Stefan Elbers

127 Co-designing relapse prevention strategies components from each rudimentary prototype (e.g., a prompt to set calendar reminders after a goal-setting procedure) and coded these according to the Behaviour Change Technique Taxonomy V1 (see page 15 in Appendix 1) (Michie et al., 2013). Subsequently, they determined how to transfer the components to a workbook version and performed literature searches to find ideas for optimizing the effectiveness of each component. For example, to assist the formulation of personal values, various value generation procedures were found (e.g. Chase et al., 2013) and integrated into the prototype. In addition, the core team checked to which extent the list of intervention components corresponded with the themes of the interview dataset. Of the 19 intervention components, 17 components were related to one or more themes from the dataset, and 27 of the 45 themes were related to one or more intervention components. For example, 4 components in the goal-setting intervention, including specific probing questions to help formulate meaningful values, were associated with the theme “remembering important goals and values after treatment.” A designer, a text editor, and 3 HCPs provided feedback with the conversion to a paper workbook intervention and respectively focused on the design, readability, and appropriate terminology. In Appendix 1, page 16 shows examples of the 2 included strategies: the value-based goal forms (b and c) and the Insight Cards (d). Reflection. Previous difficulties with recruiting sufficient patients for co-creation sessions caused us to search for alternative ways to include their viewpoint. The personas proved a useful method to incorporate various patient perspectives by proxy during the evaluation of the rudimentary prototypes. Furthermore, the validation check indicated that the majority of the intervention components could be traced back to the original stakeholder themes from the interventions in the “Discover” phase and vice versa. This illustrates that stakeholder input has been incorporated in the design. However, the decision to combine both prototype ideas into one intervention was unexpected, which resulted in last-minute planning and consequently in limited stakeholder involvement during the design of the workbook. This may threaten the usability of this prototype in clinical practice. DISCUSSION Principal Findings The primary aim of this study was to reflect on the value and function of co-design methodology during the development of an intervention that prevents relapse after successful pain treatment. In the analysis, we focused on idea generation, stakeholder involvement, and the incorporation of stakeholder input within the development process. Overall, the generative techniques that were employed supported patients and HCPs with sharing their perspectives on pain treatment and relapse, which was in line with