Digital Health Secondary Prevention Using Co-Design Procedures: Focus Group Study With Health Care Providers and Patients With Myocardial Infarction

Background Secondary prevention is an important strategy to reduce the burden of cardiovascular disease (CVD), a leading cause of death worldwide. Despite the growing evidence for the effectiveness of digital health interventions (DHIs) for the secondary prevention of CVD, the majority are designed with minimal input from target end users, resulting in poor uptake and usage. Objective This study aimed to optimize the acceptance and effectiveness of a DHI for the secondary prevention of CVD through co-design, integrating end users’ perspectives throughout. Methods A theory-driven, person-based approach using co-design was adopted for the development of the DHI, known as INTERCEPT. This involved a 4-phase iterative process using online workshops. In phase 1, a stakeholder team of health care professionals, software developers, and public and patient involvement members was established. Phase 2 involved identification of the guiding principles, content, and design features of the DHI. In phase 3, DHI prototypes were reviewed for clarity of language, ease of navigation, and functionality. To anticipate and interpret DHI usage, phase 4 involved usability testing with participants who had a recent cardiac event (<2 years). To assess the potential impact of usability testing, the System Usability Scale was administered before and after testing. The GUIDED (Guidance for Reporting Intervention Development Studies in Health Research) checklist was used to report the development process. Results Five key design principles were identified: simplicity and ease of use, behavioral change through goal setting and self-monitoring, personalization, system credibility, and social support. Usability testing resulted in 64 recommendations for the app, of which 51 were implemented. Improvements in System Usability Scale scores were observed when comparing the results before and after implementing the recommendations (61 vs 83; P=.02). Conclusions Combining behavior change theory with a person-based, co-design approach facilitated the development of a DHI for the secondary prevention of CVD that optimized responsiveness to end users’ needs and preferences, thereby potentially improving future engagement.

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Development of a Digital Health Intervention for the Secondary Prevention of Cardiovascular Disease (INTERCEPT): Co-Design and Usability Testing Study (Preprint)

Gibson,

Neubeck,

Corcoran

et al. 2024

Preprint

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BACKGROUND Secondary prevention is an important strategy to reduce the burden of cardiovascular disease (CVD), a leading cause of death worldwide. Despite the growing evidence for the effectiveness of digital health interventions (DHI) for the secondary prevention of CVD, the majority are designed with minimal input from target end users, resulting in poor uptake and usage. OBJECTIVE The objective of this study was to optimise the acceptance and effectiveness of a DHI for the secondary prevention of (CVD) through co-design, integrating end-users perspectives throughout. METHODS A theory driven, person-based approach using co-design was adopted for the development of the DHI, known as INTERCEPT. This involved a four-phase iterative process using online workshops. In phase one, a stakeholder team of healthcare professionals, software developers and public and patient involvement members was established. Phase two involved identification of the guiding principles, content and design features of the DHI. In phase three, DHI prototypes were reviewed for clarity of language, ease of navigation and functionality. To anticipate and interpret DHI usage, phase four involved usability testing with participants who had a recent cardiac event (<2 years). Improvements in usability of the DHI were assessed pre- and post-acceptance testing with the System Usability Scale (SUS). The ‘Guidance for reporting intervention development studies in health research’ (GUIDED) checklist was used to report the development process. RESULTS Five key design principles were identified: simplicity and ease of use; behavioural change through goal setting and self-monitoring; personalisation; system credibility and social support. Usability testing resulted in 64 recommendations for the app of which 51 were implemented. Significant improvements in SUS scores were observed comparing before and after implementation of recommendations (61 vs 83, P=.02). CONCLUSIONS Combining both behaviour change theory with a person based, co-design approach facilitated the development of a DHI for the secondary prevention of CVD that optimsed responsiveness to end-users needs and preferences, thereby potentially improving future engagement.

show abstract

Digital Health Secondary Prevention Using Co-Design Procedures: Focus Group Study With Health Care Providers and Patients With Myocardial Infarction

Cited by 3 publications

References 47 publications

Integrating Digital Coaching into Cardiac Practice: Strategies to Advance Health Equity

Integrating Digital Coaching into Cardiac Practice: Strategies to Advance Health Equity

Development of a Digital Health Intervention for the Secondary Prevention of Cardiovascular Disease (INTERCEPT): Co-Design and Usability Testing Study

Development of a Digital Health Intervention for the Secondary Prevention of Cardiovascular Disease (INTERCEPT): Co-Design and Usability Testing Study (Preprint)

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