Evaluation of content validity and feasibility of the eVISualisation of physical activity and pain (eVIS) intervention for patients with chronic pain participating in interdisciplinary pain rehabilitation programs

PLoS One. 2023 Mar 10;18(3):e0282780. doi: 10.1371/journal.pone.0282780. eCollection 2023.

Abstract

Background: Chronic pain negatively influences most aspects of life, including aerobic capacity and physical function. The "eVISualisation of physical activity and pain" (eVIS) intervention was developed to facilitate individualized physical activity for treatment in interdisciplinary pain rehabilitation programs (IPRPs). The objective of this study was to evaluate the content validity and feasibility of the eVIS intervention prior to an effectiveness trial.

Methods: In order to determine pre-clinical content validity, experts (n = 10) (patients, caregivers, researchers) participated in three assessment rounds using a Likert-scale survey where relevance, simplicity, and safety were rated, whereafter the intervention was revised. Item-content validity index (I-CVI), average, and overall CVI were used to quantify ratings. To determine content validity and feasibility in the clinical context, experts (n = 8) (patients and physiotherapists) assessed eVIS after a 2-3-week test trial, with the feasibility aspects acceptability, demand, implementation, limited efficacy-testing, and practicality in focus. Additional expert interviews (with physiotherapists, physicians) were conducted on two incomplete areas.

Results: The intervention was iteratively revised and refined throughout the study. After three assessment and revision rounds, the I-CVI ratings for relevance, simplicity, and safety ranged between 0.88 and 1.00 (≥0.78) in most items, giving eVIS "excellent" content validity. In the IPRP context, the intervention emerged as valid and feasible. Additional interviews further contributed to its content validity and clinical feasibility.

Conclusions: The proposed domains and features of the eVIS intervention are deemed valid in its content and feasible in the IPRP context. The consecutive step-by-step evaluation process enabled careful intervention development with revisions to be made in close collaboration with stakeholders. Findings implicate a robust base ahead of the forthcoming effectiveness trial.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chronic Pain*
  • Exercise
  • Feasibility Studies
  • Humans
  • Pain Management
  • Patients

Grants and funding

Funding This work was supported by the Swedish Research Council for Health, Working Life and Welfare [L.V., grant number 2017-00491, https://forte.se/]; the Research Council [L.V., grant number 2018-02455, https://www.vr.se/]; the Swedish Association for Survivors of Polio, Accident, and Injury [L.V., grant number 2020-03, https://rtp.se/], and research funding from Dalarna University [L.V., No grant number, https://www.du.se/]. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.