The Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program: protocol for a two-arm parallel partially nested randomized controlled feasibility trial with progression to full-scale trial
Julia Nordlund,
Richard S. Henry,
Linda Kwakkenbos,
Marie-Eve Carrier,
Brooke Levis,
Warren R. Nielson,
Susan J. Bartlett,
Laura Dyas,
Lydia Tao,
Claire Fedoruk,
Karen Nielsen,
Marie Hudson,
Janet Pope,
Tracy Frech,
Shadi Gholizadeh,
Sindhu R. Johnson,
Pamela Piotrowski,
Lisa R. Jewett,
Jessica Gordon,
Lorinda Chung,
Dan Bilsker,
Alexander W. Levis,
Kimberly A. Turner,
Julie Cumin,
Joep Welling,
Catherine Fortuné,
Catarina Leite,
Karen Gottesman,
Maureen Sauve,
Tatiana Sofía Rodríguez-Reyna,
Maggie Larche,
Ward van Breda,
Maria E. Suarez-Almazor,
Amanda Wurz,
Nicole Culos-Reed,
Vanessa L. Malcarne,
Maureen D. Mayes,
Isabelle Boutron,
Luc Mouthon,
Andrea Benedetti,
Brett D. Thombs,
on behalf of the SPIN Investigators
Affiliations
Julia Nordlund
Lady Davis Institute of the Jewish General Hospital
Richard S. Henry
Lady Davis Institute of the Jewish General Hospital
Linda Kwakkenbos
Department of Clinical Psychology, Radboud University
Marie-Eve Carrier
Lady Davis Institute of the Jewish General Hospital
Brooke Levis
Centre for Prognosis Research, School of Medicine, Keele University
Warren R. Nielson
St. Joseph’s Health Care
Susan J. Bartlett
Department of Medicine, McGill University
Laura Dyas
Scleroderma Foundation, Michigan Chapter
Lydia Tao
Lady Davis Institute of the Jewish General Hospital
Claire Fedoruk
Lady Davis Institute of the Jewish General Hospital
Karen Nielsen
Scleroderma Society of Ontario
Marie Hudson
Lady Davis Institute of the Jewish General Hospital
Janet Pope
Department of Medicine, University of Western Ontario
Tracy Frech
Department of Internal Medicine, University of Utah
Shadi Gholizadeh
California School of Professional Psychology/Alliant
Sindhu R. Johnson
Toronto Scleroderma Program, Mount Sinai Hospital & Toronto Western Hospital
Pamela Piotrowski
Private practice – Nutrition
Lisa R. Jewett
Department of Psychology, Jewish General Hospital
Jessica Gordon
Department of Medicine, Hospital for Special Surgery
Lorinda Chung
Department of Medicine, Stanford University
Dan Bilsker
Faculty of Health Sciences, Simon Fraser University
Alexander W. Levis
Department of Biostatistics, Harvard T. H. Chan School of Public Health
Kimberly A. Turner
Lady Davis Institute of the Jewish General Hospital
Julie Cumin
Lady Davis Institute of the Jewish General Hospital
Joep Welling
NVLE Dutch patient organization for systemic autoimmune diseases
Catherine Fortuné
Ottawa Scleroderma Support Group
Catarina Leite
University of Minho
Karen Gottesman
Scleroderma Foundation
Maureen Sauve
Scleroderma Society of Ontario
Tatiana Sofía Rodríguez-Reyna
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Maggie Larche
Department of Health Research Methods, Evidence and Impact, McMaster University
Ward van Breda
Faculty of Behavioural and Movement Sciences, VU University
Maria E. Suarez-Almazor
Department of General Internal Medicine, University of Texas MD Anderson Cancer Center
Amanda Wurz
School of Kinesiology, University of the Fraser Valley
Nicole Culos-Reed
Faculty of Kinesiology, University of Calgary
Vanessa L. Malcarne
Department of Psychology, San Diego State University
Maureen D. Mayes
Department of Internal Medicine, University of Texas McGovern School of Medicine
Isabelle Boutron
Université de Paris, Centre of Research Epidemiology and Statistics (CRESS), Inserm, INRA
Luc Mouthon
Service de Médecine Interne, Centre de Référence Maladies Autoimmunes Systémiques Rares d’Ile de France, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP)
Andrea Benedetti
Department of Medicine, McGill University
Brett D. Thombs
Lady Davis Institute of the Jewish General Hospital
Abstract Background Systemic sclerosis (scleroderma; SSc) is a rare autoimmune connective tissue disease. We completed an initial feasibility trial of an online self-administered version of the Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program using the cohort multiple randomized controlled trial (RCT) design. Due to low intervention offer uptake, we will conduct a new feasibility trial with progression to full-scale trial, using a two-arm parallel, partially nested RCT design. The SPIN-SELF Program has also been revised to include facilitator-led videoconference group sessions in addition to online material. We will test the group-based intervention delivery format, then evaluate the effect of the SPIN-SELF Program on disease management self-efficacy (primary) and patient activation, social appearance anxiety, and functional health outcomes (secondary). Methods This study is a feasibility trial with progression to full-scale RCT, pending meeting pre-defined criteria, of the SPIN-SELF Program. Participants will be recruited from the ongoing SPIN Cohort ( http://www.spinsclero.com/en/cohort ) and via social media and partner patient organizations. Eligible participants must have SSc and low to moderate disease management self-efficacy (Self-Efficacy for Managing Chronic Disease (SEMCD) Scale score ≤ 7.0). Participants will be randomized (1:1 allocation) to the group-based SPIN-SELF Program or usual care for 3 months. The primary outcome in the full-scale trial will be disease management self-efficacy based on SEMCD Scale scores at 3 months post-randomization. Secondary outcomes include SEMCD scores 6 months post-randomization plus patient activation, social appearance anxiety, and functional health outcomes at 3 and 6 months post-randomization. We will include 40 participants to assess feasibility. At the end of the feasibility portion, stoppage criteria will be used to determine if the trial procedures or SPIN-SELF Program need important modifications, thereby requiring a re-set for the full-scale trial. Otherwise, the full-scale RCT will proceed, and outcome data from the feasibility portion will be utilized in the full-scale trial. In the full-scale RCT, 524 participants will be recruited. Discussion The SPIN-SELF Program may improve disease management self-efficacy, patient activation, social appearance anxiety, and functional health outcomes in people with SSc. SPIN works with partner patient organizations around the world to disseminate its programs free-of-charge. Trial registration ClinicalTrials.gov NCT04246528 . Registered on 27 January 2020