Challenges in co-designing an intervention to increase mobility in older patients: a qualitative study

Abstract

PurposeThe aim of this study is to explore and discuss key challenges associated with having stakeholders take part in co-designing a health care intervention to increase mobility in older medical patients admitted to two medical departments at two hospitals in Denmark.Design/methodology/approachThe study used a qualitative design to investigate the challenges of co-designing an intervention in five workshops involving health professionals, patients and relatives. “Challenges” are understood as “situations of being faced with something that needs great mental or physical effort in order to be done successfully and therefore tests a person's ability” (Cambridge Dictionary). Thematic content analysis was conducted with a background in the analytical question: “What key challenges arise in the material in relation to the co-design process?”.FindingsTwo key challenges were identified: engagement and facilitation. These consisted of five sub-themes: recruiting patients and relatives, involving physicians, adjusting to a new researcher role, utilizing contextual knowledge and handling ethical dilemmas.Research limitations/implicationsThe population of patients and relatives participating in the workshops was small, which likely affected the co-design process.Practical implicationsResearchers who want to use co-design must be prepared for the extra time required and the need for skills concerning engagement, communication, facilitation, negotiation and resolution of conflict. Time is also required for ethical discussions and considerations concerning different types of knowledge creation.Originality/valueEngaging stakeholders in co-design processes is increasingly encouraged. This study documents the key challenges in such processes and reports practical implications.

Empowering patients to co‐design Covid‐19 responses: the role of online health communities

“…Co‐design has been cited as being successful in creating greater staff awareness of patients’ experiences, improvements in care and treatment processes and better health outcomes (Boyd et al, 2012; Goodyear‐Smith and Jackson, 2015). Implementing co‐design in healthcare is challenging, particularly it can be time‐consuming, adding to already high clinical workloads (Kirk et al, 2021). Truly equalising power and challenging dominating relationships and practices between servicer users and providers might be an obstacle to true participation (Farrington, 2016; Farr, 2018).…”

Development of an intervention to facilitate dissemination of community-based training to respond to out-of-hospital cardiac arrest: FirstCPR

“…Using a co-design approach to develop community-based interventions can add significant value to public health research [ 33 ]. Although such co-design strives to align researchers’ aims with end-users’ needs, meaningful consumer and stakeholder engagement comes with an array of challenges related to matching researchers’ and end-users’ contexts, goals, evaluation metrics, expertise, and resources, as well as additional time to facilitate the intervention [ 34 ]. Despite these challenges, striving to consult where suitable and engage broadly is known to result in both higher levels of participation and improved outcomes.…”

Estrategias de apropiación social del conocimiento en salud: revisión sistemática

“…Para esta fase, algunos artículos reportaron un estudio piloto, donde se motivó la participación con incentivos económicos o alimenticios (24,36,48,59). En múltiples ocasiones, las intervenciones las efectuaron los líderes de la comunidad o facilitadores diferentes a los investigadores, con previa capacitación (35,39,44,46,53). Se utilizaron herramientas visuales como pancartas, pósteres, folletos o presentaciones durante el desarrollo de la intervención (43,45).…”

“…En la implementación se encontraron intervenciones únicas (46), es decir, de una sola sesión; intervenciones múltiples, con varias sesiones y con diferentes metodologías, y múltiples intervenciones multinivel, que además de intervenir a la población en múltiples ocasiones, contaban con diferentes fases dentro de la intervención y que avanzaban en complejidad de la temática de una fase a otra (29,42,45,51,53,56). Algunas de las intervenciones se desarrollaron en varios grupos focales, según los criterios de los investigadores, o en un solo grupo, con todos los participantes (29,46,51).…”

“…La última fase de las estrategias de intervención contempló la evaluación. Para este proceso se utilizaron diferentes métodos; sin embargo, el más utilizado fue el análisis cualitativo de los grupos focales y entrevistas semiestructuradas, que evaluó la factibilidad, satisfacción, aceptación, percepciones sobre la implementación y los índices de deseo para apoyar la sostenibilidad de la estrategia en la comunidad (25,28,36,37,(43)(44)(45)50,53,59). En esta fase se utilizó la evaluación de conocimientos y resultados en salud (índice de masa corporal, hemoglobina glicosilada y tiempo de actividad física) para determinar la eficacia de las estrategias ( (33,61).…”