance of such technology and avoid reactance, unintended harm, inconvenience, and information overload