Co-producing an online platform for people with long-term physical health conditions:A development and usability study

<b>Background: </b>There is relatively limited psychological support dedicated to people living with long-term physical health conditions and subthreshold depressive disorder. Online peer support may be an appropriate intervention to help bolster patients’ mental wellbeing to prevent progression of their symptoms to Major Depressive Disorder. For interventions to be successfully integrated into the self-management routines of people with long-term physical health conditions, they should be co-designed to ensure they align with the wants and needs of the target audience. <br/><br/><b>Objective:</b> To co-produce an online peer support intervention with people with lived experience, software experts, clinicians, and academics through an iterative process of co-design and subsequent co-validation through usability testing. <br/><br/><b>Methods: </b>We followed a four-stage co-production process: co-assess, co-design, co-validate, and co-deliver. Our Research Advisory Group were actively involved in all stages, consisting of one co-investigator and six people with lived experience of long-term physical and/or mental health co-morbidities. The co-assess and co-design stages involved our Participatory Design Panel, which included 10 members living with various long-term conditions. The Participatory Design Panel participated in online focus groups to assess their unmet psychosocial needs and then co-designed the intervention prototype through online workshops with software developers. The co-validation stage involved an additional group of participants (n=12) with long-term physical health conditions. During co-validation, the prototype underwent usability testing, including think-aloud exercises and semi-structured interviews. Content analysis identified the priorities for the iterative development that formed the basis of further Research Advisory Group co-design workshops. The next stage, co-delivery, involved co-producing the protocol of a feasibility and acceptability randomised controlled trial. <br/><br/><b>Results: </b> Participants highlighted that a platform must feel safe and trustworthy for the space to support the mental wellbeing of those living with long-term health conditions. A Participatory Design Panel co-designed a platform prototype to meet this need. During the co-validation stage, the think-aloud exercises identified common issues related to navigation challenges and feature glitches. Content analysis of the semi-structured interviews confirmed that the community forum, resources, and other platform pages were appropriate and acceptable, but revealed usability concerns. Participants stressed the need for intuitive navigation and suggested new features that would enhance user experience. Facilitators and barriers to engagement were also noted, including the importance of fostering trust in the platform’s ethos and branding to create a safe space. Through iterative development and subsequent usability testing, the final prototype was approved. <br/><br/><b>Conclusions:</b> We have provided a worked example of a comprehensive, co-production process where we worked alongside people with lived experience to successfully design an online peer support platform with embedded psychoeducation. The platform, called CommonGround, is ready to be evaluated in a feasibility randomised controlled trial.<br/>