Digital Health Implementation Strategies Coproduced With Adults With Acquired Brain Injury, Their Close Others, and Clinicians: Mixed Methods Study With Collaborative Autoethnography and Network Analysis.

Miao, M; Morrow, R; Salomon, A; Mcculloch, B; Evain, J-C; Wright, MR; Murphy, MT; Welsh, M; Williams, L; Power, E; Rietdijk, R; Debono, D; Brunner, M; Togher, L

Digital Health Implementation Strategies Coproduced With Adults With Acquired Brain Injury, Their Close Others, and Clinicians: Mixed Methods Study With Collaborative Autoethnography and Network Analysis.

Miao, M Morrow, R Salomon, A Mcculloch, B Evain, J-C Wright, MR Murphy, MT Welsh, M Williams, L Power, E

Rietdijk, R Debono, D

Brunner, M Togher, L

Permalink

Publisher:: JMIR Publications
Publication Type:: Journal Article
Citation:: J Med Internet Res, 2023, 25, pp. e46396
Issue Date:: 2023-09-19

Open Access

Copyright Clearance Process

Recently Added
In Progress
Open Access

This item is open access.

Adobe PDF

Download Published versionAdobe PDF (1.26 MB)

View on publisher's site

View statistics

Full metadata record

Field	Value	Language
dc.contributor.author	Miao, M
dc.contributor.author	Morrow, R
dc.contributor.author	Salomon, A
dc.contributor.author	Mcculloch, B
dc.contributor.author	Evain, J-C
dc.contributor.author	Wright, MR
dc.contributor.author	Murphy, MT
dc.contributor.author	Welsh, M
dc.contributor.author	Williams, L
dc.contributor.author	Power, E https://orcid.org/0000-0002-2638-0406
dc.contributor.author	Rietdijk, R
dc.contributor.author	Debono, D https://orcid.org/0000-0003-2095-156X
dc.contributor.author	Brunner, M
dc.contributor.author	Togher, L
dc.date.accessioned	2023-09-28T05:32:02Z
dc.date.available	2023-08-03
dc.date.available	2023-09-28T05:32:02Z
dc.date.issued	2023-09-19
dc.identifier.citation	J Med Internet Res, 2023, 25, pp. e46396
dc.identifier.issn	1439-4456
dc.identifier.issn	1438-8871
dc.identifier.uri	http://hdl.handle.net/10453/172364
dc.description.abstract	BACKGROUND: Acquired brain injuries (ABIs), such as stroke and traumatic brain injury, commonly cause cognitive-communication disorders, in which underlying cognitive difficulties also impair communication. As communication is an exchange with others, close others such as family and friends also experience the impact of cognitive-communication impairment. It is therefore an internationally recommended best practice for speech-language pathologists to provide communication support to both people with ABI and the people who communicate with them. Current research also identifies a need for neurorehabilitation professionals to support digital communication, such as social media use, after ABI. However, with >135 million people worldwide affected by ABI, alternate and supplementary service delivery models are needed to meet these communication needs. The "Social Brain Toolkit" is a novel suite of 3 interventions to deliver communication rehabilitation via the internet. However, digital health implementation is complex, and minimal guidance exists for ABI. OBJECTIVE: This study aimed to support the implementation of the Social Brain Toolkit by coproducing implementation knowledge with people with ABI, people who communicate with people with ABI, clinicians, and leaders in digital health implementation. METHODS: A maximum variation sample (N=35) of individuals with living experience of ABI, close others, clinicians, and digital health implementation leaders participated in an explanatory sequential mixed methods design. Stakeholders quantitatively prioritized 4 of the 7 theoretical domains of the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework as being the most important for Social Brain Toolkit implementation. Qualitative interview and focus group data collection focused on these 4 domains. Data were deductively analyzed against the NASSS framework with stakeholder coauthors to determine implementation considerations and strategies. A collaborative autoethnography of the research was conducted. Interrelationships between considerations and strategies were identified through a post hoc network analysis. RESULTS: Across the 4 prioritized domains of "condition," "technology," "value proposition," and "adopters," 48 digital health implementation considerations and 52 tailored developer and clinician implementation strategies were generated. Benefits and challenges of coproduction were identified. The post hoc network analysis revealed 172 unique relationships between the identified implementation considerations and strategies, with user and persona testing and responsive design identified as the potentially most impactful strategies. CONCLUSIONS: People with ABI, close others, clinicians, and digital health leaders coproduced new knowledge of digital health implementation considerations for adults with ABI and the people who communicate with them, as well as tailored implementation strategies. Complexity-informed network analyses offered a data-driven method to identify the 2 most potentially impactful strategies. Although the study was limited by a focus on 4 NASSS domains and the underrepresentation of certain demographics, the wealth of actionable implementation knowledge produced supports future coproduction of implementation research with mutually beneficial outcomes for stakeholders and researchers. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/35080.
dc.format	Electronic
dc.language	eng
dc.publisher	JMIR Publications
dc.relation.ispartof	J Med Internet Res
dc.relation.isbasedon	10.2196/46396
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	08 Information and Computing Sciences, 11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences
dc.subject.classification	Medical Informatics
dc.subject.classification	4203 Health services and systems
dc.subject.mesh	Brain
dc.subject.mesh	Humans
dc.subject.mesh	Brain Injuries
dc.subject.mesh	Data Collection
dc.subject.mesh	Communication
dc.subject.mesh	Adult
dc.subject.mesh	Brain Injuries, Traumatic
dc.title	Digital Health Implementation Strategies Coproduced With Adults With Acquired Brain Injury, Their Close Others, and Clinicians: Mixed Methods Study With Collaborative Autoethnography and Network Analysis.
dc.type	Journal Article
utslib.citation.volume	25
utslib.location.activity	Canada
utslib.for	08 Information and Computing Sciences
utslib.for	11 Medical and Health Sciences
utslib.for	17 Psychology and Cognitive Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health/GSH.Speech Pathology
utslib.copyright.status	open_access	*
dc.date.updated	2023-09-28T05:32:01Z
pubs.publication-status	Published online
pubs.volume	25

Abstract:

BACKGROUND: Acquired brain injuries (ABIs), such as stroke and traumatic brain injury, commonly cause cognitive-communication disorders, in which underlying cognitive difficulties also impair communication. As communication is an exchange with others, close others such as family and friends also experience the impact of cognitive-communication impairment. It is therefore an internationally recommended best practice for speech-language pathologists to provide communication support to both people with ABI and the people who communicate with them. Current research also identifies a need for neurorehabilitation professionals to support digital communication, such as social media use, after ABI. However, with >135 million people worldwide affected by ABI, alternate and supplementary service delivery models are needed to meet these communication needs. The "Social Brain Toolkit" is a novel suite of 3 interventions to deliver communication rehabilitation via the internet. However, digital health implementation is complex, and minimal guidance exists for ABI. OBJECTIVE: This study aimed to support the implementation of the Social Brain Toolkit by coproducing implementation knowledge with people with ABI, people who communicate with people with ABI, clinicians, and leaders in digital health implementation. METHODS: A maximum variation sample (N=35) of individuals with living experience of ABI, close others, clinicians, and digital health implementation leaders participated in an explanatory sequential mixed methods design. Stakeholders quantitatively prioritized 4 of the 7 theoretical domains of the Nonadoption, Abandonment, Scale-up, Spread, and Sustainability (NASSS) framework as being the most important for Social Brain Toolkit implementation. Qualitative interview and focus group data collection focused on these 4 domains. Data were deductively analyzed against the NASSS framework with stakeholder coauthors to determine implementation considerations and strategies. A collaborative autoethnography of the research was conducted. Interrelationships between considerations and strategies were identified through a post hoc network analysis. RESULTS: Across the 4 prioritized domains of "condition," "technology," "value proposition," and "adopters," 48 digital health implementation considerations and 52 tailored developer and clinician implementation strategies were generated. Benefits and challenges of coproduction were identified. The post hoc network analysis revealed 172 unique relationships between the identified implementation considerations and strategies, with user and persona testing and responsive design identified as the potentially most impactful strategies. CONCLUSIONS: People with ABI, close others, clinicians, and digital health leaders coproduced new knowledge of digital health implementation considerations for adults with ABI and the people who communicate with them, as well as tailored implementation strategies. Complexity-informed network analyses offered a data-driven method to identify the 2 most potentially impactful strategies. Although the study was limited by a focus on 4 NASSS domains and the underrepresentation of certain demographics, the wealth of actionable implementation knowledge produced supports future coproduction of implementation research with mutually beneficial outcomes for stakeholders and researchers. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/35080.

Please use this identifier to cite or link to this item:

http://hdl.handle.net/10453/172364