JMIR Publications

ABSTRACT

Background:

Effective self-care is an important factor in the successful management of patients with Heart Failure (HF). Despite the importance of self-care, the majority of HF patients are not adequately taught the wide range of skills required to become proficient in self-care. Digital Health Technology (DHT) may provide a novel solution to support patients at home, in effective self-care, with the view to enhancing quality of life and ultimately improving patient outcomes. However, many of the solutions developed to date have failed to consider the users perspective at the point of design, resulting in poor effectiveness. Leveraging a human-centred design approach to the development of digital health technologies may lead to the successful promotion of self-care behaviours in HF patients.

Objective:

This study outlines the human centred design, development and evaluation process of a DHT designed to promote effective self-care in HF patients.

Methods:

A design thinking approach within the human-centred design framework was undertaken, as described in the International Standards Organisation (ISO) 9241-210:2019 regulations, using a five step process: (1) Empathise, (2) Ideate, (3) Design (4) Develop and (5) Test. HF patients were involved throughout the design and evaluation of the system. The designed system was grounded in behaviour change theory, through the use of the Theoretical Domains Framework and included behaviour change techniques. Mixed methods were used to evaluate the DHT during the testing phase.

Results:

Steps 1 to 3 of the process resulted in a set of evidence and user informed design requirements that were carried forward into the iterative development of a version 1 system. A cross-platform (iOS; Android) mobile application that integrated with Fitbit activity trackers and smart scales was developed. A two week user-testing phase highlighted the ease-of use of the system, with patient demonstrating excellent adherence. Qualitative analysis of semi-structured interviews identified early potential for the system to positively influence their self-care. Specifically, users perceived that the system increased their confidence and motivation to engage in key self-care behaviours, provided them with skills and knowledge that made them more aware of the importance of self-care behaviours, and may facilitate timely help-seeking.

Conclusions:

The use of a HCD methodology within this research has resulted in the development of a DHT that may engage HF patients and potentially impact their self-care behaviours. This comprehensive work lays the groundwork for further development and evaluation of this solution, prior to implementation into healthcare systems. The detailed description of the HCD process used within this research will help guide the development and evaluation of future DHT, across a range of disease use-cases.