13 General introduction 1 knowledge is equally valuable in a collaborative design process as the expertise of designers, developers, and researchers. Participatory design employs various tools and techniques to tap into users’ knowledge and foster mutual understanding throughout the design process (22). Within participatory design ‘knowledge’ is theoretically conceptualized into various levels of knowledge; explicit, observable, tacit and latent knowledge (see Figure 2). Explicit and observable knowledge – what people say and do – is the most accessible layer of knowledge and can be explored using conventional qualitative research techniques like interviews and observations. Deeper levels of knowledge such as tacit and latent knowledge respectively refer to knowledge that people can act upon but cannot readily express in words (like riding a bike or why something is funny) and knowledge people are not aware of yet (like knowing where to drive to, based on experience as a passenger) (23). Desires, needs, motivations and experiences are generally concealed in these deeper layers and require participatory design tools, such as creative and reflective exercises, to be elucidated (24). Consequently, employing participatory tools to effectively identify user needs and uncover deeper levels of knowledge is essential for developing eHealth interventions that address unmet user needs. Figure 2. Different research techniques access various levels of knowledge (image adopted from Sleeswijk Visser et al., 2005) While participatory design plays a pivotal role in the active involvement of end-users and stakeholders, the use of participatory design tools often remains limited to a single phase, is poorly substantiated or lacks methodological reasoning (17, 25). To support researchers in the use of participatory design it is imperative to substantiate and report on participatory design choices and establish a more comprehensive understanding of eHealth development methods (26). The creation of a knowledge base in this area requires more in-depth case studies that elucidate and reflect upon the specific applications of participatory design tools and methods.
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