eprintid: 10128217 rev_number: 16 eprint_status: archive userid: 608 dir: disk0/10/12/82/17 datestamp: 2021-05-20 09:21:18 lastmod: 2021-09-25 23:36:59 status_changed: 2021-05-20 09:21:18 type: article metadata_visibility: show creators_name: McInnerney, D creators_name: Candy, B creators_name: Stone, P creators_name: Kupeli, N title: Let It Out (LIO) study: protocol for a mixed-methods study to optimise the design and assess the feasibility of an online emotional disclosure-based intervention in UK hospices ispublished: pub divisions: UCL divisions: B02 divisions: C07 divisions: D79 keywords: mental health, palliative care, psychiatry, qualitative research, statistics & research methods note: This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ abstract: INTRODUCTION: The current COVID-19 pandemic has forced hospices to look for more ways to support people remotely, including psychological support. Emotional disclosure-based interventions hold potential as a way of providing support remotely. However, evidence of their efficacy in people with terminal illness is mixed. Reviews have highlighted this may be due to interventions not being tailored to the unique needs of this population. In response to this, we are developing Let It Out (LIO), an online, self-guided emotional disclosure-based intervention tailored for people living with terminal illness. AIMS: The primary objective of the study is to optimise the design of the LIO intervention. Secondary objectives include assessing its acceptability and feasibility; exploring potential impact on well-being; identifying potential adverse effects; and informing choice of outcome measures for potential future evaluation. METHODS AND ANALYSIS: A single arm, mixed-methods, multisite, longitudinal study. Up to 40 people living with a terminal illness under the care of hospices in England and Scotland will receive the online LIO intervention. LIO consists of 3, self-guided expression sessions over 2 weeks. The primary outcome measures are (1) a structured feedback form completed by participants after the final expression session; and (2) semi-structured interviews and focus groups with ≤15 patient participants, ≤30 hospice staff and ≤15 informal carers. These quantitative and qualitative data will be triangulated via process evaluation to inform optimisation of the intervention design. Secondary outcome measures include validated measures of physical and psychological health collected at baseline and after the final expression session (immediately, 1, 4 and 8 weeks after); and data on recruitment, retention and fidelity. ETHICS AND DISSEMINATION: The study is approved by the University College London Research Ethics Committee (reference: 15281/002). The findings will be shared through peer-reviewed scientific journals and conferences, and traditional, online and social media platforms. date: 2021-05-11 date_type: published official_url: http://doi.org/10.1136/bmjopen-2020-047135 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1865309 doi: 10.1136/bmjopen-2020-047135 pii: bmjopen-2020-047135 lyricists_name: Candy, Bridget lyricists_name: Kupeli, Nuriye lyricists_name: McInnerney, Daisy lyricists_name: Stone, Patrick lyricists_id: BCAND79 lyricists_id: NKUPE48 lyricists_id: DEMCI28 lyricists_id: PCSTO82 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner full_text_status: public publication: BMJ Open volume: 11 number: 5 article_number: e047135 event_location: England citation: McInnerney, D; Candy, B; Stone, P; Kupeli, N; (2021) Let It Out (LIO) study: protocol for a mixed-methods study to optimise the design and assess the feasibility of an online emotional disclosure-based intervention in UK hospices. BMJ Open , 11 (5) , Article e047135. 10.1136/bmjopen-2020-047135 <https://doi.org/10.1136/bmjopen-2020-047135>. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10128217/1/e047135.full.pdf