Using a human-centered design approach for collaborative decision-making in pediatric asthma care

Objectives: Human-centered design (HCD) is a qualitative methodology that empathizes with end-users and assists in formulating preferable and practical interventions. We explored the utility of HCD in improving pediatric asthma healthcare outcomes among patient and caregiver populations within an urban academic center. Study design: HCD employs a multiphase process that aims to identify the needs of end users and reframe solutions around each stakeholder's preference patterns. Methods: Ethnographic-style observations were initiated among pediatric asthma healthcare providers, community environmental activists, local government public health officials, households with a young child (<12 years of age) with asthma, and adolescent asthmatics. Common themes from the observations served as the basis for understanding users' experiences and determining actionable areas of improvement within outpatient asthma care. Multistakeholder brainstorming sessions led to the emergence of three prototypes that underwent low-fidelity field testing. Results: The first prototype elucidated caregivers' preferred outpatient asthma support systems using a newly created visual decision-making aid. The second constructed prototype was a child-oriented asthma activity sheet that allowed children to better communicate their understanding and impact of asthma care. The final prototype attempted to improve interactions between providers, caregivers, and children/adolescents using visual prompts to enhance empathetic and clinically-relevant dialogue. Conclusion: Engaging a diverse population of relevant stakeholders in disease processes that use design thinking yield relevant solutions with enhanced community buy-in. The prototypes are continuing to undergo iterative field testing in local community and academic asthma care sites.