Department of Surgery, University of California, San Francisco, CA, United States.
Department of Emergency Medicine, University of California, San Francisco, CA, United States.
JMIR Mhealth Uhealth. 2020 Aug 24;8(8):e15866. doi: 10.2196/15866.
Violence is a public health problem. Hospital-based violence intervention programs such as the San Francisco Wraparound Project (WAP) have been shown to reduce future violent injury. The WAP model employs culturally competent case managers who recruit and enroll violently injured patients as clients. Client acceptance of the WAP intervention is variable, and program success depends on streamlined, timely communication and access to resources. High rates of smartphone usage in populations who are at risk for violent reinjury create an opportunity to design a tailored information and communications technology (ICT) tool to support hospital-based violence intervention programs.
Current evidence shows that ICT tools developed in the health care space may not be successful in engaging vulnerable populations. The goal of this study was to use human-centered design methodology to identify the unique communication needs of the clients and case managers at WAP to design a mobile ICT.
We conducted 15 semi-structured interviews with users: clients, their friends and families, case managers, and other stakeholders in violence intervention and prevention. We used a human-centered design and general inductive approach to thematic analysis to identify themes in the qualitative data, which were extrapolated to insight statements and then reframed into design opportunities. Wireframes of potential mobile ICT app screens were developed to depict these opportunities.
Thematic analysis revealed four main insights that were characterized by the opposing needs of our users. (1) A successful relationship is both professional and personal. Clients need this around the clock, but case managers can only support this while on the clock. (2) Communications need to feel personal, but they do not always need to be personalized. (3) Healing is a journey of skill development and lifestyle changes that must be acknowledged, monitored, and rewarded. (4) Social networks need to provide peer support for healing rather than peer pressure to propagate violence. These insights resulted in the following associated design opportunities: (1) Maximize personal connection while controlling access, (2) allow case managers to personalize automated client interactions, (3) hold clients accountable to progress and reward achievements, and (4) build a connected, yet confidential community.
Human-centered design enabled us to identify unique insights and design opportunities that may inform the design of a novel and tailored mobile ICT tool for the WAP community.
暴力是一个公共卫生问题。基于医院的暴力干预项目，如旧金山全方位项目 (WAP)，已被证明可以减少未来的暴力伤害。WAP 模式采用文化上有能力的个案经理，他们招募和接纳受暴力伤害的病人作为客户。客户对 WAP 干预的接受程度各不相同，项目的成功取决于简化、及时的沟通和获取资源。在易受暴力再次伤害的人群中，智能手机的高使用率为设计一个定制的信息和通信技术 (ICT) 工具提供了机会，以支持基于医院的暴力干预项目。
现有证据表明，在医疗保健领域开发的 ICT 工具可能无法成功吸引弱势群体。本研究的目的是使用以人为中心的设计方法来确定 WAP 客户和个案经理的独特沟通需求，以设计一个移动 ICT。
我们对 15 名用户进行了半结构化访谈：客户、他们的朋友和家人、个案经理以及暴力干预和预防领域的其他利益相关者。我们采用以人为中心的设计和一般归纳方法对定性数据进行主题分析，从定性数据中提取主题，并将其推断为洞察陈述，然后重新构建为设计机会。开发了潜在移动 ICT 应用程序屏幕的线框，以描绘这些机会。
主题分析揭示了四个主要的见解，这些见解的特点是我们用户的需求相互对立。(1)成功的关系既是专业的，也是个人的。客户需要这种关系 24 小时不间断，但个案经理只能在工作时间内提供这种关系。(2)沟通需要有个人感，但并不总是需要个性化。(3)康复是一个技能发展和生活方式改变的过程，必须得到承认、监测和奖励。(4)社交网络需要为康复提供同伴支持，而不是传播暴力的同伴压力。这些见解导致了以下相关的设计机会：(1)在控制访问的同时最大化个人联系，(2)允许个案经理个性化自动客户交互，(3)让客户对进步负责并奖励成就，(4)建立一个有联系但保密的社区。
以人为中心的设计使我们能够确定独特的见解和设计机会，这可能为 WAP 社区设计一个新颖和定制的移动 ICT 工具提供信息。
