Establishing the feasibility of a large scale RCT of Positive Behavioural and Active Support (PBAS): a digital technology for supported living services in learning disability

Toogood, Sandy, Evans, Claire, Taylor, Valerie, Gomes, Manuel, McNamara, Rachel ORCID: https://orcid.org/0000-0002-7280-1611, Playle, Rebecca ORCID: https://orcid.org/0000-0002-2989-1092 and Totsika, Vasiliki 2025. Establishing the feasibility of a large scale RCT of Positive Behavioural and Active Support (PBAS): a digital technology for supported living services in learning disability. NIHR Open Research 5 , 60. 10.3310/nihropenres.13874.1

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Abstract

Background PBAS (Positive Behavioural and Active Support) is a digital translation of the Active Support (AS) model. AS improves quality of life by increasing activity engagement in adults with learning disabilities. This study addressed uncertainties in services so that a future trial of the PBAS app could be undertaken. The objectives were to investigate service willingness to adopt PBAS and to participate in a trial, to co-produce an evaluation package that is acceptable to staff and service users, to determine the comparator by providing an overview of systems currently used in services, and to design an economic evaluation for any Randomised Controlled Trial (RCT). Methods A service provider survey was conducted to ascertain willingness to adopt the PBAS app and participate in an RCT and to discover how activities are currently recorded. Follow-up interviews were conducted to explore facilitators and barriers. Service users and support staff views were sought to inform the design of an evaluation package. A scoping review of generic health-related Quality of Life (QoL) outcome measures was conducted. Results There was a willingness to adopt the PBAS app (45%) and participate in a future RCT (76%). Concerns were expressed about integration with existing systems, difficulties in use, costs, and demands on staff. Costs were identified as the major barrier to trial participation along with staff resistance to technology. Direct observation in people’s homes was considered acceptable by service users and staff. A suitable SCR-QoL measure (ASCOT) was identified, and a method for costing the application and existing recording systems was devised. Conclusions There was support for a trial. However, the PBAS application was discontinued. The literature on technological innovation suggests that the abandonment of new technologies with failed attempts is typical. These patterns are replicated in the health and social care sectors and may even be intensified. Keywords: Active support, Positive Behavioural Support, digital technologies, randomized controlled trials, learning disabilities, supported living.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Schools > Medicine
Publisher:	Taylor and Francis
ISSN:	2633-4402
Funders:	NIHR HTA
Date of First Compliant Deposit:	22 July 2025
Last Modified:	25 Jul 2025 10:31
URI:	https://orca.cardiff.ac.uk/id/eprint/178811

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