Health TAPESTRY: co-designing interprofessional primary care programs for older adults using the persona-scenario method

Abstract

Background Working with patients and health care providers to co-design health interventions is gaining global prominence. While co-design of interventions is important for all patients, it is particularly important for older adults who often experience multiple and complex chronic conditions. Persona-scenarios have been used by designers of technology applications. The purpose of this paper is to explore how a modified approach to the persona-scenario method was used to co-design a complex primary health care intervention (Health TAPESTRY) by and for older adults and providers and the value added of this approach. Methods The persona-scenario method involved patient and clinician participants from two academically-linked primary care practices. Local prospective volunteers and community service providers (e.g., home care services, support services) were also recruited. Persona-scenario workshops were facilitated by researchers experienced in qualitative methods. Working mostly in homogenous pairs, participants created a fictitious but authentic persona that represented people like themselves. Core components of the Health TAPESTRY intervention were described. Then, participants created a story (scenario) involving their persona and an aspect of the proposed Health TAPESTRY program (e.g., volunteer roles). Two stages of analysis involved descriptive identification of themes, followed by an interpretive phase to extract possible actions and products related to ideas in each theme. Results Fourteen persona-scenario workshops were held involving patients ( n = 15), healthcare providers/community care providers ( n = 29), community service providers ( n = 12), and volunteers ( n = 14). Fifty themes emerged under four Health TAPESTRY components and a fifth category - patient. Eight cross cutting themes highlighted areas integral to the intervention. In total, 414 actions were identified and 406 products were extracted under the themes, of which 44.8% of the products ( n = 182) were novel. The remaining 224 had been considered by the research team. Conclusions The persona-scenario method drew out feasible novel ideas from stakeholders, which expanded on the research team’s original ideas and highlighted interactions among components and stakeholder groups. Many ideas were integrated into the Health TAPESTRY program’s design and implementation. Persona-scenario method added significant value worthy of the added time it required. This method presents a promising alternative to active engagement of multiple stakeholders in the co-design of complex interventions. Electronic supplementary material The online version of this article (10.1186/s12875-019-1013-9) contains supplementary material, which is available to authorized users.

Co-creating Persona Scenarios with Diverse Users Enriching Inclusive Design

“…The co-created persona scenarios provided a narrative and insight into the lived experience of people with particular disabilities and health conditions, in a context and over time. This is in line with [14] who conducted similar types of persona-scenario workshops with patients and clinicians for a primary care intervention. They also found that this method provided rich descriptions and argue that the quality and quantity of ideas that were identified were significant and illustrate the added value and strength of this method.…”

“…Donald et al [13] had positive experiences of using personas in a consensus workshop with patients, and suggests using personas in patient-oriented research to explore their needs and preferences. Valaitis et al [14] have involved patients and clinicians in persona-scenario workshops for a primary care intervention.…”

Evaluating health service outcomes of public involvement in health service design in high-income countries: a systematic review

“…Where reported, public participant numbers ranged from 4 [ 83 ], to an estimated 1200 [ 84 ], though no numbers were given in 13 articles (14.0%) [ 45 , 47 , 49 , 58 , 69 , 72 – 74 , 77 , 85 – 88 ], and incomplete or estimated numbers were provided in a further 25 (26.9%) [ 40 , 43 , 44 , 50 , 51 , 56 , 57 , 61 – 63 , 66 , 76 , 82 , 84 , 89 – 99 ]. Some authors provided demographic data of public participants, such as age, gender, medical condition and/or race, however, there was no detail provided in more than half of articles ( n = 52, 55.9%) [ 37 , 38 , 40 , 41 , 43 – 51 , 55 , 58 , 59 , 61 , 63 , 66 , 68 , 69 , 71 – 74 , 77 , 79 , 81 – 88 , 93 , 95 – 110 ]. There were no studies where IAP2 public involvement level was rated as ‘Inform’, or ‘Empower’.…”

“…Evaluation of the reported outcome was outlined in less than half of studies ( n = 39, 43.3%) [ 38 , 41 – 45 , 47 – 50 , 53 , 54 , 56 – 59 , 61 , 65 , 66 , 68 – 71 , 80 , 81 , 83 – 85 , 87 , 92 , 93 , 99 , 102 , 105 , 107 , 109 , 110 , 123 , 131 ] (Additional file 2 ). Some evaluations were reported additionally [ 59 , 70 , 107 ] or exclusively [ 50 , 53 , 61 , 66 , 71 , 76 , 81 , 83 , 85 , 102 , 123 , 131 ] in separate publications.…”

Knowledge translation strategies for sharing evidence-based health information with older adults and their caregivers: Findings from a co-design study

“…In the rst phase, we conducted a qualitative study employing the persona-scenario method to co-design a set of generic design speci cations that could be applied to any ICT [21]. This innovative design approach engages users to inform program or resource development in a way that centralizes their perspectives when determining user requirements [22,23,24].…”