Examining the feasibility and helpfulness of an internet-delivered intervention for adults with medically managed Atrial Fibrillation (AF)

This is a single-group study. All participants will receive access to an 8 week internet-delivered, self-management course, the Chronic Conditions Course, which provides good information and skills for managing the impacts of chronic conditions on people's emotional wellbeing and quality of life. The Chronic Conditions Course is an existing psychological treatment package that has been evaluated in several randomised controlled trials to date, and was not designed specifically for this study. The treatment package was designed by Professor Blake Dear's clinical research team. The Chronic Conditions Course runs for 8 weeks and consists of: (a) 5 online lessons (in the form of presentation slides) with exercises for learning the information and skills. The duration of each lesson is approximately 20 to 30 minutes. Lessons are completed in weeks 1, 2, 4, 5 and 7. Lessons can be viewed in the online platform, or downloaded as PDF files. Lessons are accompanied by lesson worksheets which can be downloaded and/or printed as PDF files. Participants are encouraged to engage with the home-based exercises at a frequency and duration that is helpful for them, though a suggested time commitment of at least 30 minutes each week is encouraged. The first lesson (in week 1) is a introduction and overview of the course, including psycho-education about chronic health conditions and emotional wellbeing. Participants are encouraged to identify their symptoms (e.g. thinking styles, physical symptoms, unhelpful habits) as a home-based exercise. Lesson 2 (week 2) introduces cognitive challenging skills, and participants are encouraged to practice thought challenging in the following two weeks. Lesson 3 (week 4) covers behavioural activation and relaxation strategies to manage mood and anxiety symptoms, and participants are provided with the resources to undertake activity scheduling as a home-based task. Lesson 4 (week 5) introduces activity pacing to manage symptoms such as pain and fatigue, and graded exposure to manage anxiety and avoidance. Following lesson 4, participants are encouraged to attempt activity pacing and/or graded exposure tasks as a home-based exercise. Finally, Lesson 5 (week 7) includes information and strategies relating to relapse prevention, and participants are given materials to help with goal-setting for the future, and also a relapse prevention plan. (b) Automatic emails that help guide people through the course with frequency of once or twice per week. Examples of these e-mails include; reminders when new lessons are available, congratulatory messages once a lesson has been completed, brief messages that reinforce the core concepts of the lessons, and e-mails inviting contact and encouraging engagement if a participant has not logged in for a while. (c) Additional Resources (articles in PDF format) developed specifically for this study. These resources provide information about different problems people often struggle with, including managing sleep, working with health professionals, etc. (d) Case Stories and examples based on previous participants. These case stories are briefly incorporated into each lesson, commonly in the form of worked examples on worksheets, or participants' experiences learning and practicing the skills within the lesson. Additional case stories are example as optional materials that can be accessed by participants at their own discretion, which provide more in-depth information and experiences. (e) All participants are also provided access to brief support from a psychologist alongside the intervention, which is provided either via telephone or a secure messaging system. The psychologist's role is to support people through the intervention, help tailor the intervention to their particular difficulties, encourage skills practice and answer questions. Psychologist support is provided based on patient preference, and can be proactively scheduled (e.g., weekly appointments) or on request and as needed. Adherence with the intervention is monitored via the study's secure web platform, which records information such as; the number of participant log-ins, lesson completions; time spent completing each lesson; and number of downloads of additional resources. The details of the psychologist's contact with participants (type of contact, medium of contact, duration) is also recorded.