Examining Challenges to Co-Design Digital Health Interventions With End Users: Systematic Review

Area of Science:

• Digital Health Interventions (DHIs)
• Human-Computer Interaction
• Health Informatics

Background:

• Digital health interventions offer personalized healthcare but face co-design challenges.
• Stakeholder perspectives on user experience and health efficacy often diverge.
• Existing methodologies for DHI co-design show variable success.

Purpose of the Study:

• To examine advancements and challenges in co-designing DHIs with end users over the past decade.
• To identify domain-level problem areas in DHI co-design.
• To propose recommendations for improved DHI co-design approaches.

Main Methods:

• Systematic literature search of 6 databases (Jan 2015-May 2024) for co-design studies in DHIs.
• Searches focused on health behavior, user experience, and digital methodologies.
• Eligibility guided by PerSPEcTiF and PRISMA frameworks; 171 studies included in qualitative synthesis.

Main Results:

• Analysis of 171 studies revealed 5 research approaches, 8 DHI types, and 5 design methodologies.
• Key themes included participatory co-design advancements.
• Identified challenges in participatory co-design, context, testing, cost, and scale; gaps in hybrid frameworks and industry implementation.

Conclusions:

• Advocates for a pragmatic shift towards scaled, mixed-methods approaches in digital health co-design.
• Emphasizes integrating digital health co-designer vision with Agile methodology and healthcare metrics.
• Supports leveraging the big data era for enhanced DHI development.