User centered design methods to promote acceptance, comprehension and utility of eHealth

Abstract

Objectives. Compliance with eHealth interventions is problematic. In order to promote acceptance, utility and retention of eHealth interventions it is important to understand how users will interact with such interventions. User-centered design and usability testing can be used in different phases of systematic intervention development, in order to optimize the content, structure and interface of the intervention. Our aim is to discuss practical strategies that can be used as part of the design process. Method. We provide examples of the usage of different types of user-centered design strategies to optimize the design of eHealth interventions, derived from the systematic development of three different interventions: nietofwelzwanger.nl (preconception care intervention), SoaSeksCheck (web-based STI conversational agent), KitB (HPV vaccination intervention). All three interventions were systematically planned, using Intervention Mapping. User interaction methods were used at different stages of the design (pre-, design, and pretest phase) to understand content, layout, design choices (e.g., avatars, tone of voice). User-centered design strategies used were: competitive testing, storyboards, eye tracking, interactive think aloud methodology, and experimental pre-testing. Findings. These strategies greatly improved our understanding of design criteria, intervention navigation and acceptance. For instance, competitive testing (based on existing interventions) and storyboards contributed to understanding layout and interaction criteria (look and feel, navigation etc.). Eye tracking heat maps enabled understanding exposure and navigation behavior. Experimental pre-testing enabled the testing of alternative designs. Discussion. Implementation of eHealth can be greatly improved by using user-centered design. We provided strategies that promoted user involvement in the design and testing phases.