SUMMARY. As a group of graduate students, I collaborated with medical professionals and Baltimore youth to explore current approaches to providing youth (15-24 years old) with sexual health testing and treatment. We researched youth attitudes toward STI testing, synthesized our findings, and developed design interventions - with the ultimate goal of reducing the rate of STIs within Baltimore’s youth population.
ROLES: Researcher, Strategist, Author, and Presenter
SKILLS: Human Centered Design, Research Plan Design, Research, Qualitative Data Synthesis, Prototyping, Workshop Facilitation, Journey Mapping, Public Speaking, and Storytelling
COLLABORATORS. Baltimore City Healthy Department + Johns Hopkins Center for Child and Community Health Research + UChoose Youth Advisory Council + Wide Angle Youth Media + MA Social Design Students
Students at the Youth Advisory Council create mock personas to articulate the preferences of their peers as it relates to sexual health.
“How might we increase access to STI testing and normalize STI testing for Baltimore youth?”
INITIAL RESEARCH.
GET TESTED! Each member of our team created a journey map based on their own experience completing the STI testing process in Baltimore.
LEARN FROM EXPERTS. We spent time with clinicians, clinic directors, Baltimore youth, topical literature and case studies.
DEVELOP RESEARCH INSIGHTS. During our research we focused on understanding how youth accessing testing and treatment in Baltimore city, what potential barriers exist, and the concerns they might have - which include confidentiality, cost, and overall experience. We also spent time co-designing with youth to identify their ideal STI testing experience-- based on what we learned, we developed six design principles to help make the STI testing process a more positive experience for youth:
Comforting because clinic and health spaces can be “cold” and “scary” to a young person.
Enjoyable because this is often the first time young patients are interacting with clinics, and first impressions matter!
Confidential because we learned youth and clinicians have different definitions of confidentiality. Clinicians follow HIPAA protocols. Youth want to feel “invisible.”
Transparent because youth want to know what is about to happen to them at each step.
Timely because the longer youth have to wait, they’re less likely they are to complete testing.
Sex Positive because we want to move away from being punitive and towards being supportive.
Our key takeaway from all of this research was - What’s good for Baltimore youth is good for everyone.
Illustration, by Devika Menon MASD '17
FEEDBACK & PROTOTYPES.
SOLICIT FEEDBACK. We presented our research to youth, health service providers, and subject matter experts to solicit their feedback and confirm that our insights reflected their day to day reality. During these share back sessions, we led both groups through exercises to co-design ideas for interventions.
PROTOTYPE. Based on the feedback, we developed over 60 low to high fidelity prototypes.
FURTHER RESEARCH.
After additional feedback from stakeholders, we considered the time, budget, and other constraints to help us select various interventions that make the clinic experience more transparent and enjoyable for youth. Leveraging our established relationship with the Baltimore City Health Department, we began interviewing staff and touring one of their clinics exclusively to understand their policies and practices. Based on this additional research, we realized that much of a patient's experience is determined at the point of registration. Or in other words:
Unsuccessful registration can have a ripple effect on the entire patient and clinician experience
With this insight, we decided to focus on three specific interventions that would improve the intake experience, which is a critical moment in the testing journey. These interventions include:
1. Redesigning Forms
2. Installing Transparent Signage
3. Improving Staff & Patient Relations
IMPLEMENT.
FORMS. The BCHD clinic sees patients with a wide range of literacy, language, comfort, and ability levels. This affects the way they fill out forms, which impacts the accuracy of their triage at registration, and ultimately the service they receive. Since the scheduling system depends on the accurate allocation of patients, frequent errors on forms require clinicians to dedicate valuable time during a patient’s visit to fixing errors.
Forms that are redesigned and easy to interpret will result in a more positive registration experience for youth, and also lead to more accurate and efficient triage of youth patients. Forms were removed of clutter and intentionally designed with color, as it makes them much more approachable, and less intimidating for youth patients.
“I filled out the forms,
which felt like writing
an essay. We just want something that doesn’t feel like a complicated
homework assignment.”
A group collaboration on the content of the design, graphics by Illustration, by Devika Menon MASD '17
SIGNAGE. Youth patients are unable to easily gauge their progress during the wait time, a moment in the process where they feel the most anxiety. Because of this, patients can decide to drop out during the process. Process maps will increase transparency and predictability around the testing process, and reduce the fear and anxiety many youth feel while seeking care.
An example of the first sheet a patient sees when they grab their registration clipboard. Graphics by Devika Menon, MASD '17
“I want to know what to expect and what I’m in
for, because some people go and they’re scared.”
Process map which communicates the different clinic spaces and the stages of the testing process. Graphics by Devika Menon, MASD '17
STAFF & PATIENT RELATIONS. For worried youth patients, ancillary staff members are the first impression and first resource for answers to their questions. A photo wall will increase the level of familiarity and comfort between youth patients and the staff, leading to a more supportive and less anxiety provoking clinic visit.
“The doctor felt like a stranger. I didn’t want to
talk to her about these personal things.”
Prototype of potential staff photo wall.