Stefan Elbers

163 Preventing relapse after successful treatment A patient started with the Insight Cards at the final treatment phase.Nevertheless, during the refresher day his workbook was an exemplar of how they [the Insight Cards] should be used. Completely filled out and illustrated with photographs. He also mentioned that, in case of potential relapse, he could imagine himself using the workbook and browsing through his experiences. [T2] These positive outcomes were not shared by all participants. Some patients reported that the intention of the prototype intervention was not clear or questioned its efficacy. I wonder whether a workbook would be sufficient to ensure the transfer to the home situation. [P13] Also, HCPs were cautious that too much emphasis on personal values could cause patients to focus on topics and goals that were beyond the scope of the treatment. Acceptability of the Workbook Form The general appearance and structure was appealing to most participants, but some patients provided suggestions for reordering the workbook and moving all instructions to the beginning. For VBG, the written instructions were considered too elaborate and complex, which caused confusion and problems in understanding. It [the workbook instructions] should be easier to read. It may be due to my short attention span or because I am not a good reader, but I did like the underlying idea. [P9] The instruction text for the Insight Cards was shorter and easier to understand. Participants indicated that the included examples were helpful for both relapse prevention strategies. Overall, participants would prefer amobile health (mHealth) app over a printed workbook as type of delivery. In particular, the possibility of combining the strategies with smartphone functionalities such as a calendar and camera could lead to more personalized experiences and goals.Moreover, a digital app would be accessible throughout the day, allowing patients to directly record experiences, browse through insights, or plan new goals. I would prefer an app. An app can provide feedback and is able to alert you. For example, I will plan a 3k walk for tomorrow. Then I will receive a reminder that I should go for a 3k walk. If think “no! not tomorrow,” then—it is quite simple—I will modify the calendar… this is the future.. I have not grown up with this thing [mobile phone]. But nowadays people only look on their phones throughout the day. They will benefit more from this [the app] than from this paper [the workbook]. So I would think that is very important. [P8]