PS10 Walk and talk: connecting people with psoriasis. A prospective randomized controlled mixed-methods exploratory study to determine representativeness of recruitment, acceptability and feasibility of a walk-and-talk intervention for people with ps

Abstract

Social isolation poses greater risk for all-cause mortality than smoking, alcohol and obesity. People with psoriasis experience greater social isolation than the general population. Disease-specific walking groups have shown benefits. Few studies have explored peer support networks for people with psoriasis. Our primary aim was to determine the ideal format for a walk-and-talk intervention for psoriasis. Secondary aims were to determine the acceptability, representativeness and outcome measures for future studies. Patient-focused groups informed the study design. A prospective, randomized, controlled, mixed-methods exploratory design was used. Participants were randomized to control or intervention groups in a one-to-one ratio. The intervention was eight walks led by a peer or researcher. Data collection (quality of life, loneliness and mood) was carried out at baseline, immediately after the intervention (with or without a semistructured interview) and 3 months after the intervention. Thematic analysis of interviews was performed. Descriptive statistics were applied to quantitative data. In total, 1205 patients were approached, 70 of whom were recruited (34 control and 36 intervention). Their mean age was 52 years (SD 14) and 44 (63%) were female. Regarding ethnicity where reported, 32 (46%) were White, 14 (20%) were Asian and 2 (3%) were Black. The ethnic mix represented the background population. Thematic analysis generated three superordinate themes: (i) emotional impact (isolation and loneliness, reduced self-esteem, self-consciousness and resilience), (ii) management (uncertainty of recovery, symptomatology impact, experience of health system) and (iii) experience of the walk-and-talk intervention (positive responses for social space, peer-led walks and discussing psoriasis; improvements needed for adaptation for physical needs, structure to the psoriasis discussion and subgroup-­specific walks). All participants had moderate or high UCLA loneliness scale scores: intervention group mean 42.7, SD 11.8; control group mean 43.7, SD 16.7. There were no changes in Hospital Anxiety and Depression Scale, Dermatology Life Quality Index, UCLA loneliness scale or WHO-5 Well-Being Index in either group. Walk-and-talk groups may address the emotional, physical and social challenges experienced by people with psoriasis. Suggested modifications are a conversational structure, adjustment for physical needs and subgroup walks. No objective effects on quality of life, isolation or mood were identified.