Advancing Human-Centered Design Practices Among Designers in Bangladesh: Updated Insights 2024

Mental health disparities directly tie to structural racism. Digital mental health (DMH), the use of technologies to deliver services, have been touted as a way to expand access to care and reduce disparities. However, many DMH fail to mitigate the persistent disparities associated with structural racism that impact delivery (e.g., costs, dependable internet access)–and may even exacerbate them. Human-centered design (HCD) may be uniquely poised to design and test interventions alongside, rather than “for,” marginalized individuals. In employing HCD methodologies, developers may proceed with a vested interest in understanding and establishing empathy with users and their needs, behaviors, environments, and constraints. As such, HCD used to mindfully address structural racism in behavioral health care may address shortcomings of prior interventions that have neglected to elevate the voices of marginalized individuals. We argue that a paradigm shift in behavioral health services research is critically needed–one that embraces HCD as a key methodological framework for developing and evaluating interventions with marginalized communities, to ultimately promote more accessible, useful, and equitable care. The current commentary illustrates practical examples of the use of HCD methodologies to develop and evaluate DMH designed with marginalized populations, while also highlighting its limitations and need for even greater inclusivity. Following this, calls to action to learn from and improve upon HCD methodologies will be detailed. Acknowledging potential limitations of current design practices, methodologies must ultimately engage representative voices beyond research participation and invest in their active role as compensated and true collaborators to intervention design.

BackgroundThe world is aging. The number of older patients is on the rise, and along with it comes the burden of noncommunicable diseases, both clinical and economic. Attempts with mobile health (mHealth) have been made to remedy the situation with promising outcomes. Researchers have adopted human-centered design (HCD) in mHealth creation to ensure those promises become a reality.ObjectiveThis systematic review aims to explore existing literature on relevant primary research and case studies to (1) illustrate how HCD can be used to create mHealth solutions for older adults and (2) summarize the overall process with recommendations specific to the older population.MethodsWe conducted a systematic review to address the study objectives. IEEE Xplore, Medline via Ovid, PubMed, and Scopus were searched for HCD research of mHealth solutions for older adults. Two independent reviewers then included the papers if they (1) were written in English, (2) included participants equal to or older than 60 years old, (3) were primary research, and (4) reported about mHealth apps and their HCD developments from start to finish. The 2 reviewers continued to assess the included studies’ qualities using the Mixed Methods Appraisal Tool (MMAT). A narrative synthesis was then carried out and completed.ResultsEight studies passed the eligibility criteria: 5 were mixed methods studies and 3 were case studies. Some studies were about the same mHealth projects with a total of 5 mHealth apps. The included studies differed in HCD goals, target groups, and details of their HCD methodologies. The HCD process was explored through narrative synthesis in 4 steps according to the International Standardization Organization (ISO) standard 9241-210: (1) understand and specify the context of use, (2) specify the user requirements, (3) produce design solutions to meet these requirements, and (4) evaluate the designs against requirements. The overall process and recommendations unique to older adults are summarized logically with structural order and time order based on the Minto pyramid principle and ISO 9241-210.ConclusionsFindings show that HCD can be used to create mHealth solutions for older adults with positive outcomes. This review has also summarized practical HCD steps and additional suggestions based on existing literature in the subfield. However, evidence-based results are still limited because most included studies lacked details about their sampling methods and did not set objective and quantifiable goals, leading to failure to draw significant conclusions. More studies of HCD application on mHealth for older adults with measurable design goals and rigorous research strategy are warranted.

ObjectivePediatricians are well positioned to discuss early life obesity risk, but optimal methods of communication should account for parent preferences. To help inform communication strategies focused on early life obesity prevention, we employed human-centered design methodologies to identify parental perceptions, concerns, beliefs, and communication preferences about early life obesity risk.MethodsWe conducted a series of virtual human-centered design research sessions with 31 parents of infants <24 months old. Parents were recruited with a human intelligence task posted on Amazon's Mechanical Turk, via social media postings on Facebook and Reddit, and from local community organizations. Human-centered design techniques included individual short-answer activities derived from personas and empathy maps as well as group discussion.ResultsParents welcomed a conversation about infant weight and obesity risk, but concerns about health were expressed in relation to the future. Tone, context, and collaboration emerged as important for obesity prevention discussions. Framing the conversation around healthy changes for the entire family to prevent adverse impacts of excess weight may be more effective than focusing on weight loss.ConclusionsOur human-centered design approach provides a model for developing and refining messages and materials aimed at increasing parent/provider communication about early life obesity prevention. Motivating families to engage in obesity prevention may require pediatricians and other health professionals to frame the conversation within the context of other developmental milestones, involve the entire family, and provide practical strategies for behavioral change.

The integration of Artificial Intelligence (AI) into existing operational socio-technical systems presents a significant challenge, as it necessitates interventions in ongoing systems. The success of implementing new technologies critically hinges on the consideration of human factors, established workflows, and human needs. Neglecting these elements can lead to the failure of implementation at the human component. Therefore, it is imperative to involve humans not only in the development of technology but also in its implementation.This study explores how technology acceptance in socio-technical systems, particularly concerning AI, can be enhanced. Research, such as that conducted by acatech, reveals that the primary obstacle to the successful implementation of AI technologies and data-driven assistance systems is the human factor. Consequently, the inclusion of the human component in both technology development and implementation is pivotal for success.Effective knowledge transfer from research to businesses, especially within the framework of Human-Centered Design (HCD), is of utmost importance. Aligning with the United Nations’ sustainability goals is particularly supportive in creating functional networks and conserving resources. Adapting knowledge to individual practical cases is essential.The study advocates for a theoretical approach, emphasizing the necessity of HCD at different levels. HCD methodologies must be tailored to specific contexts, breaking down the approach into practical steps.There are three levels of Human Inclusion in AI Implementation:1. Technology: Adopting a genuine HCD approach, the research emphasizes moving away from inventing technology for non-existent problems or irrelevant issues. Instead, the focus should be on developing technology that addresses operational challenges.2. Organization: Training leaders, incorporating agile principles, and considering the organizational context are crucial for successful AI implementation.3. Mutual Participation: Advocating for participatory development where humans and technology collaborate, aiming to diminish technology apprehension and foster acceptance without overwhelming individuals.This study supports its arguments through existing research, logically concluding that a human-centered approach is essential for successful AI implementation. It emphasizes the need for suitable technology development aligned with operational challenges. We conclude by providing practical recommendations for implementing a human-centered approach within socio-technical systems, aiming to enhance technology acceptance without inducing change fatigue. Following the proposed approach promises technology acceptance without the negative impact of change fatigue. This outlook underscores the importance of a thoughtful and inclusive strategy in implementing AI within socio-technical systems.

Human-centered design (HCD) is a set of user-oriented principles focused on a thorough understanding of consumer needs. TRIZ focuses on the innovativeness of technical devices. TRIZ and HCD represent quite different "philosophies" of the design, manufacture and assessment of goods. It seems, however, that viewing a product from the perspective of both TRIZ and HCD methodologies provides an opportunity for consumer-focused development of products, especially consumer goods. The paper presents the cases in which emphasis is placed on product usability (TRIZ methods are applicable) as well as those areas in which HCD methods play a more significant role.

Background Digital health interventions designed through human-centered design (HCD) have shown potential to impact health equity. This scoping review aims to understand how HCD approaches in digital health impact health equity. Methodology A scoping review was undertaken. Searches were conducted on PubMed, EMBASE, Web of Science, AMC Digital Library, ProQuest Thesis and Dissertations and Global Medicus Index databases. Results A total of 6169 references were identified, and 40 of them fulfilled the inclusion criteria for analysis. The application of HCD methodologies varied greatly as did the digital health interventions. The HCD methodologies had an impact on health equity for those individuals included in the development of the digital health tools, but beyond those persons, the impact was harder to establish. Conclusion There is optimism for the role that HCD in digital health can have in reducing health inequities; however, the evidence is not robust. Most projects failed to scale up to maturity or failed to apply evaluation mechanisms to assess the health equity impact. Recommendations include rigorous application of HCD methodologies, scaling digital health tools beyond pilot projects, and embedding evaluation to determine the impact on health equity.

BackgroundThe rise in pediatric obesity and its accompanying condition, type 2 diabetes (T2D), is a serious public health concern. T2D in adolescents is associated with poor health outcomes and decreased life expectancy. Effective diabetes prevention strategies for high-risk adolescents and their families are urgently needed.ObjectiveThe aim of this study was to co-design a diabetes prevention program for adolescents by using human-centered design methodologies.MethodsWe partnered with at-risk adolescents, parents, and professionals with expertise in diabetes prevention or those working with adolescents to conduct a series of human-centered design research sessions to co-design a diabetes prevention intervention for youth and their families. In order to do so, we needed to (1) better understand environmental factors that inhibit/promote recommended lifestyle changes to decrease T2D risk, (2) elucidate desired program characteristics, and (3) explore improved activation in diabetes prevention programs.ResultsFinancial resources, limited access to healthy foods, safe places for physical activity, and competing priorities pose barriers to adopting lifestyle changes. Adolescents and their parents desire interactive, hands-on learning experiences that incorporate a sense of fun, play, and community in diabetes prevention programs.ConclusionsThe findings of this study highlight important insights of 3 specific stakeholder groups regarding diabetes prevention and lifestyle changes. The findings of this study demonstrate that, with appropriate methods and facilitation, adolescents, parents, and professionals can be empowered to co-design diabetes prevention programs.

Using TRIZ and human-centered design for consumer product development

Human-centered design, a theoretical ideal, is sometimes compromised in industry practice. Technology firms juggle competing priorities, such as adopting new technologies and generating shareholder returns, which may conflict with human-centered design values. This study sought to identify the types of workplace situations that present barriers for human-centered design, going beyond the views and behaviors of individual professionals. Q methodology was used to analyze the experiences of 14 UX professionals based in the United States. Five factors were identified, representing workplace situations in which human-centered design is inhibited, despite the involvement of UX professionals: Single-Minded Arrogance, Competing Visions, Moving Fast and Breaking Things, Pragmatically Getting By, and Sidestepping Responsibility. Underpinning these five factors are the dimensions of speed and clarity of vision. This paper demonstrates connections between the literature on UX ethics and human-centered design practice, and its findings point toward opportunities for education and intervention to better enable human-centered and ethical design in practice.

Human-centered design as a tool to improve employee experience: The case of a US plant-based food manufacturer

In the design of information technologies, the challenge of integrating a human-centered design approach with software engineering methods emerge in different forms. The main challenge is to set the ground for different disciplines and professional cultures communicate and work together. The orchestration of different contributions and the establishment of communication practices that facilitates the integration of the different languages and procedures are crucial steps to take full advantage of different research traditions. This paper presents a case study in which human-centered design and requirement engineering methodologies have been used within a large research projects aiming at developing innovative technologies and services to support professionals in nursing homes. The design process took the form of an intercultural dialogue that required human-centered and requirement-engineering professionals to work across borders. Starting from our case study, the paper presents the boundaries identified between the human-centered and the engineering perspective and proposes a framework to guide the integration process conceived as an intercultural dialogue between disciplines.KeywordsHuman-centered designRequirement engineeringinter-disciplinarity

Background Asylum seeking youth in Canada and the United States face multiple barriers to accessing healthcare, leaving them at greater risk of worse health outcomes. In a previous study, we found that limited knowledge of the Canadian health care system and few navigation supports were a key barrier to care for asylum seeking youth, yet no youth-developed intervention existed to support this population. Human-centered design (HCD) develops meaningful interventions with communities who have been historically marginalized. Objectives This study sought to co-design an intervention to increase youth empowerment and access to health care for asylum seeking youth in Canada. Design/Methods This was a community-based participatory-action research (CBPAR) study, and combined human-centered design (HCD) methodologies. We obtained research ethics board approval for this study (#SMH REB 22-117). In partnership with two community organizations that supported asylum seeking youth in a large Canadian city, a youth advisory board was created. In multiple co-creation sessions over a calendar year, an intervention was developed in rapid prototyping sessions and refined with feedback, to develop a final pilot intervention. Results A total of 7 asylum-seeking youth participated in the youth advisory board, ranging in age from 12-19, representing 3 different languages and included youth who self-identified with chronic medical conditions. Over a 15-month period, they participated in 6 co-creation sessions to develop a multi-lingual, web-based tool; youth specifically stated they did not believe an app would be helpful, but rather a resource that could be easily accessed. The youth advisory board shared they had limited understanding of the Canadian healthcare system, as well as interim and provincial health insurance. Youth felt the tool should answer questions about how health insurance worked, be brightly colored, use dyslexia-friendly font and be easily saved on a smartphone as an image. A multi-lingual wallet card was developed for youth to easily present at healthcare encounters, particularly if they did not have provincial health insurance, to help youth communicate their coverage, language and needs. Conclusion To our knowledge, we developed the first co-designed tool in Canada for youth asylum seekers, by youth, to improve and empower youth to receive health care services they are entitled to through navigation support. Given the high degree of marginalization faced by asylum seeking youth, this intervention has the promise to improve health outcomes. Feasibility and acceptability of this study will be evaluated in subsequent studies.

Human-centered design describes a process and methodology that begins and ends with accommodating the needs and desires of our end users – the patients, families, providers, and other stakeholders, who each play a crucial role in the innovative healthcare creation process. Based on the desktop research it was found that human-centered design methodologies and tools are trending in the different fields and areas of healthcare design systems. It was found that customer-centric approach is the key fact of innovation creation process whether it is product or service, technology or organization level. The conclusion is that it is time for healthcare to start solving real people problems by implementing the human-centered approach in order to achieve high results and create innovative solutions that will match their customers and stakeholders needs and desires.

This paper addresses the ongoing paradigm shift in the healthcare system towards patient empowerment, emphasizing the increasing role of patients in actively managing their care through digital applications. The focus lies on the development of a patient-centered hospital app that enhances the treatment process using human-centered design methodologies. Through eight focus group discussions, two workshops, and four individual interviews with overall 30 participants, a total of 277 implied needs were gathered, which led to the specification of 141 requirements. The iterative development as part of the human-centered design process will continuously show the extent to which the identified requirements meet these needs.

Fidelity measurement is critical to ensuring that mental health interventions are delivered as intended and achieve meaningful outcomes. However, conventional fidelity tools often face challenges in real-world mental health settings, including limited usability, high resource demands, and poor contextual fit. Human-centered design (HCD) offers a promising, participatory approach to developing pragmatic fidelity tools that are usable, acceptable, and sustainable. HCD emphasizes empathy, co-creation, iterative testing, and stakeholder engagement—principles that align closely with implementation science priorities in mental health. This mini-review synthesizes current applications of core elements of HCD in fidelity measurement for mental health interventions. Drawing on case examples from youth services, community mental health, culturally adapted programs, and digital health platforms, we illustrate how HCD can enhance tool relevance, promote equity, and support sustained adoption. We also explore tensions in co-design processes, including balancing scientific rigor with adaptability, and managing resource constraints. Despite these challenges, integrating HCD into fidelity work can improve alignment with service realities, increase stakeholder ownership, and ultimately strengthen intervention quality and equity. We recommend embedding HCD principles within implementation frameworks and expanding support for participatory fidelity development. By tailoring fidelity tools to the dynamic contexts of mental health care, HCD can help bridge the gap between evidence and practice and improve mental health outcomes across diverse populations.