Human Centered Design in Health Research 125 5 Of the 82 articles identified, 57 applied a UCD approach, 21 articles used HCD and 4 employed DT. In 14 studies, the concepts of HCD and UCD were referred to interchangeably, of which 9 studies referred to the use of the ISO 9241-210 standard. In the 4 studies that applied DT, the concept was used interchangeably with HCD in all cases. These studies referred to the IDEO Field Guide to Human-Centred Design or the HPI School of Design Thinking Guide as standard. For clarity we will continue to report results of HCD/DT and UCD studies separately in this review. Design strategies and methods 74 of the studies applied a solution-focused strategy versus 8 that applied a problemfocused strategy to drive the design process. Thus, most of the design studies focused on directly generating solutions or the development of a specific predefined solution. Only a minority employed the design-based methods to define the problem and selectively gather information before proceeding to solution development. Of the 74 studies that applied a solution focus strategy, 55 applied an UCD approach. Of the 8 studies that applied a problem focused strategy, 6 applied an HCD/DT approach. Overall, HCD/DT appears to be the preferred approach for problem driven strategies, while UCD is generally applied for solution-driven ones. The design processes consisted of several design cycles during which multiple qualitative and/or quantitative methods were used in combination with specific design methods. 47 (57%) of the studies applied a mixed methods approach and 33 (40%) qualitative methodology. A synthesis of the methods used in the different phases of the included studies is presented in table 2 (details about the described design methods can be found in supplement 3.). The first design phase, understanding the context, was often characterized using a limited range of design-based methods. During the second and third phase – problem specification and idea generation – a broader range of design methods was employed in different studies. In the fourth phase – testing of solutions – the range of design methods was reduced again. Some design-based methods are applied in multiple phases of the process, e.g. personas, intervention mapping or the Wizard of Oz technique, but most are uniquely used in one phase.
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