Latchem-Hastings, JulieButton, KateHamana, KatyAljahdali, Shaima2024-12-172024-04https://hdl.handle.net/20.500.14154/74279Background and study aim: Chronic knee pain is a widespread issue globally, affecting individuals of all ages worldwide. This challenge is intensified by an aging population, sedentary lifestyles and increasing obesity rates. There is an international shift towards promoting active management approaches in line with clinical guidelines, including physical activity, dietary changes and the support of self-management. This shift has led to an evolution of digital initiatives designed to support people to self- manage their chronic knee pain. However, despite the high prevalence of chronic knee pain in Saudi Arabia, relevant research in the region remains scarce. This study aims to explore digital self-management support for knee pain within the current physiotherapy practices in Jeddah, a prominent city in Saudi Arabia. Methods: This study employed a sequential exploratory mixed-method design. It started with qualitative interviews involving 29 participants (15 physiotherapists and 14 individuals with knee pain), analysed using reflexive thematic analysis (Phase 1). The aim was to explore how existing physiotherapy practices for knee conditions align with self-management support principles and to explore the perceptions of potential users towards digital self-management support initiatives. Part of the findings informed the adaptation of the digital intervention "TRAK" into a Saudi-specific platform named "TRAK-Saudi". In Phase 2, 12 participants (6 physiotherapists and 6 individuals with chronic knee pain) participated in remote usability testing sessions for evaluating the usability of TRAK-Saudi. The perceived usability was assessed using the Arabic System Usability Scale (A-SUS), with usability issues identified through a concurrent think-aloud approach and analysed via quantitative content analysis. Additionally, the likelihood of substituting face-to-face sessions was assessed using a 5-point Likert scale. Qualitative and quantitative data from both phases were integrated at various points to address the study's overarching aim. Findings: In Phase 1, the findings highlighted a discrepancy between current physiotherapy practices and the foundational principles of self-management support, underscoring an essential transition towards patient-centred care. Participants generally favoured digital self-management support initiatives, advocating for their role as supplementary to in-clinic therapy rather than as replacements. TRAK-Saudi was rated highly for usability, with A-SUS scores of 77.5 by individuals with chronic knee pain and 83.3 by physiotherapists. During the navigation of TRAK-Saudi, participants initiated 53 inquiries, primarily seeking guidance and assurance. Participants also expressed strong willingness to substitute in-clinic sessions with TRAK-Saudi, reflected in median ratings of 4.5 for individuals with chronic knee pain and 5 for physiotherapists, with a mode of 5 for both type of participants. Conclusion: Both physiotherapists and individuals with chronic knee pain demonstrated competence and openness to digital solutions. While TRAK-Saudi was user-friendly for Saudi users, current physiotherapy practices lack the clinical foundation to fully embrace digital self-management support initiatives. Significant changes in current practices are necessary to promote patient-centred care. At this stage, it is advisable for Jeddah’s physiotherapy clinics, if interested, to integrate TRAK-Saudi or similar initiatives as supplement to existing practices. This strategy aims to elevate the quality of knee care by enriching individuals’ knowledge, strengthening patient-provider relationship and improving self-management skills.418endigital healthhealthcaresaudi arabiaself-managementThesis