Use of Human-Centered Design to Improve Implementation of Evidence-Based Psychotherapies in Low-Resource Communities: Protocol for Studies Applying a Framework to Assess Usability

Lyon, Aaron R.; Munson, Sean A.; Renn, Brenna N.; Atkins, David C.; Pullmann, Michael D.; Friedman, Emily; Areán, Patricia A.

doi:10.2196/14990

Cited by 105 publications

(98 citation statements)

References 85 publications

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“…Health service fields like implementation science have yet to apply UCD extensively, although there are a growing number of examples for both intervention design studies (e.g., [29,30]) and conceptual models (e.g., [15,31]). Findings to date suggest that UCD has high relevance to most (if not all) EBPs, implementation strategies, and practice contexts within health care (see [31] in particular). Despite its potential, it remains unclear how UCD fits within the evolving landscape of implementation research and practice.…”

Section: Potential Of User-centered Designmentioning

confidence: 99%

“…Implementation is already a highly interdisciplinary field and new collaborations between implementation experts and UCD experts will be essential to capitalize on the promise of UCD for health services. Experts from these two fields have only recently begun joining together to examine the role of design in implementation, and their efforts have been primarily in the form of conceptual frameworks (e.g., [15,31]). As a step toward better understanding the alignment of implementation and UCD strategies, we used concept mapping [32] to characterize how experts from each discipline conceptualize the relations among the strategies described in these frameworks.…”

Section: Potential Of User-centered Designmentioning

confidence: 99%

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Aligning implementation and user-centered design strategies to enhance the impact of health services: results from a concept mapping study

Dopp

Parisi

Munson

et al. 2020

Implement Sci Commun

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Background: Innovative approaches are needed to maximize fit between the characteristics of evidence-based practices (EBPs), implementation strategies that support EBP use, and contexts in which EBPs are implemented. Standard approaches to implementation offer few ways to address such issues of fit. We characterized the potential for collaboration with experts from a relevant complementary approach, user-centered design (UCD), to increase successful implementation. Method: Using purposive and snowball sampling, we recruited 56 experts in implementation (n = 34) or UCD (n = 22). Participants had 5+ years of professional experience (M = 10.31), worked across many settings (e.g., healthcare, education, human services), and were mostly female (59%) and white (73%). Each participant completed a webbased concept mapping structured conceptualization task. They sorted strategies from established compilations for implementation (36 strategies) and UCD (30 strategies) into distinct clusters, then rated the importance and feasibility of each strategy. Results: We used multidimensional scaling techniques to examine patterns in the sorting of strategies. Based on conceptual clarity and fit with established implementation frameworks, we selected a final set of 10 clusters (i.e., groups of strategies), with five implementation-only clusters, two UCD-only clusters, and three trans-discipline clusters. The highest-priority activities (i.e., above-average importance and feasibility) were the trans-discipline clusters plus facilitate change and monitor change. Implementation and UCD experts sorted strategies into similar clusters, but each gave higher importance and feasibility ratings to strategies/clusters from their own discipline. Conclusions: In this concept mapping study, experts in implementation and UCD had perspectives that both converged (e.g., trans-discipline clusters, which were all rated as high-priority) and diverged (e.g., in importance/ feasibility ratings). The results provide a shared understanding of the alignment between implementation science and UCD, which can increase the impact and sustainability of EBP implementation efforts. Implications for improved collaboration among implementation and UCD experts are discussed.

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Section: Potential Of User-centered Designmentioning

confidence: 99%

Section: Potential Of User-centered Designmentioning

confidence: 99%

Aligning implementation and user-centered design strategies to enhance the impact of health services: results from a concept mapping study

Dopp

Parisi

Munson

et al. 2020

Implement Sci Commun

View full text Add to dashboard Cite

show abstract

“…Future research should explore the utility of collaborating with UCD experts or embedding UCD approaches in implementation research [73]. In particular, we argue that UCD's potential for promoting harmonization among EBP, context, and implementation should be tested empirically, work that is currently underway [74]. To the extent that UCD helps facilitate this harmonization, it will advance us towards the field's goal of bridging the gap between research and practice.…”

Section: Discussionmentioning

confidence: 99%

Harmonizing evidence-based practice, implementation context, and implementation strategies with user-centered design: a case example in young adult cancer care

Haines

Dopp

Lyon

et al. 2020

Preprint

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Background. Attempting to implement evidence-based practices in contexts for which they are not well-suited may compromise their fidelity and effectiveness or burden users (e.g., patients, providers, healthcare organizations) with elaborate strategies intended to force implementation. To improve the fit between evidence-based practices and contexts, implementation science experts have called for methods for adapting evidence-based practices and contexts, and tailoring implementation strategies; yet, methods for considering the dynamic interplay among evidence-based practices, contexts, and implementation strategies remain lacking. We argue that harmonizing the three can be accomplished with User-Centered Design, an iterative and highly stakeholder-engaged set of principles and methods. Methods. This paper presents a case example in which we used User-Centered Design methods and a three-phase User-Centered Design process to design a care coordination intervention for young adults with cancer. Specifically, we used usability testing to redesign an existing evidence-based practice (i.e., patient-reported outcome measure that served as the basis for intervention) to optimize usability and usefulness, an ethnographic user and contextual inquiry to prepare the context (i.e., comprehensive cancer center) to promote receptivity to implementation, and iterative prototyping workshops with a multidisciplinary design team to design the care coordination intervention and anticipate implementation strategies needed to enhance contextual fit. Results. Our User-Centered Design process resulted in the Young Adult Needs Assessment and Service Bridge (NA-SB), including a patient-reported outcome measure redesigned to promote usability and usefulness and a protocol for its implementation. By ensuring NA-SB directly responded to features of users and context, we designed NA-SB for implementation , potentially minimizing the strategies needed to address misalignment that may have otherwise existed. Furthermore, we designed NA-SB for scale-up ; by engaging users from other cancer programs across the country to identify points of contextual variation which would require flexibility in delivery, we created a tool not overly tailored to one unique context. Conclusions. User-Centered Design can help maximize usability and usefulness when designing evidence-based practices, preparing contexts, and informing implementation strategies- in effect, harmonizing evidence-based practices, contexts, and implementation strategies to promote implementation and effectiveness.

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“…[9][10][11] Despite being critical to implementation, aspects of intervention design quality, such as usability, have been insufficiently assessed. [12] No instruments exist to assess EBPI usability, greatly limiting implementation research. [13] Human-centered Design (hcd) Human-centered design (HCD; a.k.a., user-centered design) provides methods to evaluate the usability of CHIs in general, and EBPIs in particular.…”

Section: Introductionmentioning

confidence: 99%

Assessing the Usability of Complex Psychosocial Interventions: The Intervention Usability Scale

Lyon

Pullmann

Jacobson

et al. 2020

Preprint

Self Cite

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Background Usability – the extent to which an intervention can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction – is a key determinant of implementation success. However, usability is rarely assessed in implementation research and no instruments have been developed to measure the design quality of complex health interventions, such as the evidence-based psychosocial interventions that characterize the majority of effective practices in mental and behavioral health services. This study evaluated the structural validity of the Intervention Usability Scale (IUS), an adapted version of the well-established System Usability Scale for digital technologies, when measuring the usability of complex health interventions. Prior studies of the original System Usability Scale have found both one- and two-factor solutions, both of which were examined in the current study of the IUS. Methods A survey was administered to 205 healthcare professionals working at 11 primary care sites. Surveys collected demographic information, including each participant’s professional role (i.e., medical provider, mental/behavioral health provider, pharmacist), and IUS ratings for one of six common evidence-based psychosocial interventions (e.g., cognitive behavioral therapy, motivational interviewing) that they reported using most regularly. Factor analyses replicated the procedures used in prior research on the System Usability Scale, and a sensitivity analysis using analyses of variance compared IUS scores across different groups of respondents and interventions assessed. Results Analyses indicated that a two-factor solution (with “usable” and “learnable” subscales) in which one item was removed best fit the data. This solution accounted for 52.6% of the variance observed. Inter-item reliabilities for the total score, usable subscale, and learnable subscale were α = .83, α = .82, and α = .63, respectively. Resulting scores indicated that usability ranged from below acceptable standards to good, depending on the intervention. On average, behavioral health providers found the interventions to be more usable that other types of healthcare providers. Conclusions The current study provides evidence for a two-factor IUS structure consistent with some prior research, as well as acceptable reliability and sensitivity to role and intervention. Future directions for implementation research evaluating the usability of complex health interventions are discussed.

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Use of Human-Centered Design to Improve Implementation of Evidence-Based Psychotherapies in Low-Resource Communities: Protocol for Studies Applying a Framework to Assess Usability

Cited by 105 publications

References 85 publications

Aligning implementation and user-centered design strategies to enhance the impact of health services: results from a concept mapping study

Aligning implementation and user-centered design strategies to enhance the impact of health services: results from a concept mapping study

Harmonizing evidence-based practice, implementation context, and implementation strategies with user-centered design: a case example in young adult cancer care

Assessing the Usability of Complex Psychosocial Interventions: The Intervention Usability Scale

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