Developing a Digital Medication Adherence Intervention for and With Patients With Asthma and Low Health Literacy

Developing a Digital Medication Adherence Intervention for and With Patients With Asthma and Low Health Literacy: Protocol for a Participatory Design Approach

Faber, J.S. (TU Delft Design Aesthetics)
Poot, Charlotte C. (Leiden University Medical Center)
Dekkers, Tessa (University of Twente)
Romero Herrera, N.A. (TU Delft Design Conceptualization and Communication)
Chavannes, N.H. (TU Delft Biomechanical Engineering; Leiden University Medical Center)
Meijer, Eline (Leiden University Medical Center)
Visch, V.T. (TU Delft Design Aesthetics)

Biomechanical Engineering

2023

Background: Current eHealth interventions are poorly adopted by people with low health literacy (LHL) as they often fail to meet their needs, skills, and preferences. A major reason for this poor adoption is the generic, one-size-fits-all approach taken by designers of these interventions, without addressing the needs, skills, and preferences of disadvantaged groups. Participatory design approaches are effective for developing interventions that fit the needs of specific target groups; yet, very little is known about the practical implications of executing a participatory design project for and with people with LHL. Objective: This study aimed to demonstrate the application of participatory design activities specifically selected to fit the needs and skills of people with LHL and how these were manifested within an overarching eHealth design process. In addition, the study aims to present reflections and implications of these activities that could support future designers to engage people with LHL in their design processes. Methods: We used the design process of a smart asthma inhaler for people with asthma and LHL to demonstrate participatory design activities. The study was framed under 5 stages of design thinking: empathize, define, ideate, prototype, and test within 2 major iteration cycles. We integrated 3 participatory design activities deemed specifically appropriate for people with LHL: co-constructing stories, experience prototype exhibition, and video prototype evaluation. Results: Co-constructing stories was found to deepen the understanding of the participant’s motivation to use or not to use maintenance medication. This understanding informed and facilitated the subsequent development of diverse preliminary prototypes of possible interventions. Discussing these prototypes in the experience prototype exhibition helped provoke reactions, thoughts, and feelings about the interventions, and potential scenarios of use. Through the video prototype evaluation, we were able to clearly communicate the goal and functionality of the final version of our intervention and gather appropriate responses from our participants. Conclusions: This study demonstrates a participatory design approach for and with patients with asthma and LHL. We demonstrated that careful consideration and selection of activities can result in participants that are engaged and feel understood. This paper provides insight into the practical implications of participatory activities with people with LHL and supports and inspires future designers to engage with this disadvantaged target group.

asthma
eHealth
health care
health literacy
low health literacy
medication
medication adherence
mHealth
participatory design
participatory medicine
OA-Fund TU Delft

http://resolver.tudelft.nl/uuid:956476f0-dbdc-4402-a16d-c99d225c4c04

https://doi.org/10.2196/35112

JMIR Formative Research, 7

Institutional Repository

journal article

© 2023 J.S. Faber, Charlotte C. Poot, Tessa Dekkers, N.A. Romero Herrera, N.H. Chavannes, Eline Meijer, V.T. Visch