Optimising the development of sustainable internet-based occupational therapy interventions: Important key actions and perspectives to consider

Figures & data

Table 1. Overview of key actions, new perspectives and questions suggested to inform the innovation process of internet-based interventions in occupational therapy.

Key action	Perspectives and questions to consider in the key action
1. Operationalising the idea of a sustainable internet-based OT intervention	What are the driving forces that guide the innovation process of the new intervention? Which sources or methods will ensure that the users’ needs and conditions are addressed by the intervention, and how can users be involved in the creation of the idea? How can different core values of welfare innovations guide the operationalisation of the intervention idea, its content, delivery and outcome?
2. Designing the innovation process of developing an internet-based intervention	How can different approaches, frameworks and/or models guide the development phase for a sustainable innovation process? How can different approaches, frameworks and/or models guide the design of an internet-based intervention in an evidence-based frame? How can innovation models and models focussing on the design of internet interventions inform key actions important for the innovation process? How can users be involved in the design of the innovation process?
3. Identifying and developing evidence underpinning an internet-based intervention	Knowledge to inform the content of the intervention. Is there enough evidence to underpin the modelling of the content of the intervention? What is known about clients' engagement in activities in everyday life in relation to improving services and outcomes? Is there a need to develop new knowledge about client groups' activities in everyday life and their self-initiated strategies to overcome or prevent problems (by, e.g., performing empirical research or systematic literature reviews)?
	Knowledge to inform the web-design and delivery. Which characteristics in the design of internet-based interventions facilitate clients' engagement, self-regulated learning and adherence during the intervention process as well as outcomes? How can the interaction and communication between the client and the professional be designed to facilitate the client change process? Which potential barriers and facilitators are known regarding internet-based interventions, and how can this knowledge support the design? What is known about the users' (clients and professionals) access to, and ability to use internet-based services?
4. Articulating programme theory	Which theories and knowledge are needed to inform the content of the intervention to promote the outcome? What knowledge is needed about the mechanism of change to inform the design and delivery of the intervention to enhance clients’ self-regulated active learning on distance? What knowledge is needed about the mechanism of change to enhance professionals in supporting the client? How can different core values of welfare innovations guide the development of programme theory?
5. Modelling the prototype	How can previous key actions be integrated into a prototype that meets the core values of welfare innovations (improved service and outcome as well as increased productivity)? How can the prototype be designed with users? Which users are important to include in the different phases of modelling the prototype? How can the intervention be evaluated scientifically, and what research designs are suitable?

Table 2. The questions and components forming the program theory of SEE version 1.0.

Knowledge needed to develop the program theory of an internet-based OT intervention, examples of questions related to content and mechanism of change	Components in the program theory of SEE	How knowledge from the component contribute to SEE, examples
What are clients’ needs in relation to activities of everyday life?	Perspectives of clients: Evidence from empirical research and reviews of changes and needs in activities of everyday life.	Inform the need, focus and content of the intervention. Guide occupational therapists person-centered and occupation- based reasoning in the intervention process
How can the complexity of engagement in activities in everyday life, changes herein and strategies to facilitate health be understood and supported throughout the change process?	Perspectives on humans’ occupations in everyday life and how occupation can be both a mean and an end in the therapeutic processes: Models in Occupational therapy	Inform the content of the intervention of how to support activity of everyday life. Guide occupational therapists to be person-centered and utilise occupation- based reasoning during the intervention process.
How can person-centeredness be supported throughout the change process?	Person-centered health care/occupational therapy: Evidence and perspectives of person-centeredness	Inform the design of the intervention of how to enhance person-centeredness. Guide occupational therapists to tailor their reasoning and acting to each clients’ unique situation and needs during the intervention process.
How can clients’ motivation be identified and supported throughout the change process?	Perspectives of motivation: Motivation for change and motivational interviewing	Inform the design of the intervention of how to support clients’ motivation in the change process. Guide the occupational therapists reasoning about motivation and dialogue to facilitate clients’ motivation in the intervention process.
How can clients be supported to take on an active role and adopt self- management strategies?	Perspectives of managing chronic health conditions: Evidence and perspectives of self-management	Inform the design of the intervention of how to facilitate clients to take on an active role and act proactively by self- management. Guide occupational therapists reasoning of how to support self-management in the intervention process.
How can a plan for change be established through active collaboration?	Perspectives of rehabilitation: Rehabilitation methodology	Inform the design of the intervention of how clients can be supported in taking an active role in formulating the plan for their change process. Guide occupational therapists reasoning of how to support clients’ active role when establishing the plan for the change process in collaboration.
How can clients’ self-regulated learning on distance be supported?	Pedagogical perspectives: Evidence and perspectives of Flipped-classroom	Inform the design of the intervention’s combination of video- clips providing new knowledge, with clients’ reflections and digital assignments. Guide the occupational therapists reasoning of how to support clients’ reflection and self-analysis based on the new knowledge.
How can internet-based interventions be designed optimally to support users and facilitate the intended outcome of the intervention?	Perspectives on internet- based interventions: Evidence and perspectives of web-design, delivery and usability.	Inform the design of the web-format and the interaction between clients and occupational therapists to support feasibility, acceptability and efficiency.

Figure 1. A schematic illustration of SEE version 1.0.