Human-centered design as a guide to intervention planning for non-communicable diseases: the BIGPIC study from Western Kenya.
Delivery of healthcare
Human-centered design
Kenya
Microfinance
Non-communicable diseases
Problem-solving
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
12 May 2020
12 May 2020
Historique:
received:
25
04
2019
accepted:
07
04
2020
entrez:
14
5
2020
pubmed:
14
5
2020
medline:
1
12
2020
Statut:
epublish
Résumé
Non-communicable disease (NCD) care in Sub-Saharan Africa is challenging due to barriers including poverty and insufficient health system resources. Local culture and context can impact the success of interventions and should be integrated early in intervention design. Human-centered design (HCD) is a methodology that can be used to engage stakeholders in intervention design and evaluation to tailor-make interventions to meet their specific needs. We created a Design Team of health professionals, patients, microfinance officers, community health workers, and village leaders. Over 6 weeks, the Design Team utilized a four-step approach of synthesis, idea generation, prototyping, and creation to develop an integrated microfinance-group medical visit model for NCD. We tested the intervention with a 6-month pilot and conducted a feasibility evaluation using focus group discussions with pilot participants and community members. Using human-centered design methodology, we designed a model for NCD delivery that consisted of microfinance coupled with monthly group medical visits led by a community health educator and a rural clinician. Benefits of the intervention included medication availability, financial resources, peer support, and reduced caregiver burden. Critical concerns elicited through iterative feedback informed subsequent modifications that resulted in an intervention model tailored to the local context. Contextualized interventions are important in settings with multiple barriers to care. We demonstrate the use of HCD to guide the development and evaluation of an innovative care delivery model for NCDs in rural Kenya. HCD can be used as a framework to engage local stakeholders to optimize intervention design and implementation. This approach can facilitate the development of contextually relevant interventions in other low-resource settings. Clinicaltrials.gov, NCT02501746, registration date: July 17, 2015.
Sections du résumé
BACKGROUND
BACKGROUND
Non-communicable disease (NCD) care in Sub-Saharan Africa is challenging due to barriers including poverty and insufficient health system resources. Local culture and context can impact the success of interventions and should be integrated early in intervention design. Human-centered design (HCD) is a methodology that can be used to engage stakeholders in intervention design and evaluation to tailor-make interventions to meet their specific needs.
METHODS
METHODS
We created a Design Team of health professionals, patients, microfinance officers, community health workers, and village leaders. Over 6 weeks, the Design Team utilized a four-step approach of synthesis, idea generation, prototyping, and creation to develop an integrated microfinance-group medical visit model for NCD. We tested the intervention with a 6-month pilot and conducted a feasibility evaluation using focus group discussions with pilot participants and community members.
RESULTS
RESULTS
Using human-centered design methodology, we designed a model for NCD delivery that consisted of microfinance coupled with monthly group medical visits led by a community health educator and a rural clinician. Benefits of the intervention included medication availability, financial resources, peer support, and reduced caregiver burden. Critical concerns elicited through iterative feedback informed subsequent modifications that resulted in an intervention model tailored to the local context.
CONCLUSIONS
CONCLUSIONS
Contextualized interventions are important in settings with multiple barriers to care. We demonstrate the use of HCD to guide the development and evaluation of an innovative care delivery model for NCDs in rural Kenya. HCD can be used as a framework to engage local stakeholders to optimize intervention design and implementation. This approach can facilitate the development of contextually relevant interventions in other low-resource settings.
TRIAL REGISTRATION
BACKGROUND
Clinicaltrials.gov, NCT02501746, registration date: July 17, 2015.
Identifiants
pubmed: 32398131
doi: 10.1186/s12913-020-05199-1
pii: 10.1186/s12913-020-05199-1
pmc: PMC7218487
doi:
Banques de données
ClinicalTrials.gov
['NCT02501746']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
415Subventions
Organisme : NIDDK NIH HHS
ID : P30 DK111022
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL125487
Pays : United States
Organisme : NHLBI NIH HHS
ID : 5R01HL125487
Pays : United States
Commentaires et corrections
Type : ErratumIn
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