Human Centered Design in Health Research 107 5 titles and abstracts independently for inclusion eligibility and subsequently screened the full-text articles independently for inclusion. We resolved disagreements by discussion. To determine the level of agreement, both Cohen’s k and the percentage of agreement were calculated. Data retrieval and analysis We conducted a stepwise analysis of the included publications, focusing on 1) Study characteristics, including design phases and methods, 2) Level of end-user involvement and 3) Quality assessment. Study characteristics We extracted the following data from each article: year of publication, first author, title of the study, aim of the study, end-user of the innovation, type of innovation, study design, design approach, design approach reference, design process phases and applied research and design methods and the design-based problem-solving strategy. For the classification of the applied qualitative and quantitative research and design methods, research methods were defined as; ‘methods traditionally used within scientific research, oriented towards understanding’ and design methods were defined as; ‘methods not traditionally used with scientific research, oriented towards action or solution creation for defined problems’.[20], [21] These distinctions were made based on discussions between the authors. To define the design-based problem-solving strategy, we used the categories of problem-focused strategy (PFS) versus solution-focused strategy (SFS). Studies that use a PFS aim at defining or reframing the problem before formulating possible solutions. Studies that use a SFS approach focus the development of a predefined solution, investing little time in defining or reframing the problem.[22] Level of involvement of the end-user To define the level of engagement of the end-user we adopted a modified framework proposed by Druin[23], which was originally used to categorize the participating role of children in a design process. Participating roles are user, tester, informant, or design partner, with increased levels of involvement for each role. Users help researchers and designers to understand the problem context and/or user needs. The role of tester builds upon this role by including end-users as part of initial or functional prototype testing. In the role of informant, the end-users are involved during various stages of the design process and contribute to idea generation and providing feedback on initial and functional prototypes. In the role of design partner, end-users are considered equal partners to the design team and are involved at all stages of the design process and are fully included during decision making processes.
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