Developing and testing a web‐based intervention to encourage early help‐seeking in people with symptoms associated with lung cancer

Objectives
To detail the development method used to produce an online, tailored, theory‐based, user‐centred intervention to encourage help‐seeking for potential lung cancer symptoms.

Design
Intervention development was structured around the person‐based approach. The feasibility study involved a randomized controlled trial design.

Methods
Intervention development drew on qualitative inquiries, the Theory of Planned Behaviour (TPB), and identifying concrete mechanisms of change to implement in the intervention (Behaviour Change Techniques). The final intervention involved two key features: (1) tailoring and (2) ‘TPB components’ to target beliefs about help‐seeking. In an online feasibility study, we recruited people reporting potential lung cancer symptoms using mailing lists, social media, websites, and Google AdWords. Participants were randomized to the intervention, a tailored comparison group (CG) without TPB‐components, an untailored CG with TPB components, or a CG with neither. Following treatment, participants clicked a button to indicate whether they wished to make an appointment and completed a TPB questionnaire.

Results
A total of 130 participants reporting relevant symptoms were recruited (24% of website visitors). Participants in the intervention group reported higher intention to seek help than those who received tailored information without TPB components (p = .03). User comments indicate more support is needed for people who sought help for symptoms, but felt dismissed.

Conclusions
The potential for differential dropout in online randomized trials requires careful consideration. Future help‐seeking interventions should provide support for those who have previously felt dismissed by health professionals. The feasibility study provides some evidence that our ‘TPB components’ were effective, but validation in a powered trial is necessary.