Integrating Evidence From Systematic Reviews, Qualitative Research, and Expert Knowledge Using Co-Design Techniques to Develop a Web-Based Intervention for People in the Retirement Transition

Abstract

BackgroundIntegrating stakeholder involvement in complex health intervention design maximizes acceptability and potential effectiveness. However, there is little methodological guidance about how to integrate evidence systematically from various sources in this process. Scientific evidence derived from different approaches can be difficult to integrate and the problem is compounded when attempting to include diverse, subjective input from stakeholders.ObjectiveThe intent of the study was to describe and appraise a systematic, sequential approach to integrate scientific evidence, expert knowledge and experience, and stakeholder involvement in the co-design and development of a complex health intervention. The development of a Web-based lifestyle intervention for people in retirement is used as an example.MethodsEvidence from three systematic reviews, qualitative research findings, and expert knowledge was compiled to produce evidence statements (stage 1). Face validity of these statements was assessed by key stakeholders in a co-design workshop resulting in a set of intervention principles (stage 2). These principles were assessed for face validity in a second workshop, resulting in core intervention concepts and hand-drawn prototypes (stage 3). The outputs from stages 1-3 were translated into a design brief and specification (stage 4), which guided the building of a functioning prototype, Web-based intervention (stage 5). This prototype was de-risked resulting in an optimized functioning prototype (stage 6), which was subject to iterative testing and optimization (stage 7), prior to formal pilot evaluation.ResultsThe evidence statements (stage 1) highlighted the effectiveness of physical activity, dietary and social role interventions in retirement; the idiosyncratic nature of retirement and well-being; the value of using specific behavior change techniques including those derived from the Health Action Process Approach; and the need for signposting to local resources. The intervention principles (stage 2) included the need to facilitate self-reflection on available resources, personalization, and promotion of links between key lifestyle behaviors. The core concepts and hand-drawn prototypes (stage 3) had embedded in them the importance of time use and work exit planning, personalized goal setting, and acceptance of a Web-based intervention. The design brief detailed the features and modules required (stage 4), guiding the development of wireframes, module content and functionality, virtual mentors, and intervention branding (stage 5). Following an iterative process of intervention testing and optimization (stage 6), the final Web-based intervention prototype of LEAP (Living, Eating, Activity, and Planning in retirement) was produced (stage 7). The approach was resource intensive and required a multidisciplinary team. The design expert made an invaluable contribution throughout the process.ConclusionsOur sequential approach fills an important methodological gap in the literature, describing the stages and techniq...

Using a six‐step co‐design model to develop and test a peer‐led web‐based resource (PLWR) to support informal carers of cancer patients

“…A review of web‐based interventions for carers across various chronic illnesses found positive changes in psychological health, knowledge, and relationships; however, much of the quality of these studies were deemed as methodologically weak, and therefore more work on the subject is needed . It is argued that the best way to ensure that interventions meet the needs of the target population is to involve stakeholders in design and development . This process known as co‐design has the potential to increase intervention effectiveness …”

“…It is argued that the best way to ensure that interventions meet the needs of the target population is to involve stakeholders in design and development . This process known as co‐design has the potential to increase intervention effectiveness …”

“…20 It is argued that the best way to ensure that interventions meet the needs of the target population is to involve stakeholders in design and development. 21,22 This process known as co-design has the potential to increase intervention effectiveness. 21,22 In response to rising carer pressures, the team co-designed with cancer carers and health care professionals (HCP) a peer-led web-based resource (PLWR) to provide cancer carer specific practical and emotional advice on common carer issues.…”

“…21,22 This process known as co-design has the potential to increase intervention effectiveness. 21,22 In response to rising carer pressures, the team co-designed with cancer carers and health care professionals (HCP) a peer-led web-based resource (PLWR) to provide cancer carer specific practical and emotional advice on common carer issues. The acceptability of the resource was determined through user testing, examining carer's experiences of using the PLWR, and their ratings of the various components.…”

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