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ORBIT previously showed that internet-delivered, therapist-supported ERP can be clinically and cost-effective, but it required redevelopment for NHS-wide deployment. This study evaluates usability, acceptability, and early outcomes of ORBIT on an NHS compliant platform within an NHS tic disorder service.",{"@graph":69,"@context":114},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/online-remote-behavioural-intervention-for-tics-orbit-uk-protocol-of-a-single-cohort-usability-study/458810/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/online-remote-behavioural-intervention-for-tics-orbit-uk-protocol-of-a-single-cohort-usability-study/458810.png","ImageObject",300,407,{"name":92,"@type":93},"Anna Hans","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108],{"name":109,"@type":110,"acceptedAnswer":111},"How will the results be used?","Question",{"text":112,"@type":113},"Findings will inform future NHS adoption and be submitted for publication in peer-reviewed journals.","Answer","https://schema.org",{"og:url":83,"og:type":116,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":118,"canonical":83},"index,follow",{"doc_id":120,"site_id":62},458810,1790804860,{"code":4,"msg":5,"data":123},{"doc_id":120,"user_id":124,"nickname":92,"user_avatar":125,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":126,"file_id":127,"file_url":128,"file_type":129,"file_size":130,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":131,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":132,"faqs":133,"seo_title":134,"seo_description":67,"update_tm":135,"read_time":46,"preview_page_count":4},5909892332657,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Open access Protocol  \n Online Remote Behavioural Intervention for Tics (ORBIT-UK): protocol of a single cohort usability study  \nOlivia Hastings  ,1,2 Beverley J Brown  ,3,4 Kelly-Marie Prentice  ,4 Camilla May Babbage  ,5 E Bethan Davies  ,1,2 Joseph Kilgariff  ,6 Tara Murphy,7,8 Glenn McGarry,9 Boliang Guo,10 Chris Greenhalgh  ,9 Chris Hollis  ,1,2,11 Charlotte Lucy Hall  3,4  \nTo cite: Hastings O,  \nBrown BJ, Prentice K-M, et al. Online Remote Behavioural Intervention for Tics (ORBITUK): protocol of a single cohort usability study. BMJ Open 2026;16:e110121 . doi:10 . 1136/ bmjopen-2025-110121  \n► Prepublication history and additional supplemental material for this paper are available online. To view these files, please visit the journal online ([https://doi.org/10.1136/](https://doi.org/10.1136/)[ ](https://doi.org/10.1136/)[bmjopen-2025-110121](bmjopen-2025-110121)) .  \nReceived 29 August 2025 Accepted 16 December 2025  \n© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group. For numbered affiliations see end of article.  \nCorrespondence to  \nDr Charlotte Lucy Hall;  \n[charlotte.hall@nottingham.ac.uk](charlotte.hall@nottingham.ac.uk)  \nABSTRACT  \nIntroduction Tourette syndrome is a common, disabling childhood-onset condition. Exposure and response prevention (ERP) is an effective treatment for tics, yet access remains limited due to a shortage of trained therapists and uneven geographical distribution of services. The ORBIT trial demonstrated that internetdelivered ERP is both clinically and cost-effective, but was developed on a university research platform, not suitable for widescale roll-out. To enable adoption by the National Health Service (NHS) in England, ORBIT has been redeveloped on an NHS compliant platform. This study will evaluate the usability, acceptability and preliminary outcomes of ORBIT on the new platform within an NHS tic disorder service.  \nMethods and analysis This single-cohort usability study will recruit 20 children and young people (aged 9–17) with tics and their chosen supporters (parents/ carers) . Participants will receive a 10-week online ERP intervention supported by trained coaches. Outcomes include uptake, adherence, system usability, satisfaction and clinical measures such as the Yale Global Tic Severity Scale, Parent Tic Questionnaire and Goal-Based Outcomes. Qualitative feedback will be collected via semi-structured exit interviews. Usability metrics and adverse events will be monitored throughout.  \nEthics and dissemination The study has received ethical approval from North West Greater Manchester Research Ethics Committee (ref: 25/NW/0107) . The findings from the study will inform future NHS adoption. The results will be submitted for publication in peer-reviewed journals.  \nTrial registration number ISRCTN82718960 . Registered 10 July 2025. [https://doi.org/10](https://doi.org/10.1186/ISRCTN82718960)[.1186/ISRCTN82718960](https://doi.org/10.1186/ISRCTN82718960)  \nINTRODUCTION  \nTourette syndrome (TS) is a common, childhood onset condition that affects up to 1% of children and young people (CYP) and is associated with high levels of comorbidity, significant distress, psychological impairment and reduced quality of life.1 Most patients with TS experience co-occurring conditions such as attention deficit hyperactivity disorder, obsessive-compulsive disorder, depression,  \nSTRENGTHS AND LIMITATIONS OF THIS STUDY   \n⇒ Evaluates the real-world usability of a previously validated digital intervention on a new technical platform, providing insights into user experience, real-world outcomes and implementation feasibility.  \n⇒ Provides a practical example of post-trial validation, demonstrating how a clinically effective intervention can be transitioned from an academic research platform to a patient-ready product.  \n⇒ Patient and public involvement embedded in every stage of the research including platform development.  \n⇒ The small sample size (n=20) li","cbCais6CJ5pPtZuL","https://ap.wps.com/l/cbCais6CJ5pPtZuL","pdf",530545,"English","# Abstract\n# Introduction\n# Strengths and Limitations of This Study\n# Methods and Analysis\n# Ethics and Dissemination","[{\"question\":\"How will the results be used?\",\"answer\":\"Findings will inform future NHS adoption and be submitted for publication in peer-reviewed journals.\"}]","Online Remote Behavioural Intervention for Tics (ORBIT-UK) - protocol of a single cohort usability study | PDF",1790754509]