While Patient and Public Involvement (PPI) is common in health research, its use in behaviour analysis is limited. PPI is the active partnership between researchers and stakeholders in intervention development, enabling the identification of environmental barriers to participation, thereby establishing interventions that maximise contact with reinforcing consequences. We used PPI to develop an online Acceptance and Commitment Therapy (ACT) programme for parents of children with cancer. Firstly, semi-structured interviews were conducted with stakeholders (n=19) in paediatric oncology to determine the needs and challenges experienced by families. Following this, PPI panels were conducted to identify socially significant behaviours which could be meaningfully targeted in an intervention. In collaboration with this panel, the aims, design, and implementation plan for the ACT programme were determined. This process resulted in a 6-week online self-directed ACT programme for parents of children with cancer, seeking to support psychological flexibility, parenting burden and wellbeing. Discussion/Conclusion: Challenges encountered in the PPI approach, as well as methods to circumnavigate these challenges are presented, including relationship-building, balancing patient perspectives with clinical knowledge and conducting PPI remotely. This study demonstrates how the stakeholder voice can be embedded in the design of behavioural interventions, which may increase the likelihood of positive outcomes.
|Abstract: The medical realm is increasingly becoming a multidisciplinary domain. As we look toward the problems that historically fall within the domains of medicine and health care their behavioral components become apparent. These behavioral components contribute to the prognosis of a variety of medical conditions. Behavior analytic techniques can be utilized to target these components ultimately optimizing the prognosis of various medical conditions. We have applied this perspective to the interpretation of osteoarthritis and the recovery from total knee arthroplasty (Vaidya & Armshaw, 2021; Armshaw & Vaidya, in prep). Specifically, we have identified contingencies that may lead to reduced joint use and atrophy of the quadriceps. We have also identified features such as loss of proprioception that inhibit the neuromuscular retraining necessary for reestablishing functional use of the knee following surgery. We then developed a technology using surface electromyography and gamification to address some of these barriers that impede neuromuscular retraining. This presentation will have two primary areas of focus. First, we highlight the basic, translational, and applied research that we have conducted and its promising results. Secondly, we conclude with a retrospective analysis and highlighting some considerations for behavior analysts looking to begin work in neuromuscular rehabilitation more broadly.|