A co-designed intervention to support people living with achalasia to eat in a social setting: a feasibility study

Achalasia is a rare oesophageal condition that can affect eating behaviours. This study aimed to evaluate the feasibility of recruitment and assess the acceptability of a co-designed, workbook-based intervention targeting one of the most challenging eating behaviours, which was eating in a social setting.

A mixed-method approach was employed, which involved pre- and post-intervention questionnaires and semi-structured interviews. The Achalasia Action group, a UK-based support group, facilitated participant recruitment. The intervention was a workbook designed collaboratively by the researchers and people living with achalasia, with strategies built on the COM-B model (Capability, Opportunity, Motivation-Behaviour). Outcome measures were based on recruitment and retention rates, the APEASE criteria for usability and acceptability, self-reported changes in eating behaviours, and qualitative feedback from participant interviews.

The study aimed to recruit 20 participants, and this target was achieved, resulting in a 100% recruitment rate. However, the post-intervention questionnaires were completed by only 10 participants, indicating a 50% retention rate from baseline. No issues were raised with completing the pre- and post-questionnaires, from completers. The quantitative feedback from participants indicated that they found the workbook activities clear, easy to understand, and complete, with the majority reporting positive experiences. Qualitative feedback on the intervention described enhanced social support and improved symptom management of achalasia in a social setting. Furthermore, the intervention met the APEASE criteria, indicating its usability and acceptability.

This study explored the feasibility of recruiting and retaining people living with achalasia in intervention research, highlighting the acceptability of the co-designed intervention to improve social eating experiences. However, with a retention rate of only 50% at follow-up, it is evident that future studies should explore the reason behind this and also consider recruiting a larger baseline sample to ensure the target is achieved. The positive outcomes of the co-designed intervention underscore the importance of user involvement in developing interventions. The intervention demonstrated the potential to support people living with achalasia in eating in a social setting. The co-designed intervention has significant practical implications by providing healthcare professionals and support groups with a feasible, potentially effective method to enhance the social eating experience of people living with achalasia, potentially improving their overall quality of life.