R2Play-Rehab: co-designing a multidomain integrative active rehabilitation tool for concussion

To adapt a multidomain concussion assessment tool (R2Play) for integrative active rehabilitation (R2Play-Rehab) through co-design by: (1) Understanding clinician perspectives on intervention opportunities; (2) Prioritising intervention opportunities on relevance, impact, and implementation; (3) Gathering design requirements; and (4) Prioritising design requirements.

This mixed methods study followed the Generative Co-Design Framework for Healthcare Innovation. Phase 1 (pre-design) - co-design activities were planned with clinician partners and youth advisors. Phase 2 (co-design) - clinician participants were recruited to complete practice reflections and attend virtual design meetings. Phase 3 (post-design) - design meetings were analysed qualitatively and follow-up survey administered to verify and quantitatively prioritise analysed findings.

Eleven clinicians (3-30 years' experience; 7 women) from diverse clinical disciplines participated. Twenty-six field kit reflections were submitted, with each participant contributing between 1 and 5 submissions. Nine unique intervention opportunities were identified across three themes (in order of priority): (1) Enabling integrative rehabilitation; (2) Facilitating the return to play process; and (3) Promoting motivation and engagement in rehabilitation. Twenty-three design requirements were generated and organised into 10 grouped categories, with highest priority assigned to measuring and communicating progress, customising programs, scaling task demands, setting goals, and ensuring safety.

Findings revealed important clinical challenges in concussion care and highlighted opportunities for novel integrative active rehabilitation approaches, which may inform future research, policy, and rehabilitation strategies. Our co-design approach enabled sustained clinician engagement and provided highly contextualised insights about real practice issues. This process may be useful for engaging end-users and integrating their perspectives in designing healthcare innovations.