An Electronic Health Intervention for Dutch Women With Stress Urinary Incontinence: Protocol for a Mixed Methods Study

Firet, Lotte; Teunissen, Doreth; Vaart, Huub van der; Assendelft, W.J.J.; Notten, Kim J. B.; Kool, Rudolf B; Lagro-Janssen, A.L.M.

doi:10.2196/13164

Cited by 7 publications

(23 citation statements)

References 48 publications

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“…This study is part of a research project on the implementation of an internet-based intervention in the Netherlands [ 23 ]. In this qualitative study, semi-structured interviews were conducted among Dutch women who participated in this e-Health intervention for SUI.…”

Section: Methodsmentioning

confidence: 99%

“…All women interviewed in this study took part in the ‘ Baas over je blaas’ [ 24 ] (‘ Master your own bladder ’) e-Health intervention, which was the subject of an implementation study . The methods of this study have been described previously [ 23 ]. In short, it concerns a web-based intervention in which PFMT is addressed in eight escalating steps (modules), with each step opening after the woman has completed a training report.…”

Section: Methodsmentioning

confidence: 99%

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Women’s adoption of a web-based intervention for stress urinary incontinence: a qualitative study

Firet¹,

Teunissen²,

Kool³

et al. 2021

BMC Health Serv Res

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Background Stress urinary incontinence (SUI) is common among women and affects their quality of life. Pelvic floor muscle training is an effective conservative therapy, but only a minority of women seek help. E-health with pelvic floor muscle training is effective and increases access to care. To implement an e-Health intervention in a sustainable way, however, we need to understand what determines adoption. The aim is to investigate the barriers and facilitators to adopting an e-Health intervention among Dutch women with stress urinary incontinence. Methods Semi-structured telephonic interviews were carried out among participants of the Dutch e-Health intervention for women with stress urinary incontinence. Women were purposively sampled. The ‘Fit between Individuals, Task and Technology’ (FITT) framework was used for both the data collection and data analysis, to gain a more in-depth insight into the adoption of the intervention. Results Twenty women were interviewed, mean age 51 years and mostly highly educated. The adoption of e-Health for women with SUI mainly depends on the interaction between users and e-Health, and users and pelvic floor muscle training exercises. Facilitators for the adoption were the preference for an accessible self-management intervention, having a strong sense of self-discipline and having the ability to schedule the exercises routinely. Women needed to possess self-efficacy to do this intervention independently. Barriers to the adoption of e-Health were personal circumstances restricting time for scheduling pelvic floor muscle training and lacking skills to perform the exercises correctly. Despite guidance by technical features several women remained uncertain about their performance of the exercises and, therefore, wanted additional contact with a professional. Conclusions For stress urinary incontinence e-Health is an appropriate option for a target audience. Use of the FITT framework clearly demonstrates the conditions for optimal adoption. For a subgroup it was a suitable alternative for medical care in person. For others it identified the need for further support by a health care professional. This support could be provided by improvements of technical features and incorporating modes for digital communication. The additional value of integration of the e-Health intervention in primary care might be a logical next step. Trial registration The study was prospectively registered in the Netherlands Trial Registry (NTR) NTR6956.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Women’s adoption of a web-based intervention for stress urinary incontinence: a qualitative study

Firet¹,

Teunissen²,

Kool³

et al. 2021

BMC Health Serv Res

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“…The qualitative strand consisted of data from open-ended web-based survey questions. A detailed description of the study has been published previously [27]. The study was registered in the Dutch Trial Registry (NTR6956) prospectively, which is now included in the International Clinical Trial Registry Platform.…”

Section: Designmentioning

confidence: 99%

“…Women who were interested could register on the web-based eHealth intervention, and after providing informed consent, they received a short questionnaire that enabled the researcher to check their eligibility. Eligibility criteria are published in detail elsewhere [27], but, in short, women were included when aged >18 years and when having SUI or mixed urinary incontinence, which is a combination of SUI and urgency urinary incontinence [27], meaning involuntary leakage accompanied by or immediately preceded by urgency [1]. Diagnosis was based on self-assessment questions from the Questionnaire for Female Urinary Incontinence Diagnosis [29].…”

Section: Participantsmentioning

confidence: 99%

“…The baseline survey contained sociodemographic items (age, education level, and recruitment method) and incontinence-related items (type of incontinence, burden, duration, incontinence aid usage, previous contact with a health care professional, previous PFMT, expected ability to train the pelvic floor muscles, and expected training result). This questionnaire has been extensively described in the protocol [27]. Education level was divided into two levels: low (primary and lower secondary education) versus high (from upper secondary level to doctoral equivalent level).…”

Section: Demographic and Incontinence-related Variablesmentioning

confidence: 99%

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Usage of a Web-Based eHealth Intervention for Women With Stress Urinary Incontinence: Mixed Methods Study

Firet¹,

Teunissen²,

Kool³

et al. 2022

J Med Internet Res

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Background Stress urinary incontinence (SUI) is highly prevalent among women and has an impact on physical and mental well-being. eHealth with pelvic floor muscle training (PFMT) has shown to be effective in reducing complaints. The usage and nonusage attrition of eHealth for SUI is unknown, but knowledge about users and their usage patterns is crucial for implementation purposes. Objective This study aimed to evaluate how an eHealth intervention for SUI was used and by whom, explore reasons for nonusage attrition, and determine what factors are associated with usage. Methods In this observational, mixed methods study, women with SUI independently registered to a web-based eHealth intervention, Baas over je blaas, a translation of the Swedish internet program Tät-treatment of stress urinary incontinence. Log-in data were collected during 3-month access to the website, and surveys were sent at baseline. Participants were divided into three user groups (low, intermediate, and high) and were compared based on sociodemographic and incontinence-related characteristics. Nominal logistic regression analysis was used to study factors associated with eHealth usage. Qualitative content analysis was used for open-ended questions about nonusage attrition and about facilitators of and barriers to eHealth usage. Results Participants (n=561) had a mean age of 50.3 (SD 12.1) years, and most of them (340/553, 61.5%) had never visited a health care professional for SUI before. Most users were low users (295/515, 57.3%), followed by intermediate users (133/515, 25.8%) and high users (87/515, 16.9%). User groups differed significantly in age (48.3, SD 12 years; 52.1, SD 11.6 years; and 55.3, SD 10.9 years; P<.001) and in their expected ability to train the pelvic floor muscles (7.5, SD 1.4; 7.7, SD 1.4; and 8.1, SD 1.5 for low, intermediate, and high users, respectively; P=.006). Nonusage attrition was mainly caused by problems in integrating PFMT into everyday life. High age (>50 years), previous PFMT, and high expected ability to train the pelvic floor muscles are associated with high usage. Facilitators for eHealth usage were the clear explanation of exercises and the possibility of self-management. Barriers were its noncommittal character and the absence of personal contact. Conclusions eHealth fulfills a need for women with SUI who have never received treatment. Those who discontinued prematurely did so mainly because it was difficult to integrate the training schedule into their everyday lives. High eHealth usage was more likely for women aged >50 years, with previous PFMT, and with high expectations about their ability to train the pelvic floor muscles. Knowledge of these user characteristics can guide clinicians and correct their misunderstandings about the suitable target population for this intervention. Furthermore, strategies for reinforcing expectations and self-efficacy are important to upscale eHealth usage, together with paying attention to people’s need for personal contact. International Registered Report Identifier (IRRID) RR2-10.2196/13164

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Nieuw onderzoek naar implementatie van e-health-behandeling voor stressincontinentie

Firet

Teunissen

2020

Huisarts Wet

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An Electronic Health Intervention for Dutch Women With Stress Urinary Incontinence: Protocol for a Mixed Methods Study

Cited by 7 publications

References 48 publications

Women’s adoption of a web-based intervention for stress urinary incontinence: a qualitative study

Women’s adoption of a web-based intervention for stress urinary incontinence: a qualitative study

Usage of a Web-Based eHealth Intervention for Women With Stress Urinary Incontinence: Mixed Methods Study

Nieuw onderzoek naar implementatie van e-health-behandeling voor stressincontinentie

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