SSA-funded PhD student, Alice Bowen, writes about what she learned from developing a recovery app with addiction researchers and people with lived experience of substance use and recovery.

SURE Recovery is a free app for people who drink, use drugs, are in recovery, or are thinking about recovery. It includes a recovery tracker, sleep tracker, diary, platform for sharing artwork, and instructions on how to provide emergency support in the event of an overdose.

The app was developed by researchers at King’s College London, in collaboration with people with lived and living experience of substance use. I joined the project team in 2018 as a research assistant, and have worked on the development, evaluation, and dissemination of the SURE app. From the start, it was important to us to involve people who might use the app in its creation. We felt that this approach would lead to a product that was more appropriate for the intended audience.

Here are six lessons from our experience of ‘co-design’:

(1) Compromise is key

It is important to acknowledge that while you might want to incorporate everyone’s views, you will probably have to compromise. In the early phases of developing the app, we found that people had very personal experiences of substance use and recovery and had lots of different ideas about how a recovery app might work and what features should be included. Although we tried to incorporate the broadest range of views possible, it was helpful to identify commonalities and focus on these.

(2) Avoid duplication

In a collaborative project, every team member will bring their own set of expertise, but there may also be areas where skills, knowledge, or interests overlap. This has the potential to lead to the duplication of work or efforts. At the beginning of our project, the app developer conducted several ‘discovery’ workshops and interviews, which focussed on personal experiences of addiction and recovery. However, some of the themes had been covered in previous work by other members of the team who also had personal experience of substance use and recovery or had been researching this topic for many years. With hindsight, this knowledge could have been shared at the start of the project.

(3) Recognise the skills of every team member

The SURE app was developed and built by a diverse team with a broad range of skills. People in recovery and clinicians gave crucial insights into the design and content of the app. Statisticians provided advice on the data collected within the app so that it would be useful for future projects and could be analysed. The app developer provided expertise on the app’s functionality and capability. And, peer researchers and people with lived experience provided insights the app’s usability and tested each version as it was being developed. Being clear about each team member’s strengths ensures that you recognise their individual contributions as well as the collective talents of the group.

(4) Communicate, communicate, communicate

Strong communication between team members is essential. At times, we found that differences in terminology and misunderstandings about each other’s knowledge led to delays and setbacks. For example, the researchers struggled to explain to the app developer how they wanted the app to display responses to research questions. Interestingly, most of the difficulties in communicating tended to be between researchers and the app developer rather than between researchers and people with living and lived experience. This was probably because the latter had already worked together for several years, so they had a good understanding of each other’s perspectives.

(5) Don’t be afraid to go backwards

Things probably won’t go exactly to plan. There will be delays and snags along the way and it’s important to build these into project timelines. One of the main strengths of our co-design process was that community members gave feedback at each stage of app development and on each version of the app. Using this iterative process meant we were able to drop ideas that didn’t work and refine the app along the way. This would not have been possible if we had been working to a very tight timeline and budget.

(6) It will be worth it

Our main takeaway from developing the SURE app was that co-design is worth the effort and resources it requires. Ultimately, the contributions from people with living and lived experience made the app more useful for, and acceptable to, the community for which it was built.

by Alice Bowen

Alice Bowen is an SSA-funded PhD student at King’s College London. She is part of the SURE Recovery project team, along with Professor Joanne Neale, Mel Getty, and Paul Lennon.

You can download the SURE app for free on Google Play or the Apple App Store.. You can also find out more about the app and the recent updates here.

This article is based on a book chapter: Bowen, A., Getty, M., Hogan, C., Lennon, P., Long, E., Strang, J. & Neale, J. (2022). Building on Collaborative Research to Co-Design SURE Recovery, a Mobile Application for People with Experience of Alcohol & Other Drug Problems. In: Tucker, J. & Witkiewitz, K. Tucker, J. Dynamic Pathways to Recovery from Alcohol Use Disorder. Cambridge University Press.

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