Persona-scenario exercise for codesigning primary care interventions.

Stakeholder engagement is critical in the development of a new program intervention.1-3 Focus groups2 or interviews4 are traditional data collection strategies typically used for this process. The persona-scenario exercise, an alternative to traditional strategies, originated from the field of human computer interface design.4-6 This article describes how personascenario exercises were applied in the codesign of the complex primary care intervention TAPESTRY (Teams Advancing Patient Experiences: Strengthening Quality). (For more information on TAPESTRY, visit www. healthtapestry.ca). The goal of the TAPESTRY program is to determine how health care teams can be more responsive to the needs of our aging population. The program involves trained community volunteers reaching out to older adults in their homes to assess their health needs. Volunteers will be linked to patients’ health care teams using technology, which will improve communication with providers and will also maximize engagement with community service providers. The persona-scenario exercise is a structured approach that asks participants to create a fictitious, authentic “persona” based on guiding questions (eg, What is your name, age, and sex? What is your experience with intervention components?). Personas should characterize the stakeholder group that participants represent (eg, primary care provider, patient). Participants use their personas to create the potential intervention (the scenario) using another set of guiding questions (eg, How does the person get involved in the program? What are the volunteers, patients, and providers doing in the scenario? How are they interacting?). Scenarios allow for “multiple views of an interaction” and “diverse kinds and amounts of detailing.”5 This does not happen by using focus groups, in which participants take turns responding to guided questions based on past experiences and their context. The persona-scenario exercise has several potential advantages. It allows participants to use their own experiences and perceptions to help guide the development of complex interventions through the personas and scenarios that they create. In program development, in which some intervention elements are not known and incorporation of stakeholder opinion is vital, this method helps introduce the program components and identify potential interactions between them. Methods We used the persona-scenario exercise to engage stakeholders in codesigning the health service intervention TAPESTRY. The following is a discussion on the group facilitation and analysis for the 13 persona-scenario sessions that took place to design the program.