Applying agile, iterative co-design principles to the development of a smartphone app for people living with dementia

Research output: Contribution to journalArticlepeer-review


Background :

The benefits of involving those with lived experience in the design and development of health technology are well recognised and reporting of co-design best practice has increased over the past decade. However, it’s important to recognise that the methods and protocols behind patient public involvement (PPI) and co-design vary depending on the patient population accessed. This is especially important when considering individuals living with a cognitive impairment, such as dementia, who are likely to have needs and experiences unique to their cognitive capabilities.

We worked alongside individuals living with dementia and their care-partners to co-design a mobile health app. This app aimed to address a gap in our knowledge as to how cognition fluctuates over short, micro-longitudinal time scales. The app requires users to interact with built-in memory tests multiple times per-day, meaning that co-designing a platform which was easy to use, accessible and appealing was particularly important.
Here we discuss our use of Agile methodology to enable those living with dementia and their care partners to be actively involved in the co-design of a mobile health app

Objectives : The aim of this study was to explore the benefits of co-design on the development of smartphone apps. Here we share our co-design methodology and reflections on how this benefitted our completed product.

Methods: Our app was developed using Agile methodology, which allowed for patient and care partner input to be incorporated iteratively throughout the design and development process. Our co-design approach comprised 3 core elements, aligned with the values of patient co-design and adapted to meaningfully involve those living with a cognitive impairment: (1) End user representation at research and software development meetings via a patient proxy; (2) equal decision-making power for all stakeholders based on their expertise; (3) continuous user consultation, user-testing and feedback.
Results: This co-design approach resulted in multiple patient/care partner-led software alterations which, without consultation, would not have been anticipated by the research team. This included 13 software design alterations, re-naming of the product and removal of a cognitive test deemed to be too challenging for the target demographic.
Conclusion: We found patient and care partner input to be critical throughout the development process for early identification of design and usability issues, and for identifying solutions not previously considered by our research team. Since issues addressed in early co-design workshops did not re-occur subsequently, we believe this process made our product more user friendly and acceptable and will formally test this assumption through future pilot-testing.
Original languageEnglish
JournalJMIR mHealth and uHealth
Publication statusAccepted/In press - 8 Oct 2021


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