The importance of focus groups

Written by: Eline te Braake

Conducting focus groups is a common method in qualitative research. It's a good way to investigate certain opinions, current issues, and motivations. The latter, motivations, is often something that arises from the dialogues that not only the researcher has with the participants in a focus group, but which also naturally results from the interaction between the participants in the group. For example, a focus group can very nicely result in finding out 'the question behind the question'. That, in our opinion, should be central to the conduct of any focus group. However, this is not always the case.
 

‘Reading through’ focus groups

Since we are currently bombarded with the word 'focus group' in the research world, we lose a bit of its actual essence. What often happens in practice is that a list with a number of questions is simply 'read through’. You may wonder what the added value is of holding such a focus group, if the same questions could have been answered in a questionnaire. In addition, people take effort to make time and agree to participate with an intention to share their opinions: to feel heard. Thus, there should also be enough time and space for this during a focus group. Why burden people with a focus group, when we could have put the exact same questions in a questionnaire that they could have filled out from their homes and in their own time? Therefore, it is up to the researcher to reflect whether a focus group is indeed the most suitable method for answering the proposed research question. 

 

The actual added value

But what is the importance of focus groups? What can we get out of it and where is the added value? In our view, the beauty of focus groups lies in that you take the time to sit together, reflect on what is really needed, and find out where the current bottleneck really lies. Something that you can't really determine or plan in advance despite the predetermined protocols. This is also something that doesn't always come up naturally during a focus group. It is therefore up to the researcher to create a safe environment, to give space for dialogue in the group, to find starting points in the conversations that are held, and to ask questions about what is really important to the participants. Only this way, a focus group can lead to new insights that could not have been captured by other methods.

 

Making use of the dynamics of the group

In addition, a focus group also distinguishes itself from other methods in that it is held in a group. On the one hand, this means that the researcher also has to take into account the dynamics in the group. This entails that everyone should feel comfortable, feel heard, and everyone should have the opportunity to speak. On the other hand, this dynamic can be used in a positive way. Participants learn from each other, recognize themselves in each other’s situation, help each other if something is not understood, and make each other think. As a result, new insights often arise that have been obtained with and through each other.

There is so much to get out of a focus group that are more difficult to achieve with other methods. It's true that organizing and performing a good focus group takes a lot of time, but when done well, it gives so much more meaning to the topics that, according to the participants, really matter!

 

Do you also want to set up a focus group, but do you need help? Please contact us for the possibilities!

Eline te Braake

Eline te Braake

Email: e.tebraake@rrd.nl

Tel: 088 087 5734

 

The start of TREAT: Transforming healthcare through semantic interoperability and patient self-efficacy

Written by: Erik Prinsen

We are excited to be a partner in the newly started ITEA-project called TREAT. The TREAT project aims to increase patient self-efficacy in managing non-communicable disorders including diabetes, cardiac events and osteoarthritis by integrating data from wearables, journals and medical records. Through that, we aim to move healthcare access from the clinic into the patient’s daily life. In addition we aim to improve the health management skills of the patient. The project will develop novel wearables and software-based solutions to improve patient self-efficacy while driving clinical efficiencies.

Within ITEA-projects national use cases exist that work together under a common framework. The Dutch use case will focus on the development of a wearable and feedback system for individuals with diabetes mellitus that also suffer from osteoarthritis. This system will focus on stimulating healthy movement behavior in the target population. RRD will be involved in the end-user engagement, definition of the patient journey and the evaluation of the developed system.

After an exciting kick-off in Canmore, Canada, and the national kick-off in the beautiful city of Den Bosch we are ready to start improving the healthcare for individuals with diabetes mellitus and osteoarthritis!

Interested to read more about this project? Read more on the website: ITEA 4 - Project - 22022 TREAT

 

FOTO ERIC BRINKHORST
20240327 TREAT
Erik Prinsen

Erik Prinsen

Email: e.prinsen@rrd.nl

Tel: 088 087 5761

 

Writing a new project proposal: engaging with the target audience before you start

Written by: Eline te Braake and Marian Hurmuz

When writing a new project proposal, end-users are often not included. This can be due to various reasons, such as time pressure, procedures or not having access to the right end-users. As a result, the project proposal is often written by researchers only and they also mostly shape the intended goals of the project. The end-user is then involved once the project is approved. A disadvantage of involving end-users at a later stage, is that the intended purpose of the project proposal does not fit with the end-users’ actual needs. To try to avoid this problem, and thus better match end-users' needs, we collected input from end-users before writing the project proposal. In this news post, we tell you what this brought us.

 

Set-up of end-user meeting

With two researchers and panel members, we took a first step towards this 'new' way of working. On the 15th of February, they met and a focus group on medication adherence took place. The aim of the focus group was to find out what the facilitators and barriers are for being compliant. During the meeting, we went through the following 6 main categories:

  • Patient-related factors
  • Disease-related factors
  • Treatment-related factors
  • Healthcare and system related factors
  • Social and cultural factors
  • Logistical and financial factors

For each category, panel members were given time to write down their experiences and share them with the group. In addition to these categories, there was also an option at the end to name other factors that they perceived as promoting or hindering, but did not fit under any of the previous categories.

 

Results end-user meeting

During the meeting, the group was able to discuss with each other the different factors. During the discussion, we noticed that many factors recurred under several categories. One frequently recurring factor that hindered medication adherence was cost. The examples mentioned were:

  • Costs for explanation about the medication at the pharmacy
  • Costs for typing a label (which is more expensive than the medication itself)
  • Parking costs for picking up the medication from the pharmacy
  • Paying the deductible excess (related to Dutch health insurance)

Other examples of barriers they experienced were the different intake times of medication, limited availability of the medication and, with this, often the long delivery time of a medicine at the pharmacy. With regard to intake times, this mainly concerns intake before/during/after a meal. These meals do not always take place at the same time. Some medications are really only allowed to be taken after 24 hours, so there is often not enough time between taking them.

In addition to these barriers, panel members could also discuss factors that facilitate medication adherence. These factors, although fewer were mentioned, were all very relevant, for example:

  • Receiving sufficient information about the medication
  • Having good contact with the healthcare professional and good communication between the different healthcare professionals
  • Taking a medication where you notice the effect yourself

 

Are you curious to see the entire list of factors? These are available in Dutch. Click here to open it. Do you want to have this information in English? Contact the researchers below.

 

This kind of meeting was a very fun and instructive way of working, and it helped us to learn a lot about how the target group views the influencing factors in medication adherence. This 'new' approach allows us to include the target group's wishes in the project proposal in order to better meet their needs. Would you also like to hold a focus group to identify the needs of the target group in order to write a project proposal? Please contact us for the possibilities!

 

Eline te Braake
FOTO ERIC BRINKHORST

Eline te Braake

Email: e.tebraake@rrd.nl

Tel: 088 087 5734

 

Marian Hurmuz

Email: m.hurmuz@rrd.nl

Tel: 088 087 5771

 

First PhD defence of 2024 by Kira Oberschmidt about guidelines for active involvement of stakeholders in eHealth Action Research!

Written by: Marian Hurmuz

Last Friday, the first RRD PhD defence of 2024 took place! Kira Oberschmidt defended her PhD thesis, titled: “Who, When, How: Guiding the active involvement of stakeholders in eHealth Action Research”. Action Research (AR) is a collaborative research approach in which stakeholders play an active role as co-researchers. AR fits the context of eHealth research well, as its key elements can hopefully ensure a better match between the technology being developed or implemented and the needs of relevant stakeholders. Ideally, stakeholders should take on a very active role and shape the research. However, oftentimes, neither the researcher nor the stakeholders are used to working in this way. Therefore, support is needed in terms of sharing knowledge, best practices and lessons learned between projects. Yet, in AR publications explicit reflection and description of these lessons learned is often missing. This makes it difficult for AR projects to learn from each other. Kira has dedicated her PhD to provide guidance for researchers setting up their project, and specifically to support the active involvement of stakeholders. She developed a framework on stakeholder involvement in eHealth AR projects. On Friday the 19th of January (2024), she defended her thesis, which you can find here.

Kira’s thesis covers the following topics:

  • Reviewing literature to identify what is currently known about AR in eHealth projects (context of these projects, definition of AR, how to conduct AR, best practices and lessons learned from AR in eHealth projects).
  • Studying novice action researchers’ attitude towards AR.
  • Investigating how champions see their role and whether this changes over the course of AR projects.
  • Investigating the motivation of stakeholders participation in long-term, time-consuming research projects like AR.
  • Identifying how to involve participants unplanned and spontaneously.
  • Studying the alignment of interests and needs of different stakeholders in a project, in terms of what they want to achieve from the project.
  • Providing a structured way for researchers to reflect together with project partners
  • Investigating the important elements of stakeholder skill training to enable them to be involved and to enable them to interact with each other.
  • Describing an iterative method to involve patients, their perspectives and lived experiences in research

Taking into account all the recommendations made in her thesis, Kira developed a framework for stakeholder engagement in eHealth AO projects. This framework describes important issues to consider in such a project. Her framework is available on our website: https://www.rrd.nl/ar-framework/

We are very proud of Kira and her hard work at RRD! And we are happy that Kira continues working at RRD for the next steps in her career!

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20240119 PhD Kira (25)

PhD defence of Martin Tenniglo: Stiff Knee Gait in Stroke!

Written by: Marian Hurmuz

Last week, the last RRD PhD defence of 2023 took place! Martin Tenniglo defended his PhD thesis, titled: “Stiff knee gait in stroke: Walking down the road of different treatment options”. Stroke survivors often struggle with functional consequences: cognitive, emotional, sensory and motor impairments. These functional consequences lead to limitations in daily life. Of which a common problem is stiff knee gait. Many times, this problem arises due to abnormal activity of the rectus femoris during the swing phase. Two options are available for assessing this abnormal activity. But are these also suitable in this group of people? There are also several treatment options to reduce stiff knee gait. But how effective are these? Martin has dedicated his PhD to this topic. On Thursday the 7th of December (2023), he defended his thesis, which you can find here.

 

Martin's thesis covers the following topics:

  • Identifying the effect of Motor Branch Block (MBB) or NeuroMuscular Block (NMB) of the rectus femoris on knee kinematics and functional outcomes.
  • Identifying the diagnostic value of the Duncan Ely test in predicting abnormal rectus femoris activity in people after stroke who walk with a stiff knee.
  • Investigating the effect of functional electrical stimulation of the hamstrings in stroke survivors with a stiff knee gait.
  • Investigating the effect of Botulinum toxin injection in the rectus femoris in stroke survivors with a stiff knee gait.
  • Investigating the effect of rectus femoris transfer in stroke survivors with a stiff knee gait.

 

Martin ends his thesis with 6 key messages he wants to share with the clinic and that can be applied in the clinical setting. He also indicates where the focus should be on future research related to this topic.

We are very proud of Martin and his hard work! His research has meant a lot to both science and the clinic. The three different treatment options he studies are also applied at Roessingh, Centre for Rehabilitation. Martin continues his work as a physiotherapist, gait specialist and as a specialist in electrical stimulation. Amongst others, he works on the development of a knee flexion device and on the investigation of the effect of a chemodenervation in the vastii and rectus femoris. We wish him the best of luck in his career!

 

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SenSeeAct is now open-source: allowing digital health developers to benefit from and build on top of our software platform

Written by: Dennis Hofs

 

We have just released the first open-source version of SenSeeAct, our software platform that has driven many of our research projects and applications for more than ten years. During that time the platform has gone through several iterations, growing into a mature, flexible and secure backend with web portals and mobile apps.

The name SenSeeAct reflects the functionalities that the platform focuses on.

 

Sense: Collecting data through questionnaires, diaries, wearables, and smart home devices.

See: Presenting the data in user-friendly ways to both end users and health care professionals.

Act: Coaching users toward healthier behaviour with virtual agents, video exercises and gamification.

 

We now published the SenSeeAct backend as open-source software to help stimulate health technology innovation and collaboration. It facilitates the development of new applications by third parties, and enables organizations to take full control of their data ownership and access.

senseeact_app_portal

We are continuously improving the platform. Some of the new features that we anticipate in the near future are:

  • Enhanced support to author your own questionnaires and use them in our mobile app with your own backend.
  • Improved security with two-factor authentication.
  • A web interface to download your data or the data of your research participants.
  • A major update of our iOS app bringing it to the same level as the Android app.
  • Extending our earlier announced collaboration with DialogueBranch toolkit by Fruit Tree Labs.
  • More documentation and guides to help you get started with the open-source backend.

Read more about it at https://www.senseeact.com/?lng=nl

 

FOTO ERIC BRINKHORST

Dennis Hofs

Email: d.hofs@rrd.nl

Tel: 088 087 5763

 

Major research starts to tackle osteoarthritis on a tailor-made basis

By 2040, osteoarthritis is likely to be the most common chronic disease in the Netherlands. Currently, almost 1.5 million people in our country have osteoarthritis. The nature and extent of the symptoms may vary, but they always have an impact on people’s daily life. Osteoarthritis progresses differently for everyone, which requires tailor-made treatment. In order to be able to offer this as good as possible, insight is needed into the characteristics of the person and the disease process. Until now, that insight has been lacking. But this is about to change thanks to the funded research efforts of a unique partnership.

In November, researchers from the Interdisciplinary Consortium for Clinical Movement Sciences & Technology (ICMS) will start with the TopTreat project. They will follow 500 people with osteoarthritis over the next five years and will comprehensively map their characteristics. The aim is to gain insight into who qualifies for which treatment. The reason for this is because universal treatment is not effective for everyone due to the fact that the diversity among people with osteoarthritis is quite large.

 

Measuring and knowing precisely with a unique technology platform

This is the first time that the various manifestations of osteoarthritis are being measured with advanced technology and collected in a platform. The aim is to map extremely accurately how people with osteoarthritis feel, how they move, how their disease develops and which medicine is most effective for whom. Because physical, psychological and social factors all play a role in health, researchers are looking at the whole spectrum, from cell to well-being, and are conducting the study in consultation with the patients themselves. The insights from the study make it possible to optimally tailor treatment to the person with osteoarthritis. 

The promise of improvement

The research includes existing technologies such as 'joint-on-a-chip', accurate measurements of substances in the body that are indicative of the disease (biomarkers), analysis of movement with sensors, and making computer models of joint movement and load on cartilage. In doing so, the researchers aim to understand and capture specific characteristics of people with osteoarthritis. Based on these insights, practitioners can determine the most promising treatment for their patient.

Broad inclusion

Besides people with advanced osteoarthritis, two groups with an increased risk of osteoarthritis formation will also participate in the study. These are people with a broken or removed meniscus or with a leg amputation.

Moving forward together

TopTreat has a significant relevance for the progress of care of people with osteoarthritis. Moreover, the project is expected to develop a technology platform that is patent-worthy, and can be quickly translated into more healthcare applications. With this ambitious project, ICMS aims to maximise clinical and societal progress.

About ICMS

The Interdisciplinary Consortium for Clinical Movement Sciences & Technology (ICMS) is a unique partnership between RadboudUMC, Sint Maartenskliniek, Roessingh Research and Development and the TechMed Centre of the University of Twente. In TopTreat, these partners work together with ReumaNederland, the companies ATRO Medical and Moveshelf, the Rheumatism Foundation Sint Maartenskliniek, the Twente Graduate School and the Dutch Ministry of Defence. Together with funding from the Top Consortium for Knowledge and Innovation High-tech Systems & Materials, the project involves about EUR 4.8 million.

Roessingh Research and Development and Fruit Tree Labs announce formal collaboration

Summary:

  • Roessingh Research and Development, Impact Lab for Personalised Health Technology in the Netherlands and Fruit Tree Labs, a Portuguese start-up focused on open-source dialogue technology sign a partnership agreement.
  • The agreement formalizes years of existing friendly relations between the two parties.
  • Collaboration paves the way for a deeper integration of two important software platforms: SenSeeAct, the general-purpose eHealth platform by RRD and DialogueBranch, the dialogue-scripting platform by FTL.

 

The fourth quarter of 2023 begins with the happy news of an official collaboration between Roessingh Research and Development and Fruit Tree Labs.

Roessingh Research and Development (RRD) is an Impact Lab for Personalized Health Technology, based in the eastern part of the Netherlands, with close connections to the University of Twente and Roessingh Center for Rehabilitation. RRD provides scientific research on innovative healthcare technology with a focus on the end user. For RRD, co-creation with end users and stakeholders is essential to ensure the innovation meets user needs and fits into the healthcare context.

Fruit Tree Labs (FTL) is a start-up, founded early in 2023 in the Lisbon Metropolitan Area, focused on dialogue-driven interaction. The core product of FTL is a free and open-source dialogue platform that gives complete freedom and creative control to author-scripted conversations between users and virtual agents in serious web- or mobile application contexts.

CEO and Co-Founder of Fruit Tree Labs, Harm op den Akker has started his career working for RRD, obtaining his PhD degree through the University of Twente, and moving into a Senior Researcher position, strengthening the HCI-focused research at RRD between 2013 and 2021. Since then, relations have always remained warm, and collaborations continued through the co-development of open-source software. With the official collaboration agreement that is now in place, these friendly relations are now formalized in a long-lasting partnership.

For both parties, the partnership agreement comes at an exciting and fun time, as both RRD and FTL embark on new adventures in the open-source software community. RRD is in the process of publicly releasing its eHealth platform "SenSeeAct", allowing digital health developers to benefit from and build on top of a highly professional and stable software platform. At the same time, FTL recently launched the DialogueBranch platform made public (fully open-source and MIT licensed) and is looking for new partners and collaboration and funding opportunities.

With the new agreement in place, both parties commit to integrating these two open software platforms, strengthening the offering from both sides and opening new opportunities for potential users of either platform. Are you looking for a stable, highly customizable Digital Health platform, with integrated virtual agent capabilities? The combination of SenSeeAct and DialogueBranch might just be the thing for you!

 

 

Involving your end-users: how important is this?

Written by: Marian Hurmuz

Involving your end-users is getting more and more important in research. Also in the field of health research there is a need for a human centered focus. You can incorporate this by integrating social sciences and humanities (SSH) in your research! At RRD, our research focuses on the end-users. In this news article, I will tell why it is important to involve end-users and give an example of what we do to improve our relationships with our end-users.

 

Engagement of stakeholders

Through continuous engagement with end-users and other important stakeholders, we can learn a lot from their experiences regarding the topic we are studying. It is important to involve these stakeholders as soon as possible in your research. By engaging with them, you are able to take into account their actual needs and wishes and the processes in which the health technology will be used. It is very unpleasant to develop a great solution, which does not fit those needs or processes. Besides, the unpleasant feeling, it is of course also a waste of scarce resources.

The knowledge you gather in the early stage of your research, helps you to identify how to incorporate the health technology in the best way possible into the daily lives of the end-users and healthcare organisations. It is important to test and evaluate this with end-users to see whether you translated their needs correctly or changes are needed. This will help you to come to sustainable implementation of your health technology.

 

Giving something back to your stakeholders

Feedback is of course not a one-way pathway. When you want to build a relationship with your end-users or other stakeholders, you need to frequently interact with them. It is important that they do not forget about you and your research. Furthermore, they also need to feel that they are valuable to you. One of things we do at RRD to give them this feeling, is to share our early results of the studies with them. We noticed that they really appreciated this! It also led to some unprompted feedback if something is lacking in the results or interpreted wrongly.

When you share your findings with your stakeholders, you do not only ask for information from them, but you also give something back to them! This can encourage stakeholders to be actively involved in your research and more willing to help you out during your research.

For example, within the RE-SAMPLE project (Horizon grant no 965315), we have created feedback videos sharing our initial findings. As an example you will find one of these videos below.

Would you like to see this video in Dutch? Click on the following link: https://www.youtube.com/watch?v=IZQ9FWMFVSw

 

 

Are you struggling with integrating social sciences and humanities (SSH) in your research? We are always open to have a talk to help you out!

FOTO ERIC BRINKHORST

Marian Hurmuz

Email: m.hurmuz@rrd.nl

Tel: 088 087 5771

 

 

Festive farewell to prof. dr. Jaap Buurke

Last week on September 7, we said goodbye to prof. dr. Jaap Buurke, together with family, friends and (former) colleagues from the field.

After working at RRD for more than 30 years, we ushered the retirement of Jaap Buurke. Jaap started his career on September 19th, 1983 as a conscientious objector within Roessingh, centre for Rehabilitation. After completing his conscientious objector period, Jaap started working as a physiotherapist at the rehabilitation centre on May 1st, 1985. Two years later, Jaap started working in the Research & Innovation Department for 18 hours a week. For a long time, he combined his career as a physiotherapist with work as a researcher at RRD.

In 2005, Jaap obtained his PhD on research into the recovery of walking after a stroke. This research formed an important basis for the introduction of neurorehabilitation principles in the Netherlands and the start of successful courses in gait image analysis that are still provided by RRD and Roessingh, Centre for Rehabilitation. On 1 May 2008, Jaap made the full transition to RRD and became a senior researcher there and had a bridging function with the rehabilitation centre. A year later, he became cluster manager and has been a manager within RRD for many years.

In many (inter)national research projects, Jaap focused on further developing rehabilitation technology and gait analysis. He combined these tasks with a position as professor at the University of Twente (UT) in the field of movement analysis and technology. From this position, he supervised many researchers in their PhD trajectories. In addition to his work at RRD and UT, Jaap's positions included adjunct professor at North Western University in Chicago, medical scientific director of IMDI SPRINT, board member of SMALLL and president of the Dutch association for Neurorehabilitation "Keypoint".

Jaap has marked his retirement from RRD, but he will continue to be involved in various courses in gait image analysis in the coming year.

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