Dr Haiou Zhu

Design is expanding its influence on shaping future healthcare. Ideally, designers apply human-centered design and human factors that introduce theory, principles, and methods to design to optimize people's healthcare experiences in both digital and non-digital environments. To discuss and implement experience design in healthcare, consensus about experience design in healthcare is needed. Objectives: Therefore, the purpose of this study is to investigate designers' views on experience design in health, and to uncover their understanding about three experience design concepts, i.e., user experience (UX), patient experience (PEx), and digital patient experience (dPEx). We conducted online semi -structured interviews study with convenience samples who met the eligibility. We used ATLAS.ti for an indepth data coding following thematic analysis. 24 international designers of digital health solutions, either in industry or in academia took part in the interviews. We found the similarities and differences mentioned between healthcare design and non healthcare design relate to (1) design principles, (2) user attributes, and (3) design contexts. Furthermore, the differences between UX, PEx, and dPEx can be mapped on five dimensions: people, contexts, purposes, means, and usage scenarios. These insights can help designers and human factors specialists build a common design language for experience design in healthcare. Our study can also assist designers and human factors specialists with experience design in digital health by pointing out the areas where design thinking generally is appropriate and the places where particular expertise in healthcare design is needed.

Economic studies have shown that living in poverty may produce a subjective feeling of scarcity, which affects people's cognitive functions and decision-making. Understanding this mechanism could inform healthcare designers on designing inclusive health interventions by considering the psychological scarcity and limited cognitive resources of impoverished individuals. We conducted a psychological experiment to test the impact of psychological scarcity on cognitive function and health decisions of rural residents in China. We randomly assign participants to two financial scenarios (hard vs. easy) with the technique of priming to induce their immediate financial worries. Then we measure cognitive function using Ravens Progressive Matrices and uncover their decision-making priorities with a budget allocation task. 301 participants finished the study and 264 were included in the main analysis. The results show that both immediate financial worries and cumulative poverty have negative effects on participants cognitive performance. Responses to scarcity could lead to attentional focus on limited resources, thereby neglecting long-term health consequences, particularly for the lower income group. Based on the findings, we suggest a number of human factors design considerations that are critical to successful healthcare design.

Ecological-collective-flourishing (e-co-flourishing) describes the interconnected flourishing of human and non-human natural entities. Despite existing conceptual frameworks, translation into practice remains inadequate owing to insufficient synthesis of empirically tested mechanisms driving change across human and ecological systems. We conducted an umbrella review of systematic reviews examining mechanisms at the e-co-flourishing interface. Searches of seven databases and four grey literature sources identified nine eligible reviews. Evidence supported several cross-domain mechanisms, including psychological (eg, attention restoration and reduced stress), social (eg, cohesion and contact), physical (eg, activity), and environmental pathways (eg, reduced stressors and enhanced environmental quality). Psychological mechanisms showed the most consistent support, whereas evidence for other mechanism domains was mixed. Evidence for causality was weak and largely derived from cross-sectional and qualitative studies, and no reviews examined reciprocal mechanisms influencing both human and non-human flourishing. Future research should prioritise rigorous designs, theory-driven testing, and replication to strengthen evidence for equitable and sustainable e-co-flourishing pathways.

Online health consultation (OHC) platforms have been extensively used since the outbreak of COVID-19, that the number of active users has been increasing dramatically in China. OHC interfaces require a more immersive environment to support the entire medical consultation journey. This study intends to explore the design features of existing OHC platforms, and how they relate to patient experience and patient OHC journey. A literature review of design features, patient experience, and patient OHC journey was conducted to generate a framework to guide the study. Then, semi -structured interviews with 10 participants were carried out. The notions of "Design Features" were interpreted differently by individuals. For example, 'graphic design' was viewed as colour, font, icon, etc. Design Features have varying degrees of influence on "Patient Experience" and "Patient OHC Journey". This study explores what comprises Design Features of OHC platforms. The associations between Design Features and Patient Experience found in this study are different from the associations that have been found in other contexts, like e-commerce. The design on telemedicine platforms especially OHC should be studied as an independent topic to inform the design of a better patient experience throughout the OHC journey.

Converging ecological and social crises have exposed the limits of prevailing models of human progress, highlighting the need for more inclusive and interdisciplinary approaches to advancing wellbeing and flourishing across human and non-human life. In this Personal View, we propose an ecological-collective-flourishing (e-co-flourishing) approach, whereby one’s own human flourishing is pursued along with that of natural ecosystems and their collective and individual constituents. We offer a heuristic translational framework that includes a methodological approach; guiding principles; and proposed programme theory in terms of hypothesised outcomes, pathways of change (mechanisms), key contextual factors (moderators), and intervention characteristics. This framework aims to bridge theory to real-world applications of e-co-flourishing interventions that are effective, scalable, and promote change through targeted mechanisms of action. We present Mindfulness-Based Cognitive Therapy-Balanced Living for Us and the Earth’s Ocean (MBCT-BLUE) as an illustrative application of this framework to outline how the framework can be used to identify, refine, develop, and evaluate interventions with e-co-flourishing potential. We also provide definitions of key conceptual terms and proxy measurements. Practitioners, researchers, and decision makers working at the interface of mental health, public health, sustainability, and planetary health can use this framework and its resources to guide emerging research and innovation.

The assessment of local muscle fatigue during dynamic exercises is viewed as essential, since people tend to maximise effective muscle training and minimise harmful muscle injuries. This study aims to investigate how surface electromyography (sEMG) and subjective metrics together can play a role in dynamic muscle fatigue prediction during exercises to promote the design of health and fitness technology. 20 healthy male participants were recruited in the experiment, and sEMG and self-reported data were collected. Features in temporal and spatial domain were extracted from sEMG data, such as RMS (root mean square) and FInsm5 (spectral parameter proposed by Dimitrov). Our results showed that some sEMG features indicated directional changes with the increase of dynamic muscle fatigue. Spearman correlation analysis indicated that Borg ratings had strong correlations with RMS and FInsm5 (spectral parameter proposed by Dimitrov) slopes. Then this paper discusses how to use sEMG and Borg data to evaluate muscle fatigue during exercises. A framework is proposed based on the joint analysis of spectra and amplitudes across RMS and FInsm5 slopes. This paper further discusses how to design health and fitness technology for the benefits and the limitations of the study.

As an ethical design approach embedding with the human value of inclusiveness, inclusive design could contribute to economic value creation. However, research on the relationship between economic value and human values in inclusive design has seldom been explored. This preliminary literature review focuses on how value and values have been discussed in inclusive design research. The findings first present the evolving conceptions of inclusive design that formulate and transform the understanding of value and values. Then, existing literature on the economic value of inclusive design, and inclusive design for human values at both individual and social levels are reviewed respectively. We categorize these disparate discussions into 'value creation' and 'value distribution' and propose opportunities for an integrated approach that would bridge discussions on the economic value and human values in future research.

Background: Digital health (DH) brings considerable benefits, but it comes with potential risks. Human Factors (HF) play a critical role in providing high-quality and acceptable DH solutions. Consultation with designers is crucial for reflecting on and improving current DH design practices. Objectives: We investigated the general DH design processes, challenges, and corresponding strategies that can improve the digital patient experience (PEx). Methods: A semi-structured interview study with 24 design professionals. All audio recordings were transcribed, deidentified, grammatically corrected, and imported into ATLAS.ti for data analysis. Three coders participated in data coding following the thematic analysis approach. Results: We identified eight DH design stages and grouped them into four phases: preparation, problem-thinking, problem-solving, and implementation. The analysis presented twelve design challenges associated with contextual, practical, managerial, and commercial aspects that can hinder the design process. We identified eight common strategies used by respondents to tackle these challenges. Conclusions: We propose a Digital Health Design (DHD) framework to improve the digital PEx. It provides an overview of design deliverables, activities, stakeholders, challenges, and corresponding strategies for each design stage.

Background: The COVID-19 lockdowns led to significant resource constraints, potentially impacting mental health and decision-making behaviors. Understanding the psychological and behavioral consequences could inform designing interventions to mitigate the negative impacts of episodic scarcity during crises like pandemics. Objective: To investigate the effects of perceived scarcity on mental health (stress and fear), cognitive functioning, time and risk preferences (present bias and risk aversion), and trade-offs between groceries, health, and temptation goods during and after the COVID-19 lockdown in Shanghai. Methods: A quasi-natural experiment was conducted in Shanghai during and after the COVID-19 lockdown. Web-based surveys were administered in May 2022 (during lockdown) and September 2022 (post-lockdown). Propensity score matching was used to balance demographic factors between the groups (During: n=332; After: n=339). Data were analyzed using regression analyses, controlling for potential confounders and applying propensity score matching weights. Results: Perceived scarcity was significantly higher during the lockdown (mean 7.97 (SD 2.1)) than after (mean 4.35 (SD 2.27); P