title: Details of development of the resource for adults with asthma in the RAISIN (randomized trial of an asthma internet self-management intervention) study.
abstract: BACKGROUND
  Around 300 million people worldwide have asthma and prevalence is increasing. Self-management can be effective in improving a range of outcomes and is cost effective, but is underutilised as a treatment strategy. Supporting optimum self-management using digital technology shows promise, but how best to do this is not clear. We aimed to develop an evidence based, theory informed, online resource to support self-management in adults with asthma, called 'Living well with Asthma', as part of the RAISIN (Randomized Trial of an Asthma Internet Self-Management Intervention) study.
  
  
  METHODS
  We developed Living well with Asthma in two phases. Phase 1: A low fidelity prototype (paper-based) version of the website was developed iteratively through input from a multidisciplinary expert panel, empirical evidence from the literature, and potential end users via focus groups (adults with asthma and practice nurses). Implementation and behaviour change theories informed this process. Phase 2: The paper-based designs were converted to a website through an iterative user centred process. Adults with asthma (n = 10) took part in think aloud studies, discussing the paper based version, then the web-based version. Participants considered contents, layout, and navigation. Development was agile using feedback from the think aloud sessions immediately to inform design and subsequent think aloud sessions. Think aloud transcripts were also thematically analysed, further informing resource development.
  
  
  RESULTS
  The website asked users to aim to be symptom free. Key behaviours targeted to achieve this include: optimising medication use (including inhaler technique); attending primary care asthma reviews; using asthma action plans; increasing physical activity levels; and stopping smoking. The website had 11 sections, plus email reminders, which promoted these behaviours. Feedback on the contents of the resource was mainly positive with most changes focussing on clarification of language, order of pages and usability issues mainly relating to navigation difficulties.
  
  
  CONCLUSIONS
  Our multifaceted approach to online intervention development underpinned by theory, using evidence from the literature, co-designed with end users and a multidisciplinary panel has resulted in a resource which end users find relevant to their needs and easy to use. Living well with Asthma is undergoing evaluation within a randomized controlled trial.
authors.affiliation: General Practice & Primary Care, Institute of Health & Wellbeing, University of Glasgow, 1 Horselethill Road, Glasgow, G12 9LX, UK.
authors.forename: Deborah
authors.initials: D
authors.lastname: Morrison
authors.affiliation: General Practice & Primary Care, Institute of Health & Wellbeing, University of Glasgow, 1 Horselethill Road, Glasgow, G12 9LX, UK. Frances.Mair@glasgow.ac.uk.
authors.forename: Frances S
authors.initials: FS
authors.lastname: Mair
authors.affiliation: Institute of Infection, Immunity and Inflammation, Gartnavel General Hospital, University of Glasgow, 1053 Great Western Road, Glasgow, G12 0YN, UK.
authors.forename: Rekha
authors.initials: R
authors.lastname: Chaudhuri
authors.affiliation: Computer and Information Science, University of Strathclyde, Glasgow, G1 1XH, UK.
authors.forename: Marilyn
authors.initials: M
authors.lastname: McGee-Lennon
authors.affiliation: Primary Care Research, Aldermoor Health Centre, University of Southampton, Aldermoor Close, Southampton, SO16 5ST, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Thomas
authors.affiliation: Institute of Infection, Immunity and Inflammation, Gartnavel General Hospital, University of Glasgow, 1053 Great Western Road, Glasgow, G12 0YN, UK.
authors.forename: Neil C
authors.initials: NC
authors.lastname: Thomson
authors.affiliation: Department of Psychology, University of Southampton, Shackleton Building, Highfield, Southampton, SO17 1BJ, UK.
authors.forename: Lucy
authors.initials: L
authors.lastname: Yardley
authors.affiliation: Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Rm 204, 25-28 Bute Gardens, Glasgow, G12 8RS, UK.
authors.forename: Sally
authors.initials: S
authors.lastname: Wyke
mesh_terms: D000328:Adult; D001249:Asthma / Q000628:therapy*; D006801:Humans; D020407:Internet; D008491:Medical Informatics Applications; D017060:Patient Satisfaction; D016032:Randomized Controlled Trials as Topic; D012648:Self Care / Q000295:instrumentation*