Browsing by Subject "Human centered design"

Traumatic brain injury (TBI) is the most common cause of death and disability globally. TBI is a leading cause of resource consumption and disproportionately affects LMICs. Innovative solutions are required to address this high burden of TBI. Prognostic models could provide a solution since the models enhance diagnostic ability of physicians, thereby helping to tailor treatments more effectively. This study aims to evaluate the feasibility of a prognostic model developed in Tanzania for TBI patients amongst Kilimanjaro Christian Medical Center (KCMC) healthcare providers and Duke affiliated healthcare providers. Duke health system participants were included primarily to gain insight from a different context with more established practices to inform the TBI tool implementation strategy at KCMC. To evaluate the feasibility of integrating the TBI tool into potential workflows co-design interviews were conducted with emergency physicians and nursing staff. Qualitatively, the tool was assessed using human centered design (HCD) techniques. Our research design methods were created using the Consolidated Framework for Implementation Research which considers overarching characteristics of successful implementation to contribute to theory development and verification of implementation strategies across multiple contexts. Findings of this study will aid in determining under what conditions a TBI prognostic model intervention will work at KCMC and the potential use of HCD in implementation research.

Psychological treatments delivered by lay counselors, individuals with little or no previous mental health training, have been shown to be effective in treating a range of mental health problems. However, in low resource settings, the dearth of available experts to train and supervise lay counselors is a key bottleneck in scaling up lay counselor delivered psychological treatments. Locally sustainable solutions that allow experts to train and supervise large volume of lay providers are needed. Two proposed solutions include the use of digital health strategies and peer supervision. In study one, we used a human-centered design approach to develop a web application to support asynchronous clinical supervision of lay counselors providing a family therapy program in Kenya. The development process engaged seven previously trained lay counselors and three prior supervisors in a phased design process which resulted in a final application prototype, “REACH”, that supported audio and text communication via a chat and a structured session report form. In study two, we conducted a feasibility study with 30 counselors with the aim of describing the capacity of REACH support supervision practices, exploring the feasibility and acceptability of REACH compared to peer group supervision, and describing the treatment fidelity and clinical competency of a small group of counselors using REACH. REACH was perceived as highly acceptable from both peers and supervisors and demonstrated promising impacts on counselor fidelity and clinical competency. Content analysis of correspondence between the counselors and the superior via the REACH indicated the supervisor was able to implement a wide range of evidence-based supervision strategies. Limitations of bi-directional communication on potential supervision effectiveness are discussed. Overall, this project suggests digital asynchronous clinical supervision holds promise as a scalable method of clinical supervision in low-resource contexts.

Despite the clear benefits to women, families, and society, family planning is not universal. In 2015,12 percent of married or in-union women who want to prevent or delay pregnancy were are not currently using a method of family planning in 2015. In Africa, this rate is even higher, at 24 percent. In order to meet the unmet need for family planning, new approaches to service delivery are required. A critical question for anyone interested in ensuring universal access to sexual and reproductive health-care services like family planning is how to create new products, services and implementation models that work for users. The objective of this case study is to describe how Human Centered Design (HCD) was used to develop a digital marketplace for family planning in Kenya, called Nivi, and draw lessons for broader application to global health challenges. By using the HCD approach, we sought to better understand the challenges users face with the Nivi platform and the opportunities that exist to make improvements. By incorporating HCD, we were able to build a service with greater potential for use and usability for Nivi users. We believe that taking an HCD approach allowed us to build a product that has the potential to meet the unmet need for family planning services in Kenya. This case study highlights the strengths and challenges to inform the use of HCD for other health applications in emerging markets.