Human-Centered Design Techniques Research Articles

Implementing mobile health in your surgical practice: Results of a multidisciplinary convening

The perioperative journey remains complex and difficult to navigate for patients and caregivers. Poor communication and lack of care coordination lead to diminished patient satisfaction, outcomes, and system performance. Mobile health platforms have the potential to overcome some of these issues by improving care delivery through timely individualized assessments, improved patient education, and care coordination. Yet mobile health implementation in surgical practice remains limited. Based on a convening of experts using human-centered design techniques, an implementation guide for the integration of mobile health in perioperative care was created to assist with (1) identification of the use of mobile health within a specific surgical practice, (2) identification of the pathway to mobile health implementation, and (3) measurement of successful implementation including patient and surgical system impact. This article reviews those recommendations and provides references to additional literature, including the full implementation guide, to aid those seeking to implement mobile health in a surgical practice or system.

How might we motivate uptake of the Dual Prevention Pill? Findings from human-centered design research with potential end users, male partners, and healthcare providers.

Multipurpose prevention technologies (MPTs) combining contraception with HIV prevention offer a promising solution to uptake and adherence challenges faced with oral pre-exposure prophylaxis (PrEP). The Dual Prevention Pill (DPP), which combines oral PrEP with an oral contraceptive pill (OCP), could address unmet need for family planning (FP) and HIV prevention. This study aimed to identify barriers and motivators for DPP uptake to inform the development of a DPP demand generation strategy and broader introduction efforts for MPTs. Qualitative, ethnographic research employing human-centered design techniques was conducted in Kenya, South Africa, and Zimbabwe. A research consortium conducted 45 immersions, 34 key informant interviews, and 12 friendship circles with potential end users, male romantic partners, healthcare providers (HCPs), and cultural commentators. Creative concepts were subsequently co-created and validated in workshops with end users, male partners, and HCPs. Four major themes emerged. Women struggled to balance personal motivations with societal expectations. Relationship goals strongly influenced sexual and reproductive health decisions, particularly related to financial security and social status. Negative experiences, such as untrustworthy partners, were significant triggers for OCP and PrEP use. Lastly, male partners were concerned about the DPP upending gender norms but held more positive individual attitudes. Five initial audience segments for the DPP were identified: women seeking enjoyment outside of their primary relationship; new mothers adhering to social norms; women wanting to maintain romantic relationships; women at risk of unintended pregnancy; and women with unfaithful partners. Segments informed the development of three communication themes, with the preferred route highlighting the DPP as a tool to prepare for life's unpredictability. To effectively generate demand for the DPP, several strategies should be considered. Connecting with women's diverse identities and goals and celebrating their individuality is crucial. Linking the DPP to relationship goals reframes it as a means to protect relationships rather than a risk. Leveraging negative triggers through targeted media campaigns empowers women to take control of their sexual health during challenging moments. A balance in channel placement is necessary to raise public awareness while using more discrete channels for potentially controversial messages with male partners and wider communities.

Beyond satisfaction in person-centered pharmacy services

Patient self-reported satisfaction is commonly used as an assessment of service experience and quality for community pharmacy services. This commentary discusses alternative foundational approaches to evaluating service experience and quality in patient-centered care. It describes historical and recent literature pertaining to the development and use of satisfaction measures for service design and patient experience assessment. It then highlights potential limitations of patient satisfaction as an assessment tool for patient-centeredness and patient experience identified in the pharmacy literature, which include criticisms that use of patient satisfaction may compromise accuracy in measuring quality due to factors such as patients having poor knowledge of and low expectations for quality and having a predisposition toward rating satisfaction highly when experiencing no-cost and/or unfamiliar services. Moreover, satisfaction measurements may change based on service exposure, with patient preferences for service offerings changing with increased service exposure and variation in patient-specific and environmental factors. After discussing limitations and criticism of patient self-reported satisfaction, we introduce alternative assessments methods which may facilitate more accurate assessments of patient experience and patient-centered pharmacy services such as patient-reported outcomes measures (PROMs), patient-reported experience measures (PREMs), and human-centered design techniques such as journey mapping, prototyping, and user testing to design and assess patient-centered pharmacy services. These alternative assessments are rooted in, or related to preferred implementation science approaches to establishing, evaluating, and sustaining pharmacy services.

Human-centered designed communication tools for obesity prevention in early life

ObjectiveHow we communicate about obesity is critical as treatment paradigms shift upstream. We previously identified parental perceptions, concerns, beliefs, and communication preferences about early life obesity risk. We engaged parents of children 0 to 24 months of age and pediatricians from Indianapolis, Indiana, USA in the co-design of messages and tools that can be used to facilitate parent/provider conversations about early life obesity prevention. MethodsFrom April to June 2021, we conducted a series of co-design workshops with parents of children ages 0 to 24 months and pediatricians to identify their preferences for communicating obesity prevention in the setting of a pediatric well visit. Human-centered design techniques, including affinity diagraming and model building, were used to inform key elements of a communication model and communication strategy messages. These elements were combined and refined to create prototype tools that were subsequently refined using stakeholder feedback. ResultsParent participants included 11 mothers and 2 fathers: 8 white, 4 black, and 1 Asian; median age 33 years with 38% reporting annual household incomes less than $50,000. Pediatricians included 7 female and 6 male providers; 69% white. Through an iterative process of co-design, we created an exam room poster that addresses common misconceptions about infant feeding, sleep and exercise, and a behavior change plan to foster parent/provider collaboration focused on achieving children’s healthy weight. ConclusionsOur hands-on, collaborative approach may ultimately improve uptake, acceptability and usability of early life obesity interventions by ensuring that parents remain at the center of prevention efforts.

USING HUMAN CENTERED DESIGN TO DEVELOP TWO NEW MEASURES OF LIVING WELL WITH DEMENTIA

Abstract Background New measures are needed that can provide a holistic approach to capturing salient outcomes contributing to quality of life in dementia. Purpose: To use human centered design to develop, prototype and evaluate new positive psychosocial measures for persons living with dementia Methods This project used a conceptual framework of human centered design to obtain and analyze data from multiple sources, including individual and focus group interviews, observations in the field and related methods to enhance empathy for the lived experience of dementia, and to design prototypes for two new measures. Results Qualitative analysis of interview data, integration of data from the theoretical and empirical literature and human centered design techniques including brainstorming and ideation were used to define constructs and create prototypes for a new Living Well with Dementia Inventory and Good Day-Bad Day assessment tool. Results of qualitative analysis, item development, and initial validity assessment will be presented. Conclusion Human centered design is a useful method for development of person-centered measures. This method may complement traditional methods of instrument development and CBPR.

A human-centered designed outreach strategy for a youth contraception navigator program.

To identify key elements of an outreach strategy for a youth contraception navigator program designed to help young people overcome barriers to contraception access. A human-centered design approach was used to engage adolescents aged 15-17 in co-design sessions. Human-centered design techniques, such as affinity diagramming and model building were used to inform key elements of the communication model and the final outreach strategy messages. Messages focused on the individual, normalizing talking about birth control, acknowledging the challenges to obtaining birth control, explaining how the navigator program works resonate with young people. Having images of diverse participants, offering information about birth control, and showing images of reputable sources will enhance trust. A name (IN Control) and key elements of an outreach strategy were determined for the navigator program. It is important to work with key stakeholders and co-design the optimal strategy and messages to assure that the intended audience is reached, and the desired behavior change is achieved. Human-centered design techniques can be used to provide insight into programmatic outreach strategies for a contraception navigator program to increase their impact and ultimate success.

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.

Developing a Youth Contraception Navigator Program: A Human-Centered Design Approach

PurposeTo determine key elements of a contraception navigator program that provides a personalized approach to overcoming patient-specific barriers by a trained navigator in central Indiana. MethodsA human-centered design approach was used to engage adolescents and community stakeholders in co-design sessions. Sessions incorporated techniques, such as divergent brainwriting and journey maps, which led to the exploration of various themes that were ultimately used to inform key elements of the contraception navigator program. ResultsAdolescents aged 15–17 years (N = 35) and community stakeholders (N = 11) participated in co-design sessions. Analysis verified that the process of obtaining contraception for pregnancy prevention could be intimidating for young people. The importance of language, the presence of stigma, and the knowledge of side effects were all discussed. Essential elements of a contraceptive navigator program included building trust to ultimately co-create a plan that can overcome patient-specific barriers. Having a variety of communication methods available, as well as contraceptive side-effect support, will be essential. DiscussionUsing human-centered design techniques to engage adolescent and community stakeholders can help inform the development of a contraceptive navigator program. A trusted navigator that can address patient-specific barriers to contraception access both before and after contraception is obtained is a key element identified by stakeholders.

Development of a Digital Health Intervention for Rheumatoid Arthritis Symptom Management in a Biotechnology Industry Context: Protocol for the Application of a Human-Centered Design Framework.

BackgroundInvolving chronically ill patients in the management of their health is widely recognized as a vital component of high-quality health care. However, to assume the role of informed participants, patients need both access to their health information and assistance in interpreting such data. Smartphone technology with SMS text messaging functionality offers a convenient and minimally demanding mechanism for providing such dual capabilities to patients. To date, a number of similar digital tools have been developed for use in various chronic and progressive disease conditions, including rheumatoid arthritis.ObjectiveThis paper aims to describe the development of a research protocol that applies a human-centered design (HCD) approach to develop a mobile health (mHealth) intervention to support symptom management and treatment adherence for rheumatoid arthritis.MethodsTo guide the development of the mHealth intervention for use within a commercial biotechnology context, we selected and applied an HCD framework consisting of three phases: understanding, ideation, and implementation.ResultsLeveraging the framework, we mapped the key objectives and research questions to each phase and identified the HCD techniques and methods most suitable for addressing them. In addition, we identified the need to include a fourth phase, one that referred to postimplementation assessment, which would enable evaluation of patient engagement and intervention impact on symptom self-management.ConclusionsThis paper presents a research protocol that applied an HCD framework to guide the development of an mHealth intervention within a commercial biotechnology context. This type of guidance is salient because commercial entities are becoming one of the leading producers of this type of intervention. However, the methodologies used and challenges faced from a research and development perspective are not well-represented in the published research literature to date. Our application of the HCD framework yielded important findings. Each phase of the HCD framework provided important guidance for increasing the likelihood that the final product would be understandable, acceptable, feasible, and engaging to use. Consistent with other researchers in the field of mHealth interventions, we identified the need to add a fourth phase to the HCD framework, one that focused on a postimplementation assessment to guide further improvements to support adoption in real-world settings.International Registered Report Identifier (IRRID)RR1-10.2196/16430

Applying human-centered design to maximize acceptability, feasibility, and usability of mobile technology supervision in Kenya: a mixed methods pilot study protocol

BackgroundAlthough research continues to support task-shifting as an effective model of delivering evidence-based practices (EBPs), little scholarship has focused how to scale up and sustain task-shifting in low- and middle-income countries, including how to sustainably supervise lay counselors. Ongoing supervision is critical to ensure EBPs are delivered with fidelity; however, the resources and expertise required to provide ongoing supervision may limit the potential to scale up and sustain task shifting. Opportunities may exist to leverage mobile technology to replace or supplement in-person supervision in low-resource contexts, but contextual variables, such as network connectivity and lay counselor preferences surrounding mobile technology, must be examined and considered when designing and implementing mobile technology supervision.MethodsThis study builds from an existing randomized trial in Kenya, wherein teachers and community health volunteers have been trained to provide trauma-focused cognitive behavioral therapy as lay counselors. The study will use an iterative and mixed methods approach, with qualitative interviews and a Human-Centered Design (HCD) workshop informing a non-randomized pilot trial. Semi-structured interviews will be conducted with lay counselors and supervisors to understand how mobile technology is currently being used for supervision and determine the barriers and facilitators to mobile technology supervision. Data from these interviews will inform an HCD workshop, where lay counselors and supervisors “re-design” supervision to most effectively leverage mobile technology. Workshop participants will also participate in focus groups to gather perceptions on the use of HCD techniques. The final outcome of the workshop will be a set of refined workflows, which will be tested in a mixed method, nonrandomized pilot with newly trained lay counselors and existing supervisors. The pilot trial will evaluate the acceptability, feasibility, and usability of mobile technology supervision through self-report questionnaires as well as perceptions of effectiveness through qualitative interviews with a subset of lay counselors and all supervisors.DiscussionThis study will provide a launching point for future research on supervision and methods to engage stakeholders to design and tailor interventions and implementation supports to fit low-resourced contexts.Trial registrationThe parent trial from which this study builds was registered on ClinicalTrials.gov on August 9, 2017 (NCT03243396).

Human-centered design for medical devices and diagnostics in global health

So much lifesaving medical technology exists in the world, yet so little of it benefits communities with low resources. Purchase price is only one barrier. The World Health Organization found nearly three quarters of devices provided by industrialized countries are not used when they reach low resource communities. Most medical devices and diagnostics fail to operate effectively in environments with power fluctuations, high temperatures, high humidity, dust, insect infiltration, poor availability of spare parts, high-cost consumables, and low staff-to-patient ratio. To provide robust, well-designed products for low-resource environments, devices need to be developed to address the needs of the local clinics, hospitals, and communities. Human-Centered Design (HCD) is a set of tools, processes, and mindsets that can help a team uncover the essential needs of diverse stakeholders involved in the success of medical technology for global health. This paper provides an overview of the HCD techniques we have found most useful in developing medical technology for global health applications. To illustrate the HCD techniques and their benefits, we present a case study of Design that Matters’ Firefly phototherapy. The device is now treating newborn jaundice in low-resource hospitals in over 20 low and middle-income countries.

MP71-01 A TALE OF TWO SURGERIES: A NOVEL FAMILY DESIGNED RECRUITMENT STRATEGY FOR A BLINDED, RANDOMIZED SURGICAL TRIAL IN CHILDREN

You have accessJournal of UrologyPediatrics: Upper Urinary Tract Disorders and Fetal Urology (MP71)1 Apr 2020MP71-01 A TALE OF TWO SURGERIES: A NOVEL FAMILY DESIGNED RECRUITMENT STRATEGY FOR A BLINDED, RANDOMIZED SURGICAL TRIAL IN CHILDREN William Bennett, Konrad Szymanski, Mark Cain, Rosalie Misseri, and Benjamin Whittam* William BennettWilliam Bennett More articles by this author , Konrad SzymanskiKonrad Szymanski More articles by this author , Mark CainMark Cain More articles by this author , Rosalie MisseriRosalie Misseri More articles by this author , and Benjamin Whittam*Benjamin Whittam* More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000951.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There are few randomized controlled trial (RCTs) comparing techniques in pediatric surgery. We propose the use of novel patient-centered research methods to develop a recruitment approach acceptable to pediatric patients and their families and to evaluate enrollment using this approach to conduct a pilot trial comparing open pyeloplasty (OP) vs. robotic-assisted pyeloplasty (RAP). METHODS: We performed a single-center qualitative study utilizing patient engagement methods to create a recruitment tool for a blinded, randomized controlled trial of two different surgical techniques. We enrolled a total of 28 parents to participate in three sessions focused on factors influencing the decision between RAP and OP, in order to identify barriers to randomization and blinding using established human-centered design techniques to generate multimedia tools (video and handouts) for use in recruitment. Patients planning OP or RAP as well as those who already had the procedure were recruited. RESULTS: From the initial sessions of parents of children who had either OP or RAP we discovered that the concept of two operations being interchangeable was difficult for participants to grasp. We learned to refer to them, not as two “operations”, but as two “surgical approaches”. With this knowledge, we developed two videos to introduce parents of children with ureteropelvic junction obstruction (UPJO) to the concept of clinical equipoise between the two corrective surgical approaches their child could undergo. A subsequent session with parents of children ages 2-8 years and no history of surgery or UPJO watched the two videos, discussed their choice for either approach and whether the videos altered that choice. We learned that the videos improved the parents’ understanding that two surgical approaches could be interchangeable. Using input from this last session, a final video was created to be used for a pilot prospective, blinded randomized controlled trial of RAP versus OP. To date, this video has been used with a successful enrollment rate of 92% (11 of 12 families approached over 16 months). CONCLUSIONS: Using generative qualitative human-centered design sessions, we found that the concept of clinical equipoise of two surgical approaches is a difficult concept to grasp for parents. Using concepts gleaned from this approach, we created a video focused on explaining this concept. Use of this video has resulted in over 90% patient enrollment in an ongoing randomized, blinded pilot study comparing two surgical approaches in children. Source of Funding: NIH: 1R21DK108134-01 © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1064-e1064 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information William Bennett More articles by this author Konrad Szymanski More articles by this author Mark Cain More articles by this author Rosalie Misseri More articles by this author Benjamin Whittam* More articles by this author Expand All Advertisement PDF downloadLoading ...

Leveraging human-centered design in chronic disease prevention.

Bridging the knowing-doing gap in the prevention of chronic disease requires deep appreciation and understanding of the complexities inherent in behavioral change. Strategies that have relied exclusively on the implementation of evidence-based data have not yielded the desired progress. The tools of human-centered design, used in conjunction with evidence-based data, hold much promise in providing an optimal approach for advancing disease prevention efforts. Directing the focus toward wide-scale education and application of human-centered design techniques among healthcare professionals will rapidly multiply their effective ability to bring the kind of substantial results in disease prevention that have eluded the healthcare industry for decades. This, in turn, would increase the likelihood of prevention by design.