Applying Systems Thinking and Human-Centered Design to Development of Intervention Implementation Strategies: An Example from Adolescent Health Research

Abstract

Introducing innovative health interventions into clinic settings requires a comprehensive and creative approach to multiple implementation challenges. To optimize implementation of a sexual and reproductive health intervention for young women with depression, we applied systems thinking and human-centered design thinking methods to develop tools and strategies to address issues influencing intervention implementation in diverse clinics. We recruited staff from three clinics that provide sexual and reproductive health and behavioral health care to young women. Across five sessions (four video conference calls, one in-person workshop), we used systems mapping to identify key stakeholders and their relationships, processes, and challenges to care; formed clinic staff-investigator design teams; brainstormed about challenges that would influence intervention implementation and considered potential solutions; prioritized implementation challenges; and designed prototypes of solutions. Participants responded positively to the systems thinking perspective and collaborative design thinking process, which resulted in generalizable considerations about solving implementation challenges for clinic-based interventions.

An integrative review of human‐centered design and design thinking for the creation of health interventions

“…The empathy phase centers on understanding how an end-user thinks, how they feel, and what they do, engaging fully with the end-user in the environment and situation where the problem is occurring in unprecedented ways. 31 In this phase, the designers discern contextual cues through observation and interviewing to understand the problem and needs from the user's perspective. The designers put aside their suppositions of the problem or need and allow the end-user's experiences to provide insight and guide the process.…”

“…Co-design was considered if the authors stated that they included the end-users, the people for whom the problem affected, in the design process. 31 The 5 phases of DT were considered in the analysis if the authors stated the term specifically, or, for each respective phase, included terms such as:…”

Roadmap for Creating Effective Communication Tools to Improve Health Equity for Persons With Intellectual and Developmental Disabilities

“…While poor information transfer is a well-documented barrier to health equity in the IDD population, the low uptake and mixed effectiveness of the current solutions suggest that it would be helpful to take a new approach. Recent methods of person-centered clinical tool development, such as Stanfordbased Design Thinking (41) and Applied Systems thinking (42), have shown promise in improving the implementation of clinical practices. These design methods can provide valuable insights to designing more effective information tools; they not only engage users in the creation of the tools, but actively assess each user's needs, approach, and barriers to optimal performance during the iterative design process.…”

Generating Intervention Concepts for Reducing Adolescent Relationship Abuse Inequities Among Sexual and Gender Minority Youth: Protocol for a Web-Based, Longitudinal, Human-Centered Design Study

“…Therefore, youth are uniquely poised to use web-based human-centered design methods. Previous research has shown that youth can feasibly engage in web-based research as well as in-person human-centered design activities [43][44][45][46][47]. However, to our knowledge no study has explicitly tested whether human-centered design methods are feasible, acceptable, and appropriate for engaging with youth in a fully web-based environment.…”