Accepted for/Published in: JMIR Research Protocols
Date Submitted: Nov 20, 2021
Date Accepted: Nov 24, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Co-producing knowledge of the implementation of complex digital health interventions for adults with acquired brain injury and their communication partners: A mixed-methods study protocol
ABSTRACT
Background:
The Social Brain Toolkit is a novel suite of online communication interventions for people with brain injury and their communication partners, conceived and developed in partnership with stakeholders. To support effective implementation, the developers of the Social Brain Toolkit collaborated with people with brain injury, their communication partners and clinicians, as well as individuals who have implemented digital health interventions, to co-produce implementation knowledge. In recognition of the value of both experiential and academic knowledge, both types of knowledge are included within this study protocol, with input from stakeholder co-authors.
Objective:
To collaborate with stakeholders to i) prioritise theoretically-based implementation targets for the Social Brain Toolkit, ii) understand the nature of these priorities, and iii) develop targeted implementation strategies to address these priorities, to support effective implementation of the Social Brain Toolkit.
Methods:
Theoretically underpinned by the Non-Adoption, Abandonment, Scale-Up, Spread and Sustainability (NASSS) framework of digital health implementation, a maximum variation sample (n=35) of stakeholders co-produced knowledge of the implementation of the Social Brain Toolkit. Ten people with brain injury, eleven communication partners, and five clinicians participated in an initial online prioritisation survey based on the NASSS framework. Participants subsequently elaborated on their identified priorities via seven online focus groups, in which researchers and stakeholders exchanged stakeholder perspectives and research evidence from a concurrent systematic review. A speech-language pathologist supported stakeholders with brain injury to participate in the survey via video teleconference. Survey completion was also facilitated through plain English explanations and accessible captioned videos developed through three rounds of piloting. Stakeholders were supported to engage in focus groups through the use of visual supports and plain English explanations. Nine individuals with experience of digital health implementation responded to the same prioritisation questions via individual interview. Results will be deductively analysed in relation to the NASSS framework, in a co-authorship process with people with brain injury, communication partners and clinicians.
Results:
Ethical approval was received from the University of Technology Sydney Health and Medical Research Ethics Committee (ETH20-5466) on the 15th December 2020. Data were collected from 13th April to 18th November 2021. Data analysis is currently underway, with results expected for publication mid-2022.
Conclusions:
In this study, researchers supported individuals with living experience of brain injury, communicating with or clinically supporting someone post-injury, and digital health implementation to directly access and leverage the latest implementation research evidence and theory to generate new implementation knowledge of three real-world interventions. With this support, stakeholders were able to i) prioritise implementation research targets, ii) develop targeted implementation solutions and iii) co-author and publish new implementation findings, to optimise the implementation of evidence-based interventions, and thus improve the outcomes of people with brain injury and their communication partners.
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