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
Journal of Medical Internet Research
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O'Brien, N., Heaven, B., Teal, G., Evans, E., Cleland, C., Moffatt, S., Sniehotta, F., et al. (2016). 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. Journal of Medical Internet Research, 18 (8. e210) https://doi.org/10.2196/jmir.5790
BACKGROUND: Integrating 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. OBJECTIVE: The 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. METHODS: Evidence 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. RESULTS: The 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. CONCLUSIONS: Our sequential approach fills an important methodological gap in the literature, describing the stages and techniques useful in developing an evidence-based complex health intervention. The systematic and rigorous integration of scientific evidence, expert knowledge and experience, and stakeholder input has resulted in an intervention likely to be acceptable and feasible.
Internet, health behavior, intervention studies, retirement
This work was conducted as part of the LiveWell program (Grant Reference Number G0900686), which is funded through the Lifelong Health and Wellbeing cross-councils initiative in partnership with the following: Biotechnology and Biological Sciences Research Council; Engineering and Physical Sciences Research Council; Economic and Social Research Council; Medical Research Council; Chief Scientist Office of the Scottish Government Health Directorates; National Institute for Health Research/The Department of Health; The Health and Social Care Research & Development of the Public Health Agency (Northern Ireland); and Wales Office of Research and Development for Health and Social Care, Welsh Assembly Government. FFS is funded by Fuse, the UK Clinical Research Collaboration Centre for Translational Research in Public Health, and, at the time of this study, MW was director of Fuse. MW is also a member of the Centre for Diet and Activity Research (CEDAR). Both Fuse and CEDAR are UK Clinical Research Collaboration (UKCRC) Public Health Research Centres of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research, and the Wellcome Trust under the auspices of the UKCRC, is gratefully acknowledged. The views expressed in this paper are those of the authors and do not necessarily reflect those of the above named funders.
Wellcome Trust (087636/Z/08/Z)
External DOI: https://doi.org/10.2196/jmir.5790
This record's URL: https://www.repository.cam.ac.uk/handle/1810/263535