A Study Protocol for Applying User Participation and Co-Learning—Lessons Learned from the eBalance Project

Abstract

The eBalance project is based on the idea that serious exergames—i.e., computer gaming systems with an interface that requires physical exertion to play—that are well adapted to users, can become a substantial part of a solution to recognized problems of insufficient engagement in fall-prevention exercise and the high levels of fall-related injuries among older people. This project is carried out as a collaboration between eight older people who have an interest in balance training and met the inclusion criteria of independence in personal activities of daily living, access to and basic knowledge of a computer, four staff working with the rehabilitation of older adults, and an interdisciplinary group of six research coordinators covering the areas of geriatric care and rehabilitation, as well as information technology and computer science. This paper describes the study protocol of the project’s initial phase which aims to develop a working partnership with potential users of fall-prevention exergames, including its conceptual underpinnings. The qualitative methodology was inspired by an ethnographical approach implying combining methods that allowed the design to evolve through the study based on the participants’ reflections. A participatory and appreciative action and reflection (PAAR) approach, accompanied by inquiries inspired by the Normalization Process Theory (NPT) was used in interactive workshops, including exergame testing, and between workshop activities. Data were collected through audio recordings, photos, and different types of written documentation. The findings provide a description of the methodology thus developed and applied. They display a methodology that can be useful for the design and development of care service and innovations for older persons where user participation is in focus.

The use of co-design in developing physical activity interventions for older adults: a scoping review

“…• Combining appreciative action and reflection, or an integrated knowledge translation approach with normalization process theory [ 50 , 62 ]…”

“…• Lack of literature on co-creation governance and frameworks [53] • Requiring participants to complete interventions before participating in co-design [68] • Complexity of data collection measures [36] • Combining appreciative action and reflection, or an integrated knowledge translation approach with normalization process theory [50,62] • User experience honeycomb model [43] • Participatory action research [51] • Photo-elicitation [69] • Training workshop and focus group facilitators in co-creation [52] • Fieldwork tasks [53] • Involving participants early, frequently, and throughout various stages [55,59] Logistics • Open-ended questions [60] • Novice facilitators [60] • Hypothetical scenarios [39,60] • Strategies to ensure members who belong to minority or socially disadvantaged groups are time intensive [57] • Role and workshop aim clarification [53,55,62] • Debrief sessions for facilitators [62] • Sharing workshop summaries with participants [43,52] • Utilizing community organizations or creating community advisory boards to assist with recruitment [51,57] • Formal committee name and constitution [56] Relationships • Time and resources required to build trust within community of interest [57] • Bias arises from a desire to please and maintain group dynamics [36,46] • Participatory Action Research approach may create a power differential [51] • Seniors require longer interviews [36] • Building group dynamics (meeting in person, allowing time to socialize, and demonstrating appreciation for participation) [38,55,59] Participation • Fatigue/loss of concentration…”

Theory and Practice in Digital Behaviour Change: A Matrix Framework for the Co-Production of Digital Services That Engage, Empower and Emancipate Marginalised People Living with Complex and Chronic Conditions

“…In this way, the 4E matrix may serve for service designers and other health professionals as an inspiration and guide like the Rainbow Model is intended for development of integrated care solutions [59]. The examples listed in the Table 1, e.g., Transect Walks or participatory design walks [16] and Fun theories [60,61] are unconventional ways of interacting with the marginalised, socially-disadvantaged PwCCCs that can be deployed for the purposes of first identifying them and their contexts and then for engaging them in co-production of technology supported health behaviour change initiatives. In essence, the aim here is to highlight that individuals who are conventionally marginalised or under-served can be connected with and engaged with if we 'find them where they are'-this implies going to food banks, supermarkets, schools, charities, sporting events, and using both traditional and social media (e.g., TV, Local newspapers, PokemonGo, Facebook, etc.)…”

Designing an Agent-Based Model Using Group Model Building: Application to Food Insecurity Patterns in a U.S. Midwestern Metropolitan City

“…While modelers can learn more about the real world to incorporate into their models, the GMB participants can gain knowledge about the potential of systems science approaches and participate in research processes. Such co-learning synergy can help both modelers and GMB participants gain a common ground in research and community engagement through interactive processes between modelers and stakeholders to accumulate new information and perspectives and to modify their way of thinking [29].…”