DARE

DARE Delivering the digital ambition: exploring how we can develop, implement and evaluate digital health technologies in rehabilitation

What is DARE?

DARE is a project which seeks to improve how digital health technologies (for example apps, virtual reality, telerehabilitation) are used in practice.

Digital health technologies (DHT) have the potential to revolutionise healthcare. They can improve how we deliver care, streamline services and allow clinicians and patients to optimise recovery and rehabilitation. However, health services, including the NHS, have a poor track record in successfully implementing health technologies into practice. Numerous reports indicate that technologies that were anticipated to transform healthcare failed to be adopted or were quickly abandoned. They indicate that implementation of even the most promising DHT can fail because the context into which it is implemented, the design of the technology and the needs of the users have not been considered. Ultimately, this means that the potential of technology to transform healthcare is often lost. DARE seeks to change this.

Rehabilitation after stroke is a prime example of an area where DHT, if successfully implemented, could have a transformative influence on patient outcomes. Stroke is the single main cause of acquired disability in developed countries. Each year, over 100,000 people in the UK and 15 million people world-wide have a stroke. Stroke rehabilitation services face an unprecedented challenge to deliver, within available resources, the amount of evidence-based therapy recognised to be beneficial. Research findings indicate that using DHT to deliver selected interventions can enable rehabilitation staff to provide, and stroke survivors to undertake, additional, engaging rehabilitation and improve recovery. However, despite this clear potential for benefit, their current use in clinical stroke rehabilitation is negligible (for example, there are no stroke rehabilitation apps in the NHS apps library) and the factors that influence the success or failure of the integration of DHT in clinical practice are not known.

What are the objectives?

The DARE project will explore how DHT can be successfully embedded into healthcare. Specifically, it will:

1. produce a practical framework to guide how DHT can be adopted into practice,
2. bring together stroke survivors, clinicians and developers to co-design a high usable DHT – an app -to deliver an evidence based treatment for the upper limb after stroke.
3. test the framework by using it to guide the implementation of the co-designed app into clinical practice

What we are doing

The DARE project will bring together existing theories from published research with people’s experiences from using DHT in practice using interviews and focus groups. Collectively this will produce a comprehensive framework of factors we need to consider when introducing DHT into rehabilitation practice.

It’s likely that the framework will include the design of the technology, and the second stage of the project will investigate the key design factors of importance to both people after stroke and clinicians. By getting them to work with tech developers they will design a practical, easy to use, new DHT which will deliver an evidence based rehabilitative treatment (mental imagery). We will also use the experience of collaboratively developing a DHT to produce a guide for developers to help them ensure that the voices of patients and clinicians are central in the development of new technologies.

Once the DHT is ready, we will use the framework to  support the introduction of the DHT into clinical practice. We will measure if and how it is used and gather the views of both patients and clinicians. This information will be used to further shape the framework and the DHT so they both can be used more widely.

How can I get involved?

As well as delivering the DARE project, we are committed to advancing the field of rehabilitation. We want to support great work and share good practice to reduce replication and promote learning from real-world successes and failures. We know that technology is not a silver bullet – it isn’t always the best solution – we are committed to advancing understanding of how different technologies can be developed and deployed for the right person, at the right time and in the right place. If you have experiences you want to share with us and the wider community or you need help getting a project off the ground, please get in touch with us and we can see how we can work together – contact us at dare@uclan.ac.uk

Who are we?

DARE is led by Dr Rachel C Stockley, a physiotherapist and Associate Professor in Stroke Recovery and Rehabilitation at the University of Central Lancashire. DARE is funded by Rachel’s UK Research and Innovation Future Leader’s Fellowship and will run from June 2021 until February 2028.