title: Building a Tailored, Patient-Guided, Web-Based Self-Management Intervention 'ReumaUitgedaagd!' for Adults With a Rheumatic Disease: Results of a Usability Study and Design for a Randomized Control Trail.
abstract: BACKGROUND
  The chronic nature of rheumatic diseases imposes daily challenges upon those affected and causes patients to make daily decisions about the way they self-manage their illness. Although there is attention to self-management and evidence for the desirability of tailored interventions to support people with a rheumatic disease, interventions based on individual needs and preferences are scarce.
  
  
  OBJECTIVE
  To provide a systematic and comprehensive description of the theoretical considerations for building a Web-based, expert, patient-guided, and tailored intervention for adult patients with a rheumatic disease. Also, to present the results of a usability study on the feasibility of this intervention, and its study design in order to measure the effectiveness.
  
  
  METHODS
  To fit the intervention closely to the autonomy, needs, and preferences of the individual patient, a research team comprising patient representatives, health professionals, Web technicians, and communication experts was formed. The research team followed the new guidance by the Medical Research Council (MRC) for developing and evaluating complex interventions as a guide for the design of the intervention.
  
  
  RESULTS
  Considerations from self-determination theory and a comprehensive assessment of preferences and needs in patients with a rheumatic disease guided the development of the Web-based intervention. The usability study showed that the intervention was useful, easy to use, and accepted and appreciated by the target group of patients. The planned randomized controlled trial is designed to be conducted among 120 adults with a rheumatic disease, who are assigned to the self-management intervention or a self-help control group. Both groups will be asked to formulate personal goals they want to achieve concerning their self-management. Progress toward the personal goal is the primary outcome measure of this study. Self-reported Web-based measures will be assessed before randomization at baseline, and 3 and 6 months after randomization. Also, feasibility and adherence to the Web-based self-management intervention as process outcomes will be evaluated.
  
  
  CONCLUSIONS
  By identifying the individual goals at the beginning of the intervention and customizing the intervention to the individual patient, we aim to improve the usefulness and effectiveness of the Web-based self-management intervention. If proven effective, ReumaUitgedaagd! Online will be implemented in the Netherlands.
authors.affiliation: University Medical Center Utrecht, Department Rheumatology and Clinical Immunology, Utrecht, Netherlands. j.ammerlaan@umcutrecht.nl.
authors.forename: Judy W
authors.identifier: http://orcid.org/0000-0002-8481-097X
authors.initials: JW
authors.lastname: Ammerlaan
authors.forename: Olga K
authors.identifier: http://orcid.org/0000-0003-0937-6592
authors.initials: OK
authors.lastname: Mulder
authors.forename: Nienke C
authors.identifier: http://orcid.org/0000-0003-1226-1278
authors.initials: NC
authors.lastname: de Boer-Nijhof
authors.forename: Bertha
authors.identifier: http://orcid.org/0000-0002-9197-4200
authors.initials: B
authors.lastname: Maat
authors.forename: Aike A
authors.identifier: http://orcid.org/0000-0002-2753-7807
authors.initials: AA
authors.lastname: Kruize
authors.forename: Jaap
authors.identifier: http://orcid.org/0000-0001-5544-5785
authors.initials: J
authors.lastname: van Laar
authors.forename: Harmieke
authors.identifier: http://orcid.org/0000-0003-3300-2101
authors.initials: H
authors.lastname: van Os-Medendorp
authors.forename: Rinie
authors.identifier: http://orcid.org/0000-0002-6615-6708
authors.initials: R
authors.lastname: Geenen
keywords: Web-based; intervention; personal goal; pilot study; randomized controlled trial; rheumatic diseases; self-management; tailored