Box 2.

Summary of key barriers and intervention ingredients

Key barriers to target behaviours	Source	Key domain targeted	Intervention ingredients to address key barriers
Incomplete knowledge about eczema, its triggers, and its treatment	SR, I, TA	↑Knowledge about eczema and its management	Parents/carers Provide information about eczema, its treatment, and triggers Provide advice about identifying when emollients/TCS are needed for a range of different skin types and severities Provide information on when to apply emollients/TCS and when they should use them, and for how long, including advice on identifying the start and end of eczema flare-ups Provide information about how emollients and TCS differ in terms of their function and how they should be used together Provide instructional video/photos of how to correctly apply TCS Children Explain what eczema is and how it is treated in simple language using videos
Limited skills for managing and co-managing eczema and its treatments (for example, using creams, supporting transition to child self-management)	SR, I, TA	↑Skills to manage and co-manage eczema with their child	Parents/carers Use videos to demonstrate how emollients should be applied and how much Provide suggestions for activities around emollient use to make emollient times more fun and interesting for children (for example, imaginary games, singing, special toys for emollient times) Encourage parents/carers to involve their child in applying emollients so they can learn how to do it themselves Children Use videos to demonstrate how emollients should be applied and how much
Concerns and doubts about emollients and, especially, TCS	SR, I	↑Positive beliefs about consequences (of using emollients and TCS)	Parents/carers Provide a rationale for how emollients and TCS help to manage eczema including when eczema is only mild or not visible on the skin Provide persuasive and credible information about the effectiveness of emollients and TCS, including scientific evidence, user stories, quotes, and videos Provide advice about trying out new emollients and finding an emollient that works, including advice on when an emollient should be abandoned to try a new one Encourage use of a 2-week challenge to evaluate how regular use of an emollient improves eczema symptoms (redness, soreness, itching), and prompt trying a different emollient if it does not Provide advice on how to support the child to tolerate the treatments better (for example, distraction, relaxation) Provide user stories/quotes about how they dealt with unpleasant reactions in their child Acknowledge that the process of finding the right emollient can be frustrating/overwhelming/disheartening Reassure parents/carers that it is OK to ask to change emollients if their child cannot tolerate their current emollient Children Explain how emollients and TCS help eczema using easy-to-understand videos

Key barriers to target behaviours

Source

Key domain targeted

Intervention ingredients to address key barriers

Incomplete knowledge about eczema, its triggers, and its treatment

SR, I, TA

↑Knowledge about eczema and its management

Parents/carers

Provide information about eczema, its treatment, and triggers
Provide advice about identifying when emollients/TCS are needed for a range of different skin types and severities
Provide information on when to apply emollients/TCS and when they should use them, and for how long, including advice on identifying the start and end of eczema flare-ups
Provide information about how emollients and TCS differ in terms of their function and how they should be used together
Provide instructional video/photos of how to correctly apply TCS

Children

Explain what eczema is and how it is treated in simple language using videos

Limited skills for managing and co-managing eczema and its treatments (for example, using creams, supporting transition to child self-management)

SR, I, TA

↑Skills to manage and co-manage eczema with their child

Parents/carers

Use videos to demonstrate how emollients should be applied and how much
Provide suggestions for activities around emollient use to make emollient times more fun and interesting for children (for example, imaginary games, singing, special toys for emollient times)
Encourage parents/carers to involve their child in applying emollients so they can learn how to do it themselves

Children

Use videos to demonstrate how emollients should be applied and how much

Concerns and doubts about emollients and, especially, TCS

SR, I

↑Positive beliefs about consequences (of using emollients and TCS)

Parents/carers

Provide a rationale for how emollients and TCS help to manage eczema including when eczema is only mild or not visible on the skin
Provide persuasive and credible information about the effectiveness of emollients and TCS, including scientific evidence, user stories, quotes, and videos
Provide advice about trying out new emollients and finding an emollient that works, including advice on when an emollient should be abandoned to try a new one
Encourage use of a 2-week challenge to evaluate how regular use of an emollient improves eczema symptoms (redness, soreness, itching), and prompt trying a different emollient if it does not
Provide advice on how to support the child to tolerate the treatments better (for example, distraction, relaxation)
Provide user stories/quotes about how they dealt with unpleasant reactions in their child
Acknowledge that the process of finding the right emollient can be frustrating/overwhelming/disheartening
Reassure parents/carers that it is OK to ask to change emollients if their child cannot tolerate their current emollient

Children

Explain how emollients and TCS help eczema using easy-to-understand videos

EO = expert opinion. I = stage 1 interviews. PPI = patient-public involvement representatives. SR = systematic review. TA = stage 2 think-aloud interviews. TCS = topical corticosteroids.