Using Co-Design in mHealth Systems Development: A Qualitative Study with Experts in Co-design and mHealth System Development (Preprint)
BACKGROUND The proliferation of mobile devices has enabled new ways of delivering health services through mobile health systems. Researchers and practitioners have emphasized that the design of such systems is a complex endeavor with various pitfalls, including limited stakeholder involvement in design processes and integration into existing system landscapes. Co-design is an approach to address these pitfalls. Despite a rich body of literature on co-design methodologies, limited research exists to guide the co-design of mHealth systems. OBJECTIVE The objectives of our study was to (1) contextualize an existing co-design framework to mHealth applications and (2) derive guidelines to address common challenges of co-designing mHealth systems. METHODS We conducted an exploratory qualitative study consisting of 16 semi-structured interviews with co-design method experts (8) and mHealth system developers (8). Data were analyzed using thematic analysis. RESULTS The contextualized framework captures important considerations of the mHealth context, including dedicated prototyping and implementation phases. Additionally, seven guidelines were developed: (1) specificity of targeted mHealth context, (2) immersion in mHealth context, (3) health behavior change, (4) co-design facilitators, (5) post-design advocates, (6) health-specific evaluation criteria, and (7) usage data and contextual research to understand impact. CONCLUSIONS System designers encounter unique challenges when engaging in mHealth development. We hope that the contextualized framework and guidelines will serve as a shared frame of reference to facilitate interdisciplinary collaboration at the nexus of information technology and health research.