JMIR Publications

ABSTRACT

Background:

Self-monitoring applications for bipolar disorder are increasing in numbers. The application of user-centred design (UCD) is becoming standardised to optimise the reach, adoption and sustained use of this type of technology.

Objective:

This paper presents the current landscape regarding UCD and evaluation of self-monitoring applications for bipolar disorder by investigating two specific questions a) are the design principles of UCD being implemented? and b) if so, how?

Methods:

To explore these practices, we review available literature for self-tracking technology for bipolar disorder and make an overall assessment of the level of user-involvement in design. The findings from this review are used to form best practice “ingredients” for design of mental health technology, which combines the already existing practices of patient and public involvement and human-computer interaction in order to evolve from the generic guidelines of UCD and to ones that are tailored towards mental health technology.

Results:

For question a), it was found that out of the 13 novel smartphone applications included in this review, 4 self-monitoring applications were classified as having no mention of user involvement in design, 3 self-monitoring applications were classified as having low user-involvement, 4 self-monitoring applications were classified was having medium user involvement and 2 self-monitoring applications were classified as high user involvement. In regards to question b), it was found that despite the presence of recommended standards for the involvement of the user in the process of design and evaluation, there is large variability in whether the user is involved, how they are involved and to what extent there is a genuine empowerment in the voice of the user, which is the ultimate aim of design approaches involved in mental health technology.

Conclusions:

The findings of this study were reviewed by an expert panel, including an individual with lived experience of bipolar disorder. It is recommended that users are involved in all stages of design with the ultimate goal to empower and create empathy for the user. Users should be involved early in the process of design and this should not just be limited to design itself, but also associated research ensuring end-to-end involvement. The communities in healthcare based design and human-computer interaction design need to work together to increase awareness of the different methods available and to encourage the use and mixing of the methods, as well as establish better mechanisms to reach the target user group. Future research using systematic literature search methods should explore this further.