Understanding how an online resilience-training programme can be utili

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Background and study aims People with MS (PwMS) are disproportionately leaving work early. Previous research has shown that psychological factors, such as self-efficacy, play a key role in this. However, in the UK, psychological services are under significant strain with 1.6 million people reported to be on NHS waiting lists for specialised mental health support. A digital resilience-training programme called ‘READY’ has been co-developed in the UK and piloted with PwMS who report work instability. It is important to assess that the digital UK READY programme can be delivered and received as intended; this is known as intervention fidelity. Specifically, this study aims to monitor fidelity to function, i.e. measuring the core functions of the READY programme, through psychological self-report measures. This is important for checking (validating) the use of READY in a “real world” setting. To do this, the researchers will train MS healthcare professionals to support the delivery of READY and then check whether it has been delivered and received as intended. They will also check that READY leads to the intended long-term outcomes for PwMS who receive it. This study aims to assess NHS implementation of an online type of Acceptance and Commitment Therapy (ACT) codeveloped with PwMS ‘REsilience and Activities for every DaY for MS’ (READY) resource to support resilience at work for PwMS. This will be delivered through five objectives: 1. The feasibility and effectiveness of training MS health practitioners in several NHS centres to support delivery of the digital READY programme to PwMS following an immersive training programme. 2. The effectiveness of delivering the READY programme in the NHS for PwMS when supported by trained MS practitioners and the long-term outcomes 3. Which/how contexts influence how MS practitioners support/engage with PwMS completing the READY programme? 4. Which/how contexts influence how PwMS engage with the READY programme and the long-term outcomes 5. To what extent intervention fidelity mediates these long-term outcomes Who can participate? Registered healthcare professionals or allied health professionals who work in direct contact with patients diagnosed with Multiple Sclerosis OR individuals aged 18 years or above with a clinical diagnosis of multiple sclerosis and an intention to remain in work for at least 6 months. What does the study involve? All participants will be invited to complete the READY programme. The programme involves completing 7 online sessions delivered over 7 weeks and a further refresher session at 12 weeks. There is also a workbook to help with the online sessions. The whole-time commitment for all participation activities in this study is about 8 hours in total. This includes completing the READY programme modules and any questionnaires. Participants will be asked to complete questionnaires at the beginning of the study (baseline) and at 8 weeks and 6 months. A small subset of participants will also be invited to take part in research interviews to understand their experiences with using the READY programme. What are the possible benefits and risks of participating? For health professionals, the possible benefit of taking part is that the READY programme has been shown to lead to personal and professional benefits for health professionals. ACT interventions have also been shown to protect against burnout. For people with MS, the possible benefit of taking part is that the READY programme has been shown to help people with MS with ‘bouncing back’ (resilience) in the context of adversity. It aims to equip PwMS with skills to manage real-world stressors. Training health professionals to support the UK digital READY programme may improve access to psychological interventions for PwMS who would benefit from them. MS nurses, occupational therapists, and physiotherapists may also be able to offer more personalised support as part of the digital READY programme. There is an unmet need for timely interventions with a focus on keeping PwMS in work. Effective interventions need to be flexible and easily accessible for employed people. If this implementation trial is successful then the online READY may be made more widely available for PwMS to use. All of the participants in the trial will receive a full report on the outcomes of the study. In terms of risks, some people can find completing questionnaires stressful and can make them think about negative aspects of their psychological wellbeing. The READY programme may highlight thoughts and feelings that are uncomfortable or difficult to deal with. ACT-style therapy is designed to help you learn to cope with these difficult thoughts and feelings rather than avoid them, therefore, it is important to keep practising the strategies and exercises in the READY programme for this to work. Where is the study run from? Leeds Teaching Hospitals NHS Trust (UK) When is the study starting and how long is it expected to run for? April 2022 to December 2026 Who is funding the study? Multiple Sclerosis Society (UK) Who is the main contact? Dr Charli R Wicks, charlotte.wicks1@nhs.net