User-centered design in time and resource-limited settings: Enhancing the usability of 'Hearing for Life' (HeLe) Device

Introduction@#The Hearing for Life (HeLe) is a novel newborn hearing screening device initially designed according to specifications of clinicians of the Philippine National Ear Institute (PNEI). Unfortunately, targeted end-users, rural health workers, had difficulty using it. This research applied the user-centered design (UCD) methodology involving rural health workers in recommending design, content, and function requirements for HeLe. @*Objectives@#This study aims to 1) describe how UCD was applied in a time-limited and resource-constrained environment, 2) assess the usability of the design prototypes, and 3) recommend design, content, and function requirements for HeLe. @*Methods@#This research is a descriptive study using mixed methods. Six rural health units (RHU) involved in the HeLe research program were purposively selected for the study. There were 30 participants included, five health care workers per RHU. Applying the UCD method, the study had three phases: 1) user profiling (where participants accomplished a survey questionnaire, 2) inspiration phase (focus group discussions, workflow analysis, and interviews with a technical expert were conducted), and 3) ideation phase (designing and assessment of prototypes were done). @*Results@#Participatory methods and structured procedures (i.e., card sorting, MoSCoW matrix prototyping, etc.) were applied to help determine and prioritize user requirements and elicit user feedback. These methods were chosen considering the time and resource constraints in the RHU. The prototype's System Usability Scale (SUS) score (81.94) was higher than the SUS score previously obtained (68) from the older version of the interface. Accuracy, durability, in-app instructions, feedback, and an easily understood interface were the most requested requirements for the telemedicine device. The need for the technology to be aligned with the RHU's workflow and available resources was highlighted in the focus group discussions. @*Conclusions@#The study documents practices and lessons learned in applying UCD methodology in design and development that have been demonstrated to improve usability of the device. The involvement of the users surfaced in the design, content, and functional requirements which can guide future iterations of HeLe and contribute to better understanding of ways to develop user-friendly telemedicine devices in the Philippines. This paper emphasizes that users should be involved in the entire process and not just recipients of the technology.

Implementation of newborn hearing screening in Rizal, Philippines, and Northern California: Lessons learned

Objective@#The universal newborn hearing screening program has been implemented in the Philippines for the past ten years. However, screening rates in the country are still low. The current study aimed to describe the universal newborn hearing screening program (UNHSP) delivery system in Rizal, Philippines, and Northern California. @*Methods@#The study utilized a case study research design using data triangulation of FGD, KII, and document review to characterize and compare the implementation of the Universal Newborn Hearing Screening Program in Rizal Province and Northern California. @*Results@#Several differences were found in the protocols for newborn hearing screening in Rizal, Philippines, and Northern California, including centralization of the program, availability of surveillance data, screening protocols, and tracking system. @*Conclusion@#There is an immense need to disseminate universal newborn hearing screening among healthcare practitioners and create a system to monitor and evaluate real-time data.

Baseline knowledge, attitudes, and practices of healthcare practitioners in Rizal Province, Philippines toward Implementing the Universal Newborn Hearing Screening Program

Objective@#The study describes the current knowledge, attitudes, and practices of healthcare practitioners in Rizal province regarding the implementation of the universal newborn hearing screening program (UNHSP).@*Materials and Methods@#A descriptive phenomenologic research design through focus group discussions with pediatric and OBGYN consultants in a government hospital, nurses from private primary and secondary hospitals, midwives from private birthing homes, and rural health workers@*Results@#Attitudes. All participants recognized that they had important roles in implementing the program except the OBGYN consultants as they felt that information about the UNHSP should be provided by pediatricians. Practices. The lack of a screening device, trained personnel, and a referral network were the most common barriers in implementing the program. Knowledge. Most participants lacked specific knowledge about hearing loss and its implications in the UNHSP.@*Conclusion@#Most participants were able to determine the advantages and disadvantages of implementing the UNHSP. However, less than half of the participants admitted to have an established protocol to give access to newborn hearing screening services. Establishment of an information dissemination protocol and materials may be beneficial in the absence of funding for screening devices.