Co-design in mHealth Systems Development: Insights From a Systematic Literature Review

Noorbergen, Tyler J.; Adam, Marc T. P.; Roxburgh, Mark; Teubner, Timm

doi:10.17705/1thci.00147

Cited by 39 publications

(50 citation statements)

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“…A 2016 review [ 26 ] identified early mHealth studies that used co-design with many following an approach similar to the framework by Sanders and Stappers [ 13 ]. A 2021 review [ 27 ] documented the application contexts (eg, diabetes and nutrition), stakeholders (eg, caregivers, nurses, and specialists), and methods used in co-design mHealth studies, including a mapping to the Sanders and Stappers framework [ 13 ]. The methods that have been applied include cultural probes [ 28 - 31 ], storytelling [ 32 - 36 ], and journey maps [ 31 , 37 , 38 ].…”

Section: Introductionmentioning

confidence: 99%

Using Co-design in Mobile Health System Development: A Qualitative Study With Experts in Co-design and Mobile Health System Development

Noorbergen¹,

Adam²,

Teubner³

et al. 2021

JMIR Mhealth Uhealth

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Background The proliferation of mobile devices has enabled new ways of delivering health services through mobile health systems. Researchers and practitioners emphasize that the design of such systems is a complex endeavor with various pitfalls, including limited stakeholder involvement in design processes and the lack of integration into existing system landscapes. Co-design is an approach used to address these pitfalls. By recognizing users as experts of their own experience, co-design directly involves users in the design process and provides them an active role in knowledge development, idea generation, and concept development. Objective Despite the existence of a rich body of literature on co-design methodologies, limited research exists to guide the co-design of mobile health (mHealth) systems. This study aims to contextualize an existing co-design framework for mHealth applications and construct guidelines to address common challenges of co-designing mHealth systems. Methods Tapping into the knowledge and experience of experts in co-design and mHealth systems development, we conducted an exploratory qualitative study consisting of 16 semistructured interviews. Thereby, a constructivist ontological position was adopted while acknowledging the socially constructed nature of reality in mHealth system development. Purposive sampling across web-based platforms (eg, Google Scholar and ResearchGate) and publications by authors with co-design experience in mHealth were used to recruit co-design method experts (n=8) and mHealth system developers (n=8). Data were analyzed using thematic analysis along with our objectives of contextualizing the co-design framework and constructing guidelines for applying co-design to mHealth systems development. Results The contextualized framework captures important considerations of the mHealth context, including dedicated prototyping and implementation phases, and an emphasis on immersion in real-world contexts. In addition, 7 guidelines were constructed that directly pertain to mHealth: understanding stakeholder vulnerabilities and diversity, health behavior change, co-design facilitators, immersion in the mHealth ecosystem, postdesign advocates, health-specific evaluation criteria, and usage data and contextual research to understand impact. Conclusions System designers encounter unique challenges when engaging in mHealth systems development. The contextualized co-design framework and constructed guidelines have the potential to serve as a shared frame of reference to guide the co-design of mHealth systems and facilitate interdisciplinary collaboration at the nexus of information technology and health research.

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Section: Introductionmentioning

confidence: 99%

Using Co-design in Mobile Health System Development: A Qualitative Study With Experts in Co-design and Mobile Health System Development

Noorbergen¹,

Adam²,

Teubner³

et al. 2021

JMIR Mhealth Uhealth

Self Cite

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“…They also helped address some of the challenges of working in different locations and across digital and health fields. We recommend the use of an interactive prototyping tool to maximize the advantages of participatory design [ 72 , 73 ] in early design stages. Like Giunti et al [ 38 ], we found the use of personas (fictional characters that incorporate composite attributes of target users) a helpful way to capture and convey the varied nature of MS during preliminary stages of development [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

Creating a Digital Toolkit to Reduce Fatigue and Promote Quality of Life in Multiple Sclerosis: Participatory Design and Usability Study

Thomas¹,

Pulman²,

Doğan³

et al. 2021

JMIR Form Res

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Background Fatigue is one of the most common and debilitating symptoms of multiple sclerosis (MS), experienced by more than 80% of people with MS. FACETS (Fatigue: Applying Cognitive Behavioral and Energy Effectiveness Techniques to Lifestyle) is an evidence-based, face-to-face, 6-session group fatigue management program for people with MS. Homework tasks are an integral part of FACETS and are currently undertaken in a paper-based form. Feedback from a consultation undertaken with FACETS attendees and health care professionals with experience in delivering the FACETS program suggested that being able to complete the homework tasks digitally would be desirable, potentially enhancing engagement and adherence and enabling on-the-go access to fit into busy lifestyles. Relative to other long-term conditions, there are few apps specifically for MS and, of those available, many have been developed with little or no input from people with MS. Objective The purpose of this mixed methods study was to create a digital toolkit comprising the homework tasks (eg, activity diary, goal planner, thought diary) of the FACETS program for people with MS, considering end users’ unique requirements throughout the design, build, prototyping, and testing stages. Methods Phase 1 involved the elicitation of detailed user requirements for the toolkit via 2 focus groups with previous attendees of FACETS (n=3 and n=6) and wireframing. Phase 2 involved supervised usability testing with people with MS (n=11) with iterative prototyping. The usability sessions involved going through test scenarios using the FACETS toolkit on an Android test phone with video capture and concurrent think-aloud followed by completion of the System Usability Scale (SUS) and a semistructured interview collecting feedback about design, content, and functionality. Results The mean SUS score for the digital toolkit was 74.3 (SD 16.8, 95% CI 63.2-85.6; range 37.5-95), which equates to an adjective rating of good and a B grade (70th-79th percentile range) on the Sauro-Lewis curved grading scale. A number of usability and design issues (such as simplifying overall screen flow to better meet users’ needs) and suggestions for improvements (such as using location-based services and displaying personalized information and progress via a central dashboard) were addressed and implemented during the usability testing cycle. Conclusions This work highlights the importance of the participation of people with MS across the entire development cycle, working to a human-centered design methodology to enable a considered and MS-centered solution to be developed. Continued horizon scanning for emergent technological enhancements will enable us to identify opportunities for further improvements to the FACETS toolkit prior to launch. The toolkit supports self-monitoring and management of fatigue and has potential applicability to other long-term conditions where fatigue is a significant issue.

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“…10 A new area of research is the co-design of mobile health (mHealth) interventions, also known as digital health. 15 For example, one trial showed that a co-designed mHealth system supported stroke rehabilitation by improving communication of health advice and patient engagement. 16 A systematic literature review by Noorbergen et al 15 showed that co-designed strategies were of benefit to some rehabilitation patients.…”

Section: Open Accessmentioning

confidence: 99%

“…15 For example, one trial showed that a co-designed mHealth system supported stroke rehabilitation by improving communication of health advice and patient engagement. 16 A systematic literature review by Noorbergen et al 15 showed that co-designed strategies were of benefit to some rehabilitation patients. The literature emphasises early co-design and there is a paucity of research on the post-design phase.…”

Section: Open Accessmentioning

confidence: 99%

“…The literature emphasises early co-design and there is a paucity of research on the post-design phase. 15 A focus on postdesign implementation may elucidate how users experience the product, service or therapy environment. 17 The primary aim of this review is to explore patient experiences of co-designed interventions in rehabilitation hospitals.…”

Section: Open Accessmentioning

confidence: 99%

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Patient experiences of co-designed rehabilitation interventions: protocol for a rapid review

et al. 2022

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IntroductionPatient-centred care can be facilitated by co-design, which refers to collaboration between healthcare professionals and consumers in producing and implementing healthcare. Systematic reviews on co-design have mainly focused on the effectiveness of co-produced healthcare interventions. Less attention has been directed towards the experiences of patients in co-designed interventions. This rapid review aims to explore patient experiences of co-designed rehabilitation interventions and inform rehabilitation decision-making.Methods and analysisA rapid review will expedite timely information on co-design experiences for stakeholders. Four electronic databases, including Cochrane CENTRAL, MEDLINE, Embase and CINAHL, will be searched for papers published from 1 January 2000 to 1 January 2022. The Cochrane Risk of Bias tool will be used for randomised trials. Critical appraisal checklists from The Joanna Briggs Institute shall evaluate the risk of bias of non-randomised trials and qualitative studies. A narrative synthesis will be provided for the quantitative studies. Thematic synthesis will be conducted on qualitative findings. The overall strength of the evidence will be measured using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework for quantitative investigations and the GRADE-Confidence in Evidence from Reviews of Qualitative Research for qualitative studies. The results will be presented using narrative summaries, identified themes, summary tables, flow charts and quantitative statistical analyses.Ethics and disseminationEthics approval is not required for the review. The protocol and rapid review will be submitted to an online, open access and peer-reviewed journal for publication. The review findings will be rapidly translated to consumers, clinicians, healthcare leaders, organisations, researchers and policy makers via publications, evidence summaries, conferences, workshops, websites, social media and online events.PROSPERO registration numberCRD42021264547.

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Co-design in mHealth Systems Development: Insights From a Systematic Literature Review

Cited by 39 publications

References 0 publications

Using Co-design in Mobile Health System Development: A Qualitative Study With Experts in Co-design and Mobile Health System Development

Using Co-design in Mobile Health System Development: A Qualitative Study With Experts in Co-design and Mobile Health System Development

Creating a Digital Toolkit to Reduce Fatigue and Promote Quality of Life in Multiple Sclerosis: Participatory Design and Usability Study

Patient experiences of co-designed rehabilitation interventions: protocol for a rapid review

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