How do user-centered design studies contribute to cartography?

Purpose: This clinical focus article presents a modified user-centered design framework in order to facilitate the role of pediatric clinicians who treat feeding/swallowing disorders in redesigning the clinical experience in order to improve outcomes. The article establishes a physiologically based design framework and presents a user-centered design tool that clinicians may utilize to view the patient interaction from a design mindset in their practice. Method: Two case studies are presented to demonstrate the clinical application of the user-centered design tool. Case 1 applies the tool to controlled flow drinking cups and includes a pilot study that explores prototype testing of a novel cup design and the resulting patient experience. Case 2 presents a unique pediatric patient and the application of the user-centered method to analyze a modified treatment experience. Conclusions: Clinicians who treat pediatric feeding and swallowing disorders can benefit from the utilization of a user-centered design approach to observe the patient experience from a design perspective. This approach provides a structure to guide individual clinicians to key insights that may lead to improved treatments. Furthermore, user-centered methods may facilitate the analysis of complex patient scenarios by clinician-led teams, which may result in novel solutions.

BackgroundDespite the unprecedented performance of deep learning algorithms in clinical domains, full reviews of algorithmic predictions by human experts remain mandatory. Under these circumstances, artificial intelligence (AI) models are primarily designed as clinical decision support systems (CDSSs). However, from the perspective of clinical practitioners, the lack of clinical interpretability and user-centered interfaces hinders the adoption of these AI systems in practice.ObjectiveThis study aims to develop an AI-based CDSS for assisting polysomnographic technicians in reviewing AI-predicted sleep staging results. This study proposed and evaluated a CDSS that provides clinically sound explanations for AI predictions in a user-centered manner.MethodsOur study is based on a user-centered design framework for developing explanations in a CDSS that identifies why explanations are needed, what information should be contained in explanations, and how explanations can be provided in the CDSS. We conducted user interviews, user observation sessions, and an iterative design process to identify three key aspects for designing explanations in the CDSS. After constructing the CDSS, the tool was evaluated to investigate how the CDSS explanations helped technicians. We measured the accuracy of sleep staging and interrater reliability with macro-F1 and Cohen κ scores to assess quantitative improvements after our tool was adopted. We assessed qualitative improvements through participant interviews that established how participants perceived and used the tool.ResultsThe user study revealed that technicians desire explanations that are relevant to key electroencephalogram (EEG) patterns for sleep staging when assessing the correctness of AI predictions. Here, technicians wanted explanations that could be used to evaluate whether the AI models properly locate and use these patterns during prediction. On the basis of this, information that is closely related to sleep EEG patterns was formulated for the AI models. In the iterative design phase, we developed a different visualization strategy for each pattern based on how technicians interpreted the EEG recordings with these patterns during their workflows. Our evaluation study on 9 polysomnographic technicians quantitatively and qualitatively investigated the helpfulness of the tool. For technicians with <5 years of work experience, their quantitative sleep staging performance improved significantly from 56.75 to 60.59 with a P value of .05. Qualitatively, participants reported that the information provided effectively supported them, and they could develop notable adoption strategies for the tool.ConclusionsOur findings indicate that formulating clinical explanations for automated predictions using the information in the AI with a user-centered design process is an effective strategy for developing a CDSS for sleep staging.

BackgroundOlder adults are at increased risk of falls, injury, and hospitalization. Maintaining or increasing participation in physical activity during older age can prevent some of the age-related declines in physical functioning that contribute to loss of independence and low reported quality of life. Exercise snacking may overcome some commonly cited barriers to exercise and encourage older adults to engage in muscle strength and balance activity, but the best way to deliver and support this novel format remains unknown.ObjectiveOur aim was to explore how the novel exercise snacking approach, that is, incorporating short bouts of strength and balance activities into everyday routines, could be supported by technology within a home setting and what types of technologies would be acceptable for older adults who are prefrail.MethodsFollowing a user-centered design process, 2 design workshops (study 1) were conducted first to understand older adults’ (n=11; aged 69-89 years) attitudes toward technology aimed at supporting exercise snacking at home and to inform the design of 2 prototypes. Next, based on the findings of study 1, an exploratory pilot study (study 2) was conducted over 1 day with 2 prototypes (n=5; aged 69-80 years) at the participants’ homes. Participants were interviewed over the telephone afterward about their experience. Transcripts were analyzed using framework analysis.ResultsThe results showed that the participants were positive toward using technology at home to support exercise snacking, but both exercises and technology would need to be simple and match the participants’ everyday routines. Workshop discussions (study 1) led to the design of 2 prototypes using a pressure mat to support resistance and balance exercises. The exploratory pilot study (study 2) participants reported the potential in using smart devices to support exercise snacking, but the design of the initial prototypes influenced the participants’ attitudes toward them. It also hampered the acceptability of these initial versions and highlighted the challenges in fitting exercise snacking into everyday life.ConclusionsOlder adults were positive about using technology in their homes to support strength and balance exercise snacking. However, although promising, the initial prototypes require further refinement and optimization before feasibility, acceptability, and efficacy testing. Technologies to support exercise snacking need to be adaptable and personalized to individuals, to ensure that users are snacking on balance and strengthening exercises that are appropriate for them.

BackgroundDespite widespread awareness of healthy eating principles, many individuals struggle to translate this knowledge into consistent, sustainable dietary change. Food recommender systems, increasingly used in various settings, offer the potential for personalized guidance and behavior change support. However, traditional approaches may prioritize user preferences or popularity metrics without sufficiently considering long-term nutritional goals. This can inadvertently reinforce unhealthy eating patterns. Emerging research suggests that incorporating explanations into recommender systems can increase transparency, promote informed decision-making, and potentially influence food choices. Yet, the effectiveness of explanations in promoting healthy choices within complex, real-world food environments remain largely unexplored.ObjectiveThis study aims to investigate the design, implementation, and preliminary evaluation of a food recommender system that integrates explanations in a real-world food catering application. We seek to understand how such a system can promote healthy choices while addressing the inherent tensions between user control, meal variety, and the need for nutritionally sound recommendations. Specifically, our objectives are to (1) identify and prioritize key design considerations for food recommenders that balance personalization, nutritional guidance, and user experience; and (2) conduct a proof-of-principle study in a real-life setting to assess the system’s effect on user understanding, trust, and potentially on dietary choices.MethodsAn iterative, user-centered design process guided the development and refinement of the system across 4 phases: (Phase 0) an exploratory qualitative study (N=26) to understand stakeholder needs and initial system impressions, (Phases 1 and 2) rapid prototyping in real-life deployments (N=45 and N=16, respectively) to iteratively improve usability and features, and (Phase 3) a proof-of-principle study with employees (N=136) to evaluate a set of design goals. We collected a mix of data, including usage logs, pre- and post-study questionnaires, in-app feedback, and a pre- and post–Food Frequency Questionnaire to establish nutritional profiles.ResultsAlthough we experienced a high drop-out (77% after 7 weeks), motivated and remaining participants valued personalization features, particularly the ability to configure allergies and lifestyle preferences. Explanations increased understanding of recommendations and created a sense of control, even when preferences and healthy options did not fully align. However, a mismatch persisted between individual preferences and nutritionally optimal recommendations. This highlights the design challenge of balancing user control, meal variety, and the promotion of healthy eating.ConclusionsIntegrating explanations into personalized food recommender systems might be promising for supporting healthier food choices and creating a more informed understanding of dietary patterns. Our findings could highlight the importance of balancing user control with both the practical limitations of food service settings and the need for nutritionally sound recommendations. While fully resolving the tension between immediate preferences and long-term health goals is an ongoing challenge, explanations can play a crucial role in promoting more conscious decision-making.

The rapid advancement of AI technology has led to increasingly complex and opaque systems, creating a critical need for explainable AI (XAI) that enhances transparency and user trust. Despite extensive research on XAI methods and applications, the user-centered design (UCD) process for XAI remains fragmented and unclear. This systematic review analyzes 27 studies from 2020 to 2024 to develop a comprehensive framework for user-centered XAI system design (UCXAISD). We identify five key stages: contextual inquiry, explanation needs identification, XAI method selection, user interface design, and evaluation and refinement. Our framework aligns with traditional UCD processes while incorporating specialized elements for XAI, including user-centricity, transparency, and actionability. For each stage, we provide evidence-based guidelines derived from the literature. The framework serves as a blueprint for developing XAI systems that balance technical sophistication with user needs.

—Thailand, as well as many other countries worldwide, is facing a shortage of medical staff. We propose a solution to improve medical services in rural areas: a robot teleoperation system that allow patients to consult with doctors from public hospitals, and for doctors to examine and make decisions about their required care. To develop such a system, we are following a user-centred design (UCD) process. Two research questions have been addressed: how should an effective robot teleoperation system be designed to support medical diagnosis and patient communication? And does the use of a social robot improve the social interaction and examination quality in a remote consultation? This paper discusses the overall UCD process, starting from requirement analysis with Thai end-users (finished), system design and development on Pepper robot (in-progress), and user-centred evaluation (future plan).

This paper presents two case studies that suggest how to adapt Scrum for user-centered design (UCD) focused industrial projects and how to work with UCD in Scrum software development teams. The objective of the paper is to share insights gained from running such combined projects in industry in order to help others avoid some of the pitfalls associated with this way of working. There has been much published in this area within the research community. However, our work presents both perspectives: adapting a UCD way of working towards a Scrum way of working; and adapting Scrum for running projects from a UCD perspective. We explore the impact Scrum had on team members’ work-practices during a project life-cycle and what lessons were learned from our experiences.

Scientific data volumes have been growing exponentially. This has resulted in the need for new tools that enable users to operate on and analyze data. Cyber infrastructure tools, including workflow tools, that have been developed in the last few years has often fallen short if user needs and suffered from lack of wider adoption. User-centered Design (UCD) process has been used as an effective approach to develop usable software with high adoption rates. However, UCD has largely been applied for user-interfaces and there has been limited work in applying UCD to application program interfaces and cyber infrastructure tools. We use an adapted version of UCD that we refer to as Scientist-Centered Design (SCD) to engage with users in the design and development of Tigres, a workflow application programming interface. Tigres provides a simple set of programming templates (e.g., sequence, parallel, split, merge) that can be can used to compose and execute computational and data transformation pipelines. In this paper, we describe Tigres and discuss our experiences with the use of UCD for the initial development of Tigres. Our experience-to-date is that the UCD process not only resulted in better requirements gathering but also heavily influenced the architecture design and implementation details. User engagement during the development of tools such as Tigres is critical to ensure usability and increase adoption.

Even though User-Centred Design (UCD) is widely accepted and employed in the design and development of interactive systems, there are limited guiding procedures on how such approaches can be translated to the development of products, systems, and services that are focusing primarily on accessibility. This paper reports on the application of UCD for such a system within an EU project CONTENT4ALL under the domain accessibility for the Deaf. Each step in the UCD process and the respective activities within each step are described in detail with a focus on the methods and techniques adopted for assisting in the development of the novel technology. The insights gained during the entirety of the user-centred design and evaluation process have led to a compilation of important factors for creating sign-translated media content. This possible guideline comprises a list of useful and necessary components pertaining to sign language delivery in media, particularly sign television. The objective of this paper is to highlight lessons learned presented in the form of recommendations for human factors researchers on key UCD procedures for the development of accessibility products, systems and services based on the performed user activities within the project. An attempt has been made to reduce the gap in literature and add to a possible UCD guiding process exclusively for accessibility.

BackgroundAlthough assistive technology for cognition (ATC) has enormous potential to help individuals who have sustained a severe traumatic brain injury (TBI) prepare meals safely, no ATC has yet been developed to assist in this activity for this specific population.ObjectiveThis study aims to conduct a needs analysis as a first step in the design of an ATC to support safe and independent meal preparation for persons with severe TBI. This included identifying cooking-related risks to depict future users’ profiles and establishing the clinical requirements of the ATC.MethodsIn a user-centered design study, the needs of 3 future users were evaluated in their real-world environments (supported-living residence) using an ecological assessment of everyday activities, a review of their medical files, a complete neuropsychological test battery, individual interviews, observational field notes, and log journals with the residents, their families, and other stakeholders from the residence (eg, staff and health professionals). The needs analysis was guided by the Disability Creation Process framework.ResultsThe results showed that many issues had to be considered for the development of the ATC for the 3 residents and other eventual users, including cognitive issues such as distractibility and difficulty remembering information over a short period of time and important safety issues, such as potential food poisoning and risk of fire. This led to the identification of 2 main clinical requirements for the ATC: providing cognitive support based on evidence-based cognitive rehabilitation to facilitate meal preparation and ensuring safety at each step of the meal preparation task.ConclusionsThis needs analysis identified the main requirements for an ATC designed to support meal preparation for persons with severe TBI. Future research will focus on implementing the ATC in the residence and evaluating its usability.

Over 25% of Dutch young people are psychologically unhealthy. Individual and societal consequences that follow from having mental health complaints at this age are substantial. Young people need care which is often unavailable. ENgage YOung people earlY (ENYOY) is a moderated digital social therapy-platform that aims to help youngsters with emerging mental health complaints. Comprehensive research is being conducted into the effects and to optimize and implement the ENYOY-platform throughout the Netherlands. The aim of this study is to explore the usability and user experience of the ENYOY-platform. A user-centered mixed-method design was chosen. 26 young people aged 16-25 with emerging mental health complaints participated. Semi-structured interviews were conducted to explore usability, user-friendliness, impact, accessibility, inclusivity, and connection (Phase 1). Phase 2 assessed usability problems using the concurrent and retrospective Think Aloud-method. User experience and perceived helpfulness were assessed using a 10-point rating scale and semi-structured interviews (Phase 3). The Health Information Technology Usability Evaluation Scale (Health-ITUES; Phase 1) and System Usability Scale (SUS; Phase 2 and 3) were administered. Qualitative data was analyzed using thematic analysis. Task completion rate and time were tracked and usability problems were categorized using the Nielsen's rating scale (Phase 2). Adequate to high usability was found (Phase 1 Health-ITUES 4.0(0.34); Phase 2 SUS 69,5(13,70); Phase 3 SUS 71,6(5,63)). Findings from Phase 1 (N = 10) indicated that users viewed ENYOY as a user-friendly, safe, accessible, and inclusive initiative which helped them reduce their mental health complaints and improve quality of life. Phase 2 (N = 10) uncovered 18 usability problems of which 5 of major severity (e.g. troubles accessing the platform). Findings from Phase 3 (N = 6) suggested that users perceived the coaching calls the most helpful [9(0.71)] followed by the therapy content [6.25(1.41)]. Users liked the social networking aspect but rated it least helpful [6(2.1)] due to inactivity. The ENYOY-platform has been found to have adequate to high usability and positive user experiences were reported. All findings will be transferred to the developmental team to improve the platform. Other evaluation methods and paring these with quantitative outcomes could provide additional insight in future research.

This paper discusses results from a research study in the design and implementation of information documents and products in the Australian Taxation Office (ATO). It presents a composite ethnographic and case study analysis of user-centred information design practices at the ATO from 2001-2005, and shows that the ATO has been an active proponent of user centred design practices in developing business information documents and products for an extended period of time, while also identifying potential opportunities to improve business simulation, design and product construction. The article highlights that user-centred design principles may have broad based application in both the public and private sectors.

BackgroundMobile device–based tools to help adolescents practice skills outside of cognitive behavioral therapy (CBT) sessions for treating an anxiety disorder may lead to greater treatment gains.ObjectiveThis study aimed to develop, design, and test the acceptability, learnability, heuristics, and usability of MindClimb, a smartphone-based app for adolescents with anxiety to use between CBT sessions to plan and complete exposure activities using skills (cognitive, relaxation, exposure practice, and reward) learned in treatment.MethodsThis 3-phase study took place from August 2015 to December 2018. In phase 1, the app was designed and developed in consultation with young people and CBT therapists to identify desired functions and content. Feedback was subjected to thematic analysis using a general inductive approach. In phase 2, we conducted 2 high-fidelity testing sessions using the think-aloud approach (acceptability, learnability, usability) and 10-item System Usability Scale with 10 adolescents receiving CBT. The high-fidelity MindClimb app was evaluated by 5 app developers based on Nielsen’s usability heuristics and 5-point severity ranking scale. In phase 3, a total of 8 adolescents and 3 therapists assessed the usability of MindClimb during CBT sessions by recording the frequency of skills practice, use of MindClimb features, satisfaction with the app, and barriers and facilitators to app use during treatment.ResultsFeedback from phase 1 consultations indicated that the app should (1) be responsive to user needs and preferences, (2) be easy to use and navigate, (3) have relevant content to the practice of CBT for anxiety, and (4) be aesthetically appealing. Using this feedback as a guide, a fully functional app prototype for usability testing and heuristic evaluation was developed. In phase 2, think-aloud and usability data resulted in minor revisions to the app, including refinement of exposure activities. The average system usability score was 77 in both testing cycles, indicating acceptable usability. The heuristic evaluation by app developers identified only minor errors (eg, loading speed of app content, with a score of 1 on the severity ranking scale). In phase 3, adolescents considered app features for completing exposure (6.2/10) and relaxation (6.4/10) modestly helpful. Both adolescents (average score 11.3/15, SD 1.6) and therapists (average score 10.0/12, 2.6 SD) reported being satisfied with the app.ConclusionsThe user-centered approach to developing and testing MindClimb resulted in a mobile health app that can be used by adolescents during CBT for anxiety. Evaluation of the use of this app in a clinical practice setting demonstrated that adolescents and therapists generally felt it was helpful for CBT practice outside of therapy sessions. Implementation studies with larger youth samples are necessary to evaluate how to optimize the use of technology in clinical care and examine the impact of the app plus CBT on clinical care processes and patient outcomes.

User Needs Analysis and requirements engineering: Theory and practice

Scientific applications built on wide-area distributed systems such as emerging cloud based architectures and the legacy grid computing infrastructure often struggle with user adoption even though they succeed from a systems research perspective. This paper examines the coupling of user-centered design processes with modern distributed systems. Further in this paper, we describe approaches for conceptualizing a product that solves a recognized need: to develop a data gateway to serve the data management and research needs of experimentalists of electron microscopes and similar shared scientific instruments in the context of a research service laboratory. The purpose of the data gateway is to provide secure, controlled access to data generated from a wide range of scientific instruments. From the functional perspective, we focus on the basic processing of raw data that underlies the lab’s business processes, the movement of data from the laboratory to central access and archival storage points, and the distribution of data to respective authorized users. Through the gateway interface, users will be able to share the instrument data with collaborators or copy it to remote storage servers. Basic pipelines for extracting additional metadata (through a pluggable parser framework) will be enabled. The core contribution described in this paper, building on the aforementioned distributed data management capabilities, is the adoption of user-centered design processes for developing the scientific user interface. We describe the user-centered design methodology for exploring user needs, iteratively testing the design, learning from user experiences, and adapting what we learn to improve design and capabilities. We further conclude that user-centered design is, in turn, best enabled by an adaptable distributed systems framework. A key challenge to implementing a user-centered design is to have design tools closely linked with a software system architecture that can evolve over time while providing a highly available data gateway. A key contribution of this paper is to share the insights from crafting such an evolvable design-build-evaluate-deploy architecture and plans for iterative development and deployment.