A Patient and Public Involvement and Engagement Approach to Co-Design a Walking Football Intervention for People with Chronic Breathlessness

Background: Walking football (WF) was identified as a potential solution for exercise maintenance after pulmonary rehabilitation. However, WF has not previously been made available to people with chronic breathlessness. This work undertook a novel approach to Patient and Public Involvement and Engagement (PPIE) in which PPIE members, recruited from Breathe Easy Darlington (a charity), helped to co-design a WF intervention for people with chronic breathlessness. Methods: PPIE activities included: an introductory stakeholder meeting (n = 20) to discuss WF, four ‘WF sessions’ (n = 10–12), and a debrief following the first WF taster session (n = 12). Results: PPIE members listed several concerns at the introductory meeting, namely: (1) keeping pace with non-breathlessness people; (2) limited balance/turning ability; (3) requirement of walking aids/oxygen; and (4) accessible parking and low-light driving conditions. Responding to these concerns, WF taster sessions were: (1) made available exclusively to people with breathlessness with a “buddy system” employed for new players; (2) no-contact “table football-style” rules and a weighted “slow-motion” football were applied; (3) oxygen was worn on the person and walking aids could not make contact with the ball; and (4) accessible parking was abundant and sessions concluded by 2pm. Lessons learned included having trust in your PPIE members, that active forms of PPIE can work successfully when conducted in an ethical manner and when working together with PPIE members, it is important to find balance regarding researcher involvement in activities. Conclusions: PPIE led to important changes that improved the research project and intervention design. WF would not have been viable for people with chronic breathlessness without these iterative adjustments.