JMIR Publications

ABSTRACT

Background:

Physical inactivity is a modifiable risk factor for dementia. Past physical activity interventions often overlook the voices of the end-user in the design process, particularly minoritized groups living with dementia, or memory challenges. One approach to address this is utilizing the principles of human-centered design to develop physical activity interventions.

Objective:

We illustrate the utility of applying human-centered design using the Innovation Biodesign (IB) framework to develop a physical activity intervention, Nurturing Aging Through-Uplifting Activities in Restorative Environment (NATURE) program for minoritized individuals as a use case.

Methods:

Methods:

The IB framework has three domains: the 1) problem space, 2) invention, and 3) solution space. Each domain includes several activities. The problem space involves a needs assessment, needs screening, evidence-based literature review, review of existing models of programs, and iterative feedback from partners leading to an invention. The solution space encompasses implementation and validation of the invention, and outcomes. We applied the IB framework in 3-steps. Step 1. Identifying the problem: We used data points from multiple sources to identify needs and mapped them onto the problem space. These sources included reviews of the literature to identify existing interventions, findings from other nature programs to surmise gaps and focus groups to iteratively identify unmet needs. Step 2. Designing the invention: We developed NATURE with Hispanic/Latino people with memory challenges and identified their preferred outcomes. Step 3. Mapping the pilot study: we added the study protocol and planned outcomes to the solution space.

Results:

Step 1. Three evidence-based programs guided the development of NATURE to address physical inactivity and related risks of decreased well-being and dementia. We received n=50 referrals for focus group participants, n=22 were eligible and completed consent, and n=21 participants (n=6 Hispanic/Latino people with memory challenges and care partners, n=8 outdoor professionals, and n=7 health care providers) completed the focus groups. We received feedback from participants on local nature activities, program frequency, duration, and delivery mode, a referral pathway, and outcomes using 5 focus groups and 2 interviews. Step 2. The 12-week NATURE program was developed to promote an active lifestyle and well-being utilizing nature activities a person enjoys. NATURE accounts for a person’s preferences, needs, and daily situation and includes 4-6 sessions with 2 phone-check-ins. Preferred outcomes were well-being, sleep, and social connections. Step 3. We mapped the plan to pilot NATURE utilizing activity tracker technology to measure sleep, heart rate, and activity (well-being) and validated questionnaires.

Conclusions:

The IB framework provided a systematic approach for mapping the development of NATURE to address the needs of Hispanic/Latino people with memory challenges utilizing principles of human-centered design. Application of the framework can be a helpful tool to map the development of other interventions for minoritized populations. Clinical Trial: ClinicalTrials.gov NCT06403345.