The term “human-centered design” describes a toolset used in many fields to guide activities that strongly resemble clinical trial recruitment and conduct, including marketing and product design. Human-centered design involves integrating members of a given target audience into each stage of conceptualization and development. For a piece of software, this might include observation, interviews, and focus groups to identify needs and preferences, or co-design workshops where target users offer input into the look and feel of the application, and engage in many prototype iterations until the platform is both usable and valued.
A widely-cited human-centered design success in the context of health promotion is the “Lucky Fish”. Canadian researchers were interested in addressing high rates of anemia in some Cambodian communities where uptake of iron supplements was very low. As a low-cost method for treating anemia, the researchers supplied small cast-iron blocks that can be dropped into cooking pots to release iron, and those who received the blocks found them so unappealing that they generally became used as doorstops.
After speaking with members of the community, the lead researcher learned the value the community placed on fish — much of the local economy relates to fishing, they are a dietary staple, and they are prominent in folklore. Following these interviews the team began casting their iron in the shape of Try Kantrop: a fish-shaped symbol of luck, and they quickly rose in popularity (note that the efficacy of “lucky fish” for meaningfully addressing anemia has yet to be established!).
The core tenets underlying human-centered design — that different users will have different preferences that are tied to one’s personal tastes and the social and cultural influences that surround them, and designers should therefore include diverse members when crafting designs and marketing messages — can be applied directly to the design of recruitment materials.
We recently looked at participant demographics from approximately 5,000 research participants who engaged in projects housed within our Wake Forest Pepper Center. Approximately 80% of these individuals were college educated (compared with 35% in Forsyth County) and 77% earned above the median income. While many Pepper Center studies achieve their recruitment targets, clearly there are important segments of our local population who are left out.
In addition to better integrating community members into each stage of the research process, there are several lessons-learned from the practice of Human Centered Design that could help to improve representation within our studies.