Development of the web application My Stress Control—Integrating theories and existing evidence

Abstract

Aim: To describe the systematic development of an evidence-based, tailored, interactive web application for self-management of work-related stress, and to test usability issues regarding how to proceed through the programme.

Methods: Evidence from the fields of stress management, behaviour change and web-based interventions was the foundation for the theoretical framework and content. The next step was the development process of the web application and validation among experts and one possible end user. Last, a usability test with 14 possible end users was conducted.

Results: The web-application, My Stress Control (MSC), was built on a solid theoretical framework. It consists of 12 modules including: introduction, psychoeducation, ambivalence, stress management strategies, lifestyle change, and maintenance. Self-monitoring, goal-setting, re-evaluating goals, feedback, and prompting formulation of intention to change are central techniques supporting behaviour change. The usability test revealed difficulties in understanding how to proceed through the programme.

Conclusion: The development contributes to filling a gap in the literature regarding development of complex web-based interventions. MSC is dissimilar to existing programs in the field, considering the tailoring and multi-tracked opportunities. Although developed from the evidence in multiple fields, the web application would benefit from further development to support users in reaching the end module.

Keywords:

• stress management
• internet
• behaviour change
• occupational stress
• health promotion
• stress prevention

PUBLIC INTEREST STATEMENT

Stress is a major cause of sick leave in many Western countries. Work with stress management for those at risk of stress-related ill health is often restricted, due to a lack of healthcare resources. Web applications make stress management available for unlimited numbers of users, but there is a gap in the literature regarding development of complex web-based self-management programmes. We suggest a development process for tailored web-based self-management. A web-based programme, including tools identified in previous research as effective, can contribute to individuals’ learning about stress and to supporting long-term behavioural change to prevent stress from being harmful and leading to decreased health. The development process ended in the web-based programme My Stress Control. Although it was developed from current evidence in multiple fields, users had trouble reaching the end module. Thus, further development is essential to enhance the usability of the programme.

Acknowledgements

The research team would like to thank Olle Hällman for his contributions to this project regarding the programming and participation in the designing of visual elements as well as for his thoughtful comments on the content. The research team would also like to thank Sara Trangärd for her contributions regarding the four most central films included in the web application and for her input and knowledge of design principles that was used in all films included in the web application.

Competing interests

The authors report no competing interest. This study was reviewed and approved by the regional ethics committee in Uppsala, Sweden, January 20^th, 2016 (Dnr 2015/555).

Cover image

Source: Author.

Additional information

Funding

This work was funded by the Mälardalen University and AFA Insurance [130263].

Notes on contributors

Caroline Eklund

This study was conducted by a multidisciplinary research team. The first and last authors are physiotherapists working within the field of behavioural medicine. Caroline Eklund is a PhD student whose main interest is in supporting individuals performing health-related behaviour change where various stressors hinder starting a new behaviour.

Anne Söderlund is a professor in physiotherapy whose main focus is on behaviour change when the stressor is persistent pain.

Magnus L. Elfström is a licensed psychologist and associated professor in psychology. One of his research fields is stress management.

Yvonne Eriksson is a professor in information design. Her research areas are visual communication, with a focus on perceptual and cognitive processes involved in interpretation of visuals, and gender issues related to visual studies. This study is part of a wider project to develop and evaluate a web-based self-management programme for the handling of work-related stress.