Cover not available

Article published In: Information Design Journal
Vol. 24:2 (2018) ► pp.131–150

Get fulltext from our e-platform
JBE logo with link
PDF logo with download linkDownload PDF
authorization required

Developing tools to support patients and healthcare providers when in conversation about obesity

The 5As Team program

 | University of Alberta, Canada
 | University of Alberta, Canada
 | University of Alberta, Canada
 | University of Alberta, Canada
Published online: 18 April 2019
DOI logo with link
https://doi.org/10.1075/idj.00004.noe
Abstract
People living with obesity suffer from multiple health issues, including diabetes and mental health problems. Misinformation about the complex nature of this condition greatly affects the way one manages obesity. This results in unrealistic expectations by both healthcare providers and patients. Effective obesity management must be individually tailored for each patient. The objective of this project was to improve four communication tools by co-designing them with patients. A co-design approach was used to improve the efficacy and applicability of the tools through a working collaboration between patients, care providers, and researchers. While most articles describe processes to create shared-decision making (SDM) tools which compare alternative diagnosis and treatment options, few papers describe models to create SDM tools which go beyond showing benefits and risks. In this paper, we describe our process and approach to the re-design of four of the 5As obesity tools. We hope this study provides a valuable model for other teams.
Article outline
  • 1.Introduction
    • 1.1The need for shared-decision making
    • 1.2The challenges of caring for patients living with obesity (and the need for SDM)
  • 2.Methods
    • 2.1Human-centred design and the design of SDM tools
    • 2.2Participants
    • 2.3Materials
    • 2.4Study design
    • 2.5Using dialogue prompters and provotypes to foster collective thinking
    • 2.6Observing the use of the tools and interviewing to evaluate performance
    • 2.7Data analysis
  • 3.Findings
    • 3.1Understanding the design problem
    • 3.2Co-designing the tools
      • 3.2.1Using role-playing to situate the use of the tool
      • 3.2.2Using dialogue prompters to foster participation
    • 3.3Observing performance
      • 3.3.1Observing the use of the tools
      • 3.3.2Interviewing to understand people’s perception about using the tools
      • 3.3.3Document analysis: Analyzing what was used and how it was used, and what was not used
  • 4.Discussion
  • 5.Practice implications
  • 6.Conclusion
  • Acknowledgements
  • References
References (37)
References
Barthes, R. (1977). Image-music-text. New York, NY: Hill and Wang.Google Scholar logo with link to Google Scholar
Beyer, H. & Holtzblatt, K. (1997). Contextual design: Defining customer-centered systems. San Diego, CA: Elsevier.Google Scholar logo with link to Google Scholar
Boehmer, K. R., Hargraves, I. G., Allen, S. V., Matthews, M. R., Maher, C., & Montori, V. M. (2016). Meaningful conversations in living with and treating chronic conditions: Development of the ICAN discussion aid. BMC health services research, 16(1), 514. Google Scholar logo with link to Google Scholar
Breslin, M., Mullan, J., & Montori, V. (2008). The design of a decision aid about diabetes medications for use during the consultation with patients with type 2 diabetes. Patient education and counseling, 73(3), 465–472. Google Scholar logo with link to Google Scholar
Burke, T. J. & Segrin, C. (2017). Weight-related social control in couples: Associations with motives, constraints, and health behaviors. Communication Research, 44(3), 348–366. Google Scholar logo with link to Google Scholar
Card, S. K., Mackinlay, J. D., & Shneiderman, B. (1999). Information visualization: Using vision to think. San Francisco, CA: Morgan Kaufmann.Google Scholar logo with link to Google Scholar
Coulter, A., Kryworuchko, J. M. P., Ng, C. J., Stilwell, D., Weijden, T., Volk, R., & Llewellyn-Thomas, H. (2012). Using a systematic development process. Update of the International Patient Decision Aids Standards (IPDAS) collaboration’s background document. Retrieved from [URL]
Coulter, A., Roberts, S., & Dixon, A. (2013a). Delivering better services for people with long-term conditions. Building the house of care. London: The King’s Fund, 1–28.
Coulter, A., Stilwell, D., Kryworuchko, J., Mullen, P. D., Ng, C. J., & Weijden, T. (2013b). A systematic development process for patient decision aids. BMC medical informatics and decision making, 13(2), S2. Google Scholar logo with link to Google Scholar
Coulter, A., Entwistle, V. A., Eccles, A., Ryan, S., Shepperd, S., & Perera, R. (2015). Personalised care planning for adults with chronic or long-term health conditions. Cochrane Database of Systematic Reviews. Retrieved from [URL]
Elwyn, G., Kreuwel, I., Durand, M. A., Sivell, S., Joseph-Williams, N., Evans, R., & Edwards, A. (2011). How to develop web-based decision support interventions for patients: A process map. Patient education and counseling, 82(2), 260–265. Google Scholar logo with link to Google Scholar
Elwyn, G., Quinlan, C., Mulley, A., Agoritsas, T., Vandvik, P. O., & Guyatt, G. (2015). Trustworthy guidelines – excellent; customized care tools – even better. BMC medicine, 13(1), 199. Google Scholar logo with link to Google Scholar
Erwin, K., Norell, S., Martin, M. A., Paik, S. M., Press, V. G., Thompson, T. M., & Krishnan, J. A. (2018). Applying design methods to care delivery science. Information Design Journal, 23(3), 248–267. Google Scholar logo with link to Google Scholar
Frascara, J. & G. Noël. (2010). Evaluation and design of a blood components transfusion request form. Information Design Journal, 18(3), 241–249. Google Scholar logo with link to Google Scholar
. (2017). Iterative designing as a road to collective intelligence. In Design as collective intelligence. Champaign, IL: Common Ground.Google Scholar logo with link to Google Scholar
Frascara, J. (2017). Design, and design education: How can they get together? Art, Design & Communication in Higher Education, 16(1), 125–131. Google Scholar logo with link to Google Scholar
Hargraves, I., LeBlanc, A., Shah, N. D., & Montori, V. M. (2016). Shared decision making: The need for patient-clinician conversation, not just information. Health affairs, 35(4), 627–629. Google Scholar logo with link to Google Scholar
Hargraves, I. (2018). Care and capacities of human-centered design. Design Issues, 34(3), 76–88. Google Scholar logo with link to Google Scholar
Kushner, R. F. (2012). Clinical assessment and management of adult obesity. Circulation, 126(24), 2870–2877. Google Scholar logo with link to Google Scholar
Loeb, D. F., Binswanger, I. A., Candrian, C., & Bayliss, E. A. (2015). Primary care physician insights into a typology of the complex patient in primary care. The Annals of Family Medicine, 13(5), 451–455. Google Scholar logo with link to Google Scholar
Loeffler, E., Power, G., Bovaird, T., & Hine-Hughes, F. (2013). Co-production of health and wellbeing in Scotland. Governance International, Edinburgh.Google Scholar logo with link to Google Scholar
Luig, T., Elwyn, G., Anderson, R., & Campbell-Scherer, D. (2018a). Facing obesity: Adapting the collaborative deliberation model to deal with a complex long-term problem. Patient education and counseling. Advance online publication. Google Scholar logo with link to Google Scholar
Luig, T., Anderson, R., Sharma, A. M., & Campbell-Scherer, D. (2018b). Personalizing obesity assessment and care planning in primary care: Patient experience and outcomes in everyday life and health. Clinical obesity, 8(6), 411–423. Google Scholar logo with link to Google Scholar
Mayer, R. E. (1989). Models for understanding. Review of Educational Research, 59(1), 43–64. Google Scholar logo with link to Google Scholar
Morin, E. (1992). Il metodo: Ordine, disordine, organizzazione. Milano: Feltrinelli.Google Scholar logo with link to Google Scholar
Noël, G. (2017). Health Design: Mapping current situations, envisioning next steps. The Design Journal, 201(sup1), S2304–S2314. Google Scholar logo with link to Google Scholar
Nowotny, H., Scott, P., & Gibbons, M. (2001). Re-thinking science: Knowledge and the public in an age of uncertainty. Cambridge, UK: Polity Press.Google Scholar logo with link to Google Scholar
Osunlana, A. M., Asselin, J., Anderson, R., Ogunleye, A. A., Cave, A., Sharma, A. M., & Campbell-Scherer, D. L. (2015). 5As Team obesity intervention in primary care: Development and evaluation of shared decision-making weight management tools. Clinical obesity, 5(4), 219–225. Google Scholar logo with link to Google Scholar
Peek, C. J., Baird, M. A., & Coleman, E. (2009). Primary care for patient complexity, not only disease. Families, Systems, & Health, 27(4), 287–302. Google Scholar logo with link to Google Scholar
Service, O. & Gallagher, R. (2017). Think small. London: Michael O’Mara Books.Google Scholar logo with link to Google Scholar
Sharma, A. M. (2010). M, M, M & M: A mnemonic for assessing obesity. Obesity Reviews, 11(11), 808–809. Google Scholar logo with link to Google Scholar
Sharma, A. M., & Padwal, R. (2010). Obesity is a sign – over-eating is a symptom. Obesity Reviews, 11(5), 362–270. Google Scholar logo with link to Google Scholar
Simon, H. (1981). The science of the artificial. Cambridge, MA: MIT press.Google Scholar logo with link to Google Scholar
Stacey, D., Légaré, F., Lewis, K., Barry, M. J., Bennett, C. L., Eden, K. B., … & Trevena, L. (2017). Decision aids for people facing health treatment or screening decisions. Cochrane database of systematic reviews, 41.Google Scholar logo with link to Google Scholar
Stiggelbout, A. M., Weijden, T., Wit, M. P. T. D., Frosch, D., Légaré, F., Montori, V. M., … & Elwyn, G. (2012). Shared decision making: Really putting patients at the centre of healthcare. British Medical Journal (BMJ), 3441, e256. Google Scholar logo with link to Google Scholar
Witteman, H. O., Dansokho, S. C., Colquhoun, H., Coulter, A., Dugas, M., Fagerlin, A., … & Witteman, W. (2015). User-centered design and the development of patient decision aids: Protocol for a systematic review. Systematic reviews, 4(11).Google Scholar logo with link to Google Scholar
Cited by (8)

Cited by eight other publications

Ofosu, Nicole N., Jordan Tate, Charlotte Hruczkowski, Charlene Feuffel, Laurel Collier, Nonsikelelo Mathe, Marcia Bruce, Denise Campbell-Scherer & Eliana Castillo
2026. Antimicrobial Prophylaxis Practices for Obstetrical Infection Prevention in Alberta: A Multi-Method Study. Journal of Obstetrics and Gynaecology Canada 48:1 ► pp. 103173 ff. DOI logo
Ofosu, Nicole N, Westerly Luth, Shelagh K Genuis, Kelsey Tymkow, Indra Budiyanto, Taylor McGuckin, Denise Campbell-Scherer & Wendy S Johnston
2025. Challenges and opportunities for expediting ALS diagnosis in Alberta, Canada: a human-centred design approach. BMJ Open 15:9 ► pp. e104139 ff. DOI logo
Morgan, Tamara L., Emma Faught, Amanda Ross-White, Michelle S. Fortier, Mary Duggan, Rahul Jain, Kirstin N. Lane, Amanda Lorbergs, Kaleigh Maclaren, Taylor McFadden & Jennifer R. Tomasone
2023. Tools to guide clinical discussions on physical activity, sedentary behaviour, and/or sleep for health promotion between primary care providers and adults accessing care: a scoping review. BMC Primary Care 24:1 DOI logo
Cheng, Erika R., Courtney Moore, Lisa Parks, Elsie M. Taveras, Sarah E. Wiehe & Aaron E. Carroll
2022. Communicating Risk for Obesity in Early Life: Engaging Parents Using Human-Centered Design Methodologies. Frontiers in Pediatrics 10 DOI logo
Elliott, Andrea, Sarah Lang, Helen Truby, Linda Brennan & Simone Gibson
2022. Tackling the challenge of treating obesity using design research methods: A scoping review. Obesity Reviews 23:2 DOI logo
Frascara, Jorge
2022. Revisiting “Graphic Design: Fine Art or Social Science?”—The Question of Quality in Communication Design. She Ji: The Journal of Design, Economics, and Innovation 8:2 ► pp. 270 ff. DOI logo
Ofosu, Nicole Naadu, Thea Luig, Yvonne Chiu, Naureen Mumtaz, Roseanne O. Yeung, Karen K. Lee, Nancy Wang, Nasreen Omar, Lydia Yip, Sarah Aleba, Kiki Maragang, Mulki Ali, Irene Dormitorio & Denise Campbell-Scherer
2022. Understanding the bigger picture: syndemic interactions of the immigrant and refugee context with the lived experience of diabetes and obesity. BMC Public Health 22:1 DOI logo
Walker, Sue, Sue Hignett, Rosemary Lim, Caroline Parkhurst & Flora Samuel
2020. Explaining drug-resistant infection in community pharmacies through effective information design. Design for Health 4:1 ► pp. 82 ff. DOI logo

This list is based on CrossRef data as of 11 december 2025. Please note that it may not be complete. Sources presented here have been supplied by the respective publishers. Any errors therein should be reported to them.

Mobile Menu Logo with link to supplementary files background Layer 1 prag Twitter_Logo_Blue