Remote Inclusion of Vulnerable Users in mHealth Intervention Design: Retrospective Case Analysis

Abstract

Background:The COVID-19 pandemic served as a catalyst for innovation in remote user-centered research methods, particularly through an extended use of video conferencing such as Zoom for remote user involvement.Objective: This paper aims to explore opportunities and considerations that emerged from involving vulnerable user groups remotely in designing behavioral and psychological interventions.Methods: A retrospective case analysis was conducted using a reflection-on-action approach. Remote user-centered research practices from two projects were examined, involving vulnerable populations in Norway and Australia. These projects engaged low-income/unemployed groups in synchronous user-based evaluation and testing to develop interactive and web-based behavioral interventions. Visual mapping and reflection-on-action revealed opportunities and considerations of adopting remote participatory research with vulnerable users.Results: Lessons learned for future research were identified as 1) Reduced barriers to research inclusion, 2) Digital literacy transition, 3) Contextualized insights: A window into people's lives, 4) Seamless enactment of roles and 5) Increased flexibility for researchers and participants. Conclusions:Our findings contribute knowledge on research practices that underwent substantial change during COVID-19. The analysis shows that maturing technologies and increased participant and researcher experience alleviated initial challenges. Remote methods facilitated recruitment, eased the burden of research participation, and provided a rich and relevant environment for user-centered evaluation. Unexpected benefits were found, including improved power balance between researchers and vulnerable participants as participants gained more control. The development of support procedures and tools for remote testing will be crucial to fully capitalize on efficiency gains and protect participants' privacy.