Anna Hurley-Wallace, Sophie Fletcher, Talar R. Moukhtarian, Krishane Patel, Agatha Payne, Tabitha Jackson, Carla Toro, Guy Daly, Sean Russel, Lukasz Walasek, Nicole K. Y. Tang, Caroline Meyer
Introduction
Sleep and mental health problems are common across the working adult population. This process evaluation provides insight into the experiences of employees who took part in a digital intervention trial: Supporting Employees with Insomnia and Emotional Regulation Problems (SLEEP). The programme combined digital CBT for insomnia with emotion regulation. Digital content was supported by remote therapy. The objectives of this process evaluation were to explore participants' experiences of the intervention, and identify how the intervention achieved change.
Methods
Twenty-one semi-structured interviews were conducted using videoconferencing. A stratified sample of participants from within each of five cohorts of the SLEEP trial was interviewed. Thematic analysis utilized a collaborative codebook and framework approach. To conceptualize mechanisms of change, behaviour change techniques were retrospectively coded onto participant interview data.
Results
An overarching theme: ‘Better sleep, better wellbeing’ was generated, with three interlinking themes conceptualizing the process by which positive changes to sleep and wellbeing were achieved. These were: ‘Procedure: The value of therapy sessions versus digital-only’, ‘Context: Working on mental health from home during COVID-19’, and ‘Mechanisms: Practice, feedback and problem solving.’
Conclusions
Participants' experiences of SLEEP were predominantly positive and suggested a spillover effect of improved sleep on overall wellbeing. Triangulation of quantitative outcomes showed congruent improvements. Maintaining therapist contact to facilitate behaviour change throughout the programme was important. Furthermore, providing a private space for therapist calls was essential to facilitate the intervention in the workplace; an important insight for the development of digital mental health interventions intended for the workplace.
{"title":"‘Better sleep, better wellbeing’: Qualitative process evaluation of a hybrid, digital cognitive behavioural therapy programme for employees with sleep and emotion regulation problems","authors":"Anna Hurley-Wallace, Sophie Fletcher, Talar R. Moukhtarian, Krishane Patel, Agatha Payne, Tabitha Jackson, Carla Toro, Guy Daly, Sean Russel, Lukasz Walasek, Nicole K. Y. Tang, Caroline Meyer","doi":"10.1111/bjhp.70041","DOIUrl":"10.1111/bjhp.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Sleep and mental health problems are common across the working adult population. This process evaluation provides insight into the experiences of employees who took part in a digital intervention trial: Supporting Employees with Insomnia and Emotional Regulation Problems (SLEEP). The programme combined digital CBT for insomnia with emotion regulation. Digital content was supported by remote therapy. The objectives of this process evaluation were to explore participants' experiences of the intervention, and identify how the intervention achieved change.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty-one semi-structured interviews were conducted using videoconferencing. A stratified sample of participants from within each of five cohorts of the SLEEP trial was interviewed. Thematic analysis utilized a collaborative codebook and framework approach. To conceptualize mechanisms of change, behaviour change techniques were retrospectively coded onto participant interview data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>An overarching theme: ‘Better sleep, better wellbeing’ was generated, with three interlinking themes conceptualizing the process by which positive changes to sleep and wellbeing were achieved. These were: ‘Procedure: The value of therapy sessions versus digital-only’, ‘Context: Working on mental health from home during COVID-19’, and ‘Mechanisms: Practice, feedback and problem solving.’</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Participants' experiences of SLEEP were predominantly positive and suggested a spillover effect of improved sleep on overall wellbeing. Triangulation of quantitative outcomes showed congruent improvements. Maintaining therapist contact to facilitate behaviour change throughout the programme was important. Furthermore, providing a private space for therapist calls was essential to facilitate the intervention in the workplace; an important insight for the development of digital mental health interventions intended for the workplace.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"31 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12676197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145670302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mental illness stigma is widely examined in healthcare, yet less is known about its intersections with the stigma of chronic physical conditions in shaping distinct forms of disadvantage. Here, we investigate whether patients with concurrent mental and physical health conditions are perceived and treated differently by prospective medical doctors.
Methods
Using a mixed-methods design, preclinical medical students (N = 463) evaluated clinical vignettes describing patients with single (i.e., mental or physical chronic disease) and multiple health conditions (i.e., concurrent mental and physical conditions). We assessed emotional reactions, attributions of disease aetiology, caregiving attitudes and meta-beliefs about patients' disclosure behaviour. Participants were also asked to report as accurately as possible on symptoms presented by each patient in the vignette.
Results
Findings revealed that stigmatized conditions were associated with higher levels of caregiving discomfort, greater disease disclosure reticence and lower levels of symptom recall accuracy. Compared with patients with single conditions, those with concurrent mental and physical illnesses were less likely to receive care, were attributed a lesser tendency to conceal their conditions and had their symptoms recalled less accurately.
Conclusions
Results indicate that when mental and physical illnesses intersect, patients with multiple stigmatized conditions may be differentially perceived in the eyes of medical students and may become (in)visible targets of discrimination in a healthcare setting. We discuss implications for enhancing awareness of social determinants of health and disease for a more representative, responsive and inclusive healthcare curriculum and practice.
{"title":"The (in)visible cloak: How intersecting stigmas associated with mental and chronic physical disease shape perceptions in a healthcare setting","authors":"Edita Fino, Paolo Maria Russo, Maria Ida Gobbini","doi":"10.1111/bjhp.70038","DOIUrl":"https://doi.org/10.1111/bjhp.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Mental illness stigma is widely examined in healthcare, yet less is known about its intersections with the stigma of chronic physical conditions in shaping distinct forms of disadvantage. Here, we investigate whether patients with concurrent mental and physical health conditions are perceived and treated differently by prospective medical doctors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a mixed-methods design, preclinical medical students (<i>N</i> = 463) evaluated clinical vignettes describing patients with single (i.e., mental or physical chronic disease) and multiple health conditions (i.e., concurrent mental and physical conditions). We assessed emotional reactions, attributions of disease aetiology, caregiving attitudes and meta-beliefs about patients' disclosure behaviour. Participants were also asked to report as accurately as possible on symptoms presented by each patient in the vignette.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Findings revealed that stigmatized conditions were associated with higher levels of caregiving discomfort, greater disease disclosure reticence and lower levels of symptom recall accuracy. Compared with patients with single conditions, those with concurrent mental and physical illnesses were less likely to receive care, were attributed a lesser tendency to conceal their conditions and had their symptoms recalled less accurately.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Results indicate that when mental and physical illnesses intersect, patients with multiple stigmatized conditions may be differentially perceived in the eyes of medical students and may become (in)visible targets of discrimination in a healthcare setting. We discuss implications for enhancing awareness of social determinants of health and disease for a more representative, responsive and inclusive healthcare curriculum and practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"31 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/bjhp.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editorial Acknowledgement","authors":"","doi":"10.1111/bjhp.70036","DOIUrl":"https://doi.org/10.1111/bjhp.70036","url":null,"abstract":"","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"31 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Editorial: Introducing the special issue on the role of positive psychological factors in health","authors":"Fuschia M. Sirois, Andrew R. Thompson","doi":"10.1111/bjhp.70037","DOIUrl":"https://doi.org/10.1111/bjhp.70037","url":null,"abstract":"","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"31 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145585264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wladyslawa Czuber-Dochan, Vari Wileman, Lesley Dibley, Paramasivan Shankavi, Alawi Fatima, Christine Norton, Rona Moss-Morris, Stephanie J. C. Taylor
Purpose
This parallel process evaluation examined the implementation of a randomised controlled trial (RCT) of IBD-BOOST—a digital, interactive, facilitator-supported self-management intervention targeting fatigue, pain and urgency/faecal incontinence in individuals with inflammatory bowel disease (IBD). The RCT, involving 780 participants, compared IBD-BOOST with usual care but found no significant differences in quality of life (QoL) or symptom relief at six months post-randomisation.
Methods
A concurrent mixed methods design was employed. Qualitative data were gathered through semi-structured interviews; quantitative data were derived from the intervention platform's built-in analytics. Qualitative data were analysed using narrative thematic and framework analysis; quantitative data were examined using descriptive statistics.
Results
Interviews were conducted with participants pre- (n = 30) and post-intervention (n = 28). At baseline, participants highlighted a need for improved education and support targeting fatigue, pain and urgency/faecal incontinence, expressing a preference for digital delivery due to its flexibility. Post-intervention, treatment group interviewees reported high satisfaction with the intervention's content and structure, with many continuing to use the strategies learned, reporting enhanced symptom management and QoL. However, quantitative data indicated low adherence. Control group interviewees expressed disappointment with their allocation but anticipated benefits from deferred access to the intervention.
Conclusions
Although the RCT found no statistically significant effect of IBD-BOOST on primary outcomes, the process evaluation results revealed perceived benefits in symptom understanding and developing new management strategies. The intervention was well-received, and patients reported improvements in QoL. There was strong patient support for the IBD-BOOST intervention to be freely available to all individuals with IBD.
{"title":"Process evaluation findings contradict RCT results of the IBD-BOOST digital self-management intervention for fatigue, pain and faecal urgency in inflammatory bowel disease: A mixed methods study of patient perspectives","authors":"Wladyslawa Czuber-Dochan, Vari Wileman, Lesley Dibley, Paramasivan Shankavi, Alawi Fatima, Christine Norton, Rona Moss-Morris, Stephanie J. C. Taylor","doi":"10.1111/bjhp.70035","DOIUrl":"10.1111/bjhp.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This parallel process evaluation examined the implementation of a randomised controlled trial (RCT) of IBD-BOOST—a digital, interactive, facilitator-supported self-management intervention targeting fatigue, pain and urgency/faecal incontinence in individuals with inflammatory bowel disease (IBD). The RCT, involving 780 participants, compared IBD-BOOST with usual care but found no significant differences in quality of life (QoL) or symptom relief at six months post-randomisation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A concurrent mixed methods design was employed. Qualitative data were gathered through semi-structured interviews; quantitative data were derived from the intervention platform's built-in analytics. Qualitative data were analysed using narrative thematic and framework analysis; quantitative data were examined using descriptive statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Interviews were conducted with participants pre- (<i>n</i> = 30) and post-intervention (<i>n</i> = 28). At baseline, participants highlighted a need for improved education and support targeting fatigue, pain and urgency/faecal incontinence, expressing a preference for digital delivery due to its flexibility. Post-intervention, treatment group interviewees reported high satisfaction with the intervention's content and structure, with many continuing to use the strategies learned, reporting enhanced symptom management and QoL. However, quantitative data indicated low adherence. Control group interviewees expressed disappointment with their allocation but anticipated benefits from deferred access to the intervention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although the RCT found no statistically significant effect of IBD-BOOST on primary outcomes, the process evaluation results revealed perceived benefits in symptom understanding and developing new management strategies. The intervention was well-received, and patients reported improvements in QoL. There was strong patient support for the IBD-BOOST intervention to be freely available to all individuals with IBD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"30 4","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/bjhp.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rhiannon Phillips, Britt Hallingberg, Anna Torrens-Burton, Fiona Wood, David Gillespie, Clare Glennan, Paul Sellars, Sherina Lowe, Aleysha Caffoor, Wouter Poortinga, Karin Wahl-Jorgensen, Denitza Williams
Objectives
To investigate the relationship between motivation and COVID-19 infection–prevention behaviour during the first 2 years of the COVID-19 pandemic.
Design
Prospective longitudinal online survey in a UK community-based cohort.
Methods
During March/April 2020, n = 11,113 people, recruited via the HealthWise Wales research registry and social media advertising, completed the COVID-19 Public Experiences (COPE) study baseline survey, with follow-up at 3, 12, 18 and 24 months. Online questionnaires assessed COVID-19 infection–prevention behaviour, perceived susceptibility, fear, personal control over infection transmission and reliability of information from media and government. Repeated-measures ANOVA identified changes in motivation and behaviour over time. Multivariable regression models at each time point assessed associations between motivation and behaviour.
Results
COVID-19 infection–prevention behaviour and motivational variables (fear of COVID-19, perceived susceptibility and perceived control) fluctuated over time as the disease and socio-political environment changed, decreasing overall by 24 months. Regression models for association between motivational variables and COVID-19 infection–prevention behaviour were statistically significant at three (F(10, 5981) = 76.69, p < .001, adjusted R2 .112), 12 (F(11, 3732) = 48.40, p < .001, adjusted R2 .122), 18 (F(11, 3665) = 108.34, p < .001, adjusted R2 .243) and 24 months (F(11, 3355) = 136.20, p < .001, adjusted R2 .306). Higher levels of fear, older age, lower perceived personal control over infection transmission, more trust in government and less trust in social media were associated with more infection–prevention behaviour.
Conclusions
Motivation to engage in infection–prevention behaviour during a pandemic is multi-factorial and dynamic. Beliefs about infection and trust in government and media need to be considered in developing effective communication strategies.
目的：探讨COVID-19大流行前2年动机与COVID-19感染预防行为之间的关系。设计：英国社区队列的前瞻性纵向在线调查。方法：在2020年3月/ 4月期间，通过HealthWise Wales研究注册中心和社交媒体广告招募的n = 11,113人完成了COVID-19公共体验（COPE）研究基线调查，并在3、12、18和24个月进行了随访。在线问卷评估了COVID-19感染预防行为、感知易感性、恐惧、个人对感染传播的控制以及媒体和政府信息的可靠性。重复测量方差分析确定了动机和行为随时间的变化。每个时间点的多变量回归模型评估动机和行为之间的关联。结果：COVID-19感染预防行为和动机变量（对COVID-19的恐惧、感知易感性和感知控制）随着疾病和社会政治环境的变化而随时间波动，总体下降24个月。动机变量与COVID-19感染预防行为之间的关联回归模型在3 （F(10,5981) = 76.69, p 2）时具有统计学意义。112), 12 (F(11,3732) = 48.40, p 2。122), 18 (F(11,3665) = 108.34, p 2。243)和24个月（F(11, 3355) = 136.20, p 2.306）。恐惧程度越高、年龄越大、对感染传播的个人控制程度越低、对政府的信任度越高、对社交媒体的信任度越低，与更多的感染预防行为有关。结论：大流行期间参与感染预防行为的动机是多因素和动态的。在制定有效的传播战略时，需要考虑到对感染的看法和对政府和媒体的信任。
{"title":"Are you afraid of COVID-19? Motivation and engagement in infection–prevention behaviour in a UK community cohort during the first 2 years of the COVID-19 pandemic","authors":"Rhiannon Phillips, Britt Hallingberg, Anna Torrens-Burton, Fiona Wood, David Gillespie, Clare Glennan, Paul Sellars, Sherina Lowe, Aleysha Caffoor, Wouter Poortinga, Karin Wahl-Jorgensen, Denitza Williams","doi":"10.1111/bjhp.70034","DOIUrl":"10.1111/bjhp.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate the relationship between motivation and COVID-19 infection–prevention behaviour during the first 2 years of the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective longitudinal online survey in a UK community-based cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>During March/April 2020, <i>n</i> = 11,113 people, recruited via the HealthWise Wales research registry and social media advertising, completed the COVID-19 Public Experiences (COPE) study baseline survey, with follow-up at 3, 12, 18 and 24 months. Online questionnaires assessed COVID-19 infection–prevention behaviour, perceived susceptibility, fear, personal control over infection transmission and reliability of information from media and government. Repeated-measures ANOVA identified changes in motivation and behaviour over time. Multivariable regression models at each time point assessed associations between motivation and behaviour.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>COVID-19 infection–prevention behaviour and motivational variables (fear of COVID-19, perceived susceptibility and perceived control) fluctuated over time as the disease and socio-political environment changed, decreasing overall by 24 months. Regression models for association between motivational variables and COVID-19 infection–prevention behaviour were statistically significant at three (<i>F</i><sub>(10, 5981)</sub> = 76.69, <i>p</i> < .001, adjusted <i>R</i><sup>2</sup> .112), 12 (<i>F</i><sub>(11, 3732)</sub> = 48.40, <i>p</i> < .001, adjusted <i>R</i><sup>2</sup> .122), 18 (<i>F</i><sub>(11, 3665)</sub> = 108.34, <i>p</i> < .001, adjusted <i>R</i><sup>2</sup> .243) and 24 months (<i>F</i><sub>(11, 3355)</sub> = 136.20, <i>p</i> < .001, adjusted <i>R</i><sup>2</sup> .306). Higher levels of fear, older age, lower perceived personal control over infection transmission, more trust in government and less trust in social media were associated with more infection–prevention behaviour.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Motivation to engage in infection–prevention behaviour during a pandemic is multi-factorial and dynamic. Beliefs about infection and trust in government and media need to be considered in developing effective communication strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"30 4","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/bjhp.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rosie Essery, Mary Steele, Stephanie Easton, Sebastien Pollet, Charlotte Cairns, Rebekah LeFeuvre, Julie Hooper, Taeko Becque, Tanith Kane, Georgina Hart, Tracey Sach, Nick Francis, Paul Little, Lucy Yardley, Sophie Dove, Kate Henaghan-Sykes, Irene Soulsby, Kim S. Thomas, Matthew J. Ridd, Beth Stuart, Alison M. Layton, Andrew R. Thompson, Mahendra Patel, Adam Yates, Miriam Santer, Ingrid Muller
Objectives
To showcase the planning and optimization processes involved in developing a digital behaviour change intervention through the example of a self-management support tool for young people with acne (‘Acne Care Online’).
Design
Following Medical Research Council guidance, a theory, evidence, and person-based approach was employed, drawing on existing evidence, stakeholder expertise, health psychology theory, and qualitative methods to underpin intervention content, structure and functionality.
Methods
Systematic reviews of literature concerning acne help-seeking and treatment adherence, theoretical understandings of health-related behaviour, guidance from public contributors, and interviews with young people with acne (n = 24), their parents/carers (n = 8) and healthcare professionals (n = 18), informed the intervention's guiding principles and logic model. Draft intervention content was then developed by a multidisciplinary study team including public contributors and health professionals, and optimized through 53 think-aloud interviews with intended users.
Results
The development process created Acne Care Online ready for trial evaluation. It also provided insights into self-management challenges amongst this group – including their reluctance to consult, and misconceptions about treatments that hinder effective management (e.g., using products with no active ingredients, concerns about side effects, and unrealistic expectations). Acne Care Online appeared engaging, informative and relevant, with early feedback from health professionals suggesting it could be integrated into current healthcare practice.
Conclusions
This study provides insights into theory and person-informed development processes for behaviour change interventions. Here, the acceptability and perceived value of Acne Care Online was evidenced. The work also provides important insights for clinicians managing young people seeking support for acne.
{"title":"Planning and optimizing a digital self-management support intervention: Acne Care Online","authors":"Rosie Essery, Mary Steele, Stephanie Easton, Sebastien Pollet, Charlotte Cairns, Rebekah LeFeuvre, Julie Hooper, Taeko Becque, Tanith Kane, Georgina Hart, Tracey Sach, Nick Francis, Paul Little, Lucy Yardley, Sophie Dove, Kate Henaghan-Sykes, Irene Soulsby, Kim S. Thomas, Matthew J. Ridd, Beth Stuart, Alison M. Layton, Andrew R. Thompson, Mahendra Patel, Adam Yates, Miriam Santer, Ingrid Muller","doi":"10.1111/bjhp.70033","DOIUrl":"10.1111/bjhp.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To showcase the planning and optimization processes involved in developing a digital behaviour change intervention through the example of a self-management support tool for young people with acne (‘Acne Care Online’).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Following Medical Research Council guidance, a theory, evidence, and person-based approach was employed, drawing on existing evidence, stakeholder expertise, health psychology theory, and qualitative methods to underpin intervention content, structure and functionality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Systematic reviews of literature concerning acne help-seeking and treatment adherence, theoretical understandings of health-related behaviour, guidance from public contributors, and interviews with young people with acne (<i>n</i> = 24), their parents/carers (<i>n</i> = 8) and healthcare professionals (<i>n</i> = 18), informed the intervention's guiding principles and logic model. Draft intervention content was then developed by a multidisciplinary study team including public contributors and health professionals, and optimized through 53 think-aloud interviews with intended users.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The development process created Acne Care Online ready for trial evaluation. It also provided insights into self-management challenges amongst this group – including their reluctance to consult, and misconceptions about treatments that hinder effective management (e.g., using products with no active ingredients, concerns about side effects, and unrealistic expectations). Acne Care Online appeared engaging, informative and relevant, with early feedback from health professionals suggesting it could be integrated into current healthcare practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provides insights into theory and person-informed development processes for behaviour change interventions. Here, the acceptability and perceived value of Acne Care Online was evidenced. The work also provides important insights for clinicians managing young people seeking support for acne.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"30 4","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12587102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kristina Pfeffer, Malte Nejst Larsen, Mathilde Grøn Laursen, Trine Grønbek Hamborg, Josef Heidler, Knud Ryom, Peter Krustrup, Nikos Ntoumanis
Objectives
Assessing fidelity is essential to understanding the effectiveness of behavioural interventions, yet reporting often lacks detail and consistency. This study developed and applied a fidelity checklist to evaluate both training and treatment delivery in a school-based health education intervention. This is one of the first applications of The Behaviour Change Technique Ontology to inform the development of a fidelity checklist. The checklist was created for the 11 for Health (11fH) intervention—an intervention shown to be effective in improving health for youth.
Methods
Two fidelity checklists were developed, one for health education sessions and one for football sessions. The checklists comprised 24 behaviour change techniques (BCTs) identified in the intervention manual and intervention components identified by intervention creators. Training fidelity and treatment delivery were coded by three independent raters through 8 h of video observations of the training and 10 video observations of 45 min each of the delivery of the 11fH sessions using the checklists.
Results
Kappa coefficients indicated moderate to substantial observer agreement. The fidelity of training was 98.9% and the fidelity of delivery was 77.5%. Fidelity was high for items such as ‘Instruct how to perform a behaviour’ and ‘Student inclusion’, whereas the BCTs ‘Inform about emotional and social consequences’ and ‘Substitute one behaviour with another’ were delivered with lower fidelity.
Conclusion
We provide a template of how to develop and evaluate aspects of fidelity that can be used in similar health education interventions, thereby enhancing both their evaluation and implementation.
{"title":"Developing a checklist to assess fidelity of training and treatment delivery of 11 for Health, a football-based health education intervention for youth","authors":"Kristina Pfeffer, Malte Nejst Larsen, Mathilde Grøn Laursen, Trine Grønbek Hamborg, Josef Heidler, Knud Ryom, Peter Krustrup, Nikos Ntoumanis","doi":"10.1111/bjhp.70032","DOIUrl":"10.1111/bjhp.70032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Assessing fidelity is essential to understanding the effectiveness of behavioural interventions, yet reporting often lacks detail and consistency. This study developed and applied a fidelity checklist to evaluate both training and treatment delivery in a school-based health education intervention. This is one of the first applications of The Behaviour Change Technique Ontology to inform the development of a fidelity checklist. The checklist was created for the 11 for Health (11fH) intervention—an intervention shown to be effective in improving health for youth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two fidelity checklists were developed, one for health education sessions and one for football sessions. The checklists comprised 24 behaviour change techniques (BCTs) identified in the intervention manual and intervention components identified by intervention creators. Training fidelity and treatment delivery were coded by three independent raters through 8 h of video observations of the training and 10 video observations of 45 min each of the delivery of the 11fH sessions using the checklists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Kappa coefficients indicated moderate to substantial observer agreement. The fidelity of training was 98.9% and the fidelity of delivery was 77.5%. Fidelity was high for items such as ‘Instruct how to perform a behaviour’ and ‘Student inclusion’, whereas the BCTs ‘Inform about emotional and social consequences’ and ‘Substitute one behaviour with another’ were delivered with lower fidelity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We provide a template of how to develop and evaluate aspects of fidelity that can be used in similar health education interventions, thereby enhancing both their evaluation and implementation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"30 4","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145394191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vasiliki Christodoulou, Katerina Artemiou, Vasilis S. Vasiliou
Purpose
Dissemination and implementation of socially prescribed community-based programmes for individuals with rheumatic conditions remain rare. However, such programmes can help overcome key barriers, including limited access to evidence-based psychological interventions, individuals' preference for psychosocial care outside of rheumatology clinics and the prevention of isolation and loneliness.
Methods
This study presents a qualitative process evaluation of a community-based Acceptance and Commitment Therapy (ACT) group intervention, delivered as part of a psychosocial service within a support organization for individuals with rheumatic conditions. We conducted 12 semi-structured qualitative interviews following participants' completion of five in-person ACT group sessions. Reflexive thematic analysis was used to assess acceptability and explore how participants conceptualized ACT's processes of change.
Results
Four key themes emerged, offering practical considerations for planning and delivering ACT groups for individuals with rheumatic conditions: (1) the process of finding peace through mindfulness while managing practice-related difficulties, (2) recognizing the importance of making values-consistent choices, (3) navigating an ambivalent relationship with pain and (4) the dual nature of the group experience—both comforting and awkward.
Conclusions
Findings highlight the implications of programme duration in planning ACT groups for individuals with rheumatic conditions in the community. The study suggests that acceptance and mindfulness may be time-bound and context-sensitive processes, influenced by the fluctuating symptomatology of rheumatic conditions. Mindfulness is best developed step by step, starting with body awareness, understanding symptoms and slowly bringing mindfulness into daily life. Pain acceptance should focus more on facilitating momentary patterns of activity engagement, rather than willingness towards the fluctuating symptoms.
{"title":"Community-based Acceptance and Commitment Therapy Programmes for rheumatic conditions: An acceptability and qualitative process evaluation study","authors":"Vasiliki Christodoulou, Katerina Artemiou, Vasilis S. Vasiliou","doi":"10.1111/bjhp.70031","DOIUrl":"10.1111/bjhp.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Dissemination and implementation of socially prescribed community-based programmes for individuals with rheumatic conditions remain rare. However, such programmes can help overcome key barriers, including limited access to evidence-based psychological interventions, individuals' preference for psychosocial care outside of rheumatology clinics and the prevention of isolation and loneliness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study presents a qualitative process evaluation of a community-based Acceptance and Commitment Therapy (ACT) group intervention, delivered as part of a psychosocial service within a support organization for individuals with rheumatic conditions. We conducted 12 semi-structured qualitative interviews following participants' completion of five in-person ACT group sessions. Reflexive thematic analysis was used to assess acceptability and explore how participants conceptualized ACT's processes of change.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four key themes emerged, offering practical considerations for planning and delivering ACT groups for individuals with rheumatic conditions: (1) the process of finding peace through mindfulness while managing practice-related difficulties, (2) recognizing the importance of making values-consistent choices, (3) navigating an ambivalent relationship with pain and (4) the dual nature of the group experience—both comforting and awkward.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Findings highlight the implications of programme duration in planning ACT groups for individuals with rheumatic conditions in the community. The study suggests that acceptance and mindfulness may be time-bound and context-sensitive processes, influenced by the fluctuating symptomatology of rheumatic conditions. Mindfulness is best developed step by step, starting with body awareness, understanding symptoms and slowly bringing mindfulness into daily life. Pain acceptance should focus more on facilitating momentary patterns of activity engagement, rather than willingness towards the fluctuating symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"30 4","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/bjhp.70031","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Florence Sheen, Lucy Porter, Trisevgeni Papakonstantinou, Maria Ceka, Paulina Bondaronek
Objectives
Use artificial intelligence–Human collaboration to investigate the unintended consequences of the most popular commercial fitness apps through social listening via X (formerly Twitter) posts.
Design
Machine-assisted topic analysis (MATA).
Methods
X posts (n = 58,881) referring to the five most profitable fitness apps were collected via application programming interface and filtered for negative sentiment, resulting in 13,799. MATA was used to generate a structural topic model. This organized the data into topics and provided 20 representative posts per topic for further qualitative analysis, informed by a thematic analysis approach.
Results
Six topics were generated by machine analysis and subsequently retained as independent themes during human analysis. These reflected key challenges and unintended consequences of using commercial fitness apps, including negative psychological and behavioural impacts. These centred around the challenges of quantifying real-world activities, implications for accuracy, difficulties associated with achieving algorithm-set goals, and subsequent negative impacts on emotions, motivations, and engagement with apps and health behaviours more generally.
Conclusions
This study highlights the negative behavioural and psychological consequences of commercial fitness apps as reported by users on social media. Our findings suggest that these may undermine the apps' potential to promote health behaviour change and well-being. This highlights the need for a more user-centred app design based on psychological theory, prioritizing well-being and intrinsic motivation over rigid, quantitative goals.
{"title":"Living well? The unintended consequences of highly popular commercial fitness apps through social listening using Machine-Assisted Topic Analysis: Evidence from X","authors":"Florence Sheen, Lucy Porter, Trisevgeni Papakonstantinou, Maria Ceka, Paulina Bondaronek","doi":"10.1111/bjhp.70026","DOIUrl":"10.1111/bjhp.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Use artificial intelligence–Human collaboration to investigate the unintended consequences of the most popular commercial fitness apps through social listening via X (formerly Twitter) posts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Machine-assisted topic analysis (MATA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>X posts (<i>n</i> = 58,881) referring to the five most profitable fitness apps were collected via application programming interface and filtered for negative sentiment, resulting in 13,799. MATA was used to generate a structural topic model. This organized the data into topics and provided 20 representative posts per topic for further qualitative analysis, informed by a thematic analysis approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six topics were generated by machine analysis and subsequently retained as independent themes during human analysis. These reflected key challenges and unintended consequences of using commercial fitness apps, including negative psychological and behavioural impacts. These centred around the challenges of quantifying real-world activities, implications for accuracy, difficulties associated with achieving algorithm-set goals, and subsequent negative impacts on emotions, motivations, and engagement with apps and health behaviours more generally.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights the negative behavioural and psychological consequences of commercial fitness apps as reported by users on social media. Our findings suggest that these may undermine the apps' potential to promote health behaviour change and well-being. This highlights the need for a more user-centred app design based on psychological theory, prioritizing well-being and intrinsic motivation over rigid, quantitative goals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48161,"journal":{"name":"British Journal of Health Psychology","volume":"30 4","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12541294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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