Codesign approaches involving older adults in the development of electronic healthcare tools: a systematic review

Abstract

ObjectiveThe primary aim was to review and synthesise the current evidence of how older adults are involved in codesign approaches to develop electronic healthcare tools (EHTs). The secondary aim was to identify how the codesign approaches used mutual learning techniques to benefit older adult participants.DesignSystematic review following the Preferred Reporting Items for Systematic Reviews 2020 checklist.Data sourcesPubMed, Embase and Scopus databases were searched for studies from January 2010 to March 2021.Eligibility criteriaInclusion criteria were studies employing codesign approaches to develop an EHTs, and the study population was aged 60 years and older.Data extraction and synthesisData were extracted for analysis and risk of bias. We evaluated the quality of studies using the Agency for Healthcare Research and Quality Evidence-based Practice Center approach.ResultsTwenty-five studies met the inclusion criteria for this review. All studies used at least two involvement processes, with interviews and prototypes used most frequently. Through cross-classification, we found an increased utilisation of functional prototypes in studies reaching the ‘empower’ level of participation and found that studies which benefitted from mutual learning had a higher utilisation of specific involvement processes such as focus groups and functional prototyping.ConclusionsWe found gaps to support which involvement processes, participation levels and learning models should be employed when codesigning with older adults. This is important because higher levels of participation may increase the user’s knowledge of technology, enhance learning and empower participants. To ensure studies optimise participation and learning of older adults when developing EHTs, there is a need to place more emphasis on the approaches promoting mutual learning.PROSPERO registration numberCRD42021240013.

Commentary: Strength-based co-design that EMPOWERs – Lessons from codesigning with older adults

“…Extending roles beneficiaries play in the planning and execution of the research is an essential part of empowerment. However, one of the challenges of co-designing with consumers experiencing vulnerability is that co-design research does not automatically guarantee participation (Cole et al , 2022). There is a risk that co-design research may be used to tick the participation box when, in reality, it might only offer tokenistic participation opportunities to participants, e.g.…”

“…As older consumers often reject market offerings that stereotype seniors, a deeper approach to co-design that focuses on working “with” instead of working “for” can have a real impact (Spinelli et al , 2020). Therefore, to co-design more effectively with older adults, it has been proposed to include them in the process from the recognition of needs throughout prototyping and social impact stages (Fischer et al , 2020; Cole et al , 2022).…”

Digital Health Interventions for Promoting Healthy Aging: A Systematic Review of Adoption Patterns, Efficacy, and User Experience

“…Acceptability and satisfaction are influenced by factors such as perceived usefulness, perceived ease of use, and perceived benefits. Older adults are more likely to adopt and engage with digital health interventions when they perceive them as valuable additions to their healthcare routines and as tools that enhance their overall well-being [69]. Personalization of interventions based on individual needs, preferences, and health goals can also contribute to higher acceptability and satisfaction among older adults [70].…”

“…Entertainment-based programs focusing on enjoyment over health promotion can avoid stigma and increase acceptance [68]. Codesigning interventions with end users and iteratively testing acceptability can help ensure tools align with older adults' needs and interests prior to definitive trials [69].…”

Shifting Responsibilities: Developing a Pan-European Service Model for an eHealth Technology Supporting Self-Management of People with Chronic Obstructive Pulmonary Disease and Comorbidities

“…Such co-design approaches may enhance learning and empower patients. 24 In this way, group specific challenges (such as low (e) Health literacy and low motivation 25 ) can be taking into consideration early on and the technology can be fitted towards the specific needs and capabilities of the patients. In recent years, many self-management eHealth technologies have been developed, aiming to support patients with chronic diseases and positively change healthcare (eg, 26–28 ).…”