JMIR Publications

ABSTRACT

Background:

People often prefer evidence-based psychosocial interventions (EBPIs) for mental health care, but these interventions often remain unavailable to people in non specialty or integrated settings, such as primary care and schools. Previous research has suggested that usability–a concept from human centered design–could support an understanding of the barriers and facilitators to successful adoption of EBPIs and support the redesign of EBPIs and implementation strategies.

Objective:

We sought to identify and categorize usability issues in EBPIs and implementation strategies.

Methods:

We adapted as usability issue analysis and reporting format from human centered design. Thirteen projects supported by the NIMH-funded ALACRITY Center at the University of Washington used this format to describe usability issues the EBPIs and implementation strategies with which they were working. Center researchers used an iterative affinity diagramming and coding process to identify usability issue categories. Based on these categories and underlying issues, we propose heuristics for the design or redesign of EBPIs and implementation strategies.

Results:

The thirteen projects reported a total of 90 usability issues, which we categorized into twelve categories, including: complex and/or cognitively overwhelming; time required exceeds time available; incompatibility with interventionist preference or practice; incompatibility with existing workflow; insufficient customization to clients/recipients; intervention buy-in (value); interventionist buy-in (trust); overreliance on technology; requires unavailable infrastructure inadequate scaffolding for client/recipient; inadequate training and scaffolding for interventionist; and lack of support for necessary communication. These issues range from minor inconveniences that affect a few interventionists or recipients to severe issues that prevent all interventionists or recipients in a setting from completing part or all of the intervention. We propose twelve corresponding heuristics to guide EBPI and implementation strategy designers in preventing and addressing these usability issues.

Conclusions:

Usability issues are prevalent in the studied EBPIs and implementation strategies. We recommend using the lens of usability evaluation to understand and address barriers to effective use and reach of EBPIs and implementation strategies.