Codesigning the web-based “Preoperative Rehab-readiness, Education and Preparation for Surgery” program for people undergoing a total shoulder replacement procedure

BACKGROUND: Using a codesign process with patients, clinicians, and researchers, we created the Preoperative Rehab-readiness, Education and Preparation for Surgery (PREPS) program for patients undergoing a total shoulder replacement surgery. PREPS is designed to improve patient preparedness for surgery, increase rehab adherence/awareness and empower patients during their replacement journey. PURPOSE: To codesign, test and evaluate the PREPS program for patients undergoing a shoulder replacement surgery. STUDY DESIGN: A codesign process integrated multiple methods. METHODS: PREPS integrated multiple literature reviews, quantitative surveys, qualitative interviews and consultation analyses. Guided by a patient-centered approach, module content and design were reviewed by an expert advisory group comprising of academic and clinical experts (n=10) and consumers (n=5). Evaluation of usability was conducted using the Patient Education Materials Assessment Tool. Codesign process was guided by the TEACH-it framework. RESULTS: PREPS is a 6-week multimodal program that consists of both a website with video modules and a graphical education booklet that replicates the same online information. This format allows for increased accessibility of information for older adults. PREPS is self-guided at home. Content and design were continuously and iteratively refined over two years. Understandability was rated on average 94% by three raters. Few expressed they preferred the print version due to limited tech access. The content, format and delivery of PREPS was impacted by the codesign process, resulting in a very different program than had previously been delivered at the institution using traditional processes. CONCLUSIONS: PREPS is an integrative co-designed virtual preoperative program that supports patients' preparation for a shoulder replacement. Codesign is a time-consuming iterative process whose dividends are evident in better usability and usefulness of the product. Mapping interventions to patient needs and clinical goals, considering diverse users and using an inclusive equity lens can potentially improve the quality of web-based health care interventions.