title: Feasibility and acceptability of web-based enhanced relapse prevention for bipolar disorder (ERPonline): trial protocol.
abstract: BACKGROUND
  Relapse prevention interventions for Bipolar Disorder are effective but implementation in routine clinical services is poor. Web-based approaches offer a way to offer easily accessible access to evidence based interventions at low cost, and have been shown to be effective for other mood disorders.
  
  
  METHODS
  This protocol describes the development and feasibility testing of the ERPonline web-based intervention using a single blind randomised controlled trial. Data will include the extent to which the site was used, detailed feedback from users about their experiences of the site, reported benefits and costs to mental health and wellbeing of users, and costs and savings to health services. We will gain an estimate of the likely effect size of ERPonline on a range of important outcomes including mood, functioning, quality of life and recovery. We will explore potential mechanisms of change, giving us a greater understanding of the underlying processes of change, and consequently how the site could be made more effective. We will be able to determine rates of recruitment and retention, and identify what factors could improve these rates.
  
  
  CONCLUSIONS
  The findings will be used to improve the site in accordance with user needs, and inform the design of a large scale evaluation of the clinical and cost effectiveness of ERPonline. They will further contribute to the growing evidence base for web-based interventions designed to support people with mental health problems.
authors.affiliation: Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK. Electronic address: f.lobban@lancaster.ac.uk.
authors.forename: F
authors.initials: F
authors.lastname: Lobban
authors.affiliation: Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
authors.forename: A L
authors.initials: AL
authors.lastname: Dodd
authors.affiliation: Cumbria Partnership NHS Foundation Trust, UK.
authors.forename: D
authors.initials: D
authors.lastname: Dagnan
authors.affiliation: Faculty of Medicine, Lancaster University, UK; Institution for Infection and Global Health, University of Liverpool, UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Diggle
authors.affiliation: Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
authors.forename: M
authors.initials: M
authors.lastname: Griffiths
authors.affiliation: Division of Health Research, Lancaster University, Lancaster, UK.
authors.forename: B
authors.initials: B
authors.lastname: Hollingsworth
authors.affiliation: Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
authors.forename: D
authors.initials: D
authors.lastname: Knowles
authors.affiliation: Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
authors.forename: R
authors.initials: R
authors.lastname: Long
authors.affiliation: Alberta Health Services, Toronto, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Mallinson
authors.affiliation: School of Medicine, University of Nottingham, UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Morriss
authors.affiliation: Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
authors.forename: R
authors.initials: R
authors.lastname: Parker
authors.affiliation: Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
authors.forename: A P
authors.initials: AP
authors.lastname: Sawczuk
authors.affiliation: Spectrum Centre for Mental Health Research, Lancaster University, Lancaster, UK.
authors.forename: S
authors.initials: S
authors.lastname: Jones
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001714:Bipolar Disorder / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D010342:Patient Acceptance of Health Care; D036301:Qualitative Research; D011788:Quality of Life; D055502:Secondary Prevention; D012648:Self Care / Q000379:methods*; D016037:Single-Blind Method; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome
keywords: Bipolar; Online; Psychological intervention; Relapse prevention; Trial; Web-based