Planning and optimizing a digital self-management support intervention: Acne Care Online.

OBJECTIVES: To showcase the planning and optimization processes involved in developing a digital behaviour change intervention through the example of a self-management support tool for young people with acne ('Acne Care Online'). DESIGN: Following Medical Research Council guidance, a theory, evidence, and person-based approach was employed, drawing on existing evidence, stakeholder expertise, health psychology theory, and qualitative methods to underpin intervention content, structure and functionality. METHODS: Systematic reviews of literature concerning acne help-seeking and treatment adherence, theoretical understandings of health-related behaviour, guidance from public contributors, and interviews with young people with acne (n = 24), their parents/carers (n = 8) and healthcare professionals (n = 18), informed the intervention's guiding principles and logic model. Draft intervention content was then developed by a multidisciplinary study team including public contributors and health professionals, and optimized through 53 think-aloud interviews with intended users. RESULTS: The development process created Acne Care Online ready for trial evaluation. It also provided insights into self-management challenges amongst this group - including their reluctance to consult, and misconceptions about treatments that hinder effective management (e.g., using products with no active ingredients, concerns about side effects, and unrealistic expectations). Acne Care Online appeared engaging, informative and relevant, with early feedback from health professionals suggesting it could be integrated into current healthcare practice. CONCLUSIONS: This study provides insights into theory and person-informed development processes for behaviour change interventions. Here, the acceptability and perceived value of Acne Care Online was evidenced. The work also provides important insights for clinicians managing young people seeking support for acne.