User-led Approach Research Articles

The Healthy Hearts Project: Development and evaluation of a website for cardiovascular risk assessment and visualisation and self-management through healthy lifestyle goal-setting.

Materially deprived communities in the UK have excess morbidity and mortality from cardiovascular disease (CVD) but are less likely to engage with formal care pathways. Community engagement and e-health may be more effective ways to promote risk-reducing lifestyle change. The "Healthy Hearts Project" website was designed for use by community health workers (CHWs) for cardiovascular risk assessment and lifestyle goal setting, or for independent use by community members. This paper describes the website's development and evaluation. The website was developed using interactive wire frame prototypes in a user-led approach. Qualitative evaluation of the completed website's usability and acceptability was conducted using the "Thinking Aloud" method in a purposive sample of 10 participants (one voluntary sector employee, three CHWs, two community members and four healthcare professionals). Thinking Aloud interview transcripts were thematically analysed using an inductive approach. A separate quantitative evaluation of usability and the effect of using the website on CVD knowledge and beliefs was conducted. A random sample of 134 participants, recruited using the online platform Prolific, completed the "Attitudes and Beliefs About Cardiovascular Disease" (ABCD) questionnaire before and after using the website, along with the System Usability Scale (SUS). Qualitative evaluation-Four key themes were identified: 1) Website functionality and design-participants generally found the website easy to use and understood the risk communication graphics and the feedback and goal-setting features,; 2) Inclusivity and representation-most participants considered the website inclusive of a range of users/cultures; 3) Language and comprehension-participants found the language used easy to understand but suggested reducing the amount of text; 4) Motivation and barriers to change-participants liked the personalized feedback and empowerment offered by goal-setting but commented on the need for self-motivation. Quantitative evaluation-The mean score across all domains of the ABCD questionnaire (from 2.99 to 3.11, p<0.001) and in the sub-domains relating to attitudes and beliefs around healthy eating and exercise increased after using the website. The mean(sd) score on the SUS was 77.5 (13.5). The website's usability was generally rated well by both quantitative and qualitative measures, and measures of CVD knowledge improved after use. A number of general recommendations for the design of eHealth behaviour change tools are made based on participants' suggestions to improve the website.

Personal Care Records—An Innovative User-Led Approach to Social Education

Personal Care Records—An Innovative User-Led Approach to Social Education

Evaluating User Feedback for an Artificial Intelligence-Enabled, Cognitive Behavioral Therapy-Based Mental Health App (Wysa): Qualitative Thematic Analysis.

BackgroundDigital mental health apps are rapidly becoming a common source of accessible support across the world, but their effectiveness is often influenced by limited helpfulness and engagement.ObjectiveThis study’s primary objective was to analyze feedback content to understand users’ experiences with engaging with a digital mental health app. As a secondary objective, an exploratory analysis captured the types of mental health app users.MethodsThis study utilized a user-led approach to understanding factors for engagement and helpfulness in digital mental health by analyzing feedback (n=7929) reported on Google Play Store about Wysa, a mental health app (1-year period). The analysis of keywords in the user feedback categorized and evaluated the reported user experience into the core domains of acceptability, usability, usefulness, and integration. The study also captured key deficits and strengths of the app and explored salient characteristics of the types of users who benefit from accessible digital mental health support.ResultsThe analysis of user feedback found the app to be overwhelmingly positively reviewed (6700/7929, 84.50% 5-star rating). The themes of engaging exercises, interactive interface, and artificial intelligence (AI) conversational ability indicated the acceptability of the app, while the nonjudgmentality and ease of conversation highlighted its usability. The app’s usefulness was portrayed by themes such as improvement in mental health, convenient access, and cognitive restructuring exercises. Themes of privacy and confidentiality underscored users’ preference for the integrated aspects of the app. Further analysis revealed 4 predominant types of individuals who shared app feedback on the store.ConclusionsUsers reported therapeutic elements of a comfortable, safe, and supportive environment through using the digital mental health app. Digital mental health apps may expand mental health access to those unable to access traditional forms of mental health support and treatments.

Capacity development in pursuit of social change: an examination of processes and outcomes

ABSTRACT Understanding “what works” for capacity development support in an international development setting remains an important area for operational research. This mixed-methods study explored this topic within a global programme that supports civil society organisations in fifteen countries to secure the health and human rights of marginalised and underserved populations. Taking a complex adaptive systems approach, and seeking to understand the phenomena from the “receiver” perspective, the study found that the programme fostered the development of four interconnected domains of capacity through a reflexive, user-led approach. These capacity gains could be linked, although not causally, to important programmatic achievements for the programme’s focus populations.

Design for Climate Services

Droughts, floods and other climate-related hazards present critical challenges for communities across the world. Design is well-placed to respond to such wicked problems (Buchanan, 1992) however a user-led approach to the development of climate services is rare (Christel et al, 2017). Instead, scientists and governments rely on research and innovation between science and industry to develop climate services for early warning systems and decision-making. The design community is uniquely placed to contribute to such developments, particularly in proposing new perspectives where citizens are themselves potential users of such services and at the forefront of change-making practices.

Implementing personal health budgets in England: a user-led approach to substance misuse.

Personal health budgets (PHBs) in England have been viewed as a vehicle for developing a personalised patient‐based strategy within the substance misuse care pathway. In 2009, the Department of Health announced a 3‐year pilot programme of PHBs to explore opportunities offered by this new initiative across a number of long‐term health conditions, and commissioned an independent evaluation to run alongside as well as a separate study involving two pilot sites that were implementing PHBs within the substance misuse service. The study included a quantitative and qualitative strand. The qualitative strand involved 20 semi‐structured interviews among organisational representatives at two time points (10 at each time point) between 2011 and 2012 which are the focus for this current paper. Overall, organisational representatives believed that PHBs had a positive impact on budget‐holders with a drug and/or alcohol misuse problem, their families and the health and social care system. However, a number of concerns were discussed, many of which seemed to stem from the initial change management process during the early implementation stage of the pilot programme. This study provides guidance on how to implement and offer PHBs within the substance misuse care pathway: individuals potentially would benefit from receiving their PHB post‐detox rather than at a crisis point; PHBs have the potential to improve the link to after‐care services, and direct payments can provide greater choice and control, but sufficient protocols are required.

Retrofitting an accessible highway: a user-led approach

Although accessibility for mobility-impaired pedestrians is ensured at the planning stage for new highway developments, and accessible features such as dropped kerbs would normally be included in refurbishment works, the risk is that many areas of the existing public highway will otherwise remain inaccessible for years to come. This paper details one practical response to this problem, adopted by Leeds City Council in the UK, aimed at creating accessible routes linking places where disabled people live with local facilities. The paper illustrates how the local authority works directly with users who are currently encountering problems on their regular journeys, or are unable to travel independently because of the barriers in the street environment, and with other stakeholders, to formulate a targeted programme of works (with a dedicated annual budget) to retrofit the highway and alleviate the identified access problems. This approach seems to have a number of benefits, including the allocation of resources to the areas where they are most needed and are most likely to make a difference. Initial feedback indicates wider benefits for the wellbeing and independence of disabled people, better participation and social activities and community life, reduced cost of travel and reduced reliance on care services.

DO GP USER-FEES AFFECT A&E USAGE? GP CHARGES DRIVE A&E DEMAND, FOR RICHER, FOR POORER

Objectives & BackgroundTo establish whether the need to pay for GP services including consultations, phlebotomy and referrals, affects how households utilise A&E in Jersey. To describe the reasons why households...

Provision of an integrated data analysis platform for computational neuroscience experiments

Purpose – The purpose of this paper is to provide an integrated analysis base to facilitate computational neuroscience experiments, following a user-led approach to provide access to the integrated neuroscience data and to enable the analyses demanded by the biomedical research community. Design/methodology/approach – The design and development of the N4U analysis base and related information services addresses the existing research and practical challenges by offering an integrated medical data analysis environment with the necessary building blocks for neuroscientists to optimally exploit neuroscience workflows, large image data sets and algorithms to conduct analyses. Findings – The provision of an integrated e-science environment of computational neuroimaging can enhance the prospects, speed and utility of the data analysis process for neurodegenerative diseases. Originality/value – The N4U analysis base enables conducting biomedical data analyses by indexing and interlinking the neuroimaging and clinical study data sets stored on the grid infrastructure, algorithms and scientific workflow definitions along with their associated provenance information.

CBT and Recovery From Psychosis in the ISREP Trial: Mediating Effects of Hope and Positive Beliefs on Activity

CBT and Recovery From Psychosis in the ISREP Trial: Mediating Effects of Hope and Positive Beliefs on Activity

Designing technology to improve quality of life for people with dementia: user-led approaches

This paper addresses the design of assistive technology that specifically aims to support an improvement in the quality of life of people with dementia. Starting from interviews with users, a grounded theory approach was used to compile a wish list of issues important for maintaining quality of life. A large list of potential technologies that could address these issues was generated, and four were selected for initial development: a music player, a device to reduce social isolation, a conversation prompter, and a device to support sequences of tasks. The music player and social isolation device are described in this paper in detail. A user-led approach to their design was followed, including approaches to finding control interfaces that were intuitive for people with dementia. The paper concludes with a list of recommendations for designers looking to develop equipment of this kind.

“It Gets You Away From Everyday Life”: Local Woodlands and Community Use—What Makes a Difference?

This paper explores who uses woodlands near their homes, why they visit, what benefits they believe they obtain and what makes the difference between them choosing to visit or not. In the research, supported by the Forestry Commission, a multi-method, user-led approach was used, based on focus groups, questionnaire surveys and on-site observation in relation to five different communities in the central belt of Scotland. The conclusions demonstrate the overriding importance of childhood woodland visits as predictors of adult patterns of use. Proximity of woodlands is important for regular woodland users and freedom from rubbish is the physical quality people care most about. The physical qualities that make a difference as to whether people visit woodlands or not include directional signs, good information boards, variety of trees and tidiness of appearance. Perceptions of woodlands differ according to age and sex but are predominantly positive across all groups sampled: most people feel at peace in a woodland.

What is the way forward for a user-led approach to the delivery of mental health services in primary care?

This paper describes a piece of action research which obtained users and GPs' views on the delivery of primary mental health care in Birmingham and integrated this feedback into service developments through the Practice Service Development Plan, a document submitted by all practices in Birmingham to the Family Health Services Authority (FHSA).The plan is a means whereby resources are allocated and data are collected across the city relating to practice activity. The interviews revealed that service users and GPs recognised the need for an improvement in service delivery, although the groups differed to some extent regarding which service features they wanted to see available in general practice. Despite the small numbers involved, the research has provided an essential starting point by identifying multi-professional training needs and facilitating the direct provision of funds and information to practices in order to enable the primary health care team develop a more systematic approach to mental health care which is also ultimately sensitive to the needs of service users.

User-Led Approach to Information System Investments

Summary Information-system (IS) expenditures for upstream E&amp;P have come under strong review along with other overhead expenses. Increasing frustration with IS budgets and concern about their business value led Unocal Corp. to change the way it begins, manages, and implements IS projects. Successful IS investments are aligned with the goals and functions of work groups or business units and are balanced against other investments. The twin demands of business needs and sound technical design must be served together to achieve long-term success from IS investments. This paper describes project organizations and methods to achieve these two objectives.