Abstract:
Human-centered design (HCD) is an increasingly recognized approach for engaging stakeholders and
developing contextually appropriate health interventions. As a component of the ongoing STRENGTHS
study (Strengthening Referral Networks for Management of Hypertension Across the Health System), we
report on the process and outcomes of utilizing HCD to develop the implementation strategy prior to a
cluster-randomized controlled trial.
Methods
We organized a design team of 15 local stakeholders to participate in an HCD process to develop
implementation strategies. We tested prototypes for acceptability, appropriateness, and feasibility
through focus group discussions (FGDs) with various community stakeholder groups and a pilot study
among patients with hypertension. FGD transcripts underwent content analysis, and pilot study data were
analyzed for referral completion and reported barriers to referral. Based on this community feedback, the
design team iteratively updated the implementation strategy. During each round of updates, the design
team research other settings.