Lessons learned from eight teams: The value of pilot and feasibility studies in self-management science

Development and Use of a Tech-Based Data Management System for a Cognitive Rehabilitation Randomized Controlled Trial for People With Type 2 Diabetes

Successful technology-based interventions to improve patients' self-management are providing an incentive for researchers to develop and implement their own technology-based interventions. However, the literature lacks guidance on how to do this. In this article, we describe the electronic process with which we designed and implemented a technology-based data management system to implement a randomized controlled trial of a comprehensive cognitive rehabilitation intervention to improve cognitive function and diabetes self-management in people with type 2 diabetes. System development included feasibility assessment, interdisciplinary collaboration, design mapping, and use of institutionally and commercially available software. The resulting framework offers a template to support the development of technology-based interventions. Initial development may be time-consuming, but the benefits of the technology-based format surpass any drawbacks.

Hypermobile Ehlers-Danlos syndrome/hypermobility spectrum disorders in older women: A feasibility study

INTRODUCTION

Hypermobile Ehlers-Danlos syndrome and hypermobility spectrum disorders cause joint instability, chronic pain, fatigue and progressive multisystemic dysfunction, increasing symptom burden and decreasing quality of life. Researchers know little about how these disorders progress in women as they age.

OBJECTIVE

This research aimed to determine the feasibility of an internet-based study to understand the clinical characteristics, symptom burden and health-related quality of life in older women with symptomatic hypermobility disorders.

METHODS

This cross-sectional, internet-based survey studied recruitment methods, suitability and usability of survey instruments and obtained baseline data on women aged 50 and older with hEDS/HSD. Researchers recruited participants from a Facebook group for older adults with Ehlers-Danlos syndrome. Outcome measures included health history, the Multidimensional Health Assessment Questionnaire and the RAND Short Form 36 health survey.

RESULTS

Researchers recruited 32 participants from a single Facebook group within 2 weeks. Nearly all participants were satisfied with the survey length, clarity and navigation, with 10 participants providing free-text recommendations for survey improvement. The survey suggests a high symptom burden and poor quality of life in older women with hEDS/HSD.

CONCLUSION

The results support the feasibility and importance of a future internet-based comprehensive study about hEDS/HSD in older women.

Conscious connected breathing with breath retention intervention in adults with chronic low back pain: protocol for a randomized controlled pilot study

BACKGROUND

Chronic pain is a major source of human suffering, and chronic low back pain (cLBP) is among the most prevalent, costly, and disabling of pain conditions. Due to the significant personal and societal burden and the complex and recurring nature of cLBP, self-management approaches that can be practiced at home are highly relevant to develop and test. The respiratory system is one of the most integrated systems of the body, and breathing is bidirectionally related with stress, emotion, and pain. Thus, the widespread physiological and psychological impact of breathing practices and breathwork interventions hold substantial promise as possible self-management strategies for chronic pain. The primary aim of the current randomized pilot study is to test the feasibility and acceptability of a conscious connected breathing with breath retention intervention compared to a sham control condition.

METHODS

The rationale and procedures for testing a 5-day conscious connected breathing with breath retention intervention, compared to a deep breathing sham control intervention, in 24 adults (18-65 years) with cLBP is described. Both interventions will be delivered using standardized audio recordings and practiced over 5 days (two times in-person and three times at-home), and both are described as Breathing and Attention Training to reduce possible expectancy and placebo effects common in pain research. The primary outcomes for this study are feasibility and acceptability. Feasibility will be evaluated by determining rates of participant recruitment, adherence, retention, and study assessment completion, and acceptability will be evaluated by assessing participants' satisfaction and helpfulness of the intervention. We will also measure other clinical pain, psychological, behavioral, and physiological variables that are planned to be included in a follow-up randomized controlled trial.

DISCUSSION

This will be the first study to examine the effects of a conscious connected breathing with breath retention intervention for individuals with chronic pain. The successful completion of this smaller-scale pilot study will provide data regarding the feasibility and acceptability to conduct a subsequent trial testing the efficacy of this breathing self-management practice for adults with cLBP.

TRIAL REGISTRATION

Clinicaltrials.gov, identifier NCT04740710 . Registered on 5 February 2021.

Towards multimodal boosting of motivation for fall-preventive physical activity in seniors: An iterative development evaluation study

Background

Many seniors need to increase their physical activity (PA) and participation in fall prevention exercise. Therefore, digital systems have been developed to support fall-preventive PA. Most of them lack video coaching and PA monitoring, two functionalities that may be relevant for increasing PA.

Objective

To develop a prototype of a system to support seniors' fall-preventive PA, which includes also video coaching and PA monitoring, and to evaluate its feasibility and user experience.

Methods

A system prototype was conceived by integrating applications for step-monitoring, behavioural change support, personal calendar, video-coaching and a cloud service for data management and co-ordination. Its feasibility and user experience were evaluated in three consecutive test periods combined with technical development. In total, 11 seniors tested the system at home for four weeks with video coaching from health care professionals.

Results

Initially, the system's feasibility was non-satisfactory due to insufficient stability and usability. However, most problems could be addressed and amended. In the third (last) test period, both seniors and coaches experienced the system prototype to be fun, flexible and awareness-raising. Interestingly, the video coaching which made the system unique compared to similar systems was highly appreciated. Nonetheless, even the users in the last test period highlighted issues due to insufficient usability, stability and flexibility. Further improvements in these areas are needed.

Conclusions

Video coaching in fall-preventive PA can be valuable for both seniors and health care professionals. High reliability, usability and flexibility of systems supporting seniors are essential.

Investigation of Healthcare Professionals' Knowledge of Evidence-Based Clinical Practices for Preterm Neonatal Skin Care-A Pilot Study

Neonatal skin care practices are considered crucial for a neonate's survival and are closely related to healthcare professionals' (HPs) knowledge and skills in delivering scientifically valid neonatal care interventions. In this descriptive cross-sectional pilot study, conducted in 2022, we aimed to assess HPs' basic theoretical knowledge of neonatal vernix caseosa, skin microbiota, and bathing as well as knowledge regarding evidence-based clinical practices (referred to as "clinical knowledge") for preterm neonatal skin care. Eligible participants were neonatologists, pediatricians, obstetricians, midwives and nurses working in the Greek setting. The research instrument was an online questionnaire designed by the research team. Finally, 123 HPs took part in the study. The theoretical, clinical and total knowledge scores were all significantly associated with age, healthcare profession and the sources used for education. Participants' theoretical and clinical knowledge scores were compared and found not to differ significantly (p = 0.566). A significant and positive correlation was found between theoretical and clinical knowledge scores. Thus, it is concluded that HPs should be updated with the latest evidence-based knowledge and clinical guidelines in order to provide neonatal skin care with high-quality standards.