Developing digital health solutions for consumers

How do we develop the best consumer-facing digital health intervention, using the best available resources and theories to change meaningful health outcomes?

consumer informatics principles

Consumer informatics is increasing in reach, functionality and desirability. Consumer informatics involves digital health interventions targeting consumers, patients and families. Digital health interventions are defined as “a discrete functionality of digital technology that is applied to achieve health objectives and is implemented within digital health applications and ICT systems, including communication channels such as text messages.”(1) Digital health interventions include eHealth, defined as “the use of information and communications technology in support of health and health-related fields”.(2)

Digital health intervention haves the potential to improve the accessibility of universal health care. There are examples of scalable digital health interventions, that are available to many consumers, delivering measurable changes to validated health outcomes. In the child mental health space, BRAVE online, Sparx and Triple P Online are the standout DHIs, having been rigorously evaluated demonstrating measurable change to meaningful health outcomes.(3–5)

In the future, consumer-facing digital health interventions have the potential to augment the effectiveness of clinicians. Especially as clinicians are forced to look after patients with more complex needs, with greater demands for patient-centred care, in shorter appointments. With regret, there is no standardised resource that encompasses all the theoretical components of a quality consumer-facing digital health intervention. However, these are the resources that I have used to design consumer-facing digital health interventions to improve health outcomes.

It is important to note, these resources do not include important phases of developing a consumer-facing digital health intervention. Specifically, working out what problem is (collaborating with experts, literature review, needs analysis), why it is best solved by a digital health intervention (needs analysis, theory), and whether we succeeded in solving that problem with our new digital health intervention (evaluation).

User-centred design Co-creation and the new landscapes of design
(https://www.tandfonline.com/doi/full/10.1080/15710880701875068)

A user-centred model for designing consumer mobile health (mHealth) applications (apps) (https://www.sciencedirect.com/science/article/pii/S1532046416000241)

User-centred Design and Interactive Health Technologies for Patients (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2818536/)

Innovating From Within: A Process Model for User-Centered Digital Development in Academic Medical Centers. (https://www.ncbi.nlm.nih.gov/pubmed/30567688)

Persuasive technology The relationship between persuasive technology principles, adherence and effect of web-Based interventions for mental health: A meta-analysis. (https://www.ncbi.nlm.nih.gov/pubmed/27117057)
Behaviour change theory and techniques used in interventions A taxonomy of behaviour change techniques used in interventions. (https://www.ncbi.nlm.nih.gov/pubmed/18624603)
Patient-centred care Patient-centredness: a conceptual framework and review of the empirical literature (https://www.sciencedirect.com/science/article/abs/pii/S0277953600000988?via%3Dihub)
Principles for digital development Principles for digital development (https://digitalprinciples.org/)
  1. World Health Organisation. WHO guideline: recommendations on digital interventions for health system strengthening. Geneva; 2019.
  2. Report of the third global survey on eHealth Global Observatory for eHealth Global diffusion of eHealth: Making universal health coverage achievable [Internet]. Geneva: World Health Organization; 2016. Available from: https://apps.who.int/iris/bitstream/handle/10665/252529/9789241511780-eng.pdf;jsessionid=37355CF9E0E5E37B0FE42DA9B2A74C1E?sequence=1
  3. Sanders MR, Baker S, Turner KMT. A randomized controlled trial evaluating the efficacy of Triple P Online with parents of children with early-onset conduct problems. Behav Res Ther [Internet]. 2012;50(11):675–84. Available from: http://dx.doi.org/10.1016/j.brat.2012.07.004
  4. March S, Spence SH, Donovan CL. The Efficacy of an Internet-based CBT Intervention for Child Anxiety Disorders. J Pediatr Psychol. 2009;34(5):474–87.
  5. Merry SN, Stasiak K, Shepherd M, Frampton C, Fleming T, Lucassen MFG. The effectiveness of SPARX, a computerised self help intervention for adolescents seeking help for depression: Randomised controlled non-inferiority trial. BMJ [Internet]. 2012;344(7857):1–16. Available from: http://dx.doi.org/doi:10.1136/bmj.e2598

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