Implementing a stakeholder selection procedure with generative co-design to develop a serious game for cancer patients (Preprint)

BACKGROUND The involvement of stakeholders such as patients, care professionals and care managers is considered to play an important role in developing digital health. To this end generative co-design (GCD) is widely used to develop digital health. Yet, even though active stakeholder involvement is key in GCD, the justification to involve specific stakeholders is lacking in GCD research to develop digital health. Therefore a generative co-design methodology (GCDM) based on theory has previously been developed to improve the scientific rigor regarding stakeholder involvement. OBJECTIVE In this study, we implement the GCDM recommendations concerning stakeholder involvement in a GCD project to develop a serious game for cancer patients. Here, the stakeholder involvement recommendations are further operationalised as a stakeholder selection procedure. METHODS Snowball sampling was used to identify potential stakeholders, and short interviews involving eight criteria were used to assess their relevant knowledge and abilities. On this basis, those deemed most appropriate as participants in GCD were allocated to Group 1 and those with fewer of the desired skills to Group 2. Both groups participated in identical GCD workshops. The influences of the implemented stakeholder selection procedure and the resulting allocations were qualitatively assessed by comparing the knowledge output and the related knowledge processing in the two workshops. RESULTS We found that the interaction quantities in the two workshops were broadly similar but the Group 1 stakeholders had a stronger and more positive influence on the diversity and density of knowledge processing, which resulted in a better quality of knowledge output than from Group 2. In terms of further developing the theory about the role of stakeholders in the GCDM, we would encourage researchers to explore the role given to abduction-2 inference in the selection procedure, and the role of facilitation with abduction-2 and contextual certainties in the GCD process. CONCLUSIONS We encourage the further validation of our stakeholder selection process in GCD. Ultimately, this will help GCD researchers come to more methodologically sound findings and to further refine the methodological recommendations to involve robust decisions and then report them in a sound way, both of which will improve the scientific rigor of GCD science for digital health.