Moderator’s Note: This post was authored by Katie Halkyard MPH, CHES, who served as Research Manager for CIRP’s Digital Health Initiative. A trained public health professional and health educator, her work at CIRP focused on identifying evidence-based strategies to effectively develop, evaluate, and disseminate health information in the digital age. As of July 2016, Ms. Halkyard has left CIRP to pursue her career elsewhere.
As the field of injury prevention science is still relatively young, it is often worthwhile to look to other established areas of public health research as guides to develop effective prevention programming. As with most things, there are great, good and some “so-so” educational resources out there. Although well-intended, many health interventions cannot adequately improve patient or client outcomes because they were not developed using evidence and behavioral objectives with the end-user in mind.
CIRP@CHOP’s Digital Health Initiative (DHI) works to integrate best practice approaches into program development. For instance, a health intervention should be patient-centered, offer value to the target audience, and encourage certain healthy behaviors. In a recent study published in Patient Education and Counseling, Linda Fleisher, PhD, my colleague and leader of DHI, shared how she and her team applied best practice approaches in designing educational intervention tools for cancer prevention. Although their work focused on the creation of a decision support website for cancer patients, the multi-step development process is universally applicable to public health topics in general, including pediatric injury prevention.
The article emphasized the following best practices in designing public health interventions:
- Engage a Multidisciplinary Development Team – Strive to include experts from a variety of backgrounds to gain many different perspectives on appropriate intervention content and design to produce a high quality product.
- Tailor the Intervention to Fit Patients’ Needs – Conducting focus groups or surveys with the target audience, as well as reviewing the literature on the topic can help guide the design process to make the intervention relevant, usable, engaging, and understandable to patients.
- Involve Patients Along the Way – Dr. Fleisher and her team received feedback from potential intervention participants throughout the development process to maximize the final result. The intervention website content, including the text, video scripts, and actors, and the look and feel of the website, were all designed using comments and reactions from patients. In this way, the intervention was truly “patient-centered.”
- Evaluate, Evaluate, Evaluate – Conducting process evaluations at various stages of program development can help ensure that the intervention is well-received by your target audience. These evaluations can also help you determine which aspects of the intervention matter most to them, and how they might use the intervention in their daily lives. Most important, program evaluation along the way can help alleviate potentially poor outcomes once patients begin using the final product.
Dr. Fleisher and colleagues’ article serves as an example of best practice approaches in integrating both research-based evidence and patients’ voices into intervention development. CIRP@CHOP is no stranger to these approaches, as exemplified by Dr. Nancy Kassam-Adams’ recent blog post on optimal interventions to address child trauma.
These principles also apply to our work in digital health. Our goal is to share these best practices with others working in the digital health space to ensure that they are theory based and help manage health. For me it raises questions the following questions:
- How should we apply these best practices in designing patient-centered health apps?
- How do we evaluate the impact on health behaviors?
- Where and how is the evidence included in mobile medical apps?
- How can patients and providers find out if an app is evidence-based?
- How can we create medical apps that are more patient-centered and evidence-based?
Creating and evaluating evidence-based digital health and helping others do the same is the fundamental goal of our Digital Health Initiative. We would love to hear more about how you are addressing these issues or ideas about how to build evidence into digital health.