# Co-Designing an Inclusive Stakeholder Engagement Strategy for Rehabilitation Technology Training Using the I-STEM Model

## TL;DR

This paper presents a stakeholder-driven strategy to improve inclusive training for rehabilitation technologies, aiming to reduce health inequalities for people with disabilities.

## Contribution

The paper introduces a co-created stakeholder engagement strategy using the I-STEM model to enhance inclusive rehabilitation technology training.

## Key findings

- Priority domains for inclusive training include physical, sensory, and cognitive accessibility.
- A co-created stakeholder engagement strategy was developed using the I-STEM model.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Equitable access to rehabilitation technologies is essential for reducing health inequalities, particularly for people with sensory, cognitive, or physical impairments.Training that is inaccessible or poorly designed can limit the effectiveness of rehabilitation technologies, undermining recovery outcomes and long-term independence.

Equitable access to rehabilitation technologies is essential for reducing health inequalities, particularly for people with sensory, cognitive, or physical impairments.

Training that is inaccessible or poorly designed can limit the effectiveness of rehabilitation technologies, undermining recovery outcomes and long-term independence.

Public health significance—Why is this work of significance to public health?
This study identifies systemic barriers that prevent diverse populations from benefiting fully from rehabilitation technologies.It provides evidence-based priorities for designing inclusive training approaches that support equitable participation in rehabilitation.

This study identifies systemic barriers that prevent diverse populations from benefiting fully from rehabilitation technologies.

It provides evidence-based priorities for designing inclusive training approaches that support equitable participation in rehabilitation.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Practitioners should adopt training models that address physical, sensory, and cognitive accessibility to ensure all users can engage effectively with rehabilitation technologies.Policymakers and researchers can use the co-created stakeholder engagement strategy to guide future intervention development and strengthen inclusive rehabilitation practices.

Practitioners should adopt training models that address physical, sensory, and cognitive accessibility to ensure all users can engage effectively with rehabilitation technologies.

Policymakers and researchers can use the co-created stakeholder engagement strategy to guide future intervention development and strengthen inclusive rehabilitation practices.

Background: Rehabilitation technologies, including assistive devices, adaptive software, and robotic systems, are increasingly integral to contemporary rehabilitation practice. Yet, ensuring that training in their use is inclusive and accessible remains a critical challenge. Methods: This study reports findings from patient and public involvement (PPI) activities conducted by the National Institute for Health and Care Research (NIHR) HealthTech Research Centre in Rehabilitation. Fifteen contributors participated, comprising rehabilitation professionals and educators, individuals with lived experience of serious illness, injury, or disability requiring rehabilitation, and technology innovators. The purpose of these activities was to identify the factors necessary to ensure that training in rehabilitation technologies is equitable for people with sensory, cognitive, and physical impairments. Findings: Contributors highlighted a series of priority domains that together capture the breadth of challenges and opportunities in this area. These included the need to address physical, sensory, and cognitive accessibility; to foster participation, motivation, and engagement; to strengthen instructional design and delivery; to ensure technological accessibility and integration; to enhance staff training and competence; and to embed participant-centred and policy approaches. Contributions in these domains were synthesised into thematic categories that provide a structured understanding of the training requirements of rehabilitation technology recipients. Evaluation: The PPI process was evaluated using the Guidance for Reporting Involvement of Patients and the Public (GRIPP2) Short Form, supplemented by an evaluation survey. This dual approach ensured that the contributions were systematically documented and critically appraised. Implications: Guided by implementation science, the principal output of this work was a co-created stakeholder engagement strategy, structured using the Implementation STakeholder Engagement Model (I-STEM). This plan will serve as a foundation for future research exploring the education and training needs of diverse stakeholder groups, thereby contributing to the development of more inclusive and effective rehabilitation technology training practices.