SMART2
Project Leads
Professor Gail Mountaing.a.mountain@sheffield.ac.uk
Professor Mark Hawleymark.hawley@sheffield.ac.uk
Other Project Staff/Students
Dr Simon Brownsells.brownsell@sheffield.ac.uk
Dr Annette Haywooda.haywood@sheffield.ac.uk
Dr Nasrin Nasrn.nasr@sheffield.ac.uk
Sam Humberstones.humberstone@sheffield.ac.uk
Professor Sue Mawsonsusan.mawson@sth.nhs.uk
Dr. Jack Parkerjack.parker@sheffield.ac.uk

Background
The SMART consortium works across multiple partner sites. For full project and partner information please see the consortium website, here. These CLAHRC SY pages focus on the activities being undertaken within our region.

The aim of the project is to deepen understanding of the potential for technology in the support of self-management. This will be achieved by creating user-centred designs for technology, resulting in a personalised self-management system, and by carrying out extensive studies with the technology in use. Users with three common conditions (chronic pain, stroke and congestive heart failure) will be involved in all stages of the project. The proposed study aims to investigate the effectiveness of technology in encouraging people with long term conditions to take more responsibility and control over their own life.

Aims

The project aim will be achieved through four objectives and within six work packages:

  • To investigate how technology can be used to construct tailored plans of interventions to be undertaken by individuals to meet specific needs.
  • To identify how relevant signs, symptoms and lifestyle consequences of long term conditions can be effectively monitored, modelled and analysed.
  • To identify how information on signs, symptoms and lifestyle consequences can be fed back to users in a meaningful and useable way in order to support self management.
  • To examine the extent to which behaviour change is promoted through personalised feedback, remote from a health care professional, but delivered within a tailored plan of interventions.

Methodology

The World Health Organisation's International Classification of functioning, disability and health (ICF-2) is used to guide our approach towards the research methodology. This model is valuable for considering the treatment goals for each of the long term conditions and how each might be met through technological assistance. The typical requirements of people with each condition in terms of therapeutic goals, self-reporting requirements and measurement domains will be examined. We adopt a user centred approach towards design and testing, building on our earlier SMART 1 project. There will be a series of participatory design meetings involving designers, programmers and end users and also a range of user evaluations in the context-of-use throughout the project.

Research Programme

The project is described in a series of inter-related work packages. These are:

  • Evidence and Knowledge Review
  • User Engagement and User-centred Design
  • Integration of Personalised Self Management System
  • Construction of Therapy Content
  • Decision Support
  • Evaluation of Behaviour Changes
  • Dissemination

Each work package will be coordinated by a designated Investigator who will ensure that the work is undertaken appropriately and on time. Each coordinator will act as the primary contact for the project lead (Professor Gail Mountain) and technical lead (Professor Mark Hawley).

CLAHRC Project Partners

University of Sheffield

Sheffield Hallam University

Other Partner Organisations
Bath University
Ulster University
Newcastle University
The Stroke Association
British Heart Foundation
Expert Patient Programme Community Interest Company

Resources 
For further project information including more detailed information on other aspects of the SMART onsortium's activities, please visit the consortium's website here.

SMART2 - Project Update
Most Recently Updated March 2012

To evaluate the final PSMS prototypes we use Realist Evaluation methodology. Focus groups were conducted with CHF, Pain and Stroke professionals to search their knowledge, experiences and stories. The focus group data were analysed and the findings were used to examine "what is about the SMART PSMS which seems to have the most impact in changing users‚ behaviour and what type of users are more likely to use the system?"

CHF: 
In Phase One of the evaluation, Heart Failure Specialist Nurses confirmed, refined and further developed the Context, Mechanism, Outcome (CMO) configurations specific to the Congestive Heart Failure (CHF) PSMS. Phase Two involved the deployment of the PSMS prototype with five participants in their own homes over a four week period. Following this, a semi structured interview was conducted with each participant using a schedule developed around the proposed Mechanisms activated by the PSMS. This explored topic areas relating to the conjectured CMO configurations. Despite a number of technological problems, analysis revealed that participants were willing to accept such a system and would be motivated to use it to self manage their condition. The system is currently undergoing some technical 
adjustments and a further five deployments are planned over the next two months.

Pain:
To evaluate the pain PSMS, context-mechanism-outcome (CMO) configurations specific to the pain system and patient group were developed in combination with pain management professionals. All ten pain systems have now been deployed within patients‚ homes. Three patients have completed the trial and the remaining seven patients are at different stages of the five week trial. The data from the trial are now being used to verify and modify the CMO configurations and to develop new CMO configurations. Measures and methods employed to evaluate the pain PSMS are consistent with those being used within the CHF and stroke prototypes. This parallelism will support the identification of similarities and differences across the three systems and patient groups.

The development of the stroke prototype in relation to Insole shoe and mobile device is being carried out at the University of Ulster.