Coproducing Virtual Reality Technologies for Rehabilitation Dido Green Occupational Therapy Royal Free Hospital & Jönköping University London UK & Jönköping Sweden dido.green@nhs.net Shana Boltin & Aimee Ward Occupational Therapy Royal Free Hospital London UK shana.boltin@nhs.net aimee.ward@nhs.net Francesca Gowing Clinical Research Royal Free Hospital London UK fancesca.gowing@nhs.net Betty Hutchon Occupational Therapy Royal Free Hospital &Univ College London London UK bettyhutchon@nhs.net Abstract Co-production: What is it, what it not and how to do it in relation to Virtual Reality technology design and research? A modified Delphi approach involving key stakeholders was used to: identify and prioritise outcomes of importance in relation to VR technology design in order to address clinical issues; usability/development of bespoke project measures and clinical trial design. Results reflect three key themes of motivation: autonomy, relatedness and competence. Key principles of co-production are discussed with consideration to impact on technology design and therapeutic strategies to support engagement and adherence to therapy protocols using VR technologies. Keywords—coproduction, motivation, VR design, patient reported outcome measures I. INTRODUCTION (HEADING 1) Co-production is being seen as increasingly important to engage key-stakeholders – patients and or individuals with disability – in critical issues involving health care and rehabilitation [1]. Co-production is not just about inviting articulate patients or clients to a meeting to discuss potential research priorities or review a research proposal. Co- production requires a number of essential ingredients, notably: Sharing of power in which decision making and research are owned jointly between team members to achieve a joint understanding; Inclusion of a representative team to cover multiple perspectives and skills; Equal importance of members giving respect and value of experience and knowledge to all equally; Reciprocity in which everybody will benefit from collaborative working; Relationship building and maintaining within the team; and, Power – whereby a joint understanding and consensus is set with clarity over roles and activities [2]. With respect to the design of Virtual Reality technologies and their use in rehabilitation, few projects have involved key stakeholders, patients and individuals with disability including children, young people and their families, in design concepts, research priorities and measurement of research outcomes. This paper reports on a co-production project in which key stakeholders – children and young adults with disability – are involved in all stages of technology design, research design and determination and evaluation of research outcomes. The key issues to be addressed were to: • discuss the key issues of importance in the design of VR rehabilitation tools • define outcomes of importance in relation to the 5- themes of the VR4REHAB programme: 1. Pain Management 2. Engagement and Immersion to support (home- based) therapy adherence 3. Behavioural and cognitive training in children and adolescents with brain injury 4. Lower limbs and mobility 5. Training of upper limb movements • identify usability of recommended measurement tools and or consider development of bespoke project measures • outline clinical trial format and methods evaluation II. METHODS A. Participant Selection Purposive sampling with snowballing was used to invite young people and or their parents to a ‘co-production’ afternoon. Individuals were identified via patient lists of children and young people as young people with Cerebral Palsy or Acquired Brain Injury for home intensive rehabilitation has been shown to be beneficial but for whom rehabilitation services are limited in the UK National Health Service. Individuals were free to promote the session to friends and teachers. Exclusions were younger children whose attention or cognitive ability may limit their ability to engage with the main discussions over the 3 hour period. B. Process A modified Delphi approach was used to begin a multistage process for gaining consensus on key issues, outcomes of importance and measurement tools. In the first session the Identify applicable funding agency here. If none, delete this text box. Note: This is not the official copyright released version of the IEEE proceedings paper. When citing this paper, use the following format: Green D, Boltin S, Ward A, Gowing F and Hutchon B, "Coproducing Virtual Reality Technologies for Rehabilitation", Proc. 13th Int'l Conf. on Virtual Rehab., WG Wright, S Subramanian, G Fluet, M Agmon, RM Proffitt, M Roberts (Eds), Tel Aviv, Israel, 21-24 July 2019.