Digital Health Co-Design
Mindsets
In this section you can find a range of standards and principles (often referred to as mindsets) that are used to frame how people approach co-designing digital health technologies. These evidence-based co-design mindsets range from agile development principles to visualization principles. Please click on each co-design mindset below for more details.
👉 You can watch a short animated video which provides an introduction to co-design mindsets.
Agile Development Principles
Description: Agile Development Principles provide a flexible and adaptive way of developing digital health interventions. Rather than relying on rigid, linear processes, agile emphasises delivering working solutions in short, iterative cycles, responding effectively to changes in requirements, and maintaining close collaboration with users and stakeholders. (Al-Saqqa et al. 2020)
Application Example: Herrmann et al. (2021)
EquiP Method Design
Description: EquiP Method Design is a participatory design approach developed to address power imbalances in co-design processes. It focuses on creating more equitable collaboration between stakeholders by enhancing participants’ ability to influence outcomes, fostering genuine co-creation, and supporting fair, cooperative relationships. By promoting power-sharing, the EquiP method helps ensure that design processes and results are more inclusive, balanced, and sustainable. (Çarçani et al., 2023)
Application Example: Çarçani et al. (2023)
Behavioural Change Principles
Description: Behaviour Change Principles provide evidence-based guidance for designing interventions that help people adopt and sustain healthier behaviours. By applying these principles, co-designers can create digital health solutions that are more engaging, effective, and sustainable in real-world use.
Application Example: Bron et al. (2022)
Ethical Principles Design
Description: Ethical Principles guide the responsible design and use of digital health technologies by ensuring respect, fairness, and accountability throughout the process. They emphasise protecting users’ rights and autonomy, minimising harm while maximising benefits, promoting equity and justice in access and outcomes, and maintaining transparency and integrity in all decisions. (Kelly, 2019)
Application Example: Hochstenbach et al. (2017)
Human-Centred Design
Description: Human-Centred Design (HCD) is 'an approach to interactive systems development that aims to make systems usable and useful by focusing on the users, their needs and requirements, and by applying human factors/ergonomics, and usability knowledge and techniques.' (ISO, 9241-210:2019)
Application Example: Brown et al. (2022)
International Patient Decision Aid Standards
Description: The International Patient Decision Aid Standards (IPDAS) provide a globally recognised set of quality criteria for the development and evaluation of patient decision aids. These standards ensure that decision aids present health information in a clear, balanced, and evidence-based way, support patients in clarifying their values, and facilitate informed discussions with health professionals. IPDAS covers key aspects such as content accuracy, development process, presentation of options and outcomes, and effectiveness in improving patient knowledge and decision quality. (Stacey et al., 2021)
Application Example: Brown et al. (2022)
Human Factors Principles
Description: Human Factors Principles focus on designing systems, tools, and environments that fit human abilities and limitations. They emphasise reducing cognitive and physical workload, supporting situation awareness, preventing errors, and promoting safety, usability, and efficiency. By applying these principles, co-designers can ensure that digital health technologies are not only functional but also intuitive, safe, and supportive of both patients and professionals in real-world contexts. (Sujan et al. 2021)
Application Example: Prince et al. (2019)
Iterative Cycles Principle
Description: Iterative cycles are a core principle of co-design and participatory design, emphasising the continuous process of planning, acting, observing, and reflecting. Rather than following a linear path, interventions are refined step by step, with each cycle incorporating participant feedback and insights. This principle supports mutual learning between users and designers, ensuring that solutions evolve to better reflect user needs, contexts, and expectations (Spinuzzi et al., 2005).
Application Example: Ostervang et al., (2022)
Nielsen’s Usability Heuristics
Description: Nielsen’s Usability Heuristics are ten general principles for user interface design developed by Jakob Nielsen. They provide a widely used framework for evaluating and improving usability, covering key aspects such as system visibility, consistency, user control, error prevention, efficiency, and minimalist design. By applying these heuristics, designers can create interfaces that are more intuitive, accessible, and user-friendly, helping users achieve their goals effectively and with confidence. (Jiménez et al., 2021)
Application Example: Richardson et al. (2021)
Person-Based Approach to Intervention Development
Description: The Person-Based Approach is a set of principles for developing health interventions that places strong emphasis on understanding the perspectives, needs, and psychosocial contexts of target users. It involves qualitative research at every stage of development—from planning through feasibility testing and implementation—to gain deep insights into user experiences. These insights are then translated into guiding principles that shape how the intervention addresses specific behavioural challenges, ensuring that the final design is persuasive, feasible, and relevant to the people who will use it. (Yardley et al., 2015)
Application Example: Stawarz et al. (2023)
Participatory Design
Description: Participatory Design (PD) is an approach that actively involves users, stakeholders, and communities as co-designers throughout the design process. It emphasises collaboration, shared decision-making, and mutual learning to ensure that outcomes reflect the needs, values, and experiences of those who will use them.
Application Example: Partogi et al. (2022)
Social Justice Design
Description: Social Justice Design is an approach that integrates equity, inclusion, and fairness into the design process. It seeks to challenge systemic inequalities by ensuring that the voices of marginalised and underrepresented groups are meaningfully included. By addressing power imbalances and promoting accessibility, social justice design helps create technologies and services that are not only effective but also more inclusive, ethical, and socially responsible.
Application Example: Latulippe et al. (2020)
User-Centred Design
Description: User-Centred Design (UCD) is an iterative process that keeps users and their context at the heart of every stage of design and development. It ensures that digital health technologies are usable, meaningful, and effective. The process typically involves four stages: understanding the context of use, specifying user requirements, designing solutions, and evaluating against those requirements. (Schaffer & Lahiri, 2014)
Application Example: Ray et al. (2019)
User Innovation Management Principles
Description: User Innovation Management Principles focus on how organisations can systematically support, manage, and benefit from innovations that originate with users. These principles emphasise recognising users as active innovators, creating structures for capturing their ideas, fostering collaboration between users and professionals, and integrating user-driven insights into product or service development. By applying these principles, co-designers can harness user creativity, improve relevance, and ensure that solutions are more closely aligned with real-world needs. (Kanstrup & Bertelsen, 2011)
Application Example: Nielsen et al. (2018)
User Experience Perspective Design
Description: Using a User Experience (UX) perspective in design means going beyond simply meeting functional needs. It views the use of technology as a personal, context-dependent, and multifaceted experience shaped by the user’s inner state, the characteristics of the product, and the context of interaction. (Unger & Chandler, 2023)
Application Example: Giroux et al. (2019)
Visualisation Principles
Description: Visualisation principles are design guidelines grounded in visual perception and Gestalt psychology that help present complex information in clear, intuitive, and meaningful ways. By combining graphical and textual elements, they reduce cognitive load, highlight patterns and relationships, and support faster, more accurate decision-making. In co-design, visualization principles ensure that digital health technologies communicate information effectively and are aligned with how users naturally perceive and interpret visual data. (Gordon, 2004)
Application Example: Tiase et al., (2021)