Stefan Elbers

118 Chapter 5 influence their motivation and engagement. Moreover, patients, policy makers, and HCPs can experience conflicting interests during intervention development projects, because the assumed best possible care is generally limited by finite resources or specific treatment guidelines within a particular health care environment (Greger & Hatami, 2013). Factors such as these could endanger the main principles of co-design and should be further examined in the context of health care (Boyd et al., 2012; Donetto et al., 2015). Co-Design in the Context of Chronic Pain In the present project, called the SOLACE project (grant number: SIA RAAK 2014-01-23), we developed a relapse prevention intervention for patients with chronic musculoskeletal pain who participate in an interdisciplinary, multimodal pain treatment program. The primary reason for adopting a co-design approach was that, despite high prevalence rates of relapse after successful treatment, there is a paucity of available research to explain relapse for this particular population (Morley, 2008; Turk & Rudy, 1991). In these situations, a design-based approach may be particularly appropriate, because it allows for new insights to be recursively fed into future development cycles, thereby gradually increasing the knowledge base over time (Barab, 2014; Stappers & Giaccardi, 2017). Because patients with chronic pain often experience distrust from their personal and medical environment (Toye et al., 2017), co-design may also prove effective in empowering patients to participate in the development process and to actively share their opinions and ideas (Eyles et al., 2016; Verbiest et al., 2018). Objectives To increase understanding of how co-design can be successfully applied in the development of interventions in the health care domain, more examples of good practice are needed (Brett et al., 2014; Donetto et al., 2015; Robert &Macdonald, 2017). Therefore, our research question was to what extent co-design practices facilitate the translation of meaningful stakeholder experiences into the design of a health care intervention. Our first aim was to provide a detailed overview of all co-design activities that were employed during the course of an example project. Our second aim was to reflect on this overview and examine how co-design may contribute to stakeholder involvement, generation of relevant insights and ideas, and incorporation of stakeholder input into the intervention design. We hypothesized that co-design activities would facilitate the generation of relevant experiences and insights from stakeholders and stimulate their active participation during this project. Consequently, we expected that this would yield prototypes that were aligned with clinical practice and would resonate with end users.