Co-design of mHealth Delivered Interventions: A Systematic Review to Assess Key Methods and Processes
Most mobile health (mHealth) programmes are designed with minimal input from target end users and are not truly personalised or adaptive to their specific and evolving needs. This review describes the methods and processes used in the co-design of mHealth interventions. Nine relevant studies of varying design were identified following searches of six academic databases. All employed co-design or participatory methods for the development of a health intervention delivered via a mobile device, with three focusing on health behaviour change (one on nutrition) and six on management of a health condition. Overall, six key phases of design and 17 different methods were used. Sufficiency of reporting was poor, and no study undertook a robust assessment of efficacy; these factors should be a focus for future studies. An opportunity exists to use co-design methods to develop acceptable and feasible mHealth interventions, especially to support improved nutrition and for minority and indigenous groups.
KeywordsCo-design Community-based participatory research Participatory action research mHealth Telemedicine Telehealth Mobile phone Methods
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 1.Forouzanfar MH, Alexander L, Anderson HR, Bachman VF, Biryukov S, Brauer M, Burnett R, Casey D, Coates MM, Cohen A, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015. doi: 10.1016/S0140-6736(15)00128-2. Published online 10 September.
- 2.Kemp S, We are social. Special report: Digital, social and mobile worldwide in 2015. Available: http://wearesocial.com/uk/special-reports/digital-social-mobile-worldwide-2015. 2015. Accessed 01 Jan 2016.
- 3.Pew Research Centre. Communications technology in emerging and developing nations. Available: http://www.pewglobal.org/2015/03/19/1-communications-technology-in-emerging-and-developing-nations/. Accessed 19 Apr 2016.
- 4.••Free C, Phillips G, Galli L, Watson L, Felix L, Edwards P, et al. The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS Med. 2013;10(1):e1001362. http://dx.doi.org/10.1371/journal.pmed.1001362 . This systematic review of randomised controlled trials summarises the current evidence for the efficacy of mobile health interventions, and includes a robust meta-analysis.CrossRefPubMedPubMedCentralGoogle Scholar
- 5.••Hall A, Cole-Lewis H, Bernhardt J. Mobile text messaging for health: a systematic review of reviews. Annu Rev Publ Health. 2015;36:393–415. This systematic review of reviews summarises the current evidence for the efficacy of text messages as an intervention to improve health and create health behaviour change.CrossRefGoogle Scholar
- 6.Johns K. Mangere Healthy Kai: an evaluation. Auckland: Auckland Regional Public Health Service; 2005.Google Scholar
- 7.••Bennett GG, Steinberg DM, Stoute C, Lanpher M, Lane I, Askew S, et al. Electronic health (eHealth) interventions for weight management among racial/ethnic minority adults: a systematic review. Obes Rev. 2014;15 Suppl 4:146–58. http://dx.doi.org/10.1111/obr.12218 . This systematic review summarises the current evidence for the efficacy of eHealth interventions to promote weight loss among indigenous and minority groups.CrossRefPubMedGoogle Scholar
- 11.Syme L. Social determinants of health: the community as an empowered partner. Prev Chronic Dis. 2004;1(1):1–5.Google Scholar
- 12.•Nakamura N. What is a community’s desire? A critical look at participatory research projects with indigenous communities. Soc Cult Geogr. 2015;16(2):165–82. doi:10.1080/14649365.2014.959549. This manuscript describes the potential long-term efficacy of co-designed interventions in indigenous communities, using two communities in Japan as case studies.CrossRefGoogle Scholar
- 14.Bratteteig T, Bødker K, Dittrich Y, Holst Mogensen P, Simonsen J. Methods: organising principles and general guidelines for participatory design projects edition. In: Simonsen J, Robertson T, editors. International Handbook of Participatory Design: Routledge. 2012.Google Scholar
- 15.World Health Organization. mHealth. New horizons for health through mobile technologies, Global Observatory for eHealth series. Geneva: World Health Organization; 2011.Google Scholar
- 16.The Cochrane Collaboration. Cochrane handbook for systematic reviews of interventions. Available: www.cochrane-handbook.org: The Cochrane Collaboration, 2015. Accessed 17 Jun 2016.
- 17.Bate P, Robert G. Experience-based design: from redesigning the system around the patient to co-designing services with the patient. Qual Saf Health Care. 2006;13(1):19–25.Google Scholar
- 20.Hingle M, Nichter M, Medeiros M, Grace S. Texting for health: the use of participatory methods to develop healthy lifestyle messages for teens. J Nutr Educ Behav 2013;45(1):12–9. doi: 10.1016/j.jneb.2012.05.001.
- 21.Lin PH, Intille S, Bennett G, Bosworth HB, Corsino L, Voils C, Grambow S, Lazenka T, Batch BC, Tyson C, et al. Adaptive intervention design in mobile health: intervention design and development in the Cell Phone Intervention for You trial. Clinical Trials 2015;12(6):634–45. http://dx.doi.org/10.1177/1740774515597222.
- 22.Ben-Zeev D, Kaiser SM, Brenner CJ, Begale M, Duffecy J, Mohr DC. Development and usability testing of FOCUS: a smartphone system for self-management of schizophrenia. Psychiatr Rehabil J 2013;36(4):289–96. doi: http://dx.doi.org/10.1037/prj0000019.
- 23.Berg M, Adolfsson A, Ranerup A, Sparud-Lundin C, University of Gothenburg Centre for Person-Centred C. Person-centered web support to women with type 1 diabetes in pregnancy and early motherhood—the development process. Diabetes Technol Ther 2013;15(1):20–5. http://dx.doi.org/10.1089/dia.2012.0217.
- 24.Hanson E, Magnusson L, Arvidsson H, Claesson A, Keady J, Nolan M. Working together with persons with early stage dementia and their family members to design a user-friendly technology-based support service. Dementia 2007;6(3):411-34 24p.Google Scholar
- 25.Dingwall KM, Puszka S, Sweet M, Nagel T. 'Like drawing into sand': acceptability, feasibility, and appropriateness of a new e-mental health resource for service providers working with aboriginal and Torres Strait islander people. Australian Psychologist 2015;50(1):60-9 10p. doi: 10.1111/ap.12100.
- 26.Groussard PY, Pigot H, Giroux S. From conception to evaluation of mobile services for people with head injury: A participatory design perspective. Neuropsychol Rehabil 2015:1–22. doi: 10.1080/09602011.2015.1117499.
- 27.Kanis M, Brinkman WP, Perry M. Designing for positive disclosure: what do you like today? Int J Ind Ergonom. 2009;39(3):564–72. http://dx.doi.org/10.1016/j.ergon.2008.10.001.
- 28.Pulman A, Hill J, Taylor J, Galvin K, Masding MG. Innovative mobile technology alcohol education for young people with type 1 diabetes. Practical Diabetes 2013;30(9):376-9a 1p. doi: 10.1002/pdi.1814.
- 30.Spinuzzi C. The methodology of participatory design. Tech Commun. 2005;52:163–74.Google Scholar
- 31.Dolbec A, Clement J. La recherche-action. In: Karsenti T, Savoie-Zajc L, editors. Introduction a la recherche en education. Sherbrooke: Editions due Centre de Ressources pedagogique de l'universite Laval; 2000.Google Scholar
- 32.Gregory J. Scandinavian approaches to participatory design. Int J Eng Educ. 2003;19(1):62–74.Google Scholar
- 36.•Glasziou P, Meats E, Heneghan C, Shepperd S. What's missing from descriptions of treatment in trials and reviews. Brit Med J. 2008;336. http://dx.doi.org/10.1136/bmj.39590.732037.47. This manuscript describes the importance of adequate resorting of interventions in trials and reviews. Common elements that are not described well and included, in addition to how authors can supply missing information.
- 37.•Hoffmann TC, Erueti C, Glasziou PP. Poor description of non-pharmacological interventions: analysis of consecutive sample of randomised trials. Brit Med J. 2013;347(f3755). doi:10.1136/bmj.f3755 . This manuscript describes the magnitude of insufficient reporting of non-pharmacological interventions, and what should be done about it.
- 38.Agarwal S, LeFevre AE, Lee J, L'Engle K, Mehl G, Sinha C, Labrique A, WHO mHelath Technical Evidence Review Group. Guidelines for reporting of health interventions using mobile phones: mobile health (mHealth) evidence reporting and assessment (mERA) checklist. Brit Med J. 2016;352. doi: http://dx.doi.org/10.1136/bmj.i74.
- 39.World Health Organization. Indigenous peoples and participatory health research. Available: http://www.who.int/ethics/indigenous_peoples/en/index6.html. Accessed 21 Apr 2016
- 40.Hoffman TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, Altman DG, Barbour V, Macdonald H, Johnston M, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. Brit Med J. 2014;348. doi: http://dx.doi.org/10.1136/bmj.g1687).