Developing digital health interventions for falls prevention An innovative user-centered design approach

Digital health interventions are promising for improving the efficiency and quality of care delivery, but their broader adoption remains limited due to design approaches that often do not adequately address user needs. This dissertation aimed to enhance the iterative cycle of User-Centered Design (UCD) and applied this improved cycle for the development of two digital falls prevention interventions for use by health care professionals (HCPs), namely an online multifactorial falls risk assessment tool (i.e., Fall Analysis 2.0) and a medication-related clinical decision support system (i.e., ADFICE_IT CDSS). Chapters 2 and 3 detail the construction of theory-driven personas and journey maps to foster user-focused thinking and guide design and implementation requirements for the Fall Analysis 2.0. Chapter 4 demonstrates how interdisciplinary collaboration supported the development of the ADFICE_IT CDSS. Chapter 5 introduces a novel approach to usability problem prioritization, emphasizing severity based on the problem’s potential negative impact on the secondary (patient) rather than primary (HCP) user experience. In chapter 6, the effectiveness, user experience, and implementation of the Fall Analysis 2.0 is examined in Dutch primary care, revealing that the UCD developed tool positively influenced HCPs falls risk management behavior by facilitating fully completed multifactorial falls risk assessments in older adults at high risk of falling. Together, the findings set new standards for the development and testing of UCD-driven digital health interventions for HCPs, both within and beyond the context of falls prevention. The final chapter discusses the implications of these findings for research and (clinical) practice.