There are some parallels between evaluations of HCD interventions and evaluations of interventions incorporating adaptive management or quality improvement where the intervention can also change over timeġ4. However, the iterative and flexible nature of HCD potentially poses some unique challenges for evaluationħ and examples of evaluations of HCD public health interventions have so far been limitedĨ. Intervention evaluation is an essential component of public health research and programming, and detailed guidance on evaluation approaches and methodologies existĦ. HCD shares some characteristics with other methods used to design programmes such as traditional socio-behavioural research but tends to be more ‘nimble/flexible/iterative’ and less protocol driven The approach has a high tolerance for both ambiguity and failureģ. HCD is a creative approach to programme design that focuses on building empathy with the population of interest, and generating and iteratively testing many potential solutions to complex problems. In the field of public health, human-centred design (HCD), also known as design thinking, is increasingly being used during intervention development, and sometimes implementation, to design innovative solutions to complex problemsġ. A phased approach would delay the availability of evaluation findings but would allow for a more appropriate and tailored evaluation design. Future HCD-based initiatives should consider a phased evaluation, focusing initially on programme theory refinement and process evaluation, and then, when the intervention program details are clearer, following with outcome evaluation and cost-effectiveness analysis. Robust evaluation of interventions designed using HCD, a promising and increasingly popular approach, is warranted yet challenging. Opportunities included the potential to inform programmatic decision-making in real-time to ensure that interventions adequately met the contextualized needs in targeted areas. As much time and resources went into the creation of a new design approach, separating one-off “creation” costs versus those costs associated with actually implementing the programme was challenging. This resulted in a more time-consuming and resource-intensive study design process. The HCD process meant that key information such as intervention components, settings, and eligible populations were unclear and changed over outcome evaluation and cost-effectiveness protocol development. The evaluation team had to be flexible and align closely with the work plan of the implementers. We reflect on evaluation opportunities and challenges associated with measuring the application and impact of this novel HCD-led design approach.įor the process evaluation, participant observations were key to capturing the depth of the fast-paced, highly-iterative HCD process, and to understand decision-making within the design process. The A360 external evaluation includes a process evaluation, quasi-experimental outcome evaluation, and a cost-effectiveness study. The innovative A360 approach is led by human-centred design (HCD), combined with social marketing, developmental neuroscience, public health, sociocultural anthropology and youth engagement ‘lenses’, and aims to create context-specific, youth-driven solutions that respond to the needs of adolescent girls. Adolescents 360 (A360) is a four-year initiative (2016–2020) to increase 15-19-year-old girls’ use of modern contraception in Nigeria, Ethiopia and Tanzania.

Total design 360