There are increasing concerns that digital interventions in healthcare settings could be better designed for scalable and sustained use. Implementation science is the scientific study of how to embed evidence-based interventions in practice. Calls to integrate implementation science and Human-Centred Design methods have focused on integrating design methods within implementation science processes. By contrast, we present a novel approach to integrating implementation science within Human-Centred Design for digital health interventions. Our approach leverages the socio-technical Nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework within the distinct phases of the Double Diamond process. To illustrate our proposal we demonstrate its application in the redesign of a brief health promotion intervention to reduce the risk of alcohol-attributable breast cancer in women attending routine mammography. We discuss reflections on the approach and implications for future research that targets implementation within design.

In low-and middle-income countries like India, people with severe mental illness (PSMI) rely on their families as a primary source of care, given the lack of support from healthcare systems. The demanding nature of caregiving places significant physical and mental demands on caregivers, who are the primary source of support to PSMI. We explore how caregivers in under-resourced settings can be better supported through everyday digital technologies. We conducted interviews with caregivers (from urban and rural India), as well as workshops with professionals from Indian NGOs that work directly with PSMIs. We found that technology has the potential to (1) provide carer-centred support that empowers carers who experience stigma and issues with existing support networks; (2) provide support for carers to overcome barriers and progress in the recovery of the PSMI. We conclude with design considerations, proposing how an online peer community can leverage carers’ expertise to actualise support provision.

Background: Improving preconception health can benefit all women, their children, and their families regardless of their individual pregnancy intentions. Rapidly increasing access to information technology and online engagement have created opportunities to use digital health resources to engage with preconception women regarding lifestyle behaviors. Objective: This study explores how preconception women engage with digital health resources and online platforms to inform the design and development of a digital health resource to support women to make positive behavior change for their preconception health. Methods: This codesign research followed the Double Diamond process, which focuses on contextualization and explorative processes in phase 1 and ideation and development processes in phase 2. Phase 1 is reported on in this study and was undertaken via a series of 1-on-1 in-depth interviews with female participants (N=12) aged 18-45 years over 3 months. Interviews were designed to explore participants’ lived experiences in relation to their health and desired supports for healthy lifestyle behaviors. The first interview focused on participants’ perceptions of health and health behaviors, the second interview focused on social connections for health, and the third interview focused on digital health information and supports. Conversations from the first interview informed the development of the second interview, and conversations from the second interview informed the development of the third interview. Community advisors (N=8) met to provide feedback and advice to the researchers throughout the interview process. Qualitative analyses of transcripts from interviews were undertaken by 2 researchers before a deductive process identified themes mapped to the capability, opportunity, motivation, and behavior (COM-B) framework. Results: In total, 9 themes and 8 subthemes were identified from 124 codes. In relation to digital health resources, specifically, participants were already engaging with a range of digital health resources and had high expectations of these. Digital health resources needed to be easy to access, make women’s busy lives easier, be evidence based, and be reputable. Social connectedness was also highly important to our participants, with information and advice from peers with similar experiences being preferred over yet more online health information. Online communities facilitated these social interactions. Participants were open to the idea of chatbots and virtual assistants but acknowledged that they would not replace authentic social interactions. Conclusions: Codesigned digital health resources should be evidence based, reputable, and easy to access. Social connections were considered highly important to women, and designers of digital health resources should consider how they can increase opportunities for women to connect and learn from each other to promote health behaviors.

While online parenting interventions have been shown to improve youth mental health, parents find it challenging to engage with and implement strategies from self-directed interventions. Our study purposefully designed a parent peer-support community for parents seeking support. Our two-phased qualitative study included parent interviews and design workshops. Our findings show that while parents need others’ lived experiences to learn about parenting, perceived judgment and self-doubt can stop them from actively contributing to the peer support group. To address this design challenge, we operationalised parents’ needs and challenges gained in the interviews and workshops into design implications. We demonstrate a parent-centered design approach where we formulate design implications that integrate parents’ needs and expectations with multidisciplinary theoretical and empirical evidence to deepen and concretise the design for an online parent peer-support community that cultivates empathy, encourages confidence and self-efficacy, and motivates change and growth.