BackgroundInfection prevention and control can be seen as a wicked public health problem as there is no consensus regarding problem definition and solution, multiple stakeholders with different needs and values are involved, and there is no clear end-point of the problem-solving process. Co-creation with stakeholders has been proposed as a suitable strategy to tackle wicked problems, yet little information and no clear step-by-step guide exist on how to do this. The objectives of this study were to develop a guideline to assist developers in tackling wicked problems using co-creation with stakeholders, and to apply this guideline to practice with an example case in the field of infection prevention and control.MethodsA mixed-method approach consisting of the integration of both quantitative and qualitative research was used. Relevant stakeholders from the veterinary, human health, and public health sectors were identified using a literature scan, expert recommendations, and snowball sampling. The stakeholder salience approach was used to select key stakeholders based on 3 attributes: power, legitimacy, and urgency. Key values of stakeholders (N = 20) were derived by qualitative semi-structured interviews and quantitatively weighted and prioritized using an online survey.ResultsOur method showed that stakeholder identification and analysis are prerequisites for understanding the complex stakeholder network that characterizes wicked problems. A total of 73 stakeholders were identified of which 36 were selected as potential key stakeholders, and only one was seen as a definite stakeholder. In addition, deriving key stakeholder values is a necessity to gain insights into different problem definitions, solutions and needs stakeholders have regarding the wicked problem. Based on the methods used, we developed a step-by-step guideline for co-creation with stakeholders when tackling wicked problems.ConclusionsThe mixed-methods guideline presented here provides a systematic, transparent method to identify, analyze, and co-create with stakeholders, and to recognize and prioritize their values, problem definitions, and solutions in the context of wicked problems. This guideline consists of a general framework and although it was applied in an eHealth context, may be relevant outside of eHealth as well.

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Humans have remarkable perceptual capabilities. These capabilities are heavily underestimated in current visualizations [759]. Often, this is due to the lack of an in-depth user study to set the requirements for optimal visualizations. The designer does not understand what kind of information should be visualized, how it should be presented or what kind of interactions should be supported. The key elements of successful information visualization are the correct data using the best visualization technique and the best interaction techniques with respect to users. If one of these elements is ignored, people might interpret the data in the wrong way and thus might not understand the underlying information or a pattern.In order to design effective interactive visualizations, it is important to take into account the limitations of human perception, context of use, and the goals and activities that are to be performed to reach these goals. In order to obtain a usable application, developers have to pay attention to the user's working environment and tasks; this focus-on-user idea is comprised in the human-centered concept.The next section discusses usability (the property of being usable) from the human-centered point of view. Usability has application in many areas, but our focus is on the human-centered approach to design of interactive systems, also called user-centered , in order to inform the reader on how to design visualizations according to human cognitive and perceptual abilities, specific to the context of use and goals of potential users. Then, the usability concept is explained in the "Usability in Human-Centered Design" section. The next Section "User Aims and Requirements" discusses how to define a user group, establish user goals and requirements. Finally, an overview of the different evaluation methods and current evaluation practices, including the practical issues of experiment design that can help to improve the effectiveness of visualizations is presented in the "Evaluation of Visualizations Environments" and "User Studies and a Science of Visualization" sections. Stone et al. [798] describe a human-centered design giving the following definition: Human-Centered Approach

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The paper presents a design exploration into emotional communication through mobile phones for teenagers. A participatory design approach was followed, that lead to the development of two potential enhancements to text messaging services that are feasible with today's mobile phones. These enhancements refer to using MMS technology for: identifying callers through personalized avatars which are also coupled with context related information for the caller and using semi-automated text enhancements. Preliminary evaluation results are encouraging regarding the value of the emotional and contextual cues that can be conveyed in this way.