Developing evidence-based patient focused learning materials to support health behaviour change for people living with psoriatic arthritis

L. Hailey, C. Bundy, L. Howells, S. Kirtley, S. Martin, D. O'Sullivan, I. Steinkoenig, M Stepney, L. Coates

    Research output: Contribution to journalArticlepeer-review


    Background Psoriatic arthritis (PsA) is a complex condition that requires high levels of self-management from those living with the condition. It is associated with many comorbidities, including depression, metabolic syndrome, and increased cardiovascular disease risk and can adversely affect quality of life. There is growing evidence that people living with psoriatic arthritis (PsA) are more likely to be overweight, consume alcohol above recommended levels, smoke, be affected by poor sleep, fatigue, anxiety, and take insufficient exercise for healthy living. These modifiable health behaviours further increase the already known risk of cardiovascular morbidity and mortality. These issues are not systematically addressed in routine clinical care due to low confidence in effective delivery and time constraints. Objectives To co-develop evidence-based patient-focused learning materials to support healthy lifestyle changes for people living with PsA. Methods The development of the materials was overseen by a steering group of people living with PsA, psychologists, rheumatologists, and researchers. The COM-B model was used in the development of the materials, and they are designed around motivational interviewing principles. Firstly, a systematic literature review was performed to establish the evidence for the current burden and potential interventions aimed at these issues in PsA. These included diet, weight, alcohol, smoking, exercise, anxiety, depression, and stress. An initial focus group of people living with PsA was used to identify priority behaviours and ideas for content. The steering group developed draft materials, and we partnered with a design agency to create engaging materials. They developed a website and downloadable postcards. A second focus made up of people living with PsA was held for people to give their views on the draft content for the materials and initial design ideas. A third focus group was held with people living with PsA and a fourth with clinicians to refine the design materials and ensure they were accessible, interesting, and helpful to initiate and maintain change. A final evaluation survey was performed to review the draft website before launching the final materials. The Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) approved the final materials. Results Following the steering and focus groups? input, 15 candidate topics were prioritised (Table 1). A website and downloadable postcards summarising each of the topics were developed by the design team and refined following feedback from the patient focus groups. An example of the postcard for ?keeping active? can be found in Figure 1. The resources are free to use and can be accessed at
    Original languageEnglish
    Pages (from-to)845-846
    Number of pages2
    JournalAnnals of the Rheumatic Diseases
    Issue numberS1
    Publication statusPublished (VoR) - 4 Aug 2023


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