Chapter 5 110 Study characteristics 68 articles (83%) were published between 2015 and 2020 and most of the studies originated from the USA (n= 34, 41%), the Netherlands (n= 7, 9%), the UK (n= 6, 7%) and Canada (n= 6, 7%). Many of the studies focused on patients as end-users and developed health innovations with a focus on improvement of patient care. The most common type of study design was a mixed-methods strategy (n= 47, 57%), i.e. a combination of qualitative, quantitative and design methods. 33 (40%) of the studies combined only qualitative methods with design methods (figure 2). A detailed overview of the study characteristics is presented in table 1. Design theories and methodologies This review explored the various applications of human-centred design approaches, including human-centred design (HCD), user-centered design (UCD) and design thinking (DT). HCD was used in 21 (26%) of the studies, 4 (4%) applied a DT approach and the majority (n= 57, 70%) employed a UCD approach. All approaches prioritized users’ needs and the participatory and iterative nature of the design process. Some HCD definitions included a focus on a multiple stakeholder or system perspective, whereas some UCD definitions aimed at increasing usability or user friendliness of the solution. These design approaches are generally characterized using different standards or models. Three standards or models were frequently mentioned in the studies and used as reference. These models overlap in their attempt to classify the distinct phases of the design process but operationalise the steps differently. The UCD ISO Standard 9241-210 for human-centred design of interactive systems encompasses a 5-phased design process including: 1) understanding and specify context of use, 2) specify user requirements, 3) produce design solution, 4) evaluate design against requirements and 5) deliver design solution that meets user requirements. The HCD IDEO Field Guide to Human-Centred Design and the HPI School of Design Thinking models are characterized by different versions of a similar 3-phased design process: 1) Inspiration, 2) Ideation, 3) Implementation. Studies that applied DT worked with a multi-phased approach that included versions of the following phases: 1) empathize with stakeholders, 2) define the problem, 3) generate ideas for solutions, 4) prototype solutions, 5) test solutions. In figure 2 we illustrate how the different approaches to the human-centred design process align.
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