This paper describes the participatory development process of a web-based communication system focusing on disease management, particularly infection control of Methicillin-resistant Staphylococcus aureus (MRSA). These infections are becoming a major public health issue; they can have serious consequences such as pneumonia, sepsis or death [1]. This makes it even more important for people to be provided with up-to-date and reliable information. Users of a bilingual communication system (Dutch and German) participated in the development process via a needs assessment, the co-creation of the content and the system via usability tests, and in the summative evaluation of the usage of the system. The system enabled users to search efficiently and effectively for practical and relevant information. Moreover, we found that the participation of the intended users is a prerequisite to create a fit between the needs and expectations of the end-users, the technology and the social context of usage of technology. The summative evaluation showed that the system was frequently used (approximately 11,000 unique visitors per month). The most popular categories include ‘MRSA in general’ (20%, both languages) and ‘Acquiring MRSA’ (17% NL, 13% GER). Most users enter the site using internet search engines (Google) instead of the on-site search engine. When they are on the site, they prefer convenient searching via FAQ or related questions. Furthermore, the results showed that the participation of stakeholders is a prerequisite for a successful implementation of the system. To guide the participation of stakeholders we developed a roadmap that integrates human-centered development with business modelling activities.
Introduction Radical cystectomy (RC) is the standard treatment for patients with non-metastatic muscle-invasive bladder cancer, as well as for patients with therapy refractory high-risk non-muscle invasive bladder cancer. However, 50–65% of patients undergoing RC experience perioperative complications. The risk, severity and impact of these complications is associated with a patient’s preoperative cardiorespiratory fitness, nutritional and smoking status and presence of anxiety and depression. There is emerging evidence supporting multimodal prehabilitation as a strategy to reduce the risk of complications and improve functional recovery after major cancer surgery. However, for bladder cancer the evidence is still limited. The aim of this study is to investigate the superiority of a multimodal prehabilitation programme versus standard-of-care in terms of reducing perioperative complications in patients with bladder cancer undergoing RC.Methods and analysis This multicentre, open label, prospective, randomised controlled trial, will include 154 patients with bladder cancer undergoing RC. Patients are recruited from eight hospitals in The Netherlands and will be randomly (1:1) allocated to the intervention group receiving a structured multimodal prehabilitation programme of approximately 3–6 weeks, or to the control group receiving standard-of-care. The primary outcome is the proportion of patients who develop one or more grade ≥2 complications (according to the Clavien-Dindo classification) within 90 days of surgery. Secondary outcomes include cardiorespiratory fitness, length of hospital stay, health-related quality of life, tumour tissue biomarkers of hypoxia, immune cell infiltration and cost-effectiveness. Data collection will take place at baseline, before surgery and 4 and 12 weeks after surgery.Ethics and dissemination Ethical approval for this study was granted by the Medical Ethics Committee NedMec (Amsterdam, The Netherlands) under reference number 22–595/NL78792.031.22. Results of the study will be published in international peer-reviewed journals.Trial registration number NCT05480735.
