Human-centered Design Methodologies Research Articles

50 Co-designing an intervention with asylum seeking youth to improve access to healthcare in Canada using human-centered design

Abstract 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.

HumanEnerg Hotspot: Conceptual Design of an Agile Toolkit for Human Energy Reinforcement in Industry 5.0

This paper presents the conceptual design of the HumanEnerg Hotspot, an agile toolkit aimed at addressing the human energy crisis in the context of Industry 5.0. The toolkit has been developed using a blend of Design Science Research (DSR) and Human-Centered Design (HCD) methodologies, enabling a comprehensive human-centered problem identification and solution-seeking approach. The toolkit includes a variety of strategies, techniques, frameworks, and resource recommendations for industry use and has been designed to be easily adaptable for use in diverse industry settings. The toolkit is intended to support the European Union’s goal for industry to influence society through a human-centric approach to Industry 5.0 by prioritizing human energy reinforcement and creating a more resilient and productive workforce. The toolkit provides a valuable resource for employees and managers alike and offers a promising solution for addressing the human energy crisis in the era of Industry 5.0.

Centering Communities in Global Health: Using Human-Centered Design to Facilitate Collaboration and Intervention Development.

Utilizing iterative and collaborative tools, Human-centered Design (HCD) facilitates the creation of tailored solutions for multifaceted issues by fostering empathy and a deep understanding of human behaviors. This paper presents insights gleaned from employing HCD tools to center communities in global health intervention development. The study team collaborated with community members in Dailekh, Nepal to co-design interventions to address harms associated with menstrual seclusion, known as chhaupadi. A Community Design Team, comprising 10 women representing various castes and ages convened for a four-day intervention co-design workshop in the community. A Community Validation Team, comprising 12 individuals from diverse occupational and caste backgrounds provided feedback on the interventions. Additionally, six village leaders participated in Key Informant Interviews to garner additional insights. In the study's initial "discovery" phase, the Community Design Team employed HCD tools to generate a nuanced understanding of the context, stakeholders, and community experiences. Subsequently, in the second "design" phase, the Community Design Team crafted interventions to address harms associated with chhaupadi. Invaluable lessons gained from this study underscore the necessity of crafting contextually suitable tools, checklists, and prompts for participants, allocating sufficient staff, time, and resources, and adapting to participants' literacy levels and engagement preferences, whether through group or individual activities. Reflecting on these insights, our experience suggests HCD offers promising tools to authentically and equitably involve participants with diverse backgrounds in articulating their own ideas for community-based solutions in Nepal. Health practitioners, researchers, and intervention development experts are encouraged to consider adopting HCD methodologies to prioritize community voices in devising solutions for complex health challenges.

Learning engineering: Past, present and future

Learning engineering is a term and combines the process and practice that applies the sciences of learning using human-centered engineering design methodologies and data-driven decision making to support learners and their development. This term is about problem solving and aims to support learners and their development. In line with the indicated highlights and the aim of the term, this editorial study aims to investigate the history of the learning engineering. Accordingly, the study is structured into three sections: While the introduction part over the past and present perspectives of the learning engineering, the second part is constructed as follows: (1) definition of learning engineering (2) key components of learning engineering (3) instructional design in learning engineering (4) benefits of learning engineering (5) challenges and considerations (6) future of learning engineering. Finally, the conclusion and suggestion part is focused the role of learning engineering in the forthcoming era.

Integrating human-centered design in public health data dashboards: lessons from the development of a data dashboard of sexually transmitted infections in New York State.

The increased availability of public data and accessible visualization technologies enhanced the popularity of public health data dashboards and broadened their audience from professionals to the general public. However, many dashboards have not achieved their full potential due to design complexities that are not optimized to users' needs. We used a 4-step human-centered design approach to develop a data dashboard of sexually transmitted infections for the New York State Department of Health: (1) stakeholder requirements gathering, (2) an expert review of existing data dashboards, (3) a user evaluation of existing data dashboards, and (4) an usability evaluation of the prototype dashboard with an embedded experiment about visualizing missing race and ethnicity data. Step 1 uncovered data limitations and software requirements that informed the platform choice and measures included. Step 2 yielded a checklist of general principles for dashboard design. Step 3 revealed user preferences that influenced the chart types and interactive features. Step 4 uncovered usability problems resulting in features such as prompts, data notes, and displaying imputed values for missing race and ethnicity data. Our final design was accepted by program stakeholders. Our modifications to traditional human-centered design methodologies to minimize stakeholders' time burden and collect data virtually enabled project success despite barriers to meeting participants in-person and limited public health agency staff capacity during the COVID-19 pandemic. Our human-centered design approach and the final data dashboard architecture could serve as a template for designing public health data dashboards elsewhere.

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

U.S. organizations are facing a self-resignation problem. Employees are leaving their jobs in rates never seen before mainly due to human dissatisfactions. The high staff turnover rates put organizations in jeopardy compromising their entire operation. Organizations that are not able to retain and attract local talent can incur in ergonomics, quality, productivity problems and additional business risks. We propose an empirical study conducted in a plant-based food company located in the Northwest of the United States, facing a turnover problem, to bring new knowledge in the field of employee experience. Based on the Human-Centered Design (HCD) and case study methodologies, we conducted 152 in-depth interviews with the operational workforce from the company of the case study to discover the employee needs. Later, we evaluated data obtained from the interviewees applying HCD principles (convergent and divergent techniques). After grouping our data, we identified ten themes “communication”, “training”, “accountability”, “management”, “trust”, ‘safety”, “equipment functionality”, “favoritism”, “food safety”, “recognition”, “culture”, and “work environment”. We propose the themes can help decision makers to ideate organizational strategies to improve the employee experience perspective by aiming the satisfaction of human needs and human's role in the manufacturing setting.

Scoping review: exploring the equity impact of current digital health design practices

ABSTRACT 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.

Communicating Risk for Obesity in Early Life: Engaging Parents Using Human-Centered Design Methodologies.

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.

A Call to Action: Using and Extending Human-Centered Design Methodologies to Improve Mental and Behavioral Health Equity.

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.

Human-Centered Design of Mobile Health Apps for Older Adults: Systematic Review and Narrative Synthesis.

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.

Diabetes Prevention in Adolescents: Co-design Study Using Human-Centered Design Methodologies.

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.

A Patient-Centered Design Thinking Workshop to Improve Patient-Provider Communication in Cardiovascular Medicine.

Healthcare providers are expected to deliver care improvement solutions that not only provide high quality patient care, but also improve outcomes, reduce costs, ensure safety, and increase patient satisfaction. Human-centered design methodologies, such as design thinking, allow providers to collaboratively ideate solutions with patients and family members. We describe a pilot workshop designed to teach providers the stages of design thinking while working on improving patient-provider communication. Twenty-four providers (physicians, nurses, technical staff, and administrative staff) from multiple cardiovascular units attended the workshop with five former patients and family members from those units. The workshop educated on and guided teams of providers patients and family members through the stages of design thinking (empathy, define, ideate, prototype, test). Pre- and post-event assessments indicated an increase in knowledge of the design thinking methodology and participants’ ability to apply it to a clinical problem. We also present recommendations for designing a successful design thinking workshop.

Lessons Learned from Gamifying Functional Fitness Training Through Human-Centered Design Methods in Older Adults

Background: The design of meaningful and enjoyable Exergames for fitness training in older adults possesses critical challenges in matching user's needs and motivators with game elements. These challenges are often due to the lack of knowledge of seniors' game preferences and technology literacy as well as a poor involvement of the target population in the design process. Objective: This research aims at describing a detailed and scrutinized use case of applying human-centered design methodologies in the gamification of fitness training routines and illustrates how to incorporate seniors' feedback in the game design pipeline. Materials and Methods: We focus on how to use the insights from human-centered inquiries to improve in-game elements, such as mechanics or esthetics, and how to iterate the game design process based on playtesting sessions in the field. Results: We present a set of four Exergames created to train the critical functional fitness areas of older adults. We show how through rapid prototyping methods and multidisciplinary research, Exergames can be rigorously designed and developed to match individual physical capabilities. Moreover, we propose a set of guidelines for the design of context-aware Exergames based on the lessons learned. Conclusion: We highlight the process followed; it depicts 19 weeks of various activities delivering particular and actionable items that can be used as a checklist for future games for health design projects.

User experience and design thinking as a global trend in healthcare

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.

Decentering the Human in the Design of Collaborative Cities

Cities are currently being redesigned with sensors and data at their core. Environmental monitoring, crime tracking and traffic mapping are just a few examples of the socio-technical systems that are remaking cities. These systems are emergent sites of politics, values, and ethics where human and nonhuman actors collaborate, negotiate and debate the futures of their cities. One the one hand, they can be used for prediction, measurement and decision-making, but, on the other hand, they can also be harnessed to imagine alternative possible urban futures. Designers have an important role to play in mediating, making sense of, and intervening in these projects, which are at the intersection of the work of a variety of stakeholders including governments, business and citizens. This article draws on science and technology studies (STS) to think through ways designers can evolve existing human-centered design (HCD) methodologies to contend with socio-technical complexity at a time of great economic and environmental crisis. In particular, this article argues that it is necessary to create and explore methodologies that decenter the human and take the nonhuman seriously in order to meaningfully engage in the design of cities with more responsible, accountable, and ethical ways of engaging with emerging technologies.

Integracja HCD i TRIZ w projektowaniu i ocenie wyrobów

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.

Improving flight condition situational awareness through Human Centered Design

In aviation, there is currently a lack of accurate and timely situational information, specifically weather data, which is essential when dealing with the unpredictable complexities that can arise while flying. For example, weather conditions that require immediate evasive action by the flight crew, such as isolated heavy rain, micro bursts, and atmospheric turbulence, require that the flight crew receive near real-time and precise information about the type, position, and intensity of those conditions. Human factors issues arise in considering how to display the various sources of weather information to the users of that information and how to integrate this display into the existing environment. In designing weather information display systems, it is necessary to meet the demands of different users, which requires an examination of the way in which the users process and use weather information. Using Human Centered Design methodologies and concepts will result in a safer, more efficient and more intuitive solution. Specific goals of this approach include 1) Enabling better fuel planning; 2) Allowing better divert strategies; 3) Ensuring pilots, navigators, dispatchers and mission planners are referencing weather from the same sources; 4) Improving aircrew awareness of aviation hazards such as turbulence, icing, hail and convective activity; 5) Addressing inconsistent availability of hazard forecasts outside the United States Air Defense Identification Zone (ADIZ); and 6) Promoting goal driven approaches versus event driven (prediction).

Using TRIZ and human-centered design for consumer product development

TRIZ is increasingly being applied to consumer product development, in which products have to solve more than just technical problems, they have to provide compelling solutions to consumer needs. This paper discusses the use of TRIZ together with Human-Centered Design (HCD), a design methodology evolved for consumer product development. Using a case study, we illustrate why understanding user needs in consumer product development is particularly important, and then compare TRIZ and HCD methodologies. To better understand the appropriate use of TRIZ in consumer product development, we present a framework of Use, Usability and Meaning. Design situations where the emphasis is on a product‟s Use stand to benefit most from TRIZ methods, whereas for product areas with strong Meaning attached, HCD methods provide the most guidance. We finish by presenting some opportunities for successful integration of the two methodologies.

Listening to users in a manufacturing organization: a context-based approach to the development of a computer-supported collaborative work system

This paper reports the findings of a field research effort to develop a computer-supported collaborative work (CSCW) system in a power tool organization and provides an overview of the features of this system. It presents the customer-driven, context-based methodology that was used to capture the workflow and the critical issues that must be addressed by the CSCW system. It also describes the evaluation techniques and performance measures that were used to compare the resulting system with the existing product development system in the organization. It was found that a combination of ethnographic and human-centered design methodologies is a powerful approach for capturing information about stakeholder needs and using it to develop a CSCW system in such organizations. Through evaluative ethnography it was possible to determine tasks that were feasible and others that were inappropriate for integration into the CSCW system. This methodology also identified issues that hindered the adoption of the CSCW system, permitting strategies for adoption to be proposed that might serve as guidelines to designers of future CSCW systems. Lastly, this development, implementation, and evaluation of a CSCW system in an industrial environment demonstrate its effectiveness to other similar organizations that could benefit from the use of CSCW systems. Relevance to industry This paper describes the development of a computer-supported collaborative work (CSCW) system in an actual manufacturing organization using a human-centered, context-based design methodology. The evaluation of the resulting CSCW system demonstrates the effectiveness of the methodology employed, as well as the potential CSCW systems have to address the needs of product development organizations.