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Table 4 Key feedback and decisions from qualitative interviews conducted during iterative development cycles

From: Development of an intervention to increase adherence to nebuliser treatment in adults with cystic fibrosis: CFHealthHub

Feedback

Make changes

Rationale/comments

Participants thought blue adherence graphs look and homepage looked too ‘NHS’ and boring.

Accept

Changed design to look more distinctly CFHealthHub. More images

Some participants liked the picture on the homepage, other did not. There was no consensus about which image was preferable. Some participants requested to personalise with their own images.

Accept

Needs to feel like it belongs to the participant. There is no one image that meets the needs of everyone. Images could be of a goal (e.g. upcoming holiday) which could serve to act as a motivator

Participants wanted a forum or some way to interact with other people with CF, to share experiences, problems, and ideas.

Reject

Concern that this would require moderation (not practical) and that, given that low adherence is very common, could serve to normalise non-adherence and demotivate participants. Instead decided to incorporate ‘talking heads’ video clips—providing some information from others with CF but where we could control the content.

Participants want to instantly see achievements/progress on graphs. Suggested traffic light system. Wanted to see data over a longer time frame.

Accept

Some concern about traffic light system—specifically that too much red would put people off. But suggestion came up frequently. Modified over iterations so that green = hit target, amber = some treatment but not met target, red date = not treatment taken. Participants able to open out data to look over a longer period.

Participants confused by prescription entry. Suggested making this clinician entered with mechanism by which participants can flag if their prescription changes.

Accept

Correct prescription data is vital to success of the intervention as this is what the adherence data is based on. Important to get right.

Clinicians suggested that it would be useful to be able to see treatment times easily, e.g. when you hover over a bar on the charts.

Accept

Clear benefit for both patients and clinicians.

Some participants go to bed late and their last treatment appears on the following day’s graph. Would be useful to be able to modify the time for the end of day to adjust this to meet different lifestyles of patients

Reject

Extensive programming task to change the basic time set up from midnight-midnight day.