231 General discussion that this method is highly effective because the cyclical nature of design-oriented research allows for the continual refinement of interventions using real-world feedback and data, making solutions practical and effective [34]. The user-centered design increases usability and acceptance, while multidisciplinary collaboration enriches the process, providing diverse perspectives of end-users and leading to solutions [34,35]. Developed in real settings with end-users, the findings from this research have high ecological validity. Some lessons were learned. Whereas qualitative research predominantly focuses on understanding human experiences, perceptions, motivational factors, and the cultural and social contexts within which individuals operate, emphasizing the ‘why’ behind the data, design-based research is primarily focused on solving specific problems and helped us with the development of a brochure with screener through designing and adapting with end-users. Here, the iterative nature of the design helped us to align the design more closely with the needs of MHNs and their patients, and the context of their work, which ensured us that the outcomes were practical and effective [36]. This iterative and co-creative approach with end-users ensured that the design is grounded in practical realities and benefits from diverse perspectives, which enhances both the relevance and applicability. Applying the double diamond framework in human-centered design: a methodological approach for enhanced problem solving This dissertation incorporated inputs from a diverse range of end-users involved in oral health care within mental health settings, spanning multiple chapters (2, 3, 5, 6). These end-users provided various perspectives and helped to establish a solid evidence base. This approach necessitated additional efforts to engage a wide array of stakeholders in the research, but we did achieve a greater progress [37] . Studies in both chapters 5 and 6 utilized the Double Diamond (DD) framework from the Design Council to guide problem-solving within a human-centered design methodology [38]. The DD framework is a structured problem-solving approach with four main stages: discover, define, develop, and deliver [35,38]. It begins with a thorough understand of the problem through the discover and define stages, ensuring that solutions are well-tailored and effective. The develop stage encourages creativity and innovation by exploring various potential solutions without constraints. User feedback is crucial throughout, particularly in the research and prototyping phases, to ensure that the final product meets actual user needs, 7
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