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Type: Journal article
Title: Fit for purpose. Co-production of complex behavioural interventions. A practical guide and exemplar of co-producing a telehealth-delivered exercise intervention for people with stroke
Author: Ramage, E.R.
Burke, M.
Galloway, M.
Graham, I.D.
Janssen, H.
Marsden, D.L.
Patterson, A.J.
Pollack, M.
Said, C.M.
Lynch, E.A.
English, C.
Citation: Health Research Policy and Systems, 2022; 20(1):1-14
Publisher: Springer Nature
Issue Date: 2022
ISSN: 1478-4505
Statement of
Emily R. Ramage, Meredith Burke, Margaret Galloway, Ian D. Graham, Heidi Janssen, Dianne L. Marsden, Amanda J. Patterson, Michael Pollack, Catherine M. Said, Elizabeth A. Lynch, and Coralie English
Abstract: Background: Careful development of interventions using principles of co-production is now recognized as an important step for clinical trial development, but practical guidance on how to do this in practice is lacking. This paper aims (1) provide practical guidance for researchers to co-produce interventions ready for clinical trial by describing the 4-stage process we followed, the challenges experienced and practical tips for researchers wanting to co-produce an intervention for a clinical trial; (2) describe, as an exemplar, the development of our intervention package. Method: We used an Integrated Knowledge Translation (IKT) approach to co-produce a telehealth-delivered exercise program for people with stroke. The 4-stage process comprised of (1) a start-up planning phase with the co-production team. (2) Content development with knowledge user informants. (3) Design of an intervention protocol. (4) Protocol refnement. Results and refections: The four stages of intervention development involved an 11-member co-production team and 32 knowledge user informants. Challenges faced included balancing conficting demands of diferent knowledge user informant groups, achieving shared power and collaborative decision making, and optimising knowledge user input. Components incorporated into the telehealth-delivered exercise program through working with knowledge user informants included: increased training for intervention therapists; increased options to tailor the intervention to participant’s needs and preferences; and re-naming of the program. Key practical tips include ways to minimise the power diferential between researchers and consumers, and ensure adequate preparation of the co-production team. Conclusion: Careful planning and a structured process can facilitate co-production of complex interventions ready for clinical trial.
Keywords: Stakeholder participation; Integrated knowledge translation; Co-production; Research design; Research partnership; Stroke; Co-design; Intervention development
Rights: © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver (http://creativeco applies to the data made available in this article, unless otherwise stated in a credit line to the data.
DOI: 10.1186/s12961-021-00790-2
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