Abstract
Purpose
The successful design and innovation of eHealth solutions directly involve end users in the process to seek a better understanding of their needs. This article presents user-innovated eHealth solutions targeting older persons with hearing impairment. Our research question was: What are the key users' needs, expectations, and visions within future hearing rehabilitation service delivery?
Method
We applied a participatory design approach to facilitate the design of future eHealth solutions via focus groups. We involved older persons with hearing impairment (n = 36), significant others (n = 10), and audiologists (n = 8) following 2 methods: (a) human-centered design for interactive systems and (b) user innovation management. Through 3 rounds of focus groups, we facilitated a process progressing from insights and visions for requirements (Phase 1), to app such as paper version wireframes (Phase 2), and to digital prototypes envisioning future eHealth solutions (Phase 3). Each focus group was video-recorded and photographed, resulting in a rich data set that was analyzed through inductive thematic analysis.
Results
The results are presented via (a) a storyboard envisioning future client journeys, (b) 3 key themes for future eHealth solutions, (c) 4 levels of interest and willingness to invest time and effort in digital solutions, and (d) 2 technical savviness types and their different preferences for rehabilitation strategies.
Conclusions
Future eHealth solutions must offer personalized rehabilitation strategies that are appropriate for every person with hearing impairment and their level of technical savviness. Thus, a central requirement is anchoring of digital support in the clients' everyday life situations by facilitating easy access to personalized information, communication, and learning milieus. Moreover, the participants' visions for eHealth solutions call for providing both traditional analogue and digital services.
Supplemental Material
References
-
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology.Qualitative Research in Psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa -
Carroll, N., & Richardson, I. (2016). Aligning healthcare innovation and software requirements through design thinking.In Proceedings of the International Workshop on Software Engineering in Healthcare Systems, SEHS'16. New York, NY: ACM. https://doi.org/10.1145/2897683.2897687 -
Clark, J. L., & Swanepoel, D. W. (2014). Technology for hearing loss—As we know it, and as we dream it.Disability and Rehabilitation: Assistive Technology, 9(5), 408–413. https://doi.org/10.3109/17483107.2014.905642 -
Dahl, Y., & Hanssen, G. K. (2016). Breaking the sound barrier.In Proceedings of the 2016 CHI Conference on Human Factors in Computing Systems—CHI '16 (pp. 3079–3090). New York, NY: ACM Press. https://doi.org/10.1145/2858036.2858126 -
Ekberg, K., Meyer, C., Scarinci, N., Grenness, C., & Hickson, L. (2015). Family member involvement in audiology appointments with older people with hearing impairment.International Journal of Audiology, 54(2), 70–76. https://doi.org/10.3109/14992027.2014.948218 - European Committee for Standarization. (2010). Ergonomics of human–system interaction—Part 210: Human-centred design for interactive systems (ISO 9241-210:2010). Brussels, Belgium: Author.
-
Ferguson, M., Brandreth, M., Brassington, W., Leighton, P., & Wharrad, H. (2016). A randomized controlled trail to evaluate the benefits of a multimedia educational program for first-time hearing aid users.Ear and Hearing, 37(2), 123–136. -
Ferguson, M., Leighton, P., Brandreth, M., & Wharrad, H. (2018). Development of a multimedia educational programme for first-time hearing aid users: A participatory design.International Journal of Audiology, 57(8), 600–609. https://doi.org/10.1080/14992027.2018.1457803 -
Galvez, G., Turbin, M. B., Thielman, E. J., Istvan, J. A., Andrews, J. A., & Henry, J. A. (2012). Feasibility of ecological momentary assessment of hearing difficulties encountered by hearing aid users.Ear and Hearing, 33(4), 497–507. https://doi.org/10.1097/AUD.0b013e3182498c41 -
Hanssen, G. K., & Dahl, Y. (2016). A participatory design approach to develop an interactive sound environment simulator.American Journal of Audiology, 25(3S), 268–271. https://doi.org/10.1044/2016_AJA-16-0005 -
Hood, L., & Friend, S. H. (2011). Predictive, personalized, preventive, participatory (P4) cancer medicine.Nature Reviews Clinical Oncology, 8(3), 184–187. https://doi.org/10.1038/nrclinonc.2010.227 -
Kanstrup, A. M., & Bertelsen, P. (2011). User innovation management: A handbook. Aalborg, Denmark: Aalborg University Press. -
Kanstrup, A. M., Madsen, J., Nøhr, C., Bygholm, A., & Bertelsen, P. (2017). Developments in participatory design of health information technology—A review of PDC publications from 1990–2016. Amsterdam, the Netherlands: IOS Press Ebooks. https://doi.org/10.3233/978-1-61499-740-5-1 -
Kanstrup, A. M., Rotger-Griful, S., Laplante-Lévesque, A., & Cleveland Nielsen, A. (2017). Designing connections for hearing rehabilitation.In Proceedings of the 2017 Conference on Designing Interactive Systems—DIS '17 (pp. 1153–1163). New York, NY: ACM Press. https://doi.org/10.1145/3064663.3064737 -
Kvale, S. (2007). Doing interviews. London, England: Sage Publications. https://doi.org/10.4135/9781849208963 -
Laplante-Lévesque, A., Brännström, K. J., Andersson, G., & Lunner, T. (2012). Quality and readability of English-language Internet information for adults with hearing impairment and their significant others.International Journal of Audiology, 51(8), 618–626. https://doi.org/10.3109/14992027.2012.684406 -
Laplante-Lévesque, A., & Thorén, E. S. (2015). Readability of internet information on hearing: Systematic literature review.American Journal of Audiology, 24(3), 284–288. https://doi.org/10.1044/2015_AJA-14-0091 -
Layton, A., Moss, F., & Morgan, G. (1998). Mapping out the patient's journey: Experiences of developing pathways of care.Quality in Health Care, 7, S30–S36. -
Maidment, D., Brassington, W., Wharrad, H., & Ferguson, M. (2016). Internet competency predicts practical hearing aid knowledge and skills in first-time hearing aid users.American Journal of Audiology, 25(3S), 303–307. https://doi.org/10.1044/2016_AJA-16-0022 -
Morrison, L. G., Yardley, L., Powell, J., & Michie, S. (2012). What design features are used in effective e-health interventions? A review using techniques from critical interpretive synthesis.Telemedicine and E-Health, 18(2), 137–144. https://doi.org/10.1089/tmj.2011.0062 -
Mulwafu, W., Ensink, R., Kuper, H., & Fagan, J. (2017). Survey of ENT services in sub-Saharan Africa: Little progress between 2009 and 2015.Global Health Action, 10(1), 1289736. https://doi.org/10.1080/16549716.2017.1289736 -
Pearce, G., Parke, H. L., Pinnock, H., Epiphaniou, E., Bourne, C. L., Sheikh, A., & Taylor, S. J. (2016). The PRISMS taxonomy of self-management support: Derivation of a novel taxonomy and initial testing of its utility.Journal of Health Services Research & Policy, 21(2), 73–82. https://doi.org/10.1177/1355819615602725 -
Preminger, J. E. (2003). Should significant others be encouraged to join adult group audiologic rehabilitation classes?.Journal of the American Academy of Audiology, 14(10), 545–555. https://doi.org/10.3766/jaaa.14.10.3 -
Preminger, J. E., & Rothpletz, A. M. (2016). Design considerations for Internet-delivered self-management programs for adults with hearing impairment.American Journal of Audiology, 25(3S), 272–277. https://doi.org/10.1044/2016_AJA-16-0010 -
Preminger, J. E., & Yoo, J. K. (2010). Do group audiologic rehabilitation activities influence psychosocial outcomes?.American Journal of Audiology, 19(2), 109–125. https://doi.org/10.1044/1059-0889(2010/09-0027) -
Pryce, H., Hall, A., Laplante-Lévesque, A., & Clark, E. (2016). A qualitative investigation of decision making during help-seeking for adult hearing loss.International Journal of Audiology, 55(11), 658–665. https://doi.org/10.1080/14992027.2016.1202455 -
Qiang, C. Z., Yamamichi, M., Hausman, V., & Miller, R. (2012). Mobile applications for the health sector. Washington, DC: World Bank. Retrieved from http://documents.worldbank.org/curated/en/751411468157784302/Mobile-applications-for-the-health-sector -
Rolfe, C., & Gardner, B. (2016). Experiences of hearing loss and views towards interventions to promote uptake of rehabilitation support among UK adults.International Journal of Audiology, 55(11), 666–673. https://doi.org/10.1080/14992027.2016.1200146 -
Thorén, E. S., Öberg, M., Wänström, G., Andersson, G., & Lunner, T. (2013). Internet access and use in adults with hearing loss.Journal of Medical Internet Research, 15(5), e91. https://doi.org/10.2196/jmir.2221 -
Thorén, E. S., Pedersen, J. H., & Jørnæs, N. O. (2016). Usability and online audiological rehabilitation.American Journal of Audiology, 25(3S), 284–287. https://doi.org/10.1044/2016_AJA-16-0015 -
Vos, T., Barber, R. M., Bell, B., Bertozzi-Villa, A., Biryukov, S., Bolliger, I., … Murray, C. J. (2015). Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: A systematic analysis for the global burden of disease study 2013.The Lancet, 386(9995), 743–800. https://doi.org/10.1016/S0140-6736(15)60692-4 -
Windmill, I. M., & Freeman, B. A. (2013). Demand for audiology services: 30-Yr projections and impact on academic programs.Journal of the American Academy of Audiology, 24(5), 407–416. https://doi.org/10.3766/jaaa.24.5.7 - World Health Organization. (2016). Status of eHealth in the WHO European region. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0013/303322/fact-sheet-status-of-ehealth-in-who-european-region.pdf?ua=1
-
Wyatt, J. (2005, July). Carrying out pilot studies on eHealth systems and services: A system that failed.Presented at the British Computer Society Health Informatics Forum, London, UK . Retrieved from https://www.bcs.org/upload/pdf/pilotstudies.pdf
Add to your Mendeley library