Background The proliferation of mobile devices has enabled new ways of delivering health services through mobile health systems. Researchers and practitioners emphasize that the design of such systems is a complex endeavor with various pitfalls, including limited stakeholder involvement in design processes and the lack of integration into existing system landscapes. Co-design is an approach used to address these pitfalls. By recognizing users as experts of their own experience, co-design directly involves users in the design process and provides them an active role in knowledge development, idea generation, and concept development. Objective Despite the existence of a rich body of literature on co-design methodologies, limited research exists to guide the co-design of mobile health (mHealth) systems. This study aims to contextualize an existing co-design framework for mHealth applications and construct guidelines to address common challenges of co-designing mHealth systems. Methods Tapping into the knowledge and experience of experts in co-design and mHealth systems development, we conducted an exploratory qualitative study consisting of 16 semistructured interviews. Thereby, a constructivist ontological position was adopted while acknowledging the socially constructed nature of reality in mHealth system development. Purposive sampling across web-based platforms (eg, Google Scholar and ResearchGate) and publications by authors with co-design experience in mHealth were used to recruit co-design method experts (n=8) and mHealth system developers (n=8). Data were analyzed using thematic analysis along with our objectives of contextualizing the co-design framework and constructing guidelines for applying co-design to mHealth systems development. Results The contextualized framework captures important considerations of the mHealth context, including dedicated prototyping and implementation phases, and an emphasis on immersion in real-world contexts. In addition, 7 guidelines were constructed that directly pertain to mHealth: understanding stakeholder vulnerabilities and diversity, health behavior change, co-design facilitators, immersion in the mHealth ecosystem, postdesign advocates, health-specific evaluation criteria, and usage data and contextual research to understand impact. Conclusions System designers encounter unique challenges when engaging in mHealth systems development. The contextualized co-design framework and constructed guidelines have the potential to serve as a shared frame of reference to guide the co-design of mHealth systems and facilitate interdisciplinary collaboration at the nexus of information technology and health research.
BACKGROUND The proliferation of mobile devices has enabled new ways of delivering health services through mobile health systems. Researchers and practitioners have emphasized that the design of such systems is a complex endeavor with various pitfalls, including limited stakeholder involvement in design processes and integration into existing system landscapes. Co-design is an approach to address these pitfalls. Despite a rich body of literature on co-design methodologies, limited research exists to guide the co-design of mHealth systems. OBJECTIVE The objectives of our study was to (1) contextualize an existing co-design framework to mHealth applications and (2) derive guidelines to address common challenges of co-designing mHealth systems. METHODS We conducted an exploratory qualitative study consisting of 16 semi-structured interviews with co-design method experts (8) and mHealth system developers (8). Data were analyzed using thematic analysis. RESULTS The contextualized framework captures important considerations of the mHealth context, including dedicated prototyping and implementation phases. Additionally, seven guidelines were developed: (1) specificity of targeted mHealth context, (2) immersion in mHealth context, (3) health behavior change, (4) co-design facilitators, (5) post-design advocates, (6) health-specific evaluation criteria, and (7) usage data and contextual research to understand impact. CONCLUSIONS System designers encounter unique challenges when engaging in mHealth development. We hope that the contextualized framework and guidelines will serve as a shared frame of reference to facilitate interdisciplinary collaboration at the nexus of information technology and health research.
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