BACKGROUND
People living with cardiovascular disease (CVD) require flexible self-management support for health behaviour change for CVD secondary prevention. Digital health interventions can assist with these complex self-management activities. Many stakeholder groups can be involved in digital health design, including people living with CVD (users), researchers, healthcare professionals and technology developers. However, decision-making and aligning views can be difficult to negotiate within interdisciplinary teams, so the use of appropriate methodological strategies is vital.
OBJECTIVE
The aim of this paper was to design and develop Salvio, and to reflect on the methodological considerations that were the driving forces of this participatory design process.
METHODS
A triangulation of research methods was used for this iterative development process. Participatory design approaches used included guided group discussions, activity-based workshops, and think-aloud tasks. Data collection was supported by self-efficacy theory to encourage user contributions. Over a 12-month period, participants met at various time points to collectively design and develop Salvio. Workshops were 2-3 hours in length and were facilitated in small groups of 4-6 participants per session. All sessions were audio-recorded, central parts of workshop conversations were transcribed, and qualitative content analysis of data was undertaken.
RESULTS
Users (n=8) worked collaboratively with researchers (n=6) and technology developers (n=7). Findings indicated that it was critical to include an interdisciplinary team with a wide range of expertise, to build a meaningful and flexible digital platform. Effective methodological strategies were essential for genuine participation and continuous conflict resolution. Our research highlighted key elements that added to the success of this co-design process including i) the creation of a collaborative space where all voices were acknowledged and considered and ii) the effective translation of information during decision-making stages.
CONCLUSIONS
Future research is needed to expand and evaluate participatory design tools and techniques which challenge the power relations between users and other stakeholders. By exploring methods that create space for mutual learning and resolving conflict through systematic decision-making, complex digital platforms for health behaviour change can be successfully developed with diverse groups. It is clear that flexible digital platforms may be valuable to users, but further research will also be required for the successful implementation and knowledge translation of these contemporary developments.