Building Capacity in Human-Centered Design: Developing a Diabetes Mobile Health Application for and With Kenyan Adolescents

Aim #1 Train Kenyan health practitioners and software developers in HCD. We accomplished this by implementing an HCD curriculum during a three-day workshop with our Kenyan collaborators. Drs. Wyche, Olson and Holtz, travelled to Nairobi, Kenya, between September 28 and October 5 to conduct our three-day training workshop. Our collaborators from LakeHub (in Kisumu) also flew to Nairobi. Our other collaborators-from DMI-are based in Kenya's capital city. We held the workshop at the Ngong Hills Hotel in Nairobi.

Aim #2 Use HCD to build a prototype intervention for adolescents in Kenya with T1D. We accomplished this aim by conducting interviews; analyzing data; holding two design workshops; developing an initial version of a diary; conducting a pilot evaluation of the diary; and iterating upon the diary's design. Significant project outcomes include a personal diary.

In April 2022, Dr. Jennifer Olson, and our collaborators at DMI and ROA, interviewed 24 youth with T1D at two sites in Kenya (Vihiga County and Nairobi); 12 participants in each site. She also interviewed their parents/caregivers (n=22), as well as key stakeholders (e.g., doctors, teachers, community health workers). Interviews were digitally recorded (with participants' consent). During this time, we also provided youth with a digital camera and asked them to engage in a photovoice exercise (i.e., asking participants to take photographs, and then reflecting upon the reasons, emotions and experiences that motivated them to take the photos).

We hired translators-fluent in Kiswahili and English-to translate and transcribe the interviews. We also collected participants' photographs. Drs. Olson and Wyche analyzed this transcribed interviews and photographs in May-June 2022. Our objective was to deepen our understanding of how youth managed T1D and to identify possible technology interventions. A significant finding was that developing a mobile phone application would not support youths' existing practices. Most participants are not allowed to use mobile phones in school. Further, not all participants, especially those living in rural areas, had access to a smart phone.

In July 2022, Drs. Wyche and Olson travelled to Kenya. We held two, two-day design workshops (between July 3 and July 7). The first was held at Sosa Cottages (Majengo); the second was held at Ngong Hills Hotel (Nairobi). All of the youth and caregivers, who Dr. Olson interviewed in April, attended the workshops. Workshop objectives included: learning more about youth and T1D; and brainstorming design interventions that would help youth manage the disease. During these sessions, participants discussed their experiences managing T1D; they also talked about their photographs. Other significant activities include brainstorming exercises. Participants ideas included posters that would educate people about T1D, a calendar that would help youth keep track of their doctors' appointments, and diary that supported T1D-related activities. At the conclusion of the workshops Drs. Wyche and Olson determined that the diary was the most promising intervention. The diary would allow youth to track their sugar levels, as well as what they ate and their activity levels. The diary would also include useful information about how to effectively manage T1D (e.g., how to inject insulin, to make healthy meals, and properly store insulin). They worked with designed from LakeHub to develop an initial version of this diary.