The website is intended to be used by individuals with hand and upper limb amputations, their families, and their health care providers. This study used a cross-sectional approach for qualitative data collection involving telephone and web-based focus groups. We supplemented data collection with mixed methods research for refinement and usability testing of educational materials. This information enabled the elaboration and clarification of the findings, increasing the validity of the results, and informed subsequent data collection [34 (link),35 ].
Website development was guided by the Health On the Net Foundation code of conduct certification guidelines, which provide credibility that the website follows a code of ethics ensuring that it provides quality information [36 ]. The design of Within Reach followed a six-step website development process: (1) discovery phase, (2) planning, (3) design, (4) development, (5) launching the website, and (6) maintenance [37 ] (Textbox 1 ).
The selection of medical content for the website was guided by elements of informed consent, including the risks, benefits, procedures, alternatives, and voluntary nature of UE VCA. In addition, content was driven by a review of the literature; conversations with health care providers working in UE VCA (eg, UE VCA clinicians or surgeons, hand reconstructive surgeons, and occupational therapists); in-depth and semistructured interviews with individuals with UE loss and UE VCA candidates, participants, and recipients about their information needs regarding UE VCA [38 (link)]; and focus groups, which provided input on the website sitemap and topic and subtopic headers. Participants suggested topics that should be included or removed. Our study team, comprised of clinicians (ie, 2 hand surgeons, 1 UE VCA surgeon, 3 occupational therapists, and 1 VCA clinical researcher), 1 social worker, 3 social scientists, 2 ethicists, 1 instructional designer, and >10 research staff, provided feedback on several drafts of the website content. The research team consulted with the clinicians through multiple iterations of content development for clarification and refinement.
Website development was guided by the Health On the Net Foundation code of conduct certification guidelines, which provide credibility that the website follows a code of ethics ensuring that it provides quality information [36 ]. The design of Within Reach followed a six-step website development process: (1) discovery phase, (2) planning, (3) design, (4) development, (5) launching the website, and (6) maintenance [37 ] (
The selection of medical content for the website was guided by elements of informed consent, including the risks, benefits, procedures, alternatives, and voluntary nature of UE VCA. In addition, content was driven by a review of the literature; conversations with health care providers working in UE VCA (eg, UE VCA clinicians or surgeons, hand reconstructive surgeons, and occupational therapists); in-depth and semistructured interviews with individuals with UE loss and UE VCA candidates, participants, and recipients about their information needs regarding UE VCA [38 (link)]; and focus groups, which provided input on the website sitemap and topic and subtopic headers. Participants suggested topics that should be included or removed. Our study team, comprised of clinicians (ie, 2 hand surgeons, 1 UE VCA surgeon, 3 occupational therapists, and 1 VCA clinical researcher), 1 social worker, 3 social scientists, 2 ethicists, 1 instructional designer, and >10 research staff, provided feedback on several drafts of the website content. The research team consulted with the clinicians through multiple iterations of content development for clarification and refinement.
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