Project 1: Group 4

 Problem

The problem space we explored is how to enhance the trust between the Health Navigators and their clients.

Concept

Trust_Concept.pngConcept video:


Process

Introduction and team formation

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Shabeena, Vani, Rekha and Chakkaravarthy

Before embarking on the journey with the health navigators, it was essential to understand and anticipate the various aspects that the project could take on. In order to get a better understanding of the framework, time was spent on research­ing on Maya Organics, Maya Healthcare and the Health Navigators program. Most of this research was secondary, which was done using the internet.

There were also certain aspects that were discussed during the briefing that Naveen and Catalina had given.

The first site visit was carried out doing introductions between the HNs and Srishti team. The project briefing was also done both in Kannada and Eng­lish for the benefit of everyone in attend­ance.

The path to participatory design began that day. The introductions were carried out in a way that was going to be­come a model for work for the rest of the project. The HNs and Srishti team worked in their respective groups

Four teams were made with twelve health navigators and six students. Each team had three health navigators, and only two teams had two students and the other two teams had one student in it. Group four, my team includes me, Shabeena, Vani and Rekha. Vani and Rekha were in the training period whereas Shabeena was the only practicing health navigator.

Then Naveen told us to sit togeth­er in groups and get to know each other better. We had an ice breaking activity of drawing each others hobbies on the sheet of chart provided. As the three health nav­igators were not comfortable with drawing initially, they didn’t take the initiative to draw. So we made chits (random name pickup) to conclude on who should draw. Shabeena and Rekha started drawing as they got their chits, Vani needed a little push. Even when they started to draw, they were shy about their drawing. From the very first, drawing was emphasized as it is the most important element of creative

Framing needs

Chapter 1: Day-in-a-life

The objective of this activity was to study the events and activities from the perspective of the participant. It was carried out by sketching the activities, people, spaces and objects on a timeline that starts with them waking up and ends when they go to sleep at night.

Special emphasis was given to sketch the activities, people and objects with respect to the participant’s life in a day.

WHY SKETCH?

The emphasis on sketching out notes was made since this improved visual thinking skill. Visual thinking is one the precursors for design thinking. It has been observed that sketching leads to longer data retention and also to bring about the nuances of the scenario that is being sketched. For example, if the par­ticipant eats food while being seated on the floor, the drawing of mealtime would be them sitting on the floor with plates and bowls in front of them. However the drawing will look drastically different if the participant owns a table and uses it while having a meal. Such nuances be­come key artifacts during synthesis stage.

Sketching also allows them to add details rather quickly than if they were to write it all down in words.

As the first team activity we were told to map the day-in-a-life of a Health Navigator. Shabeena was the only prac­ticing health navigator in our team, so we mapped the activities that she did the previous day. Before we started to map, we were informed to use more of draw­ings than words, as drawing is the most basic and important element of creative thinking.

We mapped all the activities that Shabeena did the previous day with respect to time. We didn’t completely ignore words in our mapping, we added words wherever some explanations were required.

As Shabeena, Vani and Rekha were completely new to drawing, they felt it really difficult to draw things from their memory. It was comparatively easy for them to draw with references. They were hesitant about their drawings not being pretty. They felt comfortable to draw after they were told that the draw­ing has to be more functional and not just pretty. As they found it difficult to draw from memory, they needed some help with drawings. With a little help with drawing and everyone working together, we were able to make the first day-in-a-life map successfully.

Chapter 2: Experience map

Just as the Day in a Life was used to collect data, the Experience Map is another method to collect data, though in terms of experiences and feelings. The participant sketches out the various objects, people and spaces where interac­tion takes place during their day. This is then mapped using terms like happy, sad, concern, satisfaction etc.

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The Experience map records the experiences and feelings the participant is subjected to during their day. This map serves as a pool of information that can identify the pain and pleasure points. It is with the help of this data that a need is recognized.

On an a4 paper we marked Shabeena’s on one side and clients on the other side. Then we started mapping the people, objects and then the spaces in which these two people interact in com­mon. We found connections and joined them with arrows. Then on the arrows and the connections that we made we mapped feelings and emotions of client. During this process, as a complete team we had a lot of difficulties understanding the concept, as it had multiple factors. It was a little confusing for us to find the connections between the different elements and prioritising them.

Chapter 3: Client visit

This was the time for us to experiment the day-in-a-life map and experience map on the clients. This also helped us to understand our teams inter­pretation over these templates. Shabeena took us to two of her client’s houses. She got the contact of the clients with their relatives working in Maya organics. On the way to the client’s house, she told us about the area given to her and the number of houses and people in that area. When she elaborated, we came to know about their line listing and how to approaching clients.

Client:1

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Kharunisha

Age: 51

Sex: Female

Health Issues: High Blood pressure, Sugar and Overweight.

Kharunisha values and trusts the services of Health Navigators. She takes regular check-up, follows diet and medication properly but doesn’t do any prescribed exercise. The only exercise that she does is walking to her friend’s place, which is very close to her house. She has six sons and two daughters. She helps her daughter-in-law with cooking by chopping vegetables by sitting in the same place. Just by diet­ing and no proper exercise, she brought down her sugar level to 160 from 518 in less than three months. Still her weight and blood pressure is a threat to her.

 Client :2

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Client 2: Abeedha

Age: 35

Sex: Female

Health Issues: Sugar

Abeedha does not trust or value Health Navigators services. She refuses to take proper check-up. She does a lot of work at home, takes care of her family and even does regular exercise. Her sugar level after breakfast never came down below five hundred. Abeedha survives on insulin, she takes it two times a day. Even though she takes insulin and does proper exercise, her sugar level is not normal because of her carelessness over diet.

Synthesis

This is the phase where we make sense of the data collected. The insights collected from the previous step help organize the data in clearly defined pain areas.

In data synthesis phase the stories and narratives from the previous step is marked into green and red frames. The green frame is for marking those instances that are happening well (pleas­ure points) and the red for pain points, where there is tension and something is not going well.

Assimilating the scenario and finding tension points within them is part of the synthesis phase.

Chapter 4 : Generating insights

Interactions and observations can lead to a multitude of insights. However before one can jump into an insight, it is necessary to understand the environ­ment (both physical and psychological) that enables these interactions. Stories are a great way to put the data collected into perspective. It is also another way to collect information that was missed be­fore. Like sketching and narrating a story brings out the smaller details in the set­ting, the details that might prove to be a pain area that was not considered before. It could also be the imperceptible cause of a pain area that was marked earlier.

storyboard

In this activity, we discuss the details of the HNs, their clients and dig around for interesting facts and connec­tions. We pick up a few of these points and frame a narrative around it. The HNs help set the stage for these stories, as they understand how the channels of communication work.

Kharunisha

It was an emergency situation one day, Kharunisha was very weak. So Shaheen (Kharunisha’s fourth daughter in law) called Shabeena who was in Tamil Nadu for some personal work. So she gave the contact of another health navigator Deepa. Shaheen contacted Deepa and addressed the situation and guided them.

Insights:

  1. This client trusts Health Naviga tors.
  2. Health Navigators help each other and have a strong network.
  3. It is very helpful for clients as the Health Navigator stays close to their house.

 

Abeedha

Abeedha is a client who does not take proper check-up, she does regular exer­cise but is unable to control her cravings for sweets when she is out of house. One day Abeedha shockingly called Shabeena for a check-up. The readings before and after breakfast were 350 and 512. And then Abeedha told Shabeena about her swollen foot. As per Shabeena’s advice, Abeedha went to the doctor and now takes insulin regularly as advised.

Insights:

  1. Health Navigator has no control over multiple sources of information.
  2. This client trusts doctors more than Health Navigators.
  3. Client’s attitude towards insulin

 

Vani

As there is no specific working hours for the Health Navigators, it is very difficult for them to have a specific routine. Also they have to sacrifice a lot of their leisure time and family time for work. In case of an emergency, they are the one who are contacted first.

Insights

  1. Health Navigators have to work hard to maintain their clients.
  2. Health Navigators have to bal­ance between their house and job.

 

Chapter 5: Story Boarding

With the generated insights, we now have to make detailed version of stories around insights. We were told to make at least two stories. To make the detailed version of a story we first listed down all the minute details in a paper and then we prioritised the information. After organising the information and planning the frames, we started to draw.

After we were done with the drawing we had to find out “pain points” and “pleasure points”. We outlined the frames of pain points with “red” and pleasure points with “green”.

Then we highlighted and noted down the problems and generated pos­sible solutions to it. This way we could get a better understanding over the scene and understand the issue with multiple perspectives.

Kharunisha

It was an emergency situation one day, Kharunisha was very weak. So Shaheen (Kharunisha’s fourth daughter in law) called Shabeena who was in Tamil Nadu for some personal work. So she gave the contact of another health navigator Deepa. Shaheen contacted Deepa and addressed the situation and guided them.

 

Abeeda

Abeedha does not trust or value Health Navigators services. She refuses to take proper check-up. She does a lot of work at home, takes care of her family and even does regular exercise. Her sugar level after breakfast never came down below five hundred. Abeedha survives on insulin, she takes it two times a day. Even though she takes insulin and does proper exercise, her sugar level is not normal because of her carelessness over diet.

Creative ideation

Ideation is one of the crucial points in this process. If the collected data and insights are not strong enough, coming up with ideas will be all the more difficult. In this design process, the idea­tion stage takes inspiration from the work of Eva Brandt Camilla Grunnet at The Interactive Studio, Sweden.

Their work with the design pro­cess using props and dramatization helps the designer to have a better understand­ing of the situation more compared to a designer who were to just look at it from a third person perspective.

We picked up the Dream Tools props described in the paper and set up the props for a Magic Show.

Chapter 6: Magic Show

people at Channapatna and the Health Navigators, we have observed that their interaction with technology has been minimal. Everybody owns a basic phone (mostly feature phones) but they are aware of what and how a smartphone works.

Without this basic understand­ing of technology, many solutions may never be a practical approach in the eyes of the Health Navigator. If the question of practicality can be removed from this process for the HNs, they could come up with ideas that may be fantastic, however with technology it may be possible to make it a reality. Hence the Magic Show.

“Magic show”, lets people think with no limitations. With the help of the magic props like magic wand, crystal ball and magic box, we will be able to make, foresee, store and fetch anything. After the story boards were made and “pleas­ure and pain points” identified then came the creative ideation stage. This is the phase where every team came to­gether and ideated on each other’s issues. Each team came up with a minimum of two storyboards and at least two issues in a story board. Everyone was given chance to generate creative ideas for var­ious issues. With all teams together, we had eleven issues and we had forty seven ideas generated. Each team had at least four to six ideas generated for an issue.

Shabeena was not present that day. Vani and Rekha needed motivation, once they had gone in the front, they were able to generate ideas for issues which were given to them.

The two major issues that we focus were

Chapter 7: Selecting an Idea

llected and made sense of, the design process heads over to recognizing the crucial pain points. Here we ask the participants to look for issues that are more important in their sense of hierar­chy; issues that are unique and interesting; frequently occurring issues etc.

In this exercise it is important to let the HNs pick out the issues that are the closest to the scenarios we have sketched in the stories. The issue recognition was combined with the ideation stage. This was to bring a sense of totality to the process. Rather than identifying issues on one day and then generating ideas on another, we combine the process.

The activity was also carried out with all the groups working together. This improved participation and also makes the ideas more diverse as there is cross-partic­ipation between the four different groups on all issues that are brought up.

With eleven ideas generated for our two issues we have to prioritize the issue and select the most appropriate idea for one issue and go ahead with that idea. The selection of one idea over an issue was not random, we had a method to prioritize and select it. By using

  1. Importance
  2. Frequency and
  3. Factors that are unique and surprising

We were able to hierarchically place one issue and idea over the other.

To prioritise ideas in the second issue, every individual in our group had a chance to number those ideas from 1 to 6 accord­ing to their priorities, where 1 being the most important and 6 being the least. With the help of this method we filtered three from six ideas.

After a short discussion, looking into the pros and cons of all three ideas we selected the final one.

With the idea selected we then had to enact the idea within the group. Anyone in the group could stop the enactment if they had spotted an issue to change acting or to rapidly make a prototype in the en­actment.

The inherent idea in our enactment was that “success cases come together with Health Navigators to counsel the clients”. We had a single scene in the client’s house as the health navigator and success cases were there to counsel the clients.

Creative Ideation

In this stage we pick up one issue among those collected in the group and develop concepts to attend to them. The method we use for this phase is Enact­ment.

Chapter 8: Enactment and Rapid Prototyping

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Enactment is a mode of drama­tizing the situation in order to drive the concept development with the ground realities intact. There are several ways in which concepts are arrived at. Many of them are verbal deductions, some through brainstorming, idea elimination, algorithms, etc. However these methods tend to look at the technical aspect of the outcome.

In the context of the project, the people that are concerned and their related feelings and experiences are indispensable for a functional concept. Enactment lets you feel the fit of the shoe that you are designing for your client along with the change in experiences with the change in settings. Here, enact­ment helps us see and feel like the HNs and the Clients do and thereby design concepts that fit better into their lives. It helps us put the concept in perspective of the stakeholders.

The inherent idea in our enact­ment was that “success cases comes to­gether with Health Navigators to counsel the clients”. We had a single scene in the client’s house as the health navigator and success cases were there to counsel the clients. The roles taken by us were

Shabeena: Health navigator

Vani: Client

Rekha and Anand: Success cases

Chakkaravarthy: Clients relative

Naveen stopped us when we were enacting and gave us the idea of taking clients to the success cases house when they were exercising and counsel the client. By enacting it, we came to know if this idea is practically possible or if it needs some changes.

On the next site visit, Naveen and Catalina enacted to show us an example. Naveen acted as both the client and client’s wife, whereas Catalina acted as the Health navigator. They showed how to stop if there is a problem and make rapid prototypes and improvise on the prototype if necessary. Then all the teams were given few minutes to discuss and to get ready for the enactment.

The first group went first, other groups were told to stop and ideate if they found any pain points. As the first group of people were acting, their em­phasis was mostly on acting than focus­ing on the concept. The enactment went out of track many times. Whenever there was a pause to ideate and try the new ideas which were given by others, it took a lot of time to enact and test the idea. As their ideas were completely based on the focus group discussion, which is a long term project and that would not fit into our project timeline, they had to drop the idea.

finallllllll script

We felt the last enactment was emphasised more on the acting than on the issue. So Naveen told us to plan this session and prepare for it. He told us to make a script for enacting. He told us to identify the problem space where we have to stop for ideation and rapid pro­totyping.

Enactment went as planned, as we stopped at the pain point we had 15 for all four teams to ideate and make prototype.

Team 1: A tablet which shows the different areas and clients on the map. Showing how the health navigator got the chain of clients. Also these clients details were given for any reference
Team 2: A radar map in a mobile phone where all the clients were mapped as dots, keeping that specific client as the centre. This gives the information of other clients who takes services from the same health navigator.
Team 3: A database which gives the details of all the success cases and what would happen if they don’t take proper check-up and follow exercise and diet.
Team 4: A tablet in which all the clients are listed, and when clicked on a client, it provides the profile of the client with the readings and other information

Chapter 9: Testing and Validation

 

With the concept in hand, it is essential to understand it from the point of view of the Users. In order to develop a concept that is highly functional and effective it has to be tested with the User and feedback taken.

Concept feedback is obtained using an experience map that tracks what occurs when the interaction occurs between the concept model and the User. The activity begins with the enactment of the same scenario done in Concept Development stage. However this time, it is between the Client and the HN. At the point of tension as devised in the script, the concept model is introduced. The HN and Client interact with this model and a discussion ensues.

During this discussion, the HN quizzes the client on his/her experiences. The HN also records their experience under the following:

What do you Say when you interact with the concept?

What do you think while inter­acting with the concept?

What do you interact with the concept?

What do you feel during / after interacting with the concept?

We have combined all the ideas and made a new form of prototype. We as a group also planned on what and how to present to the client. We also did a mock up session within our self.

Before the client visit, Naveen told us that the idea that we came up with is completely city based. The information form that we used would not make sense for the people in remote areas.

As Shabeena’s clients were not available on that day we went to visit Vani’s clients to present our idea and get feedback. The client was a 76 year old lady who had diabetes. She was not interested in the conversation. We ob­served that it was the client’s son who was interested in this conversation but he was restricting himself. He wanted to speak but he was controlling himself. When we slowly brought him into the conversation he gave us many ideas and valid points.

Some of these client observations are as below:

Powdering the tablets and adding it in the food of the client without their knowledge, so that they don’t feel like patients.

A reminder must be kept for them for proper intake of medicine.

Need for a meeting which is to be organised by Maya to introduce the health navigators.

The topic was going way out of the track. It was a little difficult for me and Anand to make them focus on the prototype and get feedback

When Vani and Shabeena ex­plained the complete prototype he got the hang of it. He told us that the idea works, he also told us that it will create trust on health navigators with the clients. But he emphasised on the focus group discussion.

This is where we as a group came up with the insight that people prefer meeting one another than seeing them as data, graph and information. So we thought of showing them as real people inside the device than as data.

Final Concept

The Final Concept is the stage where we define the concept that we have arrived at. The work that is done till then is reviewed for consistency and the artifacts from concept development is consolidated. To this, any improve­ments suggested by the client or HN is added. The concept is then ready to be defined.

Using the template designed, the concept was defined based on the 5Ws and 1H (Who, Why, What, Where, When & How). Current and desired scenarios are depicted using storyboards that show how the concept improves the situation.

Throughout the concept defi­nition template and sketches are to be used to convey the message.

Chapter 10 : Final concept

In this activity, all the team par­ticipants sit together and review what has been done through the entire projects. All the artifacts are scanned and the flow of the project evaluated.

The concept is then reviewed based on the suggestions and feedback from the Client and the HNs. Final changes and improvements can be made to the concept at this stage.

Once the changes are made, the template is filled using sketches.

The second client visit was to get the feedback about our concept. We also had some observations and insights from this client visit. This is the phase where we defined the concept and made chang­es if necessary.

Firstly, we were discussing in the group and then we had a debate on what should be done. Then we finally conclud­ed the concept to have more humane way of presenting data than as alphabets and numbers. As people prefer human interactions, so we had to present the information in an audio visual manner.

We had a concept definition tem­plate. In which we defined the 5w’s and 1h, which answers all the questions over the concept.

We defined the problem state­ment.

Mapped down the technologies through which the interaction happens

Storyboarded the current and desired scenarios

And finally mapped the touch points and further possibilities

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