Stefan Elbers

124 Chapter 5 phase 1, 60 students divided over 16 teams formulated hypotheses based on the previously collected data and designed provotypes to test their ideas with both healthy participants and patients with chronic pain (see page 5 of Appendix 1). At the start of each week, they updated their provotypes based on the received feedback. During the final project session, all teams presented their final provotypes as well as their collected insights to members of the consortium. Reflection. In phase 1, we were able to create a large qualitative dataset. This dataset not only contained experiences and ideas of stakeholders but also included specific feedback in response to multiple provotypes on a wide array of topics. The consecutive planning of the 3 key activities enabled us to iteratively expand our insights on relapse after pain treatment: Interviews were prepared by using the insights from the kick-off sessions, and the student teams could build upon the preliminary analysis of the available interview data. The participating stakeholders responded positively to the co-design approach and cooperated actively during the sessions and interviews. Despite their inexperience with co-design, the sessions were considered accessible, pleasant, and relevant. However, medical ethical screening procedures and personnel deployment planning limited the possibility for last-minute requests or invitations for including HCPs and patients. The obtained dataset of patient and HCP responses also contributed to a deeper understanding of relevant factors related to relapse, which provided a solid base for further intervention development. For example, the interviews revealed important contextual information such as a “feelings of emptiness after treatment,” “difficulties sharing treatment experiences with friends and family,” and “the different context between the rehabilitation center and the personal environment.” Phase 2: “Define” Description. The “Define” phase lasted for 1 month and started with thematically organizing the interviews by means of open coding by the core team (see page 6 of Appendix 1) (Braun & Clarke, 2006; Gale et al., 2013). This resulted in 8 main themes and 45 subthemes of factors associated with relapse after successful treatment (see page 8 in Appendix 1). To facilitate subsequent co-design activities, the themes were rephrased as questions, plotted on posters, and illustrated with exemplary quotes and figures (see page 8 in Appendix 1 for an example). In addition, the core team developed a set of 74 stimulus cards that were designed to facilitate the discussion of specific insights or principles (Coughlan et al., 2007): 36 cards contained insights from the student project, 15 cards contained relevant theory on behavior regulation, and 23 cards contained theory related to chronic pain treatment (see page 9 in Appendix 1). Subsequently, patients (4), HCPs (4), researchers (9), designers (6), and students (3) were invited for a co-creation session (see page 10 in Appendix 1). During the first assignment, participants were asked to examine