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‘Eczema shouldn’t control you; you should control eczema’: qualitative process evaluation of online behavioural interventions to support young people and parents/carers of children with eczema

Greenwell, Kate; Sivyer, Katy; Howells, Laura; Steele, Mary; Ridd, Matthew J; Roberts, Amanda; Ahmed, Amina; Lawton, Sandra; Langan, Sinéad M; Hooper, Julie; Wilczynska, Sylvia; Leighton, Paul; Griffiths, Gareth; Sach, Tracey; Little, Paul; Williams, Hywel C; Thomas, Kim S; Yardley, Lucy; Santer, Miriam; Muller, Ingrid


Kate Greenwell

Katy Sivyer

Mary Steele

Matthew J Ridd

Amina Ahmed

Sandra Lawton

Sinéad M Langan

Julie Hooper

Sylvia Wilczynska

Associate Professor of Applied Health Services Research

Gareth Griffiths

Tracey Sach

Paul Little

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Professor of Dermato-Epidemiology

Lucy Yardley

Miriam Santer

Ingrid Muller


There is a lack of well-conducted randomized controlled trials evaluating the effectiveness of theory-based online interventions for eczema. To address these deficiencies, we previously developed and demonstrated the effectiveness of two online behavioural interventions: Eczema Care Online for parents/carers of children with eczema, and Eczema Care Online for young people with eczema.

To explore the views and experiences of people who have used the Eczema Care Online interventions to provide insights into how the interventions worked and identify contextual factors that may impede users’ engagement with the interventions.

Qualitative semistructured interviews were conducted with 17 parents/carers of children with eczema and 17 young people with eczema. Participants were purposively sampled from two randomized controlled trials of the interventions and recruited from GP surgeries in England. Transcripts were analysed using inductive thematic analysis, and intervention modifications were identified using the person-based approach table of changes method.

Both young people and parents/carers found the interventions easy to use, relatable and trustworthy, and perceived that they helped them to manage their eczema, thus suggesting that Eczema Care Online may be acceptable to its target groups. Our analysis suggested that the interventions may reduce eczema severity by facilitating empowerment among its users, specifically through improved understanding of, and confidence in, eczema management, reduced treatment concerns, and improved treatment adherence and management of irritants/triggers. Reading about the experiences of others with eczema helped people to feel ‘normal’ and less alone. Some (mainly young people) expressed firmly held negative beliefs about topical corticosteroids, views that were not influenced by the intervention. Minor improvements to the design and navigation of the Eczema Care Online interventions and content changes were identified and made, ready for wider implementation.

People with eczema and their families can benefit from reliable information, specifically information on the best and safest ways to use their eczema treatments early in their eczema journey. Together, our findings from this study and the corresponding trials suggest wider implementation of Eczema Care Online ( is justified.


Greenwell, K., Sivyer, K., Howells, L., Steele, M., Ridd, M. J., Roberts, A., …Muller, I. (2023). ‘Eczema shouldn’t control you; you should control eczema’: qualitative process evaluation of online behavioural interventions to support young people and parents/carers of children with eczema. British Journal of Dermatology,

Journal Article Type Article
Acceptance Date Dec 22, 2022
Online Publication Date Dec 7, 2022
Publication Date Dec 7, 2023
Deposit Date Mar 8, 2023
Publicly Available Date Mar 8, 2023
Journal British Journal of Dermatology
Print ISSN 0007-0963
Electronic ISSN 1365-2133
Publisher Wiley
Peer Reviewed Peer Reviewed
Keywords Dermatology
Public URL
Publisher URL


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