http://hdl.handle.net/10379/124 2017-10-29T22:00:48Z http://hdl.handle.net/10379/6917 Collective intelligence design and a new politics of system change Hogan, Michael; Hall, Tony; Harney, Owen While internet technologies may support an emergent wisdom of the crowd and new enhanced forms of political engagement, iterative design of technology is needed to better support our collective intelligence and collective action into the future. Future iterative designs need to include a synthesis of political philosophy, education, and technology design that supports the emergence of a new, higher-order wisdom of the crowd, specifically, a form of team-based system science intelligence that is matched to the complexity of the societal problems we face. Building upon the seminal work of John Warfield, we propose Applied Social Science as a new synthesis in this regard. Warfield argued for a form of applied systems science that incorporates basic science into a technology-supported science of design, complexity, and action, and he developed a specific methodology to support systems level thinking and action planning in problem solving teams. While it is possible to embed Warfield s methodology within the World Wide Web, we argue that this is best achieved in the context of a new approach to collective intelligence design and a new politics of system change that upholds freedom as non-domination as a principle of dialogic engagement in democratic educational and political environments. We also suggest the import of design-based research (DBR) from educational science as a methodological approach to iteratively designing and evaluating infrastructures that support new forms of democratic political engagement on the World Wide Web. 2017-01-01T00:00:00Z http://hdl.handle.net/10379/6835 Development of a feasible implementation fidelity protocol within a complex physical therapy-led self-management intervention Toomey, Elaine; Matthews, James; Guerin, Suzanne; Hurley, Deirdre A. Implementation fidelity is poorly addressed within physical therapy interventions, which may be due to limited research on how to develop and implement an implementation fidelity protocol. The purpose of this study was to develop a feasible implementation fidelity protocol within a pilot study of a physical therapy-led intervention to promote self-management for people with chronic low back pain or osteoarthritis. A 2-phase mixed-methods design was used. Phase 1 involved the development of an initial implementation fidelity protocol using qualitative interviews with potential stakeholders to explore the acceptability of proposed strategies to enhance and assess implementation fidelity. Phase 2 involved testing and refining the initial implementation fidelity protocol to develop a finalized implementation fidelity protocol. Specifically, the feasibility of 3 different strategies (physical therapist self-report checklists, independently rated direct observations, and audio-recorded observations) for assessing implementation fidelity of intervention delivery was tested, followed by additional stakeholder interviews that explored the overall feasibility of the implementation fidelity protocol. Phase 1 interviews determined the proposed implementation fidelity strategies to be acceptable to stakeholders. Phase 2 showed that independently rated audio recordings (n=6) and provider self-report checklists (n=12) were easier to implement than independently rated direct observations (n=12) for assessing implementation fidelity of intervention delivery. Good agreement (79.8%-92.8%) was found among all methods. Qualitative stakeholder interviews confirmed the acceptability, practicality, and implementation of the implementation fidelity protocol. The reliability and validity of assessment checklists used in this study have yet to be fully tested, and blinding of independent raters was not possible. A feasible implementation fidelity protocol was developed based on a 2-phase development process involving intervention stakeholders. This study provides valuable information on the feasibility of rigorously addressing implementation fidelity within physical therapy interventions and provides recommendations for researchers wanting to address implementation fidelity in similar areas. 2016-08-01T00:00:00Z http://hdl.handle.net/10379/6834 Using mixed methods to assess fidelity of delivery and its influencing factors in a complex self-management intervention for people with osteoarthritis and low back pain Toomey, Elaine; Matthews, James; Hurley, Deirdre A. Abstract Objectives and design Despite an increasing awareness of the importance of fidelity of delivery within complex behaviour change interventions, it is often poorly assessed. This mixed methods study aimed to establish the fidelity of delivery of a complex self-management intervention and explore the reasons for these findings using a convergent/triangulation design. Setting Feasibility trial of the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) intervention (ISRCTN49875385), delivered in primary care physiotherapy. Methods and outcomes 60 SOLAS sessions were delivered across seven sites by nine physiotherapists. Fidelity of delivery of prespecified intervention components was evaluated using (1) audio-recordings (n=60), direct observations (n=24) and self-report checklists (n=60) and (2) individual interviews with physiotherapists (n=9). Quantitatively, fidelity scores were calculated using percentage means and SD of components delivered. Associations between fidelity scores and physiotherapist variables were analysed using Spearman's correlations. Interviews were analysed using thematic analysis to explore potential reasons for fidelity scores. Integration of quantitative and qualitative data occurred at an interpretation level using triangulation. Results Quantitatively, fidelity scores were high for all assessment methods; with self-report (92.7%) consistently higher than direct observations (82.7%) or audio-recordings (81.7%). There was significant variation between physiotherapists’ individual scores (69.8% - 100%). Both qualitative and quantitative data (from physiotherapist variables) found that physiotherapists’ knowledge (Spearman's association at p=0.003) and previous experience (p=0.008) were factors that influenced their fidelity. The qualitative data also postulated participant-level (eg, individual needs) and programme-level factors (eg, resources) as additional elements that influenced fidelity. Conclusion The intervention was delivered with high fidelity. This study contributes to the limited evidence regarding fidelity assessment methods within complex behaviour change interventions. The findings suggest a combination of quantitative methods is suitable for the assessment of fidelity of delivery. A mixed methods approach provided a more insightful understanding of fidelity and its influencing factors. 2017-08-04T00:00:00Z http://hdl.handle.net/10379/6833 Augmenting home exercise programmes in multiple sclerosis with 'exercise buddies' : A pilot study Toomey, Elaine; Coote, Susan Background: Non-ambulatory people with multiple sclerosis comprise 25% of the multiple sclerosis population. Literature reviews show insufficient evidence exists regarding physiotherapy for this population. A qualitative study suggested benefits from exercise buddies , who were paid carers delivering a physiotherapy home exercise programme. Aims: To explore the feasibility and effects of exercise buddies for non-ambulatory people with multiple sclerosis. Methods: Twenty-nine non-ambulatory people with multiple sclerosis (age range: 43 72) were randomised to 10 weeks of usual care or the exercise buddy intervention. People with multiple sclerosis were assessed with the Multiple Sclerosis Impact Scale 29 and the Guys Neurological Disability Scale pre- and post-intervention. Their informal caregivers (12 male, 16 female, aged 21 68) completed the Adult Carer Quality of Life questionnaire. Findings: Using analysis of covariance to adjust for pre-intervention scores, there was no significant differences between groups after treatment on the Multiple Sclerosis Impact Scale 29 physical (P=0.395), Multiple Sclerosis Impact Scale 29 psychological (P=0.176) or Guys Neurological Disability Scale (P=0.177). The Adult Carer Quality of Life was also not significantly different between groups post-treatment (P=0.432). Using paired t-tests, the exercise buddy group improved significantly from baseline on the two components of the Multiple Sclerosis Impact Scale 29 (physical: P=0.024; psychological: P=0.009), which was not seen in the usual care group. Conclusions: This pilot study found no significant between group differences post-treatment. However, good feasibility and significant positive changes from baseline for the exercise buddy group warrant further exploratory work, in addition to a cost analysis. 2017-02-21T00:00:00Z