Human-centered Design Principles Research Articles

Hybrid Intelligence Systems Combining Human Expertise and AI/RPA for Complex Problem Solving

Hybrid Intelligence Systems (HIS) represent a paradigm shift in problem-solving methodologies by integrating human expertise with Artificial Intelligence (AI) and Robotic Process Automation (RPA). This paper explores the mechanisms, applications, benefits, challenges, and future directions of HIS in the context of complex problem-solving. Through collaborative synergies between human cognition and machine intelligence, HIS enhances decision-making accuracy, efficiency, and innovation. Human experts contribute domain knowledge, contextual understanding, and ethical reasoning, while AI algorithms and RPA systems offer data-driven insights, computational power, and process automation capabilities. HIS fosters inclusivity, diversity, and democratization in problem-solving processes by harnessing the collective intelligence of diverse teams and stimulating interdisciplinary collaboration. However, challenges such as privacy concerns, data security risks, and algorithmic biases must be addressed to realize the full potential of HIS. Looking ahead, the integration of Explainable AI (XAI), Edge AI, and Neuro symbolic AI holds promise for enhancing transparency, interpretability, and robustness in HIS architectures. Human-centered design principles and interdisciplinary research collaborations will shape the development and deployment of HIS, ensuring alignment with human values, preferences, and needs. Ultimately, HIS will continue to serve as a beacon of collaboration, creativity, and collective intelligence in shaping a better world for generations to come.

USER EXPERIENCE (UX) DESIGN IN MEDICAL PRODUCTS: THEORETICAL FOUNDATIONS AND DEVELOPMENT BEST PRACTICES

User Experience (UX) Design in Medical Products is pivotal in enhancing patient outcomes, satisfaction, and adherence to treatment regimens. This abstract delves into the theoretical underpinnings and best practices that underscore effective UX design within the medical domain. Grounded in human-centered design principles, this approach emphasizes understanding user needs, preferences, and limitations to develop inclusive, accessible, and intuitive interfaces. Integrating insights from behavioral psychology, UX designers leverage techniques such as persuasive design to promote healthy behaviors and facilitate adherence to medical protocols. Moreover, compliance with regulatory standards is paramount, necessitating a nuanced understanding of medical regulations and standards to ensure product safety and efficacy. Usability testing emerges as a crucial step, facilitating iterative improvements based on user feedback and ensuring that medical products are intuitive, error-resistant, and conducive to safe user interactions. Beyond functionality, considerations of data privacy and security are paramount, requiring UX designers to implement robust measures to safeguard patient confidentiality while maintaining seamless user experiences. Communication between patients and healthcare providers is also a focal point, with UX strategies aimed at enhancing information exchange, fostering trust, and facilitating informed decision-making. Additionally, optimizing workflow efficiency through streamlined task sequences and leveraging emerging technologies such as artificial intelligence and augmented reality further enhances the user experience in medical contexts. Through continual iteration and refinement, UX design in medical products strives to deliver compassionate, user-centric solutions that meet the diverse needs of patients and healthcare professionals alike, ultimately driving improved healthcare delivery and patient outcomes.
 Keywords: User Experience Design, Medical Products, Human-Centered Design, Behavioral Psychology, Regulatory Compliance, Usability Testing.

Designing an App to Support Measurement-Based Peer Supervision of Frontline Health Workers Delivering Brief Psychosocial Interventions in Texas: Multimethod Study.

The unmet need for mental health care affects millions of Americans. A growing body of evidence in implementation science supports the effectiveness of task sharing in the delivery of brief psychosocial interventions. The digitization of training and processes supporting supervision can rapidly scale up task-shared interventions and enable frontline health workers (FLWs) to learn, master, and deliver interventions with quality and support. We aimed to assess the perceived feasibility and acceptability of a novel mobile and web app designed and adapted to support the supervision, training, and quality assurance of FLWs delivering brief psychosocial interventions. We followed human-centered design principles to adapt a prototype app for FLWs delivering brief psychosocial interventions for depression, drawing from an app previously designed for use in rural India. Using a multimethod approach, we conducted focus group sessions comprising usability testing and group interviews with FLWs recruited from a large health system in Texas to assess the feasibility and acceptability of the app. The positive System Usability Scale was used to determine the app's overall usability. We also calculated the participants' likelihood of recommending the app to others using ratings of 0 to 10 from least to most likely (net promoter score). Focus group transcripts were coded and analyzed thematically, and recommendations were summarized across 4 key domains. A total of 18 FLWs varying in role and experience with client care participated in the study. Participants found the app to be usable, with an average System Usability Scale score of 72.5 (SD 18.1), consistent with the industry benchmark of 68. Participants' likelihood of recommending the app ranged from 5 to 10, yielding a net promoter score of 0, indicating medium acceptability. Overall impressions of the app from participants were positive. Most participants (15/18, 83%) found the app easy to access and navigate. The app was considered important to support FLWs in delivering high-quality mental health care services. Participants felt that the app could provide more structure to FLW training and supervision processes through the systematic collection and facilitation of performance-related feedback. Key concerns included privacy-related and time constraints regarding implementing a separate peer supervision mechanism that may add to FLWs' workloads. We designed, built, and tested a usable, functional mobile and web app prototype that supports FLW-delivered psychosocial interventions in the United States through a structured supervision mechanism and systematic collection and review of performance measures. The app has the potential to scale the work of FLWs tasked with delivering these interventions to the hardest-to-reach communities they serve. The results of this project will inform future work to evaluate the app's use and efficacy in real-world settings to support task-shared mental health programs across the United States.

An Interactive Modeling Tool for Projecting the Health and Direct Medical Cost Impact of Changes in the Sexually Transmitted Diseases Prevention Program Budgets.

Estimating the return on investment for public health services, tailored to the state level, is critical for demonstrating their value and making resource allocation decisions. However, many health departments have limited staff capacity and expertise to conduct economic analyses in-house. We developed a user-friendly, interactive Excel-based spreadsheet model that health departments can use to estimate the impact of increases or decreases in sexually transmitted infection (STI) prevention funding on the incidence and direct medical costs of chlamydia, gonorrhea, syphilis, and STI-attributable HIV infections. Users tailor results to their jurisdictions by entering the size of their population served; the number of annual STI diagnoses; their prior annual funding amount; and their anticipated new funding amount. The interface was developed using human-centered design principles, including focus groups with 15 model users to collect feedback on an earlier model version and a usability study on the prototype with 6 model users to finalize the interface. The STI Prevention Allocation Consequences Estimator ("SPACE Monkey 2.0") model will be publicly available as a free downloadable tool. In the usability testing of the prototype, participants provided overall positive feedback. They appreciated the clear interpretations, outcomes expressed as direct medical costs, functionalities to interact with the output and copy charts into external applications, visualization designs, and accessible information about the model's assumptions and limitations. Participants provided positive responses to a 10-item usability evaluation survey regarding their experiences with the prototype. Modeling tools that synthesize literature-based estimates and are developed with human-centered design principles have the potential to make evidence-based estimates of budget changes widely accessible to health departments.

More Haptic Aircraft

This paper presents a comprehensive review of haptic feedback in light aircraft control. It provides an overview of the results and experiences gained from a previous research project focused on the design and testing of pilot haptic feedback hardware. The objective of this paper is to outline a roadmap for the future development of “More Haptic Aircraft,” incorporating principles of human-centred design into light aircraft cockpits equipped with the presented haptic feedback device. The roadmap provides general requirements for pilot-aircraft interaction and highlights three specific levels of functions. These functions aim to reduce the pilot’s workload and enhance situational awareness.

Using Multiphase Optimization Strategy and Human-Centered Design to Create an Integrated Model of Palliative Care Skills in Home-Based Physical Therapy for Advanced Heart Failure.

Background: Many older adults with advanced heart failure receive home health rehabilitation after hospitalization. Yet, integration of palliative care skills into rehabilitation is limited. Objective: Describe using the Multiphase Optimization Strategy (MOST) framework with human-centered design principles to engage clinical partners in the Preparation phase of palliative physical therapy intervention development. Design: We convened a home-based physical therapy advisory team (four clinicians, three clinical leaders) to identify physical therapist needs and preferences for incorporating palliative care skills in rehabilitation and design an intervention prototype. Results: Between 2022 and 2023, we held five advisory team meetings. Initial feedback on palliative care skill preferences and training needs directly informed refinement of our conceptual model and skills in the intervention prototype. Later feedback focused on reviewing and revising intervention content, delivery strategy, and training considerations. Conclusion: Incorporating human-centered design principles within the MOST provided a useful framework to partner with clinical colleagues in intervention design.

Developing “The Health After Cancer Podcast” to amplify cancer survivors’ voices through digital storytelling

BackgroundCancer survivors experience complex medical and psychosocial challenges after a cancer diagnosis, leading to unmet informational and emotional needs. There is a paucity of cancer survivorship educational resources co-created by survivors and medical professionals. ObjectiveOur aim was to create an educational resource for cancer survivors, caregivers, and medical professionals that would leverage digital storytelling to address survivorship topics. Patient involvementOur content and production team included cancer survivors, clinicians, educators, and design experts. All content was co-created by cancer survivors and medical experts. MethodsWe conducted an environmental scan of existing cancer survivorship educational resources in academic and public domains. Applying human-centered design principles, we incorporated patient perspectives through advisory board meetings and focus groups and identified a podcast as the preferred medium. We selected content and speakers, produced the podcast, and developed a corresponding website. ResultsBased on patient recommendations, podcast episodes address mental health, fear of cancer recurrence, relationships, parenting, relating to a new body, care transitions for adult survivors of childhood cancer, disclosing health information, and financial burden of cancer. Podcast guests were invited based on lived or learned experience in these domains. Thirteen guests (survivors, experts) and four hosts (two cancer survivors, two oncologists) co-created 15 podcast episodes. Podcast guests found the storytelling experience to be powerful and therapeutic. DiscussionDigital storytelling is a scalable and accessible educational tool for communicating complex survivorship concepts that can amplify survivors’ voices and increase awareness among survivors and clinicians. Co-creation of educational resources for cancer survivorship by survivors and professionals is a feasible and innovative educational strategy. Practical ValueA podcast created by and for cancer survivors in partnership with medical experts highlights opportunities for peer-to-peer digital storytelling to foster community among survivors and caregivers. FundingPodcast production was supported by the Stanford Comprehensive Cancer Center.

Designing classroom assessments with the end user in mind

Teachers are key users of classroom assessment data; however, their needs and preferences are often overlooked in the design and development of the assessments themselves. We used principles of Human-Centered Design (HCD) to systematically solicit, study, and integrate teachers’ needs in the design and development of a classroom-based early mathematics assessment. We recruited 18 teachers to participate in a series of research activities that align with HCD methodology. Data informed the articulation of the use case and test specifications, thereby elevating teachers’ voices to improve test-development decisions that consider the end users from the start.

Interpretable AI in Medical Imaging: Enhancing Diagnostic Accuracy through Human-Computer Interaction

This study delves into the realm of Machine Learning (ML) transparency, with the goal of demystifying intricate model operations in terms of interpretability and explainability. Taking a human-centered design approach, transparency is viewed as a relational aspect between algorithms and users rather than an inherent trait of the ML model. The process involves the pivotal elements of prototyping and user evaluations to arrive at effective transparency solutions. In specialized fields such as medical image analysis, applying human-centered design principles encounters challenges due to limited user access and a knowledge gap between users and ML designers. A systematic review spanning from 2017 to 2023 scrutinized 2307 records, ultimately identifying 78 articles that met the inclusion criteria. The findings underscore the prevailing emphasis on computational feasibility in current transparent ML techniques, often at the expense of considering end users, including clinical stakeholders. Notably, a deficiency exists in formative user research guiding the design and development of transparent ML models. In response to these gaps, we put forth the INTRPRT guideline—a design directive for transparent ML in medical image analysis. Anchored in human-centered design, this guideline underscores the importance of formative user research to comprehend user needs and domain requirements. The ultimate aim is to enhance the likelihood that ML algorithms offer transparency, enabling stakeholders to harness its benefits effectively.

Addressing the Patient Experience through Human- Centred Design: A Scoping Review

Background: There is an increasing interest in patient experience for improving the quality of services together with clinical effectiveness and patient safety. Human-Centred Design (HCD), (design thinking and service design) are design approaches that are increasingly used to propose new patient-centred solutions. However, the evidence on the relationship between HCD and patient experience is at an early stage.
 Objective: This study investigates the intersection between patient experience and HCD by focusing on patient-centred care models, HCD principles, and strategies.
 Methods: First, PRISMA was used for the scoping review which includes 45 articles that apply HCD to improve patient experience. Second, the articles were analysed following the PICOS (participants, intervention, output, study design) framework. Third, a qualitative analysis of the studies was performed following the ENTREQ method to identify patterns in the relationship between HCD and patient experience. We create a framework that defines design practices in terms of three strategies (understanding people, stakeholder involvement, and systems approach) and six principles (understand, involve, evaluate, iterate, holistic experience, and multidisciplinary team), intersecting with the eight patient experience dimensions (respect, coordination, information, comfort, emotional support, involvement, continuity, access). Main results: The use of HCD primarily addresses respect for patient preferences, coordination between professionals, adequate patient information and continuity of care. 91% of the solutions derived from HCD practices pursue an improved patient experience by respecting patient values. The HCD practices reviewed to date have a high level of fidelity with ISO 9241-210 principles (78%). The most commonly employed design strategy is the involvement of patients and stakeholders in the design process. Articles that have focused on patient involvement have best met the design principles. Conclusion: This study provides a holistic understanding of how HCD has been applied to date to address the patient experience. This research organises current knowledge, identifies the dimensions of patient experience that benefit most from the application of HCD and identifies the most commonly employed design activities. 
 Patient or Public Contribution: There has been no contribution in this research other than by the authors.

Human-Centered Residential Architecture in the Post-COVID Era: Exploring Developments and Significance

This study investigates the developments and significance of human-centered residential architecture in the post-COVID era, focusing on how the pandemic has shaped architectural design better to accommodate inhabitants' evolving needs and well-being. The research employs a mixed-methods approach, combining a comprehensive literature review, expert interviews, and case studies of innovative residential projects. The literature review highlights the fundamental principles of human-centered design, emphasizing the importance of flexibility, adaptability, and the integration of outdoor and indoor spaces. Expert interviews with architects and urban planners provide insights into the challenges and opportunities faced in developing residential projects during and after the pandemic. At the same time, case studies showcase successful examples of human-centered architecture addressing the unique demands of the post-COVID context. Results indicate that the COVID-19 pandemic has accelerated the adoption of human-centered design principles in residential architecture, improving occupants' mental and physical health, enhancing social interactions, and promoting sustainability. Key findings reveal an increased emphasis on flexible living spaces, biophilic design elements, and technology integration to support remote work and communication. Furthermore, the study underscores the role of community-based amenities and shared spaces in fostering a sense of belonging and resilience. The research contributes to the growing knowledge of human-centered residential architecture post-COVID. It highlights the significance of addressing the changing needs of inhabitants to promote well-being and adaptability in an increasingly unpredictable world. The findings have practical implications for architects, urban planners, and policymakers designing and developing future residential projects. Keywords: human-centered design, residential architecture, post-COVID era, sustainable living

Advancing early relational health: a collaborative exploration of a research agenda.

Here, we introduce the Early Relational Health (ERH) Learning Community's bold, large-scale, collaborative, data-driven and practice-informed research agenda focused on furthering our mechanistic understanding of ERH and identifying feasible and effective practices for making ERH promotion a routine and integrated component of pediatric primary care. The ERH Learning Community, formed by a team of parent/caregiver leaders, pediatric care clinicians, researchers, and early childhood development specialists, is a workgroup of Nurture Connection-a hub geared toward promoting ERH, i.e., the positive and nurturing relationship between young children and their parent(s)/caregiver(s), in families and communities nationwide. In response to the current child mental health crisis and the American Academy of Pediatrics (AAP) policy statement promoting ERH, the ERH Learning Community held an in-person meeting at the AAP national headquarters in December 2022 where members collaboratively designed an integrated research agenda to advance ERH. This agenda weaves together community partners, clinicians, and academics, melding the principles of participatory engagement and human-centered design, such as early engagement, co-design, iterative feedback, and cultural humility. Here, we present gaps in the ERH literature that prompted this initiative and the co-design activity that led to this novel and iterative community-focused research agenda, with parents/caregivers at the core, and in close collaboration with pediatric clinicians for real-world promotion of ERH in the pediatric primary care setting.

From the other side of the GP's desk: a patient perspective on the Fuller report.

As the recommendations of the Fuller Review are implemented and the new system of integrated care boards becomes established, it has never been more important to involve the voices of patients and communities as we shape the future of general practice. Here, a patient offers a perspective on how we can harness multiple viewpoints and apply the principles of human-centred design to bring solutions to the challenges of access and prevention that are grounded in local communities.

Knowledge Is Power: Utilizing Human-Centered Design Principles with People Living with Dementia to Co-Design a Resource and Share Knowledge with Peers.

This paper describes the process used by a group of people living with young-onset dementia to inform the development and delivery of a post-diagnosis peer guide. It draws on the four stages of human-centered design and applies them in a new context of supporting resilience for people following a diagnosis of dementia. (1) Discover: The group discussed in-depth their perspectives on what it takes to be resilient while living with dementia and how this can be maintained. (2) Define: The group decided to collate practical information and knowledge based on their personal experiences into a booklet to support the resilience of others following a diagnosis of dementia. (3) Develop: The booklet was designed and developed together with input from other people living with dementia, facilitated by the authors. (4) Deliver: The group guided the professional production of the booklet 'Knowledge is Power'. Over 8000 copies have been distributed to memory clinics, post-diagnostic support organizations and people living with dementia across Wales. A bilingual English-Scottish Gaelic adaptation and an adaptation for people in England have since been developed. The success of 'Knowledge is Power' highlights the importance of working alongside people with dementia to share knowledge and support their resilience.

Enhancing Mental Health and Medication Adherence Among Men Who Have Sex With Men Recently Diagnosed With HIV With a Dialectical Behavior Therapy-Informed Intervention Incorporating mHealth, Online Skills Training, and Phone Coaching: Development Study Using Human-Centered Design Approach.

Mental health problems are common among men who have sex with men (MSM) living with HIV and may negatively affect medication adherence. Psychosocial interventions designed to address these urgent needs are scarce in China. Incorporating behavioral health theories into intervention development strengthens the effectiveness of these interventions. The absence of a robust theoretical basis for interventions may also present challenges to identify active intervention ingredients. This study aims to systematically describe the development of a mobile health-based intervention for MSM recently diagnosed with HIV in China, including the theoretical basis for the content and the considerations for its technological delivery. We used intervention mapping (IM) to guide overall intervention development, a behavioral intervention technology model for technological delivery design, and a human-centered design and cultural adaptation model for intervention tailoring throughout all steps of IM. The dialectical behavior therapy (DBT)-informed intervention, Turning to Sunshine, comprised 3 components: app-based individual skills learning, group-based skills training, and on-demand phone coaching. The theoretical basis for the intervention content is based on the DBT model of emotions, which fits our conceptualization of the intervention user's mental health needs. The intervention aims to help MSM recently diagnosed with HIV (1) survive moments of high emotional intensity and strong action urges, (2) change emotional expression to regulate emotions, and (3) reduce emotional vulnerability, as well as (4) augment community resources for mental health services. Technological delivery considerations included rationale of the medium, complexity, and esthetics of information delivery; data logs; data visualization; notifications; and passive data collection. This study laid out the steps for the development of a DBT-informed mobile health intervention that integrated app-based individual learning, group-based skills training, and phone coaching. This intervention, Turning to Sunshine, aims to improve mental health outcomes for MSM newly diagnosed with HIV in China. The IM framework informed by human-centered design principles and cultural adaptation considerations offered a systematic approach to develop the current intervention and tailor it to the target intervention users. The behavioral intervention technology model facilitated the translation of behavioral intervention strategies into technological delivery components. The systematic development and reporting of the current intervention can serve as a guide for similar intervention studies. The content of the current intervention could be adapted for a broader population with similar emotional struggles to improve their mental health outcomes.

Retrospective analysis of the human-centered design process used to develop a clinical decision support in the emergency department: PE Dx Study Part 2

With the growing implementation and use of health IT such as Clinical Decision Support (CDS), there is increasing attention on the potential negative impact of these technologies on patients (e.g., medication errors) and clinicians (e.g., increased workload, decreased job satisfaction, burnout). Human-Centered Design (HCD) and Human Factors (HF) principles are recommended to improve the usability of health IT and reduce its negative impact on patients and clinicians; however, challenges persist. The objective of this study is to understand how an HCD process influences the usability of health IT. We conducted a systematic retrospective analysis of the HCD process used in the design of a CDS for pulmonary embolism diagnosis in the emergency department (ED). Guided by the usability outcomes (e.g., barriers and facilitators) of the CDS use “in the wild” (see Part 1 of this research in the accompanying manuscript), we performed deductive content analysis of 17 documents (e.g., design session transcripts) produced during the HCD process. We describe if and how the design team considered the barriers and facilitators during the HCD process. We identified 7 design outcomes of the HCD process, for instance designing a workaround and making a design change to the CDS. We identify gaps in the current HCD process and demonstrate the need for a continuous health IT design process.

Assessing the implementation of user-centred design standards on assistive technology for persons with visual impairments: a systematic review.

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=307466 PROSPERO (CRD42022307466).

Risks to job quality from digital technologies: Are industrial relations in Europe ready for the challenge?

We examine job quality effects of new digital technologies, using the European frame of seven job quality domains: Pay, Working Time Quality, Prospects, Skills and Discretion, Work Intensity, Social Environment, and Physical Environment. Theoretical effects are ambivalent across all domains. The analysis of these effects confirms that digital technologies can both improve and harm job quality depending on how they are used. In light of this analysis and to think through the challenge of regulating digital technologies, we review emerging regulations across several European countries. Drawing on the principles of human-centred design, we argue that worker participation is important for securing good job quality outcomes, at both the innovation and adoption stages. We also consider the application of data protection legislation to the regulation of job quality. Overall, the paper extends debate about the future of work beyond employment and pay, on to a consideration of job quality more broadly.

Using Stakeholder Input to Guide Data Visualization and Reporting to Promote Evidence-based Practice Use in Public Schools

BackgroundHigh-quality implementation is crucial for students to reap the benefits of school-based evidence-based practices (EBP). Despite data being routinely used to support EBP delivery to students, there is a dearth of data-driven decision-making related to school-wide implementation of universal EBPs like Multi-Tiered Systems of Support (MTSS). The lack of specialized knowledge (e.g., what data to collect and how to interpret it) and systems (e.g., data teams) required to support data collection, analysis, and presentation act as barriers to school teams’ effective use of data to guide and be responsive to implementation efforts.MethodsGuided by principles of human-centered design, semi-structured interviews were conducted with 30 school-based implementation practitioners and stakeholders (principals, administrators, and expert intermediaries) to guide the development of data reports that provided information on a school or district’s implementation context (leadership, climate, and citizenship behavior).ResultsFour themes emerged from the interviews including: (1) interpretation and description of the report/feedback; (2) application of data to districts and/or schools; (3) reactions to the report; and (4) use of the report. The results of this qualitative case study point to the importance of incorporating stakeholder feedback as a methodology to ensure the end product (e.g., data report) is meaningful and applicable to the setting and has direct implications for how to incorporate stakeholder feedback to help shape and improve data visualization and interpretation for better use in schools’ decision-making process to support MTSS and other EBP implementation.ConclusionsPractical implications related to report redesign and the utility of well-designed data products to support school-based implementation are discussed.

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.