A qualitative exploration of the prospective acceptability of the MiDerm app; a complex digital intervention for adults living with skin conditions.

Objectives: Skin conditions carry a substantial psychological burden but support for patients is limited. Digital technology could support patient self-management; we found preliminary evidence for the effectiveness and acceptability of digital psychological interventions for adults living with skin conditions. We have, therefore, developed a complex digital intervention called MiDerm with patients. This qualitative study explored the prospective acceptability of the complex intervention delivered via a smartphone application (app), and possible barriers and facilitators to use.

Design: Qualitative research involving a hybrid inductive-deductive approach. Data collection and analysis were theoretically informed by The Common-Sense Model of Self-Regulation, Theoretical Framework of Acceptability and the Capability, Opportunity, Motivation - Behaviour Model.

Methods: Eight synchronous online group interviews with 43 English-speaking adults (≥ 18 years) with skin conditions. Data were analysed using Reflexive Thematic Analysis.

Results: Three superordinate themes were generated: (1) Patients' attitudes and concerns about the MiDerm app; (2) Need for personal competence, autonomy and relatedness for effective self-management; and (3) Physical, psychological and social barriers to app use.

Conclusion: Adults with skin conditions, mainly those with vitiligo and psoriasis living in the UK, expressed the need for support to self-manage the psychological aspects of their condition(s). The idea of a new intervention comprised of informational, emotional, behavioural and peer support, delivered via a smartphone app was welcomed and may be especially beneficial for specific patients. Identified barriers must be addressed to maximize engagement and giving users choice, flexibility and control is imperative to this. We have since developed the MiDerm app using these findings.