'That's just how I am': a qualitative interview study to identify factors influencing engagement with a digital intervention for tinnitus self-management

Kate Greenwell; Magdalena Sereda; Neil S Coulson; Adam W A Geraghty; Katherine Bradbury; Derek J Hoare

doi:10.1111/bjhp.12486

'That's just how I am': a qualitative interview study to identify factors influencing engagement with a digital intervention for tinnitus self-management

Br J Health Psychol. 2021 Sep;26(3):727-747. doi: 10.1111/bjhp.12486. Epub 2020 Oct 27.

Authors

Kate Greenwell^{1

2}, Magdalena Sereda², Neil S Coulson³, Adam W A Geraghty⁴, Katherine Bradbury¹, Derek J Hoare²

Affiliations

¹ Centre for Clinical and Community Applications of Health Psychology, School of Psychology, University of Southampton, UK.
² Division of Clinical Neuroscience, National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Hearing Sciences Group, School of Medicine, University of Nottingham, UK.
³ Division of Rehabilitation, Ageing and Wellbeing, School of Medicine, University of Nottingham, UK.
⁴ School of Primary Care, Population Sciences and Medical Education, University of Southampton, UK.

PMID: 33108049
DOI: 10.1111/bjhp.12486

Abstract

Objectives: To explore users' reactions to and expectations of the Tinnitus E-Programme 2.0, a digital cognitive behavioural intervention for tinnitus, and to identify contextual factors and mechanisms of action that may influence user engagement with the intervention.

Design: Qualitative interview study.

Methods: Think-aloud and semi-structured interviews were carried out with 19 people with tinnitus. Interviews explored participants' views of the intervention's information and advice, its wider intervention goals (e.g. behaviour change, self-management), and factors that may strengthen or impede users' engagement. Data were analysed using inductive thematic analysis, and findings were used to develop a conceptual model of user engagement with the intervention.

Results: Generally, participants expressed positive views of the intervention, its intervention components, and its design features. Identified contextual factors included pre-existing attitudes, beliefs, skills, and knowledge (e.g. perceptions of tinnitus symptom severity, openness to tinnitus management, and psychological techniques); previous experience of tinnitus management; and characteristics of the condition (e.g. heterogeneous nature of tinnitus, stage in healthcare journey). These contextual factors were hypothesized to influence engagement through four mechanisms of action: motivation to change tinnitus-related attitudes and behaviour; perceived personal relevance of the intervention; expectations of benefit; and appeal of the intervention techniques.

Conclusions: This study demonstrated the acceptability of the Tinnitus E-Programme 2.0 amongst its target group, while highlighting potential areas for improvement in future intervention modifications. Our findings identified contextual factors that others developing interventions for tinnitus or cognitive behavioural interventions may wish to consider.

Keywords: context; digital intervention; engagement; qualitative interviews; self-management; tinnitus.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cognitive Behavioral Therapy*
Humans
Motivation
Qualitative Research
Self-Management*
Tinnitus* / therapy