The Application of Human-Centered Design Approaches in Health Research and Innovation: A Narrative Review of Current Practices

Abstract

Background Human-centered design (HCD) approaches to health care strive to support the development of innovative, effective, and person-centered solutions for health care. Although their use is increasing, there is no integral overview describing the details of HCD methods in health innovations. Objective This review aims to explore the current practices of HCD approaches for the development of health innovations, with the aim of providing an overview of the applied methods for participatory and HCD processes and highlighting their shortcomings for further research. Methods A narrative review of health research was conducted based on systematic electronic searches in the PubMed, CINAHL, Embase, Cochrane Library, Web of Science, PsycINFO, and Sociological Abstracts (2000-2020) databases using keywords related to human-centered design, design thinking (DT), and user-centered design (UCD). Abstracts and full-text articles were screened by 2 reviewers independently based on predefined inclusion criteria. Data extraction focused on the methodology used throughout the research process, the choice of methods in different phases of the innovation cycle, and the level of engagement of end users. Results This review summarizes the application of HCD practices across various areas of health innovation. All approaches prioritized the user’s needs and the participatory and iterative nature of the design process. The design processes comprised several design cycles during which multiple qualitative and quantitative methods were used in combination with specific design methods. HCD- and DT-based research primarily targeted understanding the research context and defining the problem, whereas UCD-based work focused mainly on the direct generation of solutions. Although UCD approaches involved end users primarily as testers and informants, HCD and DT approaches involved end users most often as design partners. Conclusions We have provided an overview of the currently applied methodologies and HCD guidelines to assist health care professionals and design researchers in their methodological choices. HCD-based techniques are challenging to evaluate using traditional biomedical research methods. Previously proposed reporting guidelines are a step forward but would require a level of detail that is incompatible with the current publishing landscape. Hence, further development is needed in this area. Special focus should be placed on the congruence between the chosen methods, design strategy, and achievable outcomes. Furthermore, power dimensions, agency, and intersectionality need to be considered in co-design sessions with multiple stakeholders, especially when including vulnerable groups.

The Facilitation of Clinical and Therapeutic Discoveries in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome and Related Diseases: Protocol for the You + ME Registry Research Platform

“…The creation of the Registry integrated community input and human-centered design (HCD) methodologies [28]. Originally developed in the field of computer science and artificial intelligence, it has been adapted so that engagement with and understanding of the needs of users are common to all design disciplines and can be applied to a range of complex questions, from process optimization to product design [29][30][31]. We gathered qualitative narratives and quantitative data from multiple stakeholders to inform the Registry and symptom-tracking app product development, user experience, and data collection.…”

Development and Initial Testing of a Personalized, Adaptive, and Socially Focused Web Tool to Support Physical Activity Among Women in Midlife: Multidisciplinary and User-Centered Design Approach

“…The present set of studies represents only the formative steps in a long process to fully develop and test a new digital health tool. Consistent with many of the existing UCD studies, we used both quantitative and qualitative methods with modest sample sizes [ 73 ]. Each of these potential uses of the web application will require the noted substantive revisions to the tool (which are currently underway) and large-scale testing with large and more diverse samples of women in midlife.…”

“…Despite these delays, this study had several strengths, including a base of foundational work with the population of interest [ 32 , 37 , 60 , 61 , 69 ], adherence to widely recommended UCD principles [ 51 , 73 ], emphasis on recruiting women from racial or ethnic minority backgrounds to maximize diversity in small samples, and collaboration between flexible researchers who are committed to the project. This process also benefited from multiple phases of internal testing, including a range of testers who were familiar with and those who were naïve to the web application specifications and phases of both positive and negative testing.…”

Using Human-Centered Design Principles to Create a Decision Aid on Conservative Kidney Management for Advanced Kidney Disease

“…33 Human-centered design is also a novel application of stakeholder engagement towards intervention development that puts the needs of persons most affected by the problem front-and-center and involves them throughout the life cycle of intervention development to ensure that the intervention is responsive to their needs and feedback. 34 Collection of informant data from patients and families was approved by the Institutional Review Boards at University of Washington and Veterans Affairs Puget Sound Health Care System. Reporting of our development process of the decision aid was informed by the International Patient Decision Aids Standards (IPDAS) Collaboration DEVELOPTOOLS Reporting Checklist (Supplemental Item 1).…”