Background User involvement (1) in development of health services has been described as significant for their viability, usability and effectiveness. However, previous research has reported diverse results with both benefits and drawbacks. Involvement of users in the development of a self-management service is in accordance with a behavioral medicine approach, which requires active user involvement and acknowledgement of their ability to self-manage. While user involvement mainly has been studied on a macro-level, in terms of money, time and how it informs the new service, research describing the collaboration process is scares. During the first step of the development of a web service to support physical activity, lead users shared ideas on core features to include in the future service (2). This study reports from the second step of the co-design process.
Objectives The aim was to explore challenges of significance for feeding the co-design process forward during the requirement specification of a web service for self-management of physical activity in rheumatoid arthritis (RA).
Methods A participatory action research design was used to involve the lead users as co-designers. Lead users (n=5), a clinical physiotherapist (n=1), researchers (n=2) with knowledge in physical activity in RA and behavioral medicine, a service developer (n=1) and an officer from the patient organization (n=1), collaborated in four workshops to provide data for system requirement specifications of the web service. Data collection methods included video recordings and non-participatory observations. An inductive qualitative video-based analysis was performed.
Results Three themes characterized the collaboration and phases of the co-design process: 1) finding a common starting point, 2) merging perspectives, and 3) deciding on design solutions. Seven categories illustrated the challenges: Reaching shared understanding of goals with future service, Clarifying the complexity of participants' roles, Clarifying terminology related to system development, Establishing the rationale for features, Negotiating features, Transforming of ideas into concrete features, and Participants' alignment to agreed goal and task.
Conclusions This study indicates that co-design creates high demands on collaboration between the participants. In addition, it contributes to our understanding of challenges important to consider during planning and performance of co-design. Further, it provides a description of important issues concerning self-management of physical activity, which may be clinically relevant for health care providers within rheumatology care and rehabilitation.
Bate P, Robert G. Experience-based design: from redesigning the system around the patient to co-designing services with the patient. Qual Saf Health Care. 2006;15(5):307-10.
Revenas A, Opava C, Asenlof P. Lead users' ideas on core features to support physical activity in rheumatoid arthritis: a first step in the development of an internet service using participatory design. BMC Med Inform Decis Mak. 2014;14(21).
Disclosure of Interest None declared