This project takes a user-centred approach through needs assessment, co-design, interviews, case studies and usability testing to design and develop a product range to help children with arthritis lead more active and independent lives.
Funded by Sheffield Hallam University, Lab4Living, NIHR CYP-MedTech and Sheffield Children’s Hospital
SHU supervisors: Dr Joe Langley and Nick Dulake External supervisors: Nathaniel Mills (NIHR CYP-MedTech) and Dan Hawley (Sheffield Children’s Hospital NHS Foundation Trust)
The problem Juvenile Idiopathic Arthritis (JIA) is one of the most common causes of physical disability in childhood (National Rheumatoid Arthritis Society, 2018) with between 1,000 and 1,500 children developing it each year in the UK (Silman & Hocheberg, 2002). Despite the commonality of the issue, arthritis in children is often trivialised with many products targeted towards older users highlighting an ignored cohort and the potential for new products.
The approach This research uses co-design, interviews, surveys through support groups, case studies, sketching, form modelling and prototyping to explore technologies and products to support children with arthritis and their families to enable them to live more active and independent lives. Participatory research methods involving children, families and clinicians has led to a range of prototypes being developed.
Paediatric conditions were focused on as children have an entirely different outlook on the world from adults (Cherry, 2018). For younger children, they often have an innate confidence in themselves, unconcerned about how things they do are perceived whilst their creativity is boundless as their imaginations aren’t curbed by rules of logic (Frost, 2016). As a result, this makes them an ideal target market due to their adaptability. For older children, whilst they are more concerned with their appearance and how their actions are perceived, their key driver is increasing their independence and exploring their world, which diseases like arthritis can limit. By encouraging certain behaviours such as self-management of a condition from a young age, it gets them adapted and into the routine. In adulthood then, these early experiences will give them confidence in managing their condition allowing them to live independent lives and reduce potential ‘crisis’ scenarios.
JIA was chosen as the condition as it is not an uncommon problem yet it is treated as such, with many children feeling stigmatised and isolated. The fact that it is a ‘hidden disease’ can lead to much disbelief with an often long wait to diagnosis- “I was in a lot of pain and started to get bullied as I was different” according to one child participant. With the formation of a new charity called Versus Arthritis in September 2018 following the merger of Arthritis Care and Arthritis Research UK, there was a refreshed campaign for recognition as the condition “steals from millions of people every day” (Versus Arthritis, 2018), the currency of the issue and the extent of the ignored cohort was emphasised, leading to the decision to focus on this area.
Users were at the heart of this project with initial research looking into the needs of the different stakeholders involved: the child, the parent/ carer, the healthcare professional and the teacher. Through this, it became clear how varied the key priorities were within the group:
The child wanted “something to help with pain so that [they wouldn’t] have to stop doing fun things”.
The parent/ carer, in addition to aids to distract from pain, also wanted something to help keep better track of the condition.
The healthcare professional wanted something to help motivate physiotherapy.
The teacher needed something to help with disbelief in the classroom.
Initial thoughts about briefs had centred on improving assessment, helping with everyday activities and reducing stigma. The priorities put forward by the stakeholders slightly altered the direction, driving the decision to develop four interventions simultaneously, with each targeting a key need put forward by each group:
Helping with pain management
A way to keep track more easily
Help with communication in the classroom
Through the duration of the six month timeframe, each brief was developed by Ursula to prototype level. Workshops with children who have arthritis and their families were held at the research, initial design, further development and final prototype stage in order to ensure the products were fulfilling a need as well as to tease out issues and potential improvements. Technical requirements were tested and tweaked to ensure both ease of use and safety whilst the forms were explored through physical models and sketching, taking into account both ergonomic factors of gripping difficulty and aesthetic drivers of wanting something discreet but that also validated their condition.
Outcomes Four prototypes were developed as part of the final year project:
Heat- FIX: A wearable device that helps to distract the brain from the joint pain during a flare. It can be wrapped around any joint and fastened securely in place.
“The warmth of it is really soothing- I love the degree of control.”
(child participant with arthritis)
Active- FLEX: A motivational physio tool that has an additional link to a character on the app helping to gamify and incentivise an otherwise “boring” chore. The colours are bright and energising with the gripping texture ensuring ease of use.
“I hate nagging her to do her stretches- this way she’d want to do them.”
(parent workshop participant)
Class- COMM: A wearable to help facilitate communication between the pupil and teacher when the child is in pain/ needs help. With a form similar to a Fitbit, the wearable is discreet, helping to reduce feelings of embarassment.
“Teachers have forced her to do PE as they weren’t aware – this would help with disbelief.”
JA- CONNECT: An app with different versions for parents and children to both help keep better track of the condition as well as to create a network so that parents and children don’t feel so isolated in their experience.
“The first thing that clinicians ask when I mention a symptom is ‘do you have a photo?’. This would really help in tracking changes.”
“Being able to pass tips onto other kids would be so great.”
“The University, though the Lab4Living research group, already have a strong relationship with both Sheffield Children’s Hospital and NIHR CYP-MedTech, collaborating on a range of projects with both. This enabled Ursula to benefit from research input to her undergraduate work at organisational, operational and technical levels of her project. Subsequently, following graduation, Lab4Living has provided a ready route to enable Ursula to continue her project through to implementation.
(Dr Joe Langley, Lab4Living)
The future This project has been awarded funding from NIHR CYP MedTech through Sheffield Children’s Hospital, to further develop the product outcomes, which started in October 2019. The development will focus on improving the technology whilst also looking at the connectivity aspect of the products with the app platform. The first goal is to carry out a pilot study, the results of which can then drive further improvements, with the hope being that these products will ultimately go to market.
An evidence-based group programme created by occupational therapists and people with dementia for individuals at an early stage of their dementia journey.
Partners: Alzheimer Scotland Team: Claire Craig & Helen Fisher
Journeying through Dementia is an occupation-based intervention that aims to support people at an early stage of their dementia journey to engage in meaningful activities and maintain community connectedness.
The programme was developed in partnership with people with dementia who spoke of the value they attached to continued participation in everyday occupations and in new learning. Throughout all the co-creation activities, people with dementia were clear that wanted to have the opportunity to access groups that did not just talk about the diagnosis but that offered practical advice and support of how to continue to live well with the condition.
This intervention directly supports delivery of ambition 1 of Connecting People, Connecting Support (Alzheimer Scotland 2017) of enhanced access to enable people to be supported to look after their own health and wellbeing.
Emphasis throughout is placed on ‘doing’ rather than simply talking about strategies and challenges. Individuals are given the opportunity to put ideas into practice either within the group or through organizedout of venue activities. This helps to build confidenceand also encourages active problem solving. The community is seen as a place where skills are enacted and the place where individuals can access a wide range of resources to support roles, maintain and develop relationships and to experience enjoyable leisure activities, which support well-being.
Pilots have been carried out in Scotland with Alzheimer Scotland, Fife Health & Social Care Partnership and NHS Grampian, and the South Carmarthenshire Older Adult Mental Health Team, based in Prince Philip Hospital, Llanelli, Wales. The following video features our Llanelli Journeying Through Dementia Group.
Journeying through Dementia was inspired by a growing number of people living with dementia who were meeting together in their communities to offer each other support. This approach was best exemplified by the work of the Scottish Dementia Working group.
Gail Mountain and Claire Craig (2004) had successfully undertaken research to develop and facilitate an occupation based group aimed at community living older people called Lifestyle Matters which had enabled individuals to connect with valued occupations in later life and to adapt and enact meaningful occupations in the community and this raised the question whether a similar model (peer sharing, group work and didactic teaching) could be used with people with dementia.
Claire Craig then worked nationally with people living with the condition to build understanding of what people with a recent diagnosis of dementia identified as being helpful or resources and support they felt would have increased their quality of life. The results are reported in a paper: What should be in a self-management programme for people with early dementia? (Ageing and Mental Health, 2012)
This research then formed the basis from which Claire Craig developed the initial Journeying through Dementia Intervention. For the next ten years small pieces of funding supported the refinement of the programme and a total of six groups were facilitated, each time people with dementia gave feedback and helped Claire and Helen shape the final iteration of the programme and kit of resources that you see before you now.
With special thanks to Design Futures Packaging for bringing the resources to life.
When I go home from here, I feel better and do more. The more you do, the more you can do.
Journeying through Dementia participant
I feel we’re helping one another, being on the same wavelength. I have new friends I don’t think I will ever forget.
Funders: National Institute for Health Research (NIHR) Invention for Innovation (I4I) Grant
Partners: North Bristol NHS trust, University of the West of England, University of Oxford, Devices4Dignity, Sheffield Teaching Hospitals NHS trust
Project team: Joe Langley, Rebecca Partridge, Ursula Ankeny, Naomi Rasyzk
GPs diagnose Urinary Tract Infection (UTI) in patients based on their symptoms. Often a urine sample is sent to a laboratory to be checked for infecting bacteria and white blood cells. This current method can take up to three days. As the patient has ongoing symptoms, the GP will sometimes prescribe antibiotics before the laboratory result is back. If this result shows no infection then antibiotics could be harmful to the patient and this use of unnecessary antibiotics adds to the increasing risk of antibiotic resistance.
Partners at the University of the West of England are developing the technology for a device which can be used in primary care settings to identify UTI bacteria and inflammation. Lab4Livings role in the project is User design, Co-design and PPI engagement.
It is not currently possible to confirm UTI diagnosis at the point-of-care, as testing strategies, e.g. urine dipstick tests and clinical presentation, are non-specific. In practice, clinicians frequently prescribe antibiotics without clear-cut diagnosis, risking over-prescription (if the diagnosis was wrong), or potentially the wrong antibiotic (non-sensitive bacterium).
A mounting Public Health concern has identified multi-drug resistance due to inappropriate prescribing. Worldwide, scientists are anxious about the rise in “superbugs”, which may be caused by the overuse of antibiotics.
Through workshops and direct practice visits across Sheffield and Bristol the team has been exploring current testing practices around UTI. Seeking to understand user wants and needs from the potential device and looking for future opportunities in this sector that the introduction of such device much uncover.
Developing a new Parkinson’s service delivering home-based care. Using new technology the service will help Parkinson’s patients, carers and healthcare staff monitor a person’s condition remotely – ensuring care remains person-centred. This enables them to ask for contact and review at times they need it, removing the need for time-locked clinic reviews that fail to meet the needs of patients and carers, and contributes to staff stress.
Funded by : The Health Foundation Parkinson’s UK
Project team: Joe Langley Rebecca Partridge Ursula Ankeny
This project follows on from the previous project with Parkinson’s services in the South West Peninsula. These workshops uncovered issues in the way the service is currently run, with time-locked clinics, cancelled and delayed specialist appointments, vacant staff posts and arduous journeys to clinics for patient and carer.
Lack of clinic capacity results in limited ability to see those who require urgent review. Even when clinic review is timely and appropriate, the evaluation only captures how the patient is within those few minutes, and is otherwise dependent on patient recall, which can lead to erroneous assessment and inappropriate interventions. This sub-optimal provision of care contributes to staff dissatisfaction, stress and poor retention, which is a cause of significant threat to PD service resilience nationally, with 50% of PDNS vacant posts being due to long-term sick leave or resignation.
This project seeks to develop a new service that monitors symptoms on a monthly basis. It will use a Parkinson’s Kinetigraph (PKG®) a wrist worn, watch style device to monitor motor symptoms and a series of questionnaires for non-motor symptoms. Through this system patients will only need to attend a clinic when required and instead will be supported to self-manage minor changes and fluctuations supported remotely.
Through a series of workshops and prototypes, our role within the project has been to help the team develop the new service pathway, understand users’ needs and then co-design a series of training, support and learning resources with staff and patients. These will provide support information on the new pathway and signpost to self-management resources.
The project is due to recruit the first 30 patients to the pathway in September with a further 120 recruited later in the year.
The 100 Year Life Project will exploit and advance the role of design research in enabling older people to lead longer, more productive lives – the longevity effect. Lab4Living has been awarded funding by Research England through their Expanding Excellence in England (E3) fund to support the strategic expansion of research in this area.
Funded by: Research England
Due to higher life expectancies the number of people expected to live to be 100 will increase significantly by 2066. The changing demographics and structure of the population will bring many challenges to society, the economy and services. However this will bring new opportunities for the emergence of new markets, increased involvement in volunteering, longer working lives and possibly providing care for family members. Individuals will need to plan their life and retirement differently with existing ideas of ageing being replaced with models of a multi-stage 100 year life (birth, education, work, education, training, work, career break, education and training).
Age related products, new housing models and care technologies which enable older people to lead more independent fulfilled lives will be considered within this project answering questions on what these products are, how multi-sectorial groups of people will work together, what standards and quality assurances are required for these products and services and how this knowledge is shared across sectors.
“One in three children born in the UK today can expect to live to be 100 – and by 2066 one in two children will reach this milestone. We need to look at what this expanded life-span will mean for where and how people live; what products will they use; what the implications are for health care, communities, and, of course, the home.”
Prof Paul Chamberlain
Focusing on informing the scale and scope of the Future Home, the project will generate ideas for new aspirational products, protocols and interventions which meet the physical, cognitive and emotional needs of an ageing population within the Future Home.
This project, funded through the Getting Research into Practice (GRIP) programme, explores ways to promote exercise in stroke survivors living in Sheffield (UK), using co-production workshops.
Funded by: Getting Research into Practice (GRIP) funding programme through National Institute for Health Research Collaborations for Leadership in Applied Research and Care Yorkshire and Humber (NIHR CLAHRC YH). Partners: Gavin Church – stroke specialist physiotherapist, Sheffield Teaching Hospitals NHS Trust; Ali Ali – stroke consultant, Sheffield Teaching Hospitals NHS Trust.
Lab4Living team: Remi Bec and Joseph Langley collaborating with Mark Fisher, course tutor, BA (Hons) Product Design
Stroke is the 4th leading cause of death and the leading cause of adult disability in the UK, affecting 152,000 individuals annually and costing the UK health economy nearly £9 billion. A quarter of these strokes are recurrent and often preventable if secondary vascular risk is optimised.
It is established that physical inactivity is an independent risk factor for primary and secondary stroke and that exercise limits secondary vascular risk by reducing blood pressure, cholesterol and weight. Yet less than half of adults over the age of 65 years in the UK achieve the recommended levels of activity, and this declines further after stroke and transient ischaemic attack.
This project aims at exploring ways of promoting exercise in stroke survivors living in Sheffield, using co-production workshops. Based on the experiences of Sheffield based service users, we aim to understand the current delivery of exercise after stroke, and the myths and enablers/barriers, and to explore ways in which the service could be improved using co-production methods.
The multidisciplinary core team was composed of two health professionals (consultant and physiotherapist) and two designers who co-facilitated a series of five workshops.
Throughout the duration of the project, 71 people have been involved. At least 15 participants took part in each workshop, gathering together stroke survivors, health care professionals, exercise prescribers, social services, commissioners, medics and the voluntary sector. A group of 10 final year product design students was involved in the final two workshops.
This design-led project used co-creative methods throughout a series of divergent and convergent thinking based onto the double diamond (Design Council, 2005) approach. Based on the experiences of the services accessed by these people in Sheffield, the team learned about current delivery of exercise after stroke, considered the myths and enablers/barriers, and explored ways in which the service might be improved using co-production methods with all participants.
Eight Product Design students on the final year module ‘Graduation Design Project Portfolio’ collaborated in the project, which contributed to their final year portfolio. The students self-select from a range of projects, based on their interests and skillsets.
We always try to offer final years a live project experience and for the past few years have offered a range of briefs. The briefs range from a live project with a product design company, an enterprise project, through to the GRIP project which offers more of a service design opportunity.
Mark Fisher, BA Hons Product Design course tutor
In the second phase of the project, the students were paired with stroke survivors and healthcare professionals to develop their own brief. While briefs were developed independently for individual student assessment purposes, the briefs needed to be complementary and brought together as a single entity for development in phase three. Phase three is ongoing and focuses on securing funding to create one proof of concept to prototype and test in stroke wards.
Based on the insights gathered throughout the first three workshops, an ideal service was mapped out in a visual way. As part of this service, four touchpoints/briefs were developed by the students:
A staff training package to make sure the correct information is delivered by health practitioners at the right time and with the right language – Julian Lee;
A Stroke passport for patients that can be customised based on their preferences and goals and that could also be used as a log book – Joe Boniface and Daniel Lomas;
An animation video raising the benefits of undertaking exercise – John Williams and Emily Bough;
A multifaceted intervention (e.g. at the hospital, at home) – Dayna Booth, Ursula Ankeny and Tyra Spain.
I have learned more about the research process of design. The ways in which you can use the comments from the target market earlier on to shape the direction of the project.
For the students, the project offered a rich, live learning experience that challenged them to use the design skills and approaches learned on their product design course and apply them to a complex service scenario.
What was particularly interesting was how the students responded to the challenge of developing a range of service touchpoints with strong consideration of complex user requirements instead of focusing on developing a tangible outcome.
Mark Fisher, BA Hons Product Design course tutor
The students worked alongside stroke survivors to co-develop creative ideas in a truly immersive experience. They benefited from the support of the research and healthcare professionals, particularly making use of the invitation to regularly attend the Royal Hallamshire Hospital acute stroke ward to get feedback on their service design concepts from a wider clinical team.
When asking questions or using activities to find out information you have to ensure that you facilitate in a way that allows them to respond in a bit more depth if possible e.g. sometimes they may need a few prompts
Final year student participant
From working with the stakeholders, students gained valuable insights including eliciting user experiences and understanding requirements, considering ethics, collaborating with clinicians and facilitating workshops.
Students were able to reflect on working with users, clinicians and reported that the project had broadened their thinking and opened up a whole new area of design.
It’s been the most interesting project across all three years of university as although we’ve have live projects before, this one feels the most ‘real world’ and worthwhile as it’s helping people who seem to appreciate what you are trying to do.
Final year student participant
Work is ongoing; phase three activity is focussed on final development and implementation of the staff training package and patient facing outcomes.
This research seeks to understand the benefits that design and digital technologies might bring in offering new ways to, firstly, express a sense of who they are in the present, and, secondly, to make objects and media content that will support other people after one’s death
Funded by EPSRC
Partners: Northumbria University; Newcastle University; BBC; Marie Curie; CRUSE Bereavement; National Council for Palliative Care
Project lead: Claire Craig
Project team: Helen Fisher
The project is a design engagement with older people,
people living with dementia, people approaching the end of their lives and
people who are bereaved.
We are living in a time when life expectancy is the highest it has ever been (81.5 years average life expectancy in the UK).
However, this positive achievement of medicine and modern ways of living means that as the nature of growing older is changing, so too is end-of-life. Whilst promoting the inclusion of older people in society enriches our social make-up it also gives rise to new challenges.
For example, there is an increasing demand for care, but reductions in resource available to support the older old and a reduction in people using local authority supported care services.
In terms of bereavement, studies have identified a huge hidden cost associated not only with increased mortality of the bereaved but also their increased hospital stay and bereavement-related consultations. In Scotland alone this hidden and latent cost translates into £20 million per year.
Of the 500,000 people who die each year in the UK, currently around 92,000 die with unmet needs for palliative care. The increasingly complex needs of more people who are living longer with life-limiting conditions is positioned by Hospice UK as a current grand societal challenge as the demand for care at the end of life is set to rise steeply between 2016 and 2025.
“This research addresses the big questions to interrogate the meaning of life and death in the digital age”
Personal digital content and assets are continuously being created, by us and around us. Through social and personal media we are creating status updates, voice recordings, conversations, videos, photographs and blogs which all contribute to the coalescence of a digital trail and identity. However, what we cannot purposefully do is curate these digital assets to specifically support a sense-of-self, help people deal with their own approaching end-of-life, nor help others deal with bereavement.
This research study therefore seeks to work with individuals facing major life transitions to help curate their digital content through a creative process to embed this within a series of personal digital artefacts that the person will own and which will support them at points of transition (e.g. following bereavement, managing a long term condition).
This project sought to build understanding of the experiences of older people accessing services and to gain insight into some of the factors that led to non-attendance of appointments. The research aimed to improve the experience of older people with complex needs who use outpatient services at the Royal Hallamshire Hospital in Sheffield. The aim of greater respect for users’ dignity was particularly important.
Funded by: National Institute for Health Research (NIHR) Partners: Mark Cobb, Clinical Director, Sheffield Teaching Hospitals Project team: Dan Wolstenholme, Andy Dearden, Simon Bowen, Helena Soustar, Matt Dexter
Missed appointments are a significant issue for the UK National Health Service. Not only can this compromise treatment for individuals but it also carries a significant financial cost.
Better Out Patient Services for Older People (BOSOP) sought to build understanding of the experiences of older people accessing services and gain insight into some of the factors that led to non-attendance of appointments. The research aimed to improve the experience of older people with complex needs using outpatient services at the Royal Hallamshire Hospital in Sheffield. The aim of greater respect for users’ dignity was particularly important.
Researchers utilised a range of creative methods to elicit
the experiences of older people and key stakeholders who participated in the
study including emotion mapping, patient narratives and participatory theatre.
These methods sat within the broader methodology of Evidence Based Design (EBD)
as developed by the NHS Institute for Innovation and Improvement.
BOSOP enabled patients and staff to develop proposals to
improve patient experiences including a new appointment letter.
Dr Joe Langley’s three year fellowship explored the added value of design and making as a form of facilitating co-produced research, and of sharing, synthesising and activating knowledge within participants, systems and organisations. This work resulted in personal development in co-design and co-production and had a particular focus on the impact activities could have on relationships and systemic power structures.
Funded by: National Institute of Health Research (NIHR)
Partners: NIHR CLAHRC YH, Royal College of Midwives, The University of Sheffield, Bradford Royal Infirmary, Sheffield Children’s Hospital, NIHR Devices for Dignity HTC, TITCH Network
Project team: Dr Joe Langley
Background to the NIHR Fellowship programme
£8 billion per year is spent on health-related research and there is increasing pressure to demonstrate a return on this investment. Yet translation of health services research knowledge into everyday practice remains a challenge.
The fellowship programme aims to advance knowledge and understanding about research use, influence and impact. It looks at how research can be blended with other knowledge, such as professional practice and patient experiential knowledge. This opens the door for participatory and co-produced research methods in particular.
Through the Knowledge Mobilisation Research Fellowships, the NIHR enables up to five individuals to explore the mechanisms, barriers and enablers of Knowledge Mobilisation and to mobilise some health services research knowledge into everyday practice.
“Making things together is a great leveller.”
Prof Jo Cooke, mentor
Joe Langley’s three year Knowledge Mobilisation Research Fellowship was the first to be awarded to a researcher from outside the health disciplines. The fellowship has explored the added value of design and specifically making, within the context of co-produced research; of sharing, synthesising and activating knowledge within participants. Joe’s interest in this is focused on the creative, practical activities of ‘making’ employed by designers and applying them in participatory health research and innovation.
During the course of the fellowship, Joe’s research began to focus in particular on the impact those activities could have on relationships, systemic power structures and hierarchies in health and in wider society. The prevailing mode of communication within many such hierarchies is written and spoken language, a mode of communication associated with knowledge – and therefore power.
“This was an amazing opportunity for me to really get ‘inside’ this complex and, initially, slightly alien field. I have a far greater understanding, met some inspirational people, established great relationships and have been able to open doors to expand the work I do.”
(Dr Joe Langley)
Language is often used (consciously and unconsciously) as a means of excluding different ‘tribes’ of people, creating impenetrable barriers of sounds or ciphers that demonstrate (often academic or intellectual) ‘expertise’ whilst ignoring expertise by lived experience.
Design uses a visual language form of communication to share ideas, knowledge, information and complex concepts. In addition, design practice also uses the activity of making things (prototypes, doodles, mock-ups) as a means of thinking, reflecting and considering specific questions and challenges.
When such practices and techniques are shared with other stakeholders in a co-design initiative, and designers or design researchers take on a facilitating role, it achieves two principal things:
making activities enable people to reflect on questions, experiences and
complex ideas before they respond to the question or challenge posed. Hence
their responses are more considered and
they often realise tacit or unconscious knowledge about their experiences that may
not have been revealed through other, more direct forms of enquiry
things they make become part of the
visual mode of communication that augments their ability to collaborate with
others from different backgrounds, creating a more level playing field
This fellowship brings together knowledge, understanding and expertise from multiple worlds:
clinical practice (healthcare delivery)
health services research
implementation, knowledge translation or knowledge mobilisation research
“I am still challenged and sometimes frustrated by a common academic view of the Journal paper as the end goal; as ‘impact’. Sometimes this view is held because it is just very difficult to translate knowledge (words on paper) into actions. There is no escaping this; it is hard. But this is what designers and engineers do. Their disciplines are translational, and there is an opportunity for more academics to collaborate with designers and engineers in their research from the start, not as an afterthought.”
Dr Joe Langley, Knowledge Mobilsation Fellow
Some of these
worlds were less familiar to Joe. Hence, Joe’s methods were aimed at increasing
familiarity with the first three areas and then experimentally utilising the
design methods within them (in co-design settings) to gain an understanding of
what was happening from a Knowledge Mobilisation (KMb) perspective.
“I come from an engineering background and now use design and co-design practises within my research, working with Health Research Scientists, clinicians and patients. This gives me opportunities to use hybrid methods drawing on all these areas. This fellowship has given me a far broader appreciation of how different disciplines, expertise and world views can be woven together to create holistic knowledge that is pragmatic, relevant and works in-practise-in-context.”
Dr Joe Langley
review, which focused on the area of Implementation and KMb, together with participation
at a range of national and international research, clinical and innovation forums
in these areas (including Garfield Innovation Center, Kaiser Permanente, San
Francisco; Karolinska Institutet Stockholm, Mayo Clinic, Rochester,
USA), rapidly increased
Joe’s understanding of Knowledge Transfer (KT), Implementation Science and KMb
(in the field of healthcare).
in a Metabolic Bone centre in Sheffield Teaching Hospitals NHS Trust,
collaborations with YH CLAHRC and undertaking a number of case studies
increased Joe’s understanding of clinical practice and health services
During the fellowship, Joe was mentored by experts from different fields of expertise
Prof Jo Rycroft-Malone (Pro Vice-Chancellor, Research & Impact & Professor of Implementation & Health Services Research, Bangor University) – implementation science
Prof Jo Cooke (Deputy Director and Capacity Lead, NIHR CLAHRC Yorkshire and Humber and Honorary Professor of Health and Social Care Research, Sheffield Hallam University) – applied health research
Prof Paul Chamberlain (Director of Art and Design Research Centre and Lab4Living) – design research
“When Joe was awarded his knowledge mobilisation fellowship the contribution of design thinking and science to implementation research had not been explored. This has changed significantly, largely due to Joe’s work in raising the profile and potential of design science.
During this time it has been a pleasure to work alongside Joe. His creativity, energy and enthusiasm has brought some much needed fresh thinking to how we can improve health and care services through genuine partnerships and the co-creation of knowledge.”
Professor Jo Rycroft-Malone, Mentor
Five case studies emerged through the collaboration with YH CLAHRC and enabled Joe to apply and ‘play around with’ design and co-design practices in health service and health services research initiatives.
Improving midwifery services with and for mid-wives and expectant women – see below
Developing a mental capacity assessment support tool (MCAST) with and for speech and language therapists in community and hospital settings – see below
Development of a testicular volume assessment tool and training kit – see below
Designing gamified smart inhalers with and for school age children – resulting in concepts and working prototypes
Designing an emotional support tool with and for patients on an acute cardiac ward – resulting in concepts and working prototypes for a complex support tool that includes peer networks, paper and digital based components for patients and family members.
Case study #1
Better Births by Design: Improving midwifery services with and for mid-wives and expectant women
In this case study, which focused on improving midwifery services, two midwifery teams (one community team in Colchester and one hospital based team in Preston) participated and were trained and mentored in using co-design as a means of improving their services. An evaluation was carried out by an independent academic from Bangor University nine months later with positive outcomes.
2 years on and both teams still tweet about their co-design and improvement activity.
Case study #2
MCAST: Developing a mental capacity assessment support tool
A toolkit for assessing mental capacity has been developed with and for speech and language therapists in community and hospital settings. The toolkit is currently being tested/evaluated via a clinical trial in Sheffield Teaching Hospitals.
2 years on and both teams still tweet about their co-design and improvement activity.
“I have really enjoyed working with Joe. Using design in health services research has been highly insightful and formative in our thinking about co-production in the CLAHRC, as you can ‘see’ authentic partnership working in action. The process of making things helps to uncover people’s ideas and thoughts, to share them, and provide opportunities for synergy. Making things together is a great leveller and pays attention to power issues in the sharing process.
Design and design thinking should be an important consideration in the shape of future health service research teams.”
Professor Jo Cooke, Mentor
Case study #3
Testicular Volume Assessment: Development of an assessment tool and training kit
In this case study, a prototype simulation model was designed and built to test the accuracy of paediatric endocrinologists’ volume assessment. Once data was collected and evidence of inaccuracy established, we explored alternative approaches to training, co-designing (with endocrinologists and students) a package that included simulation and physical analogies based on everyday objects.
This was piloted in 2017 with one cohort of trainee Paediatric medics and is currently being revised based on the feedback.
Related research on Sheffield Hallam University’s Research Archive
Langley, J., Wolstenholme, D. Partridge, R., Wheeler, G., Bec, R., ‘How can creative co-production processes help to elicit, share and blend different forms of knowledge?’ a workshop for UK Knowledge Mobilisation Forum, Bristol, 6-7 Mar 2018
Ward, V., Harris, J., Carter, L., Dziedzic, K., Jones, C., Lang, I., Langley, J., Wye, L., “Using a story method for critical reflection: lessons and insights from NIHR Knowledge Mobilisation Research Fellows”, Organisational Learning, Knowledge & Capabilities, St Andrews, Scotland, 26-28 April 2016.
Lifestyle Matters is a research based intervention which equips community living older people with the skills to re-design their day to day lives.
Funded by Medical Research Council Partnered with University of Sheffield & University of Bangor
Team Lead: Claire Craig
Global ageing has been described as the greatest triumph and challenge of the twenty-first century (World Health Organisation). There is strong evidence to suggest that when older people are supported to engage in meaningful activity they experience increased quality of life and mental wellbeing.
Lifestyle Matters is an intervention aimed at helping older people to help each other to live life to the full. Comprising of group and individual sessions, community living people are enabled to explore the relationship between meaningful activity, health and wellbeing and redesign their lifestyle to embed health-promoting changes into everyday routines.
Research was undertaken in 2005 to build understanding of the experiences of older people, and the intervention was co-designed with older people (Craig and Mountain). Findings of an initial study based on this research showed that the approach empowered community living older people to examine their lives and to re-design the way that everyday activities were undertaken to accommodate some of the physical, emotional and cognitive challenges they faced as a consequence of ageing.
Between 2011-2015 the intervention was the subject of a pragmatic, two arm parallel group individually randomised controlled trial (RCT) (Lifestyle Matters vs standard care). In addition to quantitative health outcomes, a purposeful sample of 13 participants aged between 66 and 88 years from the intervention arm of the RCT were interviewed.
“Lifestyle Matters for me was a pointer, a signpost to my future as a single older person giving me some answers to what I might do and what I could do and I would recommend it to anyone.”
(Lifestyle Matters intervention interviewee)
The interviews revealed that the majority of interviewed participants were reportedly active at 24 months, with daily routines and lifestyles not changing significantly over time. All participants described benefit from attending Lifestyle Matters, including an improved perspective on life, trying new hobbies and meeting new friends. A number of intervention participants spoke of adapting to their changing circumstances, and there were significant and lasting benefits for a number of the intervention participants interviewed.
Cited as the intervention of choice
The intervention was cited in the National Institute of Clinical Health Excellence Guidelines (2008 and 2015) as the intervention of choice to promote mental well being in community living older people.
Commissioned in the UK, used world-wide
The programme is commissioned by mainstream services in the UK and is used all over the world
Related research on Sheffield Hallam University’s Research Archive