Date Presented 04/02/2022

Consumer-driven apps can improve practice efficiencies. We are using participatory action research (PAR) with purposefully recruited six-person teams to engage in a look-think-act-reflect process over a 3-year project with HESTIA NextGen apps. PAR outcomes are catalytic to the development of taxonomy, processes, intervention development, and app validation. Rigorous, consumer-driven tools are necessary for safe home environments.

Primary Author and Speaker: Noralyn D. Pickens

Additional Authors and Speakers: Rochelle Mendonca

Contributing Authors: Madeline Boutwell, Kathryn Primrose, Suzanne Burns, Roger O. Smith

PURPOSE: Consumer-driven apps have the potential to change practice efficiencies. To glean insights into best practice and utility, stakeholders need to be integrated into app development. We use participatory action research in the development of HESTIA NextGen apps in a three year NIDILRR funded project designed to further the development of a home evaluation app (HESTIA) designed to help professionals, people with disabilities, and care partners conduct comprehensive home safety evaluations and provide real-time intervention planning. Our broad research question is What is the utility in using PAR teams in the development of HESTIA NextGen apps?

DESIGN: PAR actively engages diverse stakeholders early in the research process, and integrates their perspectives throughout all aspects of the project (Anderson, 2018; Daley, et al., 2010). Grounded in social action and change methodology, PAR seeks to foster collaboration with team members, add rigor and authenticity, and foster better outcomes in order to ultimately narrow the gap between research and practice. We have two PAR stakeholder teams, each embedded in their respective app teams, myHESTIA (consumer) and HESTIApro (health care professional). The six-person teams were purposefully recruited to include people with disabilities, care partners, contractors and a range of health care providers. A total of six semi-annual PAR meetings per team are planned, with intermediary meetings as needed. The PAR teams are provided information prior to meetings to preview, followed by a review of the material and a guided facilitation, processing information together and sharing of ideas. Meetings run two hours, via Zoom video-conference software, are video-recorded, audio transcribed and documented via logs and team member notes for data triangulation. Analysis is a recursive process of a “look-think-act-reflect” spiral as extended from the work of Stringer, et al, 1999). Inductive thematic coding added depth to the findings. Analysis is triangulated between two research team members and a minimum one PAR member per PAR team.

RESULTS: As of this abstract submission, two PAR meetings (one each myHESTIA and HESTIApro) and one intermediary PAR meeting have been held. The grant is in its first year, thus the data results are unfolding and iterative. The look-think-act-reflect processes are catalytic to the research process. “From your own lens” (Look) includes respecting the different experiences of the PAR members. “Incredibility important, but how?” (Think) describes the shared thoughts as informed by individual experiences of living with a disability, serving as a care partner to someone with a disability, or providing professional services as a therapist or contractor. “We should be the hardest test” (Act) demonstrates the engaged process in which the PAR members viewed themselves as evaluating the app development and eventually processes. Their insights into the app taxonomy, infrastructure, and reporting systems pushed the research team to “Reconsider” (Reflect) plans and processes, as one PAR member noted, the “less tangible things that matter are the hardest to measure.”

CONCLUSION: The highly engaged process is catalytic in that it accelerates the development of the apps through ongoing reflection and process transparency. The use of the intermediary meetings are critical to moving HESTIA NextGen apps forward toward validation and consumer testing. Embedding PAR is demonstrating clear utility in challenging assumptions and pushing development beyond the current state of the art.

IMPACT ON PRACTICE: PEO-centered, consumer-driven and stakeholder-developed, apps for self- and professionally-driven home safety assessments are necessary to facilitating safe home environments.

References

Andersson, N. (2018). Participatory research—A modernizing science for primary health care. Journal of General and Family Medicine, 19(5), 154–159. https://doi.org/10.1002/jgf2.187

Daley, C. M., James, A. S., Ulrey, E., Joseph, S., Talawyma, A., Choi, W. S., Greiner, K. A., & Coe, M. K. (2010). Using focus groups in community-based participatory research; Challenges and resolutions. Qualitative Health Research, 20(5), 697–706. https://doi.org/10.1177/1049732310361468

Kemmis, S., & McTaggart, R. (1999). The action research planner (3rd ed.). Geelong, Australia: Deakin University Press.