Background: Digital health interventions are promising avenues for intervening on health behaviors, as they allow researchers to meet participants in the contexts (i.e., times and places) where interventions can be most impactful. The compelling influence of participants’ contexts and preferences on retention and participant engagement in an intervention warrants a stronger emphasis on the target audience (end user) during intervention development. User-centered design is an example of a widely accepted, cross-disciplinary method of incorporating end users’ perspectives into the design process. However, there is a lack of guidance on how to apply user-centered design principles in the development of digital health interventions.
Objective: To develop the User-Center Design Framework for Digital Health Interventions (UCD-4-DHI), a framework that considers the contexts of all users of the intervention and bridges perspectives between intervention participants, researchers, and others involved in the development and implementation process.
Methods: Framework development occurred synergistically and iteratively with the development of the Know How program, a digital health intervention for parents with low-income who live in rural areas. As such, the UCD-4-DHI is grounded in the principles of user-centered design and intervention design, and supported by the parallel development of an intervention.
Results: The UCD-4-DHI integrates each of the 4 principles of user-centered design—a) understand context of use, b) specify user requirements, c) design solutions, and d) evaluate against requirements—throughout the 4 stages of digital intervention design—1) Planning & Resources, 2) Intervention Design, 3) Digital Design, and 4) Delivery & Testing. For each stage, the UCD-4-DHI provides a description of the stage’s relevance to behavioral interventionists and presents target actions to complete. Lessons learned throughout the Know How program development process were incorporated into the framework, as were digital considerations for various users.
Conclusion: The UCD-4-DHI provides a systematic approach for applying the principles of user-centered design in developing digital health interventions within paradigms in which behavioral interventionists operate. Systematic approaches to developing and reporting on digital interventions can enhance their reproducibility and ultimately move the field forward towards more rigorous, community engaged, digital approaches.