Co-Creation Workshops With MaKey MaKey to Promote Participation Among People With Mental Health Conditions (MaKey4All)

Experimental: MaKey MaKey and Scratch Co-Creation Workshop Program

Participants in this single arm will take part in a group-based co-creation workshop program using MaKey MaKey and Scratch. The program will consist of six weekly sessions lasting approximately 90 minutes each, with the possibility of two additional optional sessions to complete, refine, and present the projects developed. Participants will collaboratively design musical activities, cooperative games, interactive narratives, or other creative projects adapted to their interests, abilities, and support needs.

Conductual: MaKey MaKey and Scratch Co-Creation Workshop Program

The intervention is a group-based co-creation program delivered in a mental health day hospital. It will comprise six weekly sessions of approximately 90 minutes each, with up to two optional additional sessions.

During the program, participants will become familiar with MaKey MaKey and Scratch, identify individual and shared interests, propose ideas, design tangible interfaces, perform basic block-based programming, test the projects, solve problems, and progressively refine the activities created. Projects may include musical activities, cooperative games, interactive narratives, visual experiences, or other creative proposals selected by the group.

The workshops will use a participatory and cooperative approach. Support and adaptations may include brief and sequenced instructions, flexible allocation of roles, individual assistance, pauses, adjustment of task difficulty, and reduction of environmental stimuli when necessary.

Change in social participation from baseline to post-intervention

Social participation will be measured through the self-administered Spanish short version of the Social Functioning Scale (SFS). The short version of the SFS consists of 15 items assessing social isolation and activities, interpersonal communication, independence in daily functioning, leisure activities, prosocial behavior, and employment or occupation. The instrument provides a single overall score. Score range: 0 to 45. Score interpretation: Higher scores indicate better social functioning and participation.

Change in motivation toward participation in the workshops from baseline to post-intervention

Motivation toward participation in the workshops will be measured through a self-administered, study-specific brief motivation questionnaire.

The questionnaire consists of 5 items assessing interest in participating, enjoyment of the activities, perceived involvement, perceived usefulness, and willingness to participate in similar activities in the future. Each item is scored on a 6-point Likert scale ranging from 0 (completely disagree) to 5 (completely agree). Score range: 0 to 25. Score interpretation: Higher scores indicate greater motivation toward participation in the workshops.

Change in perceived empowerment from baseline to post-intervention

Perceived empowerment will be measured through the self-administered Spanish 12-item short version of the Netherlands Empowerment List (NEL-12).

The NEL-12 consists of 12 items assessing different aspects of empowerment, including confidence and purpose, social support, self-management, connectedness, and caring community. Each item is scored on a 5-point Likert scale ranging from 1 (completely disagree) to 5 (completely agree). Score range: 12 to 60. Score interpretation: Higher scores indicate a higher level of perceived empowerment.

Change in occupational balance from baseline to post-intervention

Occupational balance will be measured through the self-administered Spanish version of the Occupational Balance Questionnaire (OBQ). The OBQ consists of 13 items assessing the person's perceived satisfaction with the amount and variety of occupations in daily life, as well as the balance between activities, rest, and participation. Each item is scored on a 6-point ordinal scale ranging from 0 (completely disagree) to 5 (completely agree). Score range: 0 to 65. Score interpretation: Higher scores indicate greater perceived occupational balance.

Perceived usability of MaKey MaKey and Scratch after the intervention

Perceived usability of MaKey MaKey and Scratch will be measured through the self-administered System Usability Scale (SUS).

The SUS consists of 10 items rated on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Item scores are converted according to the standard scoring procedure to obtain a total score ranging from 0 to 100. Score interpretation: Higher scores indicate greater perceived usability of MaKey MaKey and Scratch.

Percentage of scheduled workshop sessions attended by each participant

Attendance will be recorded by the research team at each workshop session. For each participant, the attendance rate will be calculated as the number of workshop sessions attended divided by the total number of workshop sessions offered to that participant, multiplied by 100. Percentage range: 0% to 100%. Higher percentages indicate greater attendance.

Percentage of participants who discontinue the workshop program

Discontinuation will be assessed using the attendance and continuity record completed by the research team. The discontinuation rate will be calculated as the number of enrolled participants who withdraw from the program before the final workshop session offered to them, divided by the total number of enrolled participants, multiplied by 100. The reason for discontinuation will also be recorded when known. Percentage range: 0% to 100%. Higher percentages indicate greater discontinuation from the workshop program.

Frequency of observed participation indicators during the workshop sessions

Observed participation will be assessed using a structured session observation record completed by the research team. At each workshop session, the record will document active participation, interaction with other participants, cooperation, initiative, decision-making, maintenance of a role within the group, understanding of instructions, need for support, and task completion. The frequency of each indicator across the workshop sessions will be summarized descriptively. No overall score will be calculated.

Number and type of workshop-related incidents during the intervention

Workshop-related incidents will be recorded by the research team at each workshop session. Incidents may include technical difficulties, difficulties understanding instructions, fatigue, frustration, overload, conflicts, need for additional breaks, or any other situation affecting participation or the development of the session. The total number of incidents and their frequency by category will be summarized descriptively.

Number and type of adaptations implemented during the workshop sessions

Adaptations implemented to facilitate participation will be recorded by the research team at each workshop session. These may include adjustments to materials, session duration, instructions, level of difficulty, allocation of roles, individual support, breaks, or environmental stimuli. The total number of adaptations and their frequency by category will be summarized descriptively.

Participants' experience of the co-creation workshop program

Participants' experience of the co-creation workshop program will be explored through a face-to-face focus group conducted by one of the principal investigators using a semi-structured guide. The discussion will address participants' perceptions of the sessions, positive aspects, difficulties encountered, facilitating factors, relationships within the group, perceived participation, motivation, empowerment, sense of achievement, and suggestions for improvement. The information collected will be coded and analyzed using thematic content analysis to identify the main themes. No overall numerical score will be calculated.