title: Integrating online communities and social networks with computerised treatment for insomnia: a qualitative study.
abstract: BACKGROUND
  Insomnia is a common psychological complaint. Cognitive behavioural therapy for insomnia (CBT-I), although effective, is little used because of lack of trained providers. Computerised CBT-I (CCBT-I) may be a solution to this shortfall in access.
  
  
  OBJECTIVE
  To explore patient and health professional perspectives and the role of social networking, to develop a novel CCBT-I programme to increase access to this form of intervention.
  
  
  METHODS
  Qualitative methods underpinned by the theory of planned behaviour in primary  care in Lincolnshire and Nottinghamshire.
  
  
  METHODS
  Semi-structured interviews and focus groups with a purposive sample of health professionals and adults with insomnia.
  
  
  RESULTS
  A total of 23 health professionals and 28 patients were interviewed. Features  designed to engender trust and improve functionality were perceived to improve uptake and adherence to CCBT-I. Trust lay in programme accreditation; for professionals, trust derived from evidence of effectiveness; for patients, trust depended on the doctor-patient relationship, professional  support, the quality of online peer support, and perceptions of risk. Patients wanted mobile applications; access in short periods; self-assessment; interactive, personalised information on sleep; and moderated contact with other users. Patients and practitioners differed over whether useful  information could be distinguished from less useful or potentially incorrect information.
  
  
  CONCLUSIONS
  Improving uptake and adherence to online programmes for insomnia requires design features focusing on trust and functionality. Enabling greater patient control and interaction  with other users and professionals may stimulate positive experiences of online therapy. CCBT-I would enable greater access to treatment but is limited by lack of online access or poor computer literacy.
authors.affiliation: Lincoln School of Health and Social Care, [corrected] University of Lincoln, Lincoln, USA.
authors.forename: Jo
authors.initials: J
authors.lastname: Middlemass
authors.forename: Zowie
authors.initials: Z
authors.lastname: Davy
authors.forename: Kate
authors.initials: K
authors.lastname: Cavanagh
authors.forename: Conor
authors.initials: C
authors.lastname: Linehan
authors.forename: Kevin
authors.initials: K
authors.lastname: Morgan
authors.forename: Shaun
authors.initials: S
authors.lastname: Lawson
authors.forename: A Niroshan
authors.initials: AN
authors.lastname: Siriwardena
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D004739:England; D005194:Family Practice / Q000706:statistics & numerical data; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet / Q000458:organization & administration* / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D007319:Sleep Initiation and Maintenance Disorders / Q000628:therapy*; D060756:Social Networking; D013813:Therapy, Computer-Assisted / Q000706:statistics & numerical data