User-centered Design of the eyeGuide: A Tailored Glaucoma Behavior Change Program.
We employed user-centered design to refine a prototype of the eyeGuide, a novel, tailored behavior change program intended to improve medication adherence among glaucoma patients.



Glaucoma patients age 40 years and above prescribed ≥1 glaucoma medication were included.



The eyeGuide consists of tailored educational content and tailored testimonials in which patients share how they were able to overcome barriers to improve their medication adherence. A hybrid of semistructured diagnostic and pretesting interviews were used to refine the content of the eyeGuide. Purposeful sampling was used to recruit a study population representative of the glaucoma patient population. Interviews were conducted until thematic saturation was reached. Interviews were audiorecorded and transcribed verbatim. Three researchers analyzed the transcripts, generated a codebook, and identified key themes using NVivo 10.0 to further refine the eyeGuide.



Twenty-one glaucoma patients were interviewed; mean age 72±12.4 years, 5 (24%) African Americans, 9 (43%) with poor self-reported adherence, 10 (47.6%) age 75 years and above, 10 (47.6%) with poor vision, and 9 (42.9%) women. Qualitative analysis identified 5 important themes for improving glaucoma self-management: social support, patient-provider relationship, medication routine, patients' beliefs about disease and treatment, and eye drop instillation. All participants expressed satisfaction with in-person delivery of the eyeGuide and preferred this to a Web-based module. Participant feedback resulted in revised content.



User-centered design generated improvements in the eyeGuide that would not have been possible without patient input. Participants expressed satisfaction with the tailored content.
Departments of *Ophthalmology & Visual Sciences §Internal Medicine, University of Michigan Medical School †School of Public Health ‡School of Social Work, University of Michigan, Ann Arbor, MI.
Olivia J
OJ
Killeen
Chamisa
C
MacKenzie
Michele
M
Heisler
Ken
K
Resnicow
Paul P
PP
Lee
Paula Anne
PA
Newman-Casey
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D005260:Female; D005901:Glaucoma / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009883:Ophthalmic Solutions; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires
D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions