DESIGNING WITH PATIENTS, FOR PATIENTS: USER-CENTRED DESIGN FOR DIGITAL HEALTH IN CANCER REHABILITATION

L. Brennan^1,2, B. Caulfield^1,2

Background: Digital health technologies can support patients during home rehabilitation by providing educational information, biofeedback and motivational strategies. There is a need for such technologies to be developed for cancer populations, as they often have additional challenges during rehabilitation. Many digital health technologies do not succeed in making an impact on patient care, frequently because of poor usability or because the intervention did not meet patients' needs. The impact and effectiveness of digital health technologies can be improved by involving the patient or service user throughout the design process.

Purpose: To apply a User-Centred Design process to the development of a digital health application (app) for post-operative breast cancer rehabilitation.

Methods: Breast cancer survivors (n=11) and oncology physiotherapists (n= 8) were recruited to participate in the development of a digital health post-operative exercise support app for breast cancer rehabilitation. A User-Centred Design approach was applied, involving 5 stages: plan concept; analyse user needs; develop prototype; evaluate prototype; plan the next iteration. Users were involved in a variety of research methods: focus groups, interviews, mixed-methods usability evaluation.

Results: Users provided valuable insights and feedback throughout each stage of the process. They expressed a need for a reliable, user-friendly exercise support app after surgery as an adjunct to physiotherapy treatment. Requirements for app features included biofeedback, concise educational information and use of a positive tone. Evaluation of the app revealed a good usability score (System Usability Scale 80.5 +/-6.5), along with insights into user experience and feedback regarding recommended improvements.

Conclusion(s): To develop successful and effective digital health technologies, the user should be involved in a collaborative, iterative design process. User-Centred Design provides a simple framework to achieve this, as demonstrated in the breast cancer digital health app.

Implications: An understanding of User-Centred Design principles empowers physiotherapists to develop impactful, effective and user-friendly digital health technologies or digitally-enabled services.
The User-Centred Design approach can be applied to all aspects of Physiotherapy service development.

Funding, acknowledgements: Funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement number 722012 

Keywords: User-Centred Design, digital health, breast cancer

Topic: Research methodology, knowledge translation & implementation science

Did this work require ethics approval? Yes

Institution: Beacon Hospital, Dublin, Ireland

Committee: Research Ethics Committee

Ethics number: BEA0082, BEA0129