A user-centred approach to developing bWell, a mobile app for arm and shoulder exercises after breast cancer treatment.

PURPOSE: The study aim was to develop a mobile application (app) supported by user preferences to optimise self-management of arm and shoulder exercises for upper-limb dysfunction (ULD) after breast cancer treatment. METHODS: Focus groups with breast cancer patients were held to identify user needs and requirements. Behaviour change techniques were explored by researchers and discussed during the focus groups. Concepts for content were identified by thematic analysis. A rapid review was conducted to inform the exercise programme. Preliminary testing was carried out to obtain user feedback from breast cancer patients who used the app for 8 weeks post surgery. RESULTS: Breast cancer patients' experiences with ULD and exercise advice and routines varied widely. They identified and prioritised several app features: tailored information, video demonstrations of the exercises, push notifications, and tracking and progress features. An evidence-based programme was developed with a physiotherapist with progressive exercises for passive and active mobilisation, stretching and strengthening. The exercise demonstration videos were filmed with a breast cancer patient. Early user testing demonstrated ease of use, and clear and motivating app content. CONCLUSIONS: bWell, a novel app for arm and shoulder exercises, was developed by breast cancer patients, health care professionals and academics. Further research is warranted to confirm its clinical effectiveness. IMPLICATIONS FOR CANCER SURVIVORS: Mobile health has great potential to provide patients with information specific to their needs. bWell is a promising way to support breast cancer patients with exercise routines after treatment and may improve future self-management of clinical care.

Using qualitative methods within a mixed-methods approach to developing and evaluating interventions to address harmful alcohol use among young people.

OBJECTIVE: This article illustrates how qualitative methods can be used in the development and evaluation of behavior change interventions. Although many campaigns advise young people to drink responsibly, few clarify how to convert this general advice into specific behavioral strategies. Resilience-based approaches argue that treating young non-drinkers and moderate drinkers as "experts" in responsible alcohol use may facilitate co-creation of acceptable interventions that focus on how to change behavior. METHOD: Four distinct phases of intervention development were linked to past research and future developments. RESULTS: First, analysis of correlates of alcohol use using data from a survey of 1,412 people aged 16-21 indicated that alcohol harm-reduction interventions should help young people to develop skills and strategies to resist alcohol. Second, interpretative phenomenological analysis of 25 interviews with people purposively selected from among the survey sample identified general strategies and specific tactics used by young people to manage opportunities to drink. Third, insights from the first 2 phases and past qualitative research guided development of video resources to be use in school-based alcohol education to illustrate strategies and tactics for moderate or non-use of alcohol. Fourth, 18 focus groups with students and teachers were used to evaluate the video: structured thematic analysis indicated that after revision the video would be a valuable addition to school-based alcohol education. CONCLUSIONS: Findings from the 4 phases highlight the value of using different qualitative and quantitative methods as part of a program of work designed to inform the development, refinement, and evaluation of health psychology interventions.

Validation of an iPad visual analogue rating system for assessing appetite and satiety.

The study aimed to validate appetite ratings made on a new electronic device, the Apple iPad Mini, against an existing but now obsolete electronic device (Hewlett Packard iPAQ). Healthy volunteers (9 men and 9 women) rated their appetite before and 0, 30, 60, 90 and 120 minutes after consuming both a low energy (LE: 77 kcal) and high energy (HE: 274 kcal) beverage at breakfast on 2 non-consecutive days in counter-balanced order. Rated hunger, desire to eat and how much participants could consume was significantly lower after HE than LE on both devices, although there was better overall differentiation between HE and LE for ratings on iPad. Rated satiation and fullness, and a composite measure combining all five ratings, was significantly higher after HE than LE on both devices. There was also evidence that differences between conditions were more significant when analysed at each time point than using an overall area under the curve (AUC) measure. Overall, these data confirm that appetite ratings made using iPad are at least as sensitive as those on iPAQ, and offer a new platform for researchers to collect appetite data.