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. 2022 Sep 9;9(3):e35693. doi: 10.2196/35693

Table 1.

Foundational publications on digital health design approaches.

Study Type Focus Summary
Digital health intervention design

Blandford et al [13], 2018 Commentary Interdisciplinary
research
Seven lessons on the multidisciplinary approach of health and HCIa to identify user needs and co-design interventions. The rupture between formative evaluation (HCI) and summative evaluation (health) is ever present in the cultures, values, and design assumptions presented.

Shaw et al [17], 2018 Commentary Implementation The potential impact of a service-design approach for improving the triple aim of health services (enhance patient experience, improve health outcomes, and reduce costs). A perspective on shifting from traditional implementation to an interactive cycle of value proposition design.

Thabrew et al [18], 2018 Review Children and young adults A summary of the core principles of agile co-design (the collective creativity of all stakeholders throughout a design project) in eHealth interventions for children and young people.

Hekler et al, 2016 [19] Commentary Behavior intervention An adaptation of agile science principles for real-world behavior change in health care. Adapting and adjusting evidence-based research to specific individuals and contexts.

Birnbaum et al [20], 2015 Commentary Patient engagement Digital health intervention design has shifted away from top-down implementation models to seeking to bridge the gap between health products and patient needs. A discussion on the evolution of UCDb to (PCDc) and (PLDd) as a health-centric response to this challenge.

Poole [9], 2013 Commentary Interdisciplinary research A call for interdisciplinary cooperation among technologists, health researchers, and HCI experts to address user acceptance and adoption in mobile health. The research highlights the barriers to successful collaboration.
User-centered design

Duque et al [21], 2019 Review Older adults A systematic review (2013-2018) of UCD approaches with older adults, including discussion on the challenges in better involving older patients in a UCD process.

Wysocki et al [22], 2018 Observational (design process) Parent (caretaker) A mixed methods study of parents of children aged <6 years with a chronic disease. The research describes the UCD process, illustrates the reach of crowdsourcing for design inputs, and summarizes the results of a randomized controlled trial.

Vilardaga et al [23], 2018 Observational (design process) Mental health A stage-by-stage walk-through of applying a UCD process in the design of a mobile health smoking cessation app; from the rationale, ideation, prototyping, design, and user research to the final feature set. Learnings are systematically reported from each stage.

Azimi et al [24], 2017 Review Older adults A discussion on the Internet of Things and its propensity to assist care for older adults and remote monitoring. An exploration of current UCD approaches in care for older adults is examined along with recommendations for future development.

Lyles et al [25], 2016 Observational (design process) Primary care An exploration of a UCD approach including patients, providers, and health stakeholders to improve primary care tools in iterative stages.

Lyon and Koerner [26], 2016 Commentary Implementation A report on using a UCD approach for psychosocial interventions as a supporting exploratory approach to evidence-based treatment. The “fail fast” mantra of agile development is weighed against empirical approaches in traditional health care.

Curtis et al [27], 2015 Observational (design process) Caretaker A blended approach of the behavior change wheel, UCD, and commercial approaches to systematically design a childhood weight management app. Parents were primary stakeholders through the process.
Person-based design

Devlin et al [3], 2016 Review Implementation Examining the implementation lessons from a large-scale deployment of a person-centered assisted living program. The challenges to work with heterogeneous groups, the resilience to break through barriers, the tensions in co-design processes, and the inherent market pressures to deliver products are all explored.

Yardley et al [28], 2015 Commentary Methodology 3 illustrations of how person-based design can be used to improve acceptability and feasibility in the formative design stages.

Yardley et al [28], 2015 Feasibility study Behavior intervention An understanding of the person-based design approach through the initial stage of planning, feasibility testing and implementation, and the second stage of identifying guiding principles to inspire and inform more context-specific behavioral issues. The perspectives of the people who use the solution are central, beyond the typical user-based analysis and validation.
Human-centered design

Wheelock et al [29], 2020 Commentary Methodology An overview of (HCD’se) overarching philosophy and its methods and practical implementation in health care. The analysis discusses the challenges to build trust within a complex stakeholder group and a call for better co-design methods to navigate this challenge.

Chancellor et al [30], 2019 Review Mental health A systematic literature review of human-centered machine learning exploring the human in HCD. The study resulted in 5 key findings on how the human is understood: (the specific) disorder, social media, the scientific, the data or machine learning, and the person.

Ragouzeos et al [31], 2019 Observational (design process) Patients An experiment to observe the collaboration of patients, designers, IT experts, and clinicians in an HCD process to prototype a rheumatoid-arthritis intervention.

Holeman and Kane [32], 2019 Review Implementation A contextualization of HCD for global health equity, and the unique offerings of HCD over traditional health care approaches to research and innovation. The research tracks over 70 HCD driven digital health initiatives.

Mummah et al [33], 2016 Framework Implementation IDEAS (integrate, design, assess, share), a framework strategy to design, develop and evaluate digital interventions and health behavior change incorporating a wide swathe of human-centered factors.

Harte et al [7], 2017 Framework Implementation A 3-phase methodology that blends use-case scenario, expert usability analysis and user testing in a connected health format that is iterative, seeking to improve human factors in collaboration.
Patient-centered design

Grisot et al [34], 2020 Case study Implementation An examination of designing for recombinability in health care. A total of 2 case studies are studied to better understand the blending of patient-centered approaches into health care design.

Boissy [35], 2020 Viewpoint Implementation A proposal for operationalized empathy, redesigning patient experience measurement and developing organizational readiness for patient-centeredness.

Espay et al [36], 2019 Review Implementation A discussion on how to road map a hybridized patient-centered and clinical outcome in the digital space for Parkinson disease.

Carter et al [37], 2018 Viewpoint Implementation A conceptualization of “clinician-innovators”: the merging of technology-enabled innovation and patient-centered care to bridge the implementation gap in digital health.

Van den Bulck et al [38], 2018 Cross-sectional study Health informatics An implementation road map for patient-centered digital outcome measures that considers patients characteristics, benefit-to-burden ratio, integration actualization and regulatory approval within the digital health system.

Tang et al [39], 2016 Viewpoint Implementation A discussion on the effectiveness of patient-centered information systems considering social and economic factors as well as disparity in multisector health outcomes.
Patient-led design

Kempner and Bailey [40], 2019 Case study Patient engagement A case study examining 2 websites on collectivizing self-experimentation and crowdsourcing in patient-led approaches.

Stolk-Vos et al [41], 2018 Feasibility study Patient engagement Feasibility study for the design of a patient-led hospital checklist to promote patient engagement and broader collaboration with health care professionals.

Leese et al [42], 2017 Case study Patient engagement A case study walk-through on a patient-led collaboration that discusses the practical, ethical, and sector disconnect issues in negotiating a patient-led approach.

aHCI: human-computer interaction.

bUCD: user-centered design.

cPCD: patient-centered design.

dPLD: patient-led design.

eHCD: human-centered design.