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Developing ActivABLES for community-dwelling stroke survivors using the Medical Research Council framework for complex interventions

Olafsdottir, Steinunn A. ; Jonsdottir, Helga ; Magnusson, Charlotte LU orcid ; Caltenco, Héctor LU orcid ; Kytö, Mikko ; Maye, Laura ; McGookin, David ; Bjartmarz, Ingibjörg ; Arnadottir, Solveig Asa and Hjaltadottir, Ingibjörg LU , et al. (2020) In BMC Health Services Research 20.
Abstract

Background: Novel technical solutions are called for to promote home-based exercise among community-dwelling stroke survivors supported by their caregivers. Lack of resources and knowledge about how to accomplish it, has been demonstrated. The objective of this study is to describe in detail the development of ActivABLES, a technical intervention to promote home-based exercise and physical activity engagement of community-dwelling stroke survivors with support from their caregivers. Methods: The technical development process of ActivABLES was guided by the Medical Research Council (MRC) framework for development and evaluation of complex interventions as well as by principles of human-centred design and co-design. The main steps... (More)

Background: Novel technical solutions are called for to promote home-based exercise among community-dwelling stroke survivors supported by their caregivers. Lack of resources and knowledge about how to accomplish it, has been demonstrated. The objective of this study is to describe in detail the development of ActivABLES, a technical intervention to promote home-based exercise and physical activity engagement of community-dwelling stroke survivors with support from their caregivers. Methods: The technical development process of ActivABLES was guided by the Medical Research Council (MRC) framework for development and evaluation of complex interventions as well as by principles of human-centred design and co-design. The main steps included: (1) Synthesis of evidence supporting the inclusion of balance exercises, mobility and walking exercises and exercises for the upper arm; (2) Implementation of initial user studies with qualitative data collection from individual interviews with stroke survivors, and focus group interviews with caregivers and health professionals; (3) Preliminary testing of eight prototypes with seven stroke survivors and their caregivers. Results: After the preliminary testing of eight prototypes, four prototypes were not further developed whereas four prototypes were modified further. In addition, two new prototypes were developed, leaving six prototypes for further modification: 1) ActivFOAM for balance exercises, 2) WalkingSTARR to facilitate walking, 3) ActivBALL for hand exercises, 4) ActivSTICKS for upper arm exercises, and 5) ActivLAMP and 6) ActivTREE which both give visual feedback on progress of daily exercise and physical activities. ActivFOAM, ActivBALL and ActivSTICKS are all connected to a tablet where exercise instructions are given. All the exercise prototypes can be connected to ActivLAMP and ActivTREE to give feedback on how much exercise the user has done. Settings can be individualised and recommended daily time and/or repetition can easily be changed as the user progresses to higher activity levels. Conclusions: The development process of ActivABLES was guided by the principles of human-centred design, with iterative testing of future users, and by the MRC framework of complex intervention, with a repeated process of development and testing. This process resulted in six prototypes which are available for feasibility testing among a small group of community-dwelling stroke survivors.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Home-based exercise, Stroke survivors, Technical intervention
in
BMC Health Services Research
volume
20
article number
463
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85085393420
  • pmid:32450854
ISSN
1472-6963
DOI
10.1186/s12913-020-05198-2
language
English
LU publication?
yes
id
872f189a-c420-4879-b235-15d75f029c2e
date added to LUP
2020-06-16 13:36:26
date last changed
2024-05-16 11:44:13
@article{872f189a-c420-4879-b235-15d75f029c2e,
  abstract     = {{<p>Background: Novel technical solutions are called for to promote home-based exercise among community-dwelling stroke survivors supported by their caregivers. Lack of resources and knowledge about how to accomplish it, has been demonstrated. The objective of this study is to describe in detail the development of ActivABLES, a technical intervention to promote home-based exercise and physical activity engagement of community-dwelling stroke survivors with support from their caregivers. Methods: The technical development process of ActivABLES was guided by the Medical Research Council (MRC) framework for development and evaluation of complex interventions as well as by principles of human-centred design and co-design. The main steps included: (1) Synthesis of evidence supporting the inclusion of balance exercises, mobility and walking exercises and exercises for the upper arm; (2) Implementation of initial user studies with qualitative data collection from individual interviews with stroke survivors, and focus group interviews with caregivers and health professionals; (3) Preliminary testing of eight prototypes with seven stroke survivors and their caregivers. Results: After the preliminary testing of eight prototypes, four prototypes were not further developed whereas four prototypes were modified further. In addition, two new prototypes were developed, leaving six prototypes for further modification: 1) ActivFOAM for balance exercises, 2) WalkingSTARR to facilitate walking, 3) ActivBALL for hand exercises, 4) ActivSTICKS for upper arm exercises, and 5) ActivLAMP and 6) ActivTREE which both give visual feedback on progress of daily exercise and physical activities. ActivFOAM, ActivBALL and ActivSTICKS are all connected to a tablet where exercise instructions are given. All the exercise prototypes can be connected to ActivLAMP and ActivTREE to give feedback on how much exercise the user has done. Settings can be individualised and recommended daily time and/or repetition can easily be changed as the user progresses to higher activity levels. Conclusions: The development process of ActivABLES was guided by the principles of human-centred design, with iterative testing of future users, and by the MRC framework of complex intervention, with a repeated process of development and testing. This process resulted in six prototypes which are available for feasibility testing among a small group of community-dwelling stroke survivors.</p>}},
  author       = {{Olafsdottir, Steinunn A. and Jonsdottir, Helga and Magnusson, Charlotte and Caltenco, Héctor and Kytö, Mikko and Maye, Laura and McGookin, David and Bjartmarz, Ingibjörg and Arnadottir, Solveig Asa and Hjaltadottir, Ingibjörg and Hafsteinsdottir, Thora B.}},
  issn         = {{1472-6963}},
  keywords     = {{Home-based exercise; Stroke survivors; Technical intervention}},
  language     = {{eng}},
  month        = {{05}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{BMC Health Services Research}},
  title        = {{Developing ActivABLES for community-dwelling stroke survivors using the Medical Research Council framework for complex interventions}},
  url          = {{http://dx.doi.org/10.1186/s12913-020-05198-2}},
  doi          = {{10.1186/s12913-020-05198-2}},
  volume       = {{20}},
  year         = {{2020}},
}