Fit for purpose. Co-production of complex behavioural interventions. A practical guide and exemplar of co-producing a telehealth-delivered exercise intervention for people with stroke

letter

. 2022 Jan 3;20:2. doi: 10.1186/s12961-021-00790-2

Key co-production team knowledge user contributions arising from Stage 1
Brought lived experience of the challenges of participating in research to inform the research approach Recommendations for workshop structure (e.g., time limits, pacing, language, input into the presentation of the program in Stage 4) Developed an introductory video for stroke survivor/carer workshops (Stage 2) describing the project and highlighting the role of stroke survivors	Brought knowledge and experience regarding the context that healthcare workers participating in the project are working within to inform the research approach Identified potential key healthcare worker knowledge users to be involved in the co-production Prioritised early involvement of knowledge users to optimise their contributions and ‘buy in’

Key co-production team knowledge user contributions arising from Stage 1

Stroke survivor knowledge user on the co-production team

Clinician knowledge users on the co-production team

Brought lived experience of the challenges of participating in research to inform the research approach

Recommendations for workshop structure (e.g., time limits, pacing, language, input into the presentation of the program in Stage 4)

Developed an introductory video for stroke survivor/carer workshops (Stage 2) describing the project and highlighting the role of stroke survivors

Brought knowledge and experience regarding the context that healthcare workers participating in the project are working within to inform the research approach

Identified potential key healthcare worker knowledge users to be involved in the co-production

Prioritised early involvement of knowledge users to optimise their contributions and ‘buy in’

Key protocol elements arising from knowledge users’ input (Stages 1–4)^a
Suitable patient resources (information booklet and prompt sheet) including prioritized content, aphasia friendly format, easy handling design and storage Increased options to tailor support to individual stroke survivor needs including those with visual or communication impairment, and with varying confidence using technology (e.g., options for online video/images instructions or paper-based images/instructions) Inclusion of a peer support option Tailoring of physical activity monitoring—e.g., options to use an activity diary or their own activity monitor (if preferred) in addition to a Fitbit™ Re-naming the program to reflect what it means to stroke survivors (i-REBOUND, Let’s get moving!) Option to provide home visits to provide extra support to participants who require it (e.g., for technology or home set-up) Increased emphasis on education regarding information about when not to exercise and advice regarding measures to increase safety if exercising alone Extra initial session added at the beginning of the intervention to facilitate effective assessment, build rapport, and troubleshoot Monitoring participant’s preferences for session times to determine if they are in line with the public healthcare workforce needs Highlighted pre-requisite training/knowledge/experience important for clinicians undertaking the role Support from local interpreting service Identified potential equipment needs for the program Increased time allowance pre- and post-exercise sessions for admin/troubleshooting

Key protocol elements arising from knowledge users’ input (Stages 1–4)^a

Suitable patient resources (information booklet and prompt sheet) including prioritized content, aphasia friendly format, easy handling design and storage

Increased options to tailor support to individual stroke survivor needs including those with visual or communication impairment, and with varying confidence using technology (e.g., options for online video/images instructions or paper-based images/instructions)

Inclusion of a peer support option

Tailoring of physical activity monitoring—e.g., options to use an activity diary or their own activity monitor (if preferred) in addition to a Fitbit™

Re-naming the program to reflect what it means to stroke survivors (i-REBOUND, Let’s get moving!)

Option to provide home visits to provide extra support to participants who require it (e.g., for technology or home set-up)

Increased emphasis on education regarding information about when not to exercise and advice regarding measures to increase safety if exercising alone

Extra initial session added at the beginning of the intervention to facilitate effective assessment, build rapport, and troubleshoot

Monitoring participant’s preferences for session times to determine if they are in line with the public healthcare workforce needs

Highlighted pre-requisite training/knowledge/experience important for clinicians undertaking the role

Support from local interpreting service

Identified potential equipment needs for the program

Increased time allowance pre- and post-exercise sessions for admin/troubleshooting

^aThrough collaborative decision-making knowledge users on the co-production team participated in prioritising these within our intervention protocol.