Accepted for/Published in: JMIR Formative Research
Date Submitted: Sep 16, 2018
Open Peer Review Period: Sep 20, 2018 - Nov 15, 2018
Date Accepted: May 20, 2019
(closed for review but you can still tweet)
My Whiplash Navigator, an interactive website for whiplash: Process evaluation of design and implementation
ABSTRACT
Background:
Whiplash is a world-wide health and economic burden. Contributing to this burden is poor guideline adherence and lack of identifying and addressing modifiable risk factors. Online tools that facilitate clinical pathways of care are a novel solution to improve management.
Objective:
To develop, implement and evaluate an online tool to support whiplash management following a robust framework.
Methods:
We followed the first three processes of a research translation framework including idea generation, feasibility and efficacy. Development of the website involved stakeholder consultations to discuss content, design, features and functionality. Implementation strategies included classroom education, educational meetings, educational outreach, reminders and direct phone contact. Surveys and focus group discussions were conducted amongst primary and specialist health care professionals (HCPs) and people with whiplash to assess feasibility. Outcomes evaluated were; website metrics, acceptability and self-rated improvements in knowledge amongst HCPs and website logs of treatment decisions (e.g. shared-care, specialist care, referred care) made by specialist HCPs.
Results:
The development process delivered an interactive, user-friendly and acceptable website, My Whiplash Navigator, tailored to the needs of people with whiplash and HCPs. The content and features of the website were identified following consultative meetings between researchers and industry partners and further informed by results of surveys and focus group discussions amongst people with whiplash and HCPs. 320 registrations were recorded from June 2016-March 2018, including 260 HCPs (175 student, 65 primary, 20 specialist HCPs) and 60 people with whiplash. Most effective implementation strategies were classroom teaching for students (81% uptake) and educational meetings for primary HCPs (43% uptake). Popular pages visited were those containing information about advice and exercises and risk assessment. All HCPs agreed that their knowledge regarding risk management (81.4%) and providing appropriate exercises (87.6%) improved. Specialists’ most common decision was ‘shared care’, improving their management decisions from a previous cohort. Areas to improve were navigation and access to outcome measures.
Conclusions:
A robust development process resulted in an innovative, interactive, user-friendly website, the “My Whiplash Navigator”. Implementation with HCPs was best achieved through classroom education and educational meetings. Evaluation of the website showed improved knowledge and practice to be more consistent with a risk-based clinical care pathway for whiplash. The positive results provide sufficient evidence to scale implementation nationally and involving other target markets.
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