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Cited by 27Mobile Health and mHealth ApplicationsUsability and User Interface DesignTelemedicine and Telehealth Implementation

Designing a Framework for Remote Cancer Care Through Community Co-design: Participatory Development Study

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Aronoff-Spencer, Eliah, McComsey, Melanie, Chih, Ming-Yuan, Hubenko, Alexandra, Baker, Corey, Kim, John, Ahern, David K, Gibbons, Michael Christopher +5 more·2022·Journal of Medical Internet Research
DOI 10.2196/29492PMC PMC9044168

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Abstract

Background: Recent shifts to telemedicine and remote patient monitoring demonstrate the potential for new technology to transform health systems; yet, methods to design for inclusion and resilience are lacking. Objective: The aim of this study is to design and implement a participatory framework to produce effective health care solutions through co-design with diverse stakeholders. Methods: We developed a design framework to cocreate solutions to locally prioritized health and communication problems focused on cancer care. The framework is premised on the framing and discovery of problems through community engagement and lead-user innovation with the hypothesis that diversity and inclusion in the co-design process generate more innovative and resilient solutions. Discovery, design, and development were implemented through structured phases with design studios at various locations in urban and rural Kentucky, including Appalachia, each building from prior work. In the final design studio, working prototypes were developed and tested. Outputs were assessed using the System Usability Scale as well as semistructured user feedback. Results: We co-designed, developed, and tested a mobile app (myPath) and service model for distress surveillance and cancer care coordination following the LAUNCH (Linking and Amplifying User-Centered Networks through Connected Health) framework. The problem of awareness, navigation, and communication through cancer care was selected by the community after framing areas for opportunity based on significant geographic disparities in cancer and health burden resource and broadband access. The codeveloped digital myPath app showed the highest perceived combined usability (mean 81.9, SD 15.2) compared with the current gold standard of distress management for patients with cancer, the paper-based National Comprehensive Cancer Network Distress Thermometer (mean 74.2, SD 15.8). Testing of the System Usability Scale subscales showed that the myPath app had significantly better usability than the paper Distress Thermometer (t63=2.611; P=.01), whereas learnability did not differ between the instruments (t63=–0.311; P=.76). Notable differences by patient and provider scoring and feedback were found. Conclusions: Participatory problem definition and community-based co-design, design-with methods, may produce more acceptable and effective solutions than traditional design-for approaches.

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  • Aronoff-Spencer et al [43] described a human-centered participatory design approach that engaged patients, caregivers, and community stakeholders to support rural patients experiencing distress during cancer treatment.

    “Aronoff-Spencer et al [43] also described a human-centered participatory design approach that engaged patients, caregivers, and community stakeholders to support rural patients experiencing distress during cancer treatment.”

    From User-Centered Design for Digital Patient-Navigation Tools in Oncology: Scoping Review (2026) · cites this paper as [43]

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Cited by

Sorted by citations

  • User-Centered Design for Digital Patient-Navigation Tools in Oncology: Scoping Review

    Kheirinejad, S., White, B. M., Kheirkhah Rahimabad, P., Zink, J. A., Hashtarkhani, S., Kumsa, F. A., Rashid, R., Chinthala, L., Brett, C. L., Davis, R. L., et al. (2026) · JMIR Human Factors · doi:10.2196/87686

    “Aronoff-Spencer et al [43] also described a human-centered participatory design approach that engaged patients, caregivers, and community stakeholders to support rural patients experiencing distress during cancer treatment.”

Authors
Aronoff-Spencer, E., McComsey, M., Chih, M.-Y., Hubenko, A., Baker, C., Kim, J., Ahern, D. K., Gibbons, M. C., Cafazzo, J. A., Nyakairu, P., Vanderpool, R. C., Mullett, T. W., & Hesse, B. W.
Affiliations
  • University of California San Diego (US)
  • University of Kentucky (US)
  • Brigham and Women's Hospital (US)
  • University Health Network (CA)
  • National Cancer Institute (US)
Corresponding author
Mullett, Timothy W
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2022-04-12
Volume
24
Issue
4
Pages
e29492
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/29492
PMC
PMC9044168
OpenAlex
W3209002171
Cited by
27
References
3
Citations by year
2026: 9 · 2025: 7 · 2024: 6 · 2023: 3 · 2022: 2
FWCI
3.09
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Journal of Medical Internet Research (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • Amgen
  • University of Kentucky (P30 CA177558)
  • University of California, San Diego
  • National Cancer Institute (P30CA177558)
Topics
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Physical Sciences › Computer Science › Human-Computer Interaction › Usability and User Interface Design
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
Keywords
cancer care coordination, community co-design, participatory design, mobile health apps, health disparities, Appalachia, rural health, usability, telemedicine, remote patient monitoring
MeSH terms
Delivery of Health Care, Humans, Kentucky, Neoplasms, Rural Population, Telemedicine, Mobile Applications

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