Improving Self-Report Diaries: A Respondent-Centric Design Approach

Rosaline Barendregt

1,2 a

, Yngve Lamo

3 b

and Barbara Wasson

1,2 c

Centre for the Science of Learning and Technology, University of Bergen, Norway

Department of Information Science and Media Studies, University of Bergen, Norway

Department of Computer Science, Western Norway University of Applied Sciences, Bergen, Norway

Keywords:

Digital Self-Report, Respondent Burden, Interaction Design, Respondent-Centric Design, NOW Interactions.

Abstract:

Medical self-report plays an indispensable role in healthcare, capturing vital subjective data from health and

everyday life contexts. While considerable research has been dedicated to trialling self-report to ensure their

clinical validity, there has been less focus on understanding user behaviour in self-reporting and on devising

strategies to optimise the use of these self-report tools. The traditional approach to self-report design has been

largely information-centric, relegating patients to the role of passive information providers. This can lead to

a signiﬁcant respondent burden due to the retrospective nature of the questions and the inherent challenges in

data provision. Recently, the Respondent-centric Design (RxD) Framework has been suggested as an approach

to bridge clinical needs and patient’s needs within the self-report design process. In this paper we report on

the use of the RxD framework for redesigning a headache diary. Our experience on using RxD provides

insight into its potential to reshape self-report design, RxD steered our focus during the redesign to consider

respondent perspectives more thoroughly. The redesigned headache diary received positive feedback, both

from users and experts, and the evaluation suggests improved adherence and higher respondent acceptance.

1 INTRODUCTION

Recent advancements in patient-centric healthcare

emphasise patient involvement in treatment, making

self-reporting an indispensable tool. The Respondent-

centric Design framework (RxD), grounded in In-

teraction Design (IxD) principles, has been intro-

duced (Barendregt and Wasson, subm) to elevate the

quality of self-reported data by alleviating respon-

dent burden. RxD, speciﬁcally tailored speciﬁcally

for patient-centric healthcare self-reporting, empha-

sises incorporating patients’ perspectives throughout

the design process. Situated at the intersection of self-

reporting, interaction design, and patient-centric care,

RxD places emphasis on the respondent. It focuses

on facilitating the creation of interfaces that resonate

with patients, aiming to transform self-reporting from

a tedious task to a meaningful, engaging activity. This

approach is designed to minimise response errors and

biases, which directly results in more reliable data for

healthcare decisions. By enhancing the usability and

sustainability of the designs, RxD facilitates greater

patient engagement and empowers them to be active,

https://orcid.org/0000-0002-7356-4021

https://orcid.org/0000-0001-9196-1779

https://orcid.org/0000-0003-4897-1394

informed decision-makers in their healthcare journey.

As a result, these intuitive and sustainable designs en-

hance the patients’ autonomy and empowering them

to be active, informed decision-makers.

This paper primarily aims to illustrate the ben-

eﬁts of RxD as a user-centred design approach on

data quality and respondent burden in self-report di-

aries. It describes the methods and evaluation tech-

niques adopted during the redesign and evaluation of

a self-report headache diary, integrating respondent

perspectives. The redesigned diary serves as a prac-

tical example, illustrating the effectiveness and appli-

cation of a respondent-oriented process in the devel-

opment of self-report tools.

Headache diaries are important tools for track-

ing headaches and diagnosing related conditions, typ-

ically used by patients between general practitioner

referral and neurologist consultation to record pain

timing, intensity, and medication use. In design-

ing mobile headache diaries, a key challenge is bal-

ancing usability with clinical requirements (Hundert

et al., 2014). Usability facilitates accurate data en-

try by patients, while clinical relevance ensures the

data’s medical utility. Yet, usability often remains

under-addressed in many existing applications (Hun-

dert et al., 2014).

The Norwegian Directorate of Health recom-

Barendregt, R., Lamo, Y. and Wasson, B.

Improving Self-Report Diaries: A Respondent-Centric Design Approach.

DOI: 10.5220/0012396400003657

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 17th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2024) - Volume 2, pages 529-536

ISBN: 978-989-758-688-0; ISSN: 2184-4305

529

Figure 1: The four phases of the RxD framework, from (Barendregt and Wasson, subm).

mends the use of the Brain Twin app

, developed by

the Norwegian University of Science and Technology

and St Olav University Hospital. Such a recommen-

dation emphasises the app’s clinical relevance and po-

sitions it as a foundational tool to collect headache

data for clinical assessment and research. However,

despite its prominence, as of 20th of December 2023,

the app’s moderate user satisfaction score (2.9 in

Google Play, based on 52 reviews) indicates a need

for improvements in patient-oriented features. This

gap between clinical relevance and user satisfaction

highlights the necessity of aligning clinical needs with

user experience in headache diary design.

In response to this need, our study adopts the RxD

framework to balance these aspects in the redesign of

the headache diary. Our goal is to improve user inter-

action elements, thereby reducing respondent burden

and enhancing the quality of information gathered.

The redesign of the headache diary was guided

by the RxD frameworks iterative four-phased process:

Explore, Analyse, Align & Design, and Evaluate, see

Figure 1. In each phase, we employed speciﬁc meth-

ods, including desk research to review existing liter-

ature and analyse other tools, conducting interviews,

and identifying design challenges. Key to this process

was the development and evaluation of iterative proto-

types, complemented by usability testing and inspec-

tion. Throughout the redesign process we prioritised

the respondent perspective, identifying and address-

ing weaknesses in the original diary design. This ap-

proach ensured that the redesign focused on enhance-

ments that directly beneﬁted the respondents. By ap-

helsedirektoratet.no/om-oss/forsoksordninger-og-

prosjekter/tryggere-helseapper

plying the RxD framework, we placed the patient at

the core of the design process, aiming for a balance

between the clinical needs of healthcare providers and

what patients ﬁnd meaningful to share.

In our redesign, we integrated ‘NOW Interac-

tions’, a mobile communication technique (Baren-

dregt and Wasson, 2022). This approach was specif-

ically chosen to simplify and optimise user interac-

tions. The primary goals were to enhance informa-

tion collection and address critical issues such as min-

imising respondent burden, boosting data accuracy,

and overall enhancing the user experience in the self-

report headache diary.

Integral to user-centred processes and the RxD is

the early testing of interfaces and interaction mech-

anisms, even before trials with end-users, to identify

and rectify issues with interactions. Importantly, in

this early stage testing beneﬁcial insights can also

be derived from non-end users with similar traits or

through simulated environments. In the context of

self-reporting in digital health, this allows for ef-

fective evaluation without jeopardising patient care

(Cassano-Pich

e et al., 2015).

By preemptively detecting and addressing user in-

terface and interaction issues, it is more likely that

when actual patients test the system they can concen-

trate on assessing if the solution truly ﬁts their needs,

purpose, and situation, without being sidetracked by

primary usability concerns. This makes their feed-

back more valuable and streamlines the testing pro-

cess as it allows for more rapid and efﬁcient eval-

uation of issues related to respondent burden (self-

reporting as difﬁcult, time consuming, and stressful),

rather than on interface and interaction issues.

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530

The remainder of this paper is structured as fol-

lows: First, we present the process and key activities

within RxD. Then, we present the results of the re-

design process, including the main outcomes with re-

gard to respondent burden and data quality. Lastly,

we discuss the implications of our ﬁndings related to

the use of RxD in medical self-reporting and highlight

areas for future research in the conclusion.

2 METHODOLOGY

This section identiﬁes the participants, and outlines

how the distinct phases of RxD were applied in the

context of redesigning a headache diary.

2.1 Participants

In the redesign’s exploration and evaluation phases,

we involved a neurology professor and an experi-

enced headache diary user, providing both clinical

and user-based insights. The primary participants for

evaluating the prototype were teachers from various

primary and secondary schools. Here are details of

the participants and their participation:

Proﬁle and Inclusion: 13 teachers were intro-

duced to the NOW Interactions Headache Diary dur-

ing a workshop on interaction design. Out of the

group, six teachers met the inclusion criteria, which

involved having an Android device, installing the pro-

totype, and providing informed written consent for

their data to be used to reﬁne the prototype, excluding

any medical analysis or implications.

Rationale for Participant Selection: We selected

teachers for initial testing to assess the diary in a con-

trolled, risk-free environment, to reﬁne the interac-

tion before involving patients in future clinical as-

sessments, thereby minimising patient burden at this

stage. Notably, the ﬁve teachers who completed the

testing reported experiencing headaches, emphasising

the relevance of their feedback for the diary’s design.

Duration: The study spanned 2 weeks, during

which participants were sent three daily inquiries,

plus additional ones if headaches were indicated. In

total, 41 to 82 inquiries were sent to each teacher dur-

ing the study period.

Incentives: No incentives were offered, as the aim

was to measure genuine adherence without external

motivation. The inquiry content was designed to be

engaging enough to naturally motivate participation.

Ethical Considerations: Ethical approval was ob-

tained through the university’s system for risk and

compliance for processing of personal data in re-

search, as the study did not involve patients and data

was only used to assess the prototype. Using pa-

tients would have required a longer process to ob-

tain approval from the regional committee for med-

ical and health research ethics. Though the study

did not involve patients, the selected participants pro-

vided valuable feedback on user interactions, guid-

ing future design and preparation for patient testing

in later stages. Reﬁning and optimising interactions

ﬁrst with non-patients strategically postpones patient

involvement. This approach aims to minimise im-

posed burden and increase the signiﬁcance of their

feedback during the clinical viability assessment of

the headache diary in subsequent stages.

2.2 Phase 1: Explore

This phase aimed to explore headache reporting, iden-

tifying key stakeholders (patients and clinicians) and

their perspective. It focused on understanding the re-

quired information, the context in which patients pro-

vide it, and evaluating existing headache reporting so-

lutions. Key activities included:

Studying research literature. To understand the

known challenges relating to headache self-reporting.

Criteria: Relevant, peer-reviewed articles or encyclo-

pedia entries, written in English, focusing on self-

report (design) or challenges related to headaches.

Analysis of recommended app (Brain Twin).

To identify potential opportunities for improvement

based on existing features, user interactions and inter-

faces, user reviews.

Headache diary app comparison. To identify

design features linked to user satisfaction and un-

cover opportunities for new designs. Criteria: An-

droid apps available on google play with a user rating

above 3.0, and allow for headache registration; Search

terms used: ‘headache diary’, ‘headache tracking’,

and ‘hodepinedagbok’ (Norwegian for headache di-

ary) This resulted in the inclusion of 5 apps.

Interview with domain expert. To gain a clinical

perspective on headache reporting and identify infor-

mation needs. Criteria: neurologist with experience

with headache diaries.

User interview. To gather patient perspectives and

experiences with diary app use. Criteria: used a mo-

bile headache diary for over two months.

2.3 Phase 2: Analyse

This phase focused on analysing the headache report-

ing domain, synthesising insights from the data from

Phase 1, and understanding the impact of stakeholder

needs on the problem. It involved formulating de-

sign challenges and exploring possibilities that ad-

Improving Self-Report Diaries: A Respondent-Centric Design Approach

531

dress these challenges. Key activities included:

Designing a user journey. To map key contact mo-

ments where users interact with the app.

Formulating design challenges. To pinpoint spe-

ciﬁc issues that need to be addressed in the redesign.

2.4 Phase 3: Align & Design

This phase involved iteratively creating potential de-

sign solutions that align patient needs and prefer-

ences with information requirements, addressing ear-

lier identiﬁed challenges. A variety of design and

evaluation methods were used to reﬁne these solu-

tions. Key activities included:

Prototype solutions. To explore design elements

that could improve user experience.

Evaluate prototype by self-testing, user feedback,

and usability tests. To assess if user needs are met.

Iterate and reﬁne design. To continually improve

the prototype based on feedback and test results.

2.5 Phase 4: Evaluate

In this phase, the focus was on evaluating the de-

sign’s effectiveness with respect to information qual-

ity, timeliness, respondent burden, and user experi-

ence. Key activities included:

Quantitative usability test. To measure user ac-

ceptance and adherence. Details: two weeks, 6

teacher participants, 3 daily initial inquiries. Criteria:

Android phone users, successful app installation

Engagement evaluation. To measure user engage-

ment in eHealth technologies. It was translated to

Norwegian and adapted to assess the solution’s po-

tential for future use.

Domain expert interview. To gather clinical feed-

back on the proposed solution. Criteria: a neurologist

experienced in headache diaries.

User interview. To collect feedback on proposed

solution. Criteria: experienced headache diary user.

Usability inspection. To assess system efﬁcacy

and potential reduction in respondent burden by es-

timating the number of interactions + time spent.

3 RESULTS

This section presents key results from the redesign

process using the RxD framework, highlighting how

user interaction and interface design impact quality,

timeliness, and respondent burden in a medical self-

report headache diary. Rather than reconstructing

the entire application, we focused on identifying spe-

ciﬁc areas with potential for signiﬁcant improvement.

The ﬁndings provide practical insights into how each

phase’s outcomes informed the following ones.

3.1 Explore Phase

The literature study revealed that self-reporting by pa-

tients with headaches, especially in retrospective for-

mats, poses challenges due to pain related cognitive

impacts, such as memory and attention issues (Ara

ujo

et al., 2012; Barsky, 2002). These impacts make an-

swers to retrospective inquiries, such as the severity

of their headache unreliable (McKenzie and Cutrer,

2009). Memory errors can compromise data reliabil-

ity, affecting overall data quality (Barsky, 2002).

Yet, headache diaries typically rely on retrospec-

tive data collection methods. Mobile apps, like

Brain Twin, use push notiﬁcations to prompt logging,

with reminders like “Have you remembered to regis-

ter a headache today?” (translated from Norwegian),

which inherently promote retrospective recall.

Further analysis of the Brain Twin app showed

that among various elements it most prominently dis-

plays headache intensity, medication intake, and men-

struation for logging. The app offers a wide range

of options for presenting headache data, and notably

marks dates without data as headache-free. We con-

ducted a comparative analysis of Brain Twin against

higher-rated Google Play apps and later included our

prototype, NOW, in the comparison. The ﬁndings are

summarised in Table 1.

Our comparison showed that all apps allowed for

the information registration of headache intensity and

medication use or notes. Some offer additional details

like headache duration or location (e.g., left temple).

Regarding interactions, most apps supported a ret-

rospective approach, either requiring users to remem-

ber to log data or providing a daily reminder. One

app allowed the setting of multiple reminders, and

another allowed ongoing headache registration. The

simplest in-app registration process required a mini-

mum of ﬁve interactions to log headache intensity.

As for feedback visualisation, there was a variety

of approaches across the apps. However, a common

issue was the inaccurate display of data for days with-

out headaches, a signiﬁcant oversight.

A semi-structured interview with an experienced

headache diary user revealed challenges like forget-

ting to log headaches and difﬁculties in retrospective

recall, with instances of neglect due to forgetfulness

or feeling ‘lazy’. Additionally, an interview with a

neurology professor specialising in headache moni-

toring validated the self-report challenges identiﬁed

in our study, conﬁrming their clinical signiﬁcance.

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532

Table 1: Summary of comparative analysis of Brain Twin, NOW, and other highly ranked headache diary apps.

3.2 Analyse Phase

The ﬁndings from the exploration phase, revealed that

existing headache diary apps, including Brain Twin,

struggle to address patients’ challenges and cognitive

difﬁculties during headache episodes, complicating

information registration and recall. User interviews,

literature reviews, and app evaluations identiﬁed a key

issue: the complex and time-consuming registration

processes in current apps, which pose a burden, par-

ticularly during a headache. Notably, one of the apps

had very few features, but received a high satisfac-

tion score nonetheless, possibly implying user appre-

ciation for simplicity and ease-of-use over extensive

features.

In the context of headache patients, their medi-

cal condition and daily routines are critical consid-

erations. Headaches can signiﬁcantly impair the abil-

ity to use a diary app, often resulting in missed en-

tries and retrospective reporting. To reﬂect this unique

context, a user journey was designed, highlighting

patients’ mental state and emotional attitude towards

headache logging. This journey reveals the onset of a

headache as a time of physical discomfort and priori-

tisation of pain management over app logging. Fur-

thermore, when accessing the app amidst pain, users

may experience resentment or frustration, recognis-

ing the necessity for medical tracking but feeling the

intrusion of the app as a constant reminder of their

condition.

Our analysis indicated that headache diary apps

could be improved by simplifying the registration pro-

cess, enhancing reminder systems, improving data vi-

sualisation, and including an accessible feature for

logging days without headaches. Among these po-

tential improvements, we speciﬁcally chose to focus

on reﬁning interaction-related aspects that emerged

as particularly impactful. In our redesign, we con-

centrated on headache intensity and medication intake

as the primary information needs, as these were con-

sistently featured across all apps and prominently in

Brain Twin. This focus included tailoring the regis-

tration process to better accommodate individuals ex-

periencing headaches and the cognitive challenges as-

sociated with them. The following design challenges

(DC) were identiﬁed to steer the redesign process:

• DC 1: Timely and accurate logging: Design ele-

ments that encourage users to log their headache,

or absence thereof, promptly and accurately, min-

imising delays and data entry errors.

• DC 2: Facilitating easy information logging for

people with headaches: Design interactions that

simplify registering headache information, con-

sidering the cognitive and physical challenges

faced by individuals with headaches.

3.3 Align & Design Phase

In the align & design phase we addressed the chal-

lenges of timely, accurate logging and easy logging

for people experiencing headaches. The goal was to

create a method that enables swift entries and encour-

ages logging, even in the absence of a headache. We

identiﬁed a solution in NOW Interactions (Barendregt

and Wasson, 2022), a novel mobile communication

Improving Self-Report Diaries: A Respondent-Centric Design Approach

533

Figure 2: Two NOW Interactions.

technique, utilising interactive notiﬁcations on An-

droid devices. This approach minimises interaction

time and effort by allowing users to respond directly

within the notiﬁcation, eliminating the need to open

the app. For instance, users see the notiﬁcation, sim-

ply tap their answer, and can go on with their day.

In the prototype, we implemented two NOW

Interactions, designed and reﬁned through iterative

prototyping, self-testing, usability tests, and feed-

back interviews. The ﬁrst interaction inquires about

headache presence and severity, while the second in-

teraction, prompted instantly upon an answer to the

ﬁrst, inquires about medication intake (see Figure

2). This approach merges the reminder and report-

ing steps, streamlining headache diary entries. Users

can quickly log headache intensity and medication in

just two interactions, bypassing the need to open an

app. Iterations focused on optimising question con-

tent, wording, and response formats, ensuring clarity,

conciseness, and medical relevance of the responses.

Alongside the NOW Interactions, a monthly di-

ary view was added to the app to provide meaningful

feedback on logged data (see Figure 3). It visually

distinguishes ‘no headache’ days (green circles) from

days without entries and shows the count of answered

NOW Interactions per day, with an icon for the most

severe headache. This calendar view offers an at-a-

glance overview of monthly headache patterns.

While the prototype focused on optimising in-

teractions, further enhancements could include more

in-app functionality. There is also a need to log

headaches through in-app interactions similar to the

NOW Interactions. Our examination of other apps

showed interesting data visualisations like pie charts

and calendar views. Effectively presenting data to

both users and clinicians remains key and should be

studied systematically in future research to advance

headache diary design.

3.4 Evaluation Phase

We conducted a user study with six participants to as-

sess our prototype’s acceptance and efﬁcacy

. Over

two weeks, they used the NOW Interactions headache

diary, receiving three daily inquiries and additional

inquiries after indicated headaches. This resulted in

participants being sent between 42 and 84 NOW In-

teractions, totalling 330 inquiries sent, with a 78% re-

sponse rate (262 responses). One participant dropped

out after six days without logging headaches. The re-

maining ﬁve completed the study, averaging 49 en-

tries each. Participants consistently used the proto-

type, with only one day where a participant did not

log any entry, indicating high engagement.

Participants’ expressed satisfaction with the re-

design, appreciating the more streamlined data en-

try process compared to traditional apps. The ex-

pert user highlighted the convenience of not having

to open an app for each log, a key feature of NOW

Interactions. Reinforcing this positive response, the

consulted neurology professor emphasised that incor-

porating NOW Interactions into traditional headache

diaries addresses the need for quick logging. This

is particularly beneﬁcial for chronic pain conditions

where simpliﬁed information registration is essential.

Usability inspections showed that the redesigned

headache diary signiﬁcantly reduced the number of

interactions and time required to report a headache,

indicating a lower respondent burden. The prototype

allows headache intensity and medication intake log-

ging with just two taps in interactive push notiﬁca-

Figure 3: Diary view.

More details of this user study can be found in (Baren-

dregt et al., in press).

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534

Figure 4: Comparison of processes to register a diary entry.

tions, bypassing app opening. In comparison, other

apps need 5 to 19 interactions for similar data log-

ging (see Table 1). Brain Twin, requires multiple

steps including app launch and slider use for pain

intensity, taking an estimated 15 seconds, compared

to approximately 4 seconds with NOW Interactions.

The main time-consuming elements in Brain Twin in-

volved navigating to the log page and using the slider

(see Figure 4).

3.5 Summary of Key Findings

By applying the RxD framework, we gained action-

able insights to improve headache tracking.

Explore phase: We discovered that headaches

affect cognitive abilities, including retrospective re-

sponses. All apps analysed, including Brain Twin,

featured headache intensity and medication intake.

User and expert feedback highlighted challenges in

consistent logging and afﬁrmed clinical relevance.

Analyse phase: We found that existing registration

processes were inconvenient, particularly during cog-

nitive impairment from headaches. This led to iden-

tifying two design challenges: ensuring timely, accu-

rate logging, and simplifying the process for users.

Align & Design phase: Addressing these chal-

lenges, our redesign incorporated NOW Interactions

to optimise diary entry time and effort, reduce number

of interactions, and offer timely reminders. This en-

ables immediate logging of headaches or the absence

thereof, minimising retrospective errors and enhanc-

ing the overall user experience.

Evaluation phase: Participants used the NOW In-

teractions prototype over two weeks, responding to

78% of 330 inquiries. The streamlined process re-

quired just two taps without opening the app, easing

immediate logging and improving respondent burden

and data quality by promoting real-time over retro-

spective reporting. Participants appreciated the sim-

plicity, indicating satisfaction with this approach.

4 DISCUSSION

Headache diaries are crucial for diagnosing and man-

aging headaches, yet research on their design and

its effect on respondent burden is limited. This pa-

per shows how using the RxD framework, a valuable

tool for individuals designing self-report tools to con-

sider patient context, can reﬁne interactions in exist-

ing applications, reducing respondent burden and en-

hancing user experience without compromising clini-

cal integrity. While initiating a design from scratch

presents fresh perspectives, redesigning an existing

app like Brain Twin, collaboratively developed with

headache specialists, is more time-efﬁcient. It al-

lows for a quicker identiﬁcation of improvement areas

while ensuring clinical needs are already met.

The RxD framework inherently incorporates the

clinical perspective, yet this project primarily empha-

sised the respondent’s viewpoint. Acknowledging the

importance of the clinical aspect remains essential for

comprehensive diary design (Hundert et al., 2014).

Collaboration with clinical experts does not always

guarantee effective communication of clinical needs

to developers. Had we initiated this project from

scratch using RxD, our insights could have differed,

possibly affecting the user interface and shifting clin-

ical focus. Future research could explore developing

a headache diary from the ground up using RxD, po-

tentially revealing new insights to enhance both user

experience and clinical relevance.

Using the RxD framework allowed us to identify

unique user needs, pinpoint design challenges, and

conceptualise solutions like NOW Interactions that

directly address these challenges. This study high-

Improving Self-Report Diaries: A Respondent-Centric Design Approach

535

lights the value of the RxD framework in developing

health applications and suggests potential for its wider

application in this ﬁeld. As technology evolves novel

solutions are needed to facilitate patient’s active in-

volvement in their healthcare. RxD can play a central

role in ﬁnding such approaches that align with patient

needs.

Our headache diary prototype, redesigned using

the RxD framework and incorporating NOW Interac-

tions, received positive feedback, indicating its poten-

tial to integrate with or complement existing headache

diary apps. With 5-10 users often revealing most us-

ability issues (Nielsen, 2012), our six participant us-

ability study provided valuable feedback for interface

improvements, despite not conﬁrming clinical valid-

ity. Larger studies, including clinical validity eval-

uations, are necessary for comprehensive validation.

Our usability study is a preliminary step towards this,

aiming to reﬁne user interface and interactions with

individuals sharing similar traits to our target users

before advancing to clinical trials, thereby enhancing

future trial reliability and minimising patient incon-

venience. Future research should also explore per-

sonalisation in self-report and NOW Interactions to

meet individual patient circumstances and needs, po-

tentially balancing simplicity and utility. Adjustments

in interaction timing and presentation, the nature of

requested data, and data presentation and display can

reduce perceived respondent burden and enhance rel-

evance for both patients and healthcare professionals.

The data in Table 1 reveals that both the simplest app

and the most feature-rich app received high user sat-

isfaction scores. This could imply the need for a bal-

ance between simplicity and utility. Future research

should investigate how both offering minimalist log-

ging mechanisms, such as NOW Interactions, and ex-

tensive in-app features can provide users with the ﬂex-

ibility to choose based on their immediate needs and

conditions.

5 CONCLUSION

In this paper, we demonstrated the value of the RxD

framework in the context of redesigning a headache

diary. By adhering to the framework, we were able to

understand the unique user context, notably the pain

and discomfort that directly impacts cognitive abili-

ties. We identiﬁed the critical needs of the diary to

include timely and accurate information logging and

a simple information retrieval process. In response

to these identiﬁed needs, we proposed a design solu-

tion using NOW Interactions. This solution allows for

seamless headache logging without the need to open

an app, a design choice aiming to minimise the cog-

nitive load on individuals suffering from headaches.

Evaluations showed users appreciated the reduced

necessity to open an app for every data log. This per-

spective was reinforced by a neurologist, who empha-

sised the importance of simplifying the data registra-

tion process for patients. Compared to existing so-

lutions, the NOW Interactions solution has cut down

necessary interactions by over 50%. The results sug-

gest NOW Interactions can alleviate respondent bur-

den and enhance data quality by promoting timely in-

teractions and streamlining information retrieval.

The research showed the potential of the RxD

framework and innovative interactions to enhance

user experience in medical self-report diaries, with

the overarching goal of reducing respondent burden.

Future research could explore using the RxD frame-

work to design a headache diary from the ground up,

building upon the insights from this research to push

the boundaries of patient-centric innovation.

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