Use of a human-centered design approach to adapt a nurse-led cardiovascular disease prevention intervention in HIV clinics

Abstract

Stakeholder-informed strategies addressing cardiovascular disease (CVD) burden among people living with HIV (PWH) are needed within healthcare settings. This study provides an assessment of how human-centered design (HCD) guided the adaptation of a nurse-led intervention to reduce CVD risk among PWH. Using a HCD approach, research staff guided two multidisciplinary "design teams" in Ohio and North Carolina, with each having five HCD meetings. We conducted acceptability and feasibility testing. Six core recommendations were produced by two design teams of key stakeholders and further developed after the acceptability and feasibility testing to produce a final list of 14 actionable areas of adaptation. Acceptability and feasibility testing revealed areas for adaptation, e.g. patient preferences for communication and the benefit of additional staff to support patient follow-up. In conclusion, along with acceptability and feasibility testing, HCD led to the production of 14 key recommendations to enhance the effectiveness and scalability of an integrated HIV/CVD intervention.

Keywords: CVD prevention; CVD-HIV integration; Human-centered design; Nurse-led intervention.

Figure 1:. Core components of the EXTRA-CVD clinical trial

Figure 2:. EXTRA-CVD Design Process

Figure 3. Pilot study steps

Figure 4:. Mapping site recommendations using the Adaptome model