The use of personas to involve consumers in healthcare co-design: a scoping review

Background: Consumer involvement in healthcare co-design is increasingly mandated to ensure health services are consumer-focussed. Facilitating involvement of consumers where they can most meaningfully contribute, especially those from priority populations, is challenging. In healthcare, personas are hypothetical representations that help to establish an understanding of the perspectives and experiences of individuals. These hypothetical profiles are an innovative, safe and creative participatory method. The aim of this scoping review was to identify the key characteristics of persona use to involve consumers in healthcare co-design. Method: A systematic search of six databases: CINAHL; EMBASE; Medline; PsycInfo; Scopus; and Web of Science Core Collection, identified peer-reviewed literature published from inception to November 2024 that reported co-design with consumers using personas in healthcare. No limits were placed on study design or country. Conference abstracts and grey literature were excluded. Vargas’ framework was used to identify the stages of co-design where personas were used. The PROGRESS-Plus tool was used to identify how factors that stratify health opportunities and outcomes were considered in persona development or co-design. Results: From 1,541 articles screened, 29 studies were included in the review. Studies reported used mixed (n = 12) or qualitative (n = 9) methods or were descriptive (n = 8); all but two studies were conducted in high-income countries. Personas have been used to involve consumers across all co-design processes but not consistently across all: identify (n = 1); analyse (n = 29); define (n = 26); and design (n = 8). Personas were reported to be both an effective tool to promote a user-centred approach in co-design and a valuable participatory method. The main limitations of personas are that they are resource-intensive and may be biased or unauthentic. Personas have been used to represent and involve priority populations in co-design studies although religion, race/ethnicity, socio-economic position and education are not often considered. Conclusion: The use of personas to facilitate a reflective analysis of user needs and formation of responsive actions to improve health system access is promising. Attention to the inclusion of priority populations and identification of relevant stakeholders and context at the commencement of co-design will strengthen this approach. This review illustrates a staged process with examples from existing literature.