Web-based physical activity intervention for people with progressive multiple sclerosis: application of consensus-based intervention development guidance

Abstract

ObjectivesPeople with progressive multiple sclerosis (PwPMS) report that they recognise the benefits of activity on their physical and psychological health but need support to achieve their physical activity goals. We aimed to systematically develop a theoretically informed intervention that would enable PwPMS to more readily engage in regular physical activity.DesignWe used an intervention mapping approach to inform intervention development.SettingWe conducted semistructured interviews with PwPMS and their families/carers and physiotherapists recruited from secondary care settings.ParticipantsFourteen PwPMS with an Expanded Disability Status Scale score of between 6 and 8 and 7 of their families/carers and 13 physiotherapists and 1 physiotherapy technician participated.ResultsInterview data suggested that the development of supportive coaching relationships with physiotherapists could promote the ability of PwPMS to achieve a desirable and achievable physical activity plan. These interview data informed the prototype ‘Lifestyle Exercise and Activity Package for Multiple Sclerosis’ (LEAP-MS) consisting of a secure multiuser web-based platform (with an education and activity suite, interactive components enabling selection of exercises, goal setting and activity logging), up to six flexible face-to-face or web-based physiotherapy coaching sessions and remote support via an embedded web-based messaging function that all together draw on specific theory-based methods to achieve physical activity behaviour change, namely active learning, reinforcement, modelling, feedback, facilitation, goal setting and guided practice. Implementation is within a multiuser platform accessible to participants, trained physiotherapists and researchers.ConclusionsWe have followed an inclusive, systematic and transparent process to develop the LEAP-MS intervention that enables detailed description of components, context and guiding principles to inform ongoing evaluation. Importantly, PwPMS expressed the need for autonomy in developing physical activity plans. This has been achieved through the embedding of self-management principles in the design and delivery of the LEAP-MS intervention.

A web-based life-style, exercise and activity intervention for people with progressive multiple sclerosis: Results of a single-arm feasibility study

“…Consented participants were asked to complete a range of patient-reported outcome measures online at baseline, 3 and 6-months post baseline. Selected assessments reflected our proposed logic model of change, linking performance objectives to the proposed intervention outcomes over the short and medium terms 15 . In the short term, we anticipated that adherence to the intervention would be achieved through enhanced self-efficacy as assessed by the University of Washington 6-item short form self-efficacy scale (UW-SES-SF) (MS specific) 26 .…”

“…Goal setting, appropriate communication and self-monitoring are important determinants of sustained physical activity behaviour 14 . With this in mind, we used an intervention mapping approach to systematically develop a bespoke physical activity self-management support intervention for PwPMS with advanced disability 15 . Within this patient-, family/carer-and community-centred intervention, physiotherapists provided a unique role as a physical activity coach.…”

Lifestyle, exercise and activity package for people living with progressive multiple sclerosis (LEAP-MS): protocol for a single-arm feasibility study

“…All participants will be required to complete a range of patient-reported outcome measures directly online at baseline, 3 and 6 months post-baseline (plus or minus 2 weeks; see Table 1 : schedule of enrolment, interventions and assessments). Selected assessments were reflective of our logic model of change, linking performance objectives to the proposed intervention outcomes over the short and medium terms [ 53 ]. In the shorter term, we anticipated that adherence to the intervention would be achieved through enhanced self-efficacy as assessed by the University of Washington 6-item short from self-efficacy scale (UW-SES-SF) (MS specific) [ 55 ].…”

“…In addition, participants are able to set and monitor personalised goals using a goal-setting function and input all activity undertaken through the use of an activity log. A fuller description and images of the intervention are described elsewhere [ 53 ].…”

“…Here we present the protocol for the LEAP-MS single-arm feasibility trial and embedded process evaluation. Underpinned by social cognitive theory and self-regulation theory, taking a self-management approach—LEAP-MS is a co-designed blended physiotherapy digital intervention [ 53 ]. Our primary objective is to establish the feasibility of the LEAP-MS intervention.…”