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Category Archives: Interaction Design

True Story

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We are only a few weeks away from our final AC4D presentation, and we’re excited to share with you where our exploration of designing for family discussions around aging has led us.

Currently, our team (Laura Galos and Maryanne Lee) is working on both piloting and creating ideal-state artifacts for our project, which we are calling “True Story.”

True Story is “the get-to-know-you game for people you’ve known your whole life.” It’s a card game for families in which the object is to collect stories from one another, in particular, between intergenerational players.

What Does It Do?

While collecting stories is a worthy goal for families on its own, True Story is designed to do much more. Stories provide a window into the past, but they also provide insight into the way people think, make decisions, their values, and their fears. While family members are collecting stories in the context of a game, they are also collecting perspectives from other family members about topics that might never come up in ordinary conversation.

How Does It Work?

True Story cards each feature a question about a situation that has come up in the past. Some examples are, “Tell me about a time you met a celebrity” and “Tell me about a time you went on vacation alone.”

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Other cards ask for stories around topics that our research has shown to be difficult for families to broach, such as finance, health, living arrangements, and driving. For example, a question that gets family members to talk about ill health is, “Tell me about a time you did something to improve your health.”

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Once the player has told the story, other player(s) guess whether the first player has told a true story or a fiction story. Correct guesses are awarded a token to acknowledge the collected story, and the first person to 10 tokens wins.

Why Did We Make This?

Why do families need to collect stories, perspectives, an intuitive understanding of one another’s values and ways of making decisions? Why do uncomfortable topics need to be surfaced, if only in a game setting? Why make a game of this at all?

The Making of True Story

To recap some of the thinking that went into the creation of True Stories, we returned to our last blog post about our project, written at the end of Quarter 3. At that time our goal was to develop a design solution to help facilitate the difficult conversations seniors and their families have around the major changes that come with aging. Specifically, we wanted to help start conversations about aging transitions—such as limiting driving, or looking at assisted living—between adult children and their aging parents.

While the core of idea has remained the same, over the last several months it has manifested in so many ways—from an iPad game, to a website that helps adults send letter to their aging parents, to a communication tool that uses cards to start the conversation—that amid all the changes it is affirming to look back and see how closely our current product adheres to the principles we set out at the end of Quarter 3. Based on our research and testing with families, caregivers, and aging individuals, we had developed the following criteria to which anything we made had to meet.To help families address difficult aging-related conversations, our product must:

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Design Principles: Mission Accomplished?

Use a medium older individuals already enjoy

Success! To get to True Story, we started by piloting a product we called “Playffle.” Playffle was also card-based, but felt more like a communication tool than a game per se. In our initial research back in Quarter 2, we saw that our older participants, such as Anette, 84, strongly associated cards with being social. She told us that she “love[s] to play cards. I have different groups I play with—some play more complicated games and some play less complicated ones […] It’s a good time, a lot of camaraderie there.” Our pilot participants, upon trying Playffle, greatly appreciated that the cards were non-digital. One participant, aged 82, was under the impression we were going to make a website out of our cards, was elated to hear that we intended to produce a physical product. Furthermore, even younger participants who we spoke with exhibit a wide spectrum of comfort with digital technology. Using a non-digital medium allows everyone to come to the table with a degree of certainty and comfort—a positive start to productive conversations.

Feels non-threatening for older individuals

In piloting Playffle, we explicitly created cards with questions about difficult topics, including driving, living arrangements, and daily tasks. However, we thought that by introducing these topics through hypothetical scenarios, there would be less of a sense that older individuals’ behaviors are being singled out by these conversations. In reality, declining health, trouble driving, etc. are problems that anyone can face, regardless of age. By creating scenario-based questions, we hoped to open up the dialog from one of intervention to one of mutual conscientiousness and preparedness amongst family members. For example, one of our cards looked like this:

Pilot Card for Blog

Our testing showed that hypotheticals are a great way of getting older individuals to open up about facing difficult situations. One pilot participant was very honest about how she could identify with one situation—about buttons and zippers on clothing becoming difficult to manage—and sharing with the other card player how she manages those difficulties. Another participant mentioned that she would like to use these cards with her daughter, who was making financial decisions our participant was worried about. In sum, older individuals not only felt comfortable with these cards, they identified them as useful for addressing difficult topics with their younger family members as well.

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Feels approachable to family members

In our discussions with adult children of aging parents, we found that there was a great deal of fear around broaching aging-related topics. That fear stemmed from angering their parent. One participant we talked to, aged 61, with a father in his 80s, said, “If you bring up the subject of driving, Dad will terminate the conversation. He will become extremely angry and stop talking. Particularly as your parents age, you don’t want to alienate them at the end.” We think that by providing a product that is comfortable and approachable for older individuals—something that will probably not make them feel threatened or angry—we increase the approachability to younger family members. When we introduced the idea of playing cards to another participant, she saw them as “Something I would do day to day with my Dad. My Dad would think its fun finding out about each other or the solutions to problems.”

Leads to solutions, not just fun bonding moments

Our pilot iteration, Playffle, was geared toward adult children and their aging parents at a very specific stage—one in which the adult children were already concerned about the changes their parents would have to make due to aging, but before a crisis had yet occurred. These adults are understandably feeling a lot of pressure and seeking quick, sure solutions that would alleviate their anxiety and make their parents as safe and well-cared-for as possible. Playffle was pretty direct about coming to solutions, not just fun bonding moments. However, the cards felt clinical—a major reason we moved toward our current product iteration. We doubt that Playffle was an enjoyable enough product for people to want to use on their own without us sitting beside them. So we made a decision to broaden the possible usage of our cards. Our current iteration, True Stories, is less direct. It is not meant for adult children who need answers immediately. It is meant as a game different generations of a family can play together to hear stories they would not otherwise have known, get a sense of how the other person/people think and make decisions, and bring up “taboo” topics, such as health and finance, long before a crisis forces the issue. However, in exchange for directness, True Story offers an enjoyable experience that increases the likelihood people will actually use it. One participant in our early testing is caring for her father, who has dementia. Increasingly, she must make decisions about her father’s care on her own without her father’s input. She told us that she wants to make decisions based on “what would my Dad do?” By creating a game that families like to play—and as a secondary benefit, helps family members get to know each other, how they think, and what they value earlier—they can help each other make aging-related decisions together later.

Includes a way to follow-up on conversations

One of the strengths of True Story is that by playing it, the game ensures that taboo topics, such as health, are aired before a crisis happens. A question such as “Tell me about a time you had a health scare” means that families will have heard a story about ill health and have some perspective on the thoughts and feelings around that topic. Later, if and when tough situations arise, each of these stories acts as a tiny window through which the conversation can be re-introduced. By the time a serious conversation about these topics needs to happen, the silence around the subject has already been broken.

Takes into considerations families who live far apart

Many families today live far apart. Partnerships, job opportunities, and geographical preferences can result in families members that live thousands of miles away from one another. In our research, many families we talked to see each only for visits on special occasions. We know that the time spent together under these conditions is valuable. True Story honors the family time together by focusing on the collection of family stories. Additionally, it’s portable—not a small consideration in cases where families must travel to see one another.

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Based on the design principles we laid out at the end of last quarter, we are confident that True Story can help families set the stage for open communication based on mutual understanding as they face major transitions, including those that occur with aging, together. Please feel free to explore our pilot version, Playffle, in the clickable prototype below. We will continue to pilot and evolve True Story until pencils down on May 2nd, so we welcome any feedback you have on our project in the comments section. Thanks!

Playffle Clickable Prototype

 

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Summit: Pay it down while you live it up

“I’d like to pay off my credit cards as soon as possible because it is a cloud, it is something hanging over my head.”
–Jennifer, 32

Debt can be intensely anxiety provoking and yet we saw over and over again in our research that although the young people we spoke with recognized that their financial situation was causing them stress, and that it was going to be detrimental to their future, they continued to struggle to change their day to day spending behaviors enough to pay down their debt. Why is it so difficult for people to change their behavior when it comes to money? Why aren’t all of the myriad of existing tools addressing this problem?

Satisfaction Happens Now + Fear of Missing Out

Over the last six months, through a dozen in-depth interviews, intercepts and prototype testing, we’ve gained a deeper understanding of how young adults think about their finances, how they feel about their debt, and how they manage their current financial situation.

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Through our research two things became very clear:

1. There is no satisfaction in future benefits. We need to feel immediate value to be satisfied.

2. We want to make good decisions but fear sacrificing more than necessary.

“In the moment of choosing to buy something or not, it’s really easy to make that decision– yeah fuck it, I don’t care– I want this now, and then, oh I have to rein it in now, I have to pay this off.”
–Carl, 24

People will make a budget at the beginning of the month in order to get their spending under control, but are not able to bridge the gap between the abstract goals, considered once a month, that the budget represents and their day-to-day spending decisions.

 

Designing a Solution

We believe that we can reduce the overwhelming anxiety caused by credit card debt and empower young adults to change their behavior and achieve a better financial future.

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Introducing Summit:

Turn paying down debt into a daily activity, just like spending.
Summit is a financial app that bridges the gap between long term financial goals and daily spending by allowing users to send a little extra from their checking account to the card they want to pay off. Summit sends users contextually appropriate messages inviting users to put small amounts of money toward their debt while they are spending money on the activities they enjoy, bringing long term financial goals to top of mind.

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Summit Gets Personal
Summit learns the user’s spending habits and chooses the best times to invite them to put some money towards their debt. After all, doing something good for yourself always feels good.

Summit Reduces Anxiety
Looking at a large credit card balance can be overwhelming. That’s why Summit breaks down the user’s long term goal of paying down your debt into small manageable chunks. All while helping decrease the amount of time they’ll be paying their debt.

 

Experience Summit: Click on the image below to get a preview of how Summit will work

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But…will it work?

We launched a pilot to find out. Summit promises its users to reduce the anxiety caused by credit card debt and empower them to change their behavior and achieve a better financial future. In order to find out if our service could do this, we hacked together existing technologies to test how behavior changes over time.

How the Pilot Worked

Relying on existing technologies, we created a process to test Summit’s core interaction: sending users daily messages that allow them to put money toward their debt. We used Square Cash (link) to send requests for money to our participants. Whenever a participant transfers money to Summit via cash, we use an online banking bill pay service to make a payment on that participant’s credit card.

Here’s an overview of how the pilot worked:

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Understanding our Participants:

After recruiting individuals we took them through a setup that mimicked how Summit would actually work. Like we said before, Summit has a personal element to it so that it can fit into people’s lives in a manner that is empowering and supportive. To best mimic this, we sat down with participants and had conversations around their spending habits, their debt, when they pay their bills and even how they feel during the week and on the weekends. This helped set the foundation to better integrate Summit into their daily lives.

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(Click below to experience the pilot)
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What we wanted to know:

Would people stick with their goal or would they drop off? Does the service reduce anxiety of debt or does it increase it? These are questions that we can’t answer without testing with real people.

With one more week left in the pilot, we are looking forward to making sense of all the information we’ve gathered so far. We’ll be interviewing our participants to gain a full understanding of what it was like to use Summit. In these interviews we will focus on feelings around the use of the service, why they responded to certain requests with an accept or a decline, and if the amount of debt paid down was significant for them. These interviews will be pivotal in helping us decide on our next step.

Stay tuned!

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Creating the right pilot: Trust your gut, focus on the ideal

This week I waited for my recordable greeting card to come in the mail. Anticipating that the idea was to establish a conversation with individuals, via a pen pal type situation, recording reactions and reflections that were then sent back to the first user, then to another individual to reflect or react to by recording a verbal message.  I would then use contextual inquiry to identify if this back and forth conversation (revolving around the stigma of mental illness) was helpful for the initial user in disseminating the stigma that they had to keep their condition a secret, and to be more comfortable speaking out and owning their condition, because they were at least virtually interacting with others that could identify with their emotional state on a personal level.

Unfortunately, the card did not come in, but during this time of waiting for the card to come in the mail, I was challenged with the opportunity to take a step back and ask if this was really the correct way to pilot my ideal final product. Which is a 2 week trial pack of a mood disorder medication, which included recorded stories of others who have similar conditions and how they deal with emotion, medicaiton, and manage self care. As of now I can only equate my final ideal product to the idea to those voice recorded Hallmark story books, where a child can be told a bedtime story by a loved one who may live across the country.

Yet as I was waiting for my order to come in, to pilot my idea, I had in the back of my mind that this is not the correct pilot, I just felt it in my gut. My ideal end product is actually not necessarily a back and forth conversation as the initial pilot would suggest, but a book of real people with real stories about how they felt and dealt with issues surrounding their life before a diagnosis. Then how they felt and managed getting a diagnosis, being prescribed medication, and how they felt with the idea that they may have to maintain a medication regimen perhaps for the rest of their life.

I did not believe in my first pilot idea, so I went with my gut and started gathering stories, from real people in their own words. That is what I wanted in the first place and admittedly should have spent the past week gathering these stories.

The past being the past it, was time to get to work. I created a script of questions and recruited 2 individuals to interview and record in order to deliver these stories to someone who may be hesitant to seek help, whether by stigma or general fear of a diagnosis that required them to potentially take a medication that helped them reach self-care in the long term, possibly for the rest of their lives.

This is what I did today. Surprisingly people who suffer from a mood disorder (bipolar spectrum or depression) understand what the condition is like and are more than willing to share their own stories if it has the potential to help release the stigma of being the odd man out, or the damaged ones, as well as put them at ease about the idea of having to be medicated in the long term in order to reach the goal in life they seek.

I also learned the importance of getting this information out of the computer and on to the “wall”. The wall being a place where you can visualize your journey and ideas, inspirations and wishes that you can physically look at and see on a daily basis. This allows you to be able to see where you have been, where you are going, and where you want to be. To iterate, and I acknowledge I should have done this sooner. I should have trusted my gut.

Out of respect of the two individuals I will not post the recordings until next week when I am able to edit down to the core ideals I am initially going to pilot, to a new “patient” with the same hope that it will aid in creating a virtual bond with my recorded individuals and their experiences in hopes that the stigma of being judged as the damaged one, as well as the realization that it is ok, and rather normal, often rather necessary, to seek aid of a medication regimen is not weird, or uncommon.

My pilot has changed. I now have the necessary stories/tools to relay to someone who may be feeling like they are “not normal”, but being not normal is actually ok with the appropriate treatment. Some of the greatest minds of our time have been “not normal”, and have gone on to make a true effect on changing the world.

I truly was fascinated and inspired by hearing others give their trust and conviction in helping others by revealing their personal information on tape. I appreciate the community that is willing to speak out about 1 in 4 people you may walk past on the streets where you live each day that manage and thrive some sort of mood disorder, but still having a program to not only reflect on their own actions themselves, but also be the crafters of some of the most insightful realizations about the world we live in at the same time.

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Pilot testing phase 1

At this point in the process of product development, we are able now to release a few pilot tests of rough prototypes and monitor the results in order to use the information gathered to make our final product the best user experience it can be.

The hierarchy of what my products realities are that: recovery (or stability) from a mental illness cannot solely depend on medication alone. There also needs to be a support system in place for the patient to guide them through the journey and recognize intervention points when and if the patient is having a rough time or is falling off the path to stability.

This being a hypothesis derived from the last 16 weeks of research (contextual inquiry, interviews, and secondary research) led me to beginning my first pilot, focussing on simplicity and human connection.

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Pilot 1

Value proposition of the pilot is:

Helps an individual connect with other that are “like them” and reduces personal stigma.

The pilot could be something like:

A recordable greeting card that is mailed to an individual newly diagnosed with a “mood disorder”. The card includes a story of an individuals experiences and where that person is in their diagnosis (newly diagnosed individuals will receive stories of how people dealt with hearing their diagnosis, and how they are attempting to manage self care, individuals that are further along in their diagnosis will receive stories from others on how they deal with issues such as the stigma or the diagnosis in everyday life, as well as how they deal with medications and self care).

Inside the card there is a prompt and instructions on how the user can record their own story about how they are dealing with issues surrounding their personal diagnosis. And how to put the card in the pre-posted envelope and mail it back (to me). 

For this pilot I would act as an intermediary and the letter would come to me, which then I would vet and then phase 2 would begin. A back and forth communication between chosen individuals would be under my control for this piloting stage.  

The next person that receives the card would be farther along in their diagnosis, and would be prompted to listen to the recorded story in the card, then record over it with either a positive message on how they identify with the story that was told, or a similar story about themselves.

They would then mail it back to me, I would vet it, and then pass it back to the first user. 

This would continue always with the same first time user, but received back with a different story/reflection from a new individual. Again this would be mailed back to me for the cycle to continue. 

Less like a pen-pal but more like remote group therapy. 

The cycle of mailing back and forth would last at least 4 cycles, and then I would collect feedback from the initial user. 

I would need people who:

Have been newly diagnosed with a mood disorder, have been diagnosed with a mood disorder but are reluctant to seek out a support group, and a group of individuals that are farther along in their recovery.

They would interact with the pilot by:

  • Receiving the package in the mail.
  • Opening the package to find a recordable greeting card with a pre-posted/labeled envelope.
  • Instructions on the front of the card will introduce the narrative they are about to hear and instruct the user on how to play the recorded story of an individual dealing with a point in their diagnosis (content is currently in the works).
  • After listening to the story, the user is instructed to follow the printed instructions, with a prompt to get them started, on how to record their own story about their diagnosis.
  • The user is then instructed to place the card in the pre-posted envelope and mail it back (to me). The user will be aware that I will be vetting the content as I would like to establish a sense of trust that whatever they choose to say will not be judged.
  • After a day or so, the user will receive the same card in the mail with a new message from a different individual and instructed to keep the conversation going (by re-recoding their story, or reaction).

I will use contextual inquiry with the initial user, to establish how they felt about sharing their stories, hearing the stories of others, and if the process was beneficial. I will be testing if the method of the recorded stories at all encouraged the user to go out and speak to real life individuals whether in a group setting or a confidant. This will be my measure of breaking a personal stigma, and establishing a connection with another human through the power of storytelling.

It took a few runs to realize this first pilot (separating the medication aspect from the personal connection breaking stigmas), Some scenario storyboarding and a basic process flow about how this might be realized.

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Congruently, I have been revising the story arch of a 14 day medication trial, processing what content would be on each page, along with imagery, establishing a visual heirachy that both promotes support, and directs the eye to the second component which is the medication (one pill per page).

I am currently in the process of both recruiting the individuals that I would need to successfully test my first pilot, as well as developing the content design that will actually be seen, read, and heard on the first pilot prototype.

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Q3 Summary

After 8 weeks of research, and 8 weeks of prototyping and scenario user testing, I am currently in the process of developing an audible book that brings the compassion of group therapy as well as the encouragement of a medication regimen to individuals living in isolated environments, such as rural West Texas.

This idea has the goal of bringing the voices of individuals who may be suffering the same condition to someone who may not have the resources to talk to anyone about their condition as well as the provide them with a 2 week starter pack of their prescribed medication, with information about that medication as well as intervention moments for the patient to reach out to their health care provider if they are experiencing any negative or positive effects from the medication. Ultimately the goal is to get the new patient confident enough through de-stigmatizing mental illness that they themselves reach out and talk to others, and continue the conversation through their recovery.

Here is a link to a wrap up of the research and prototyping done in quarter 3.

Q3 Wrap Up

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User testing and observation

After creating my “Thing” which I describing now as a journey kit for individuals diagnosed with a mental illness focussing particularly on the various ranges of depression, to bipolar, and anxiety disorders.

My first round of user testing was incredibly enlightening and educational. My assumptions that something playful and interactive proved to be a bit too foreign and confusing to my users. No one came out and directly said that, but by reading facial expressions and their interactions with the kit, I could tell that the whimsey surrounding the idea may have come off as not taking the user seriously.

Before I go any further I will introduce first the journey kit, in a very rough prototype that I tested with. Then the series of questions I asked, what I learned, and how I am currently moving forward.

The kit.

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I should say first that as I passed around the kit, I also passed around a potential user scenario in that described what it might be like if your Dr. gave you this thing rather than a bottle of pills. This scenario was accompanied by a one frame image of a woman being handed this box:

IMG_4281With this scenario:

“Jane has just been diagnosed by her psychiatrist as having major depressive disorder. She has been feeling overwhelmed yet hopeless for a while now, so the psychiatrist has suggested that she try out some medication as well as her therapy immediately.

Jane is pretty anxious about taking medication. She has heard a lot of horror stories of side effects, or the zombie effect, but at this point she is really just looking for some relief so she is willing to try anything.

Jane goes to the counter of the psychiatrist office to check out and is surprised when instead of the dr. giving her a sample pack or a bottle of pills she is handed a box.

All that the box says on the top is “Hello. I am here to help”, she is intrigued as to what could possibly be inside. But also confused, “Is this medicine?” she thinks.

The dr. explains that this is a starter kit for her. That having a diagnosis of depression is not the end of the world, getting to a place of self-acceptance is a journey and she would like her to give this kit a try. If the medication and kit process is working for her she would like to keep her on the program, and validates that she is not alone. She is here to help.

She explains that inside she will be guided through the process of taking her first week of medication with this kit. Inside it has day-by-day pull out pill packs, like and advent calendar, clearly labeled “Day1, Day2 etc.). There is her phone number inside the inside cover of the box if she is experiencing any side effects or just needs to talk her number is always there, and on the 4th day she would like her to use the included pre-posted notecard to answer 3 simple questions about how she is doing and mail it back to her so she can keep in touch when they are not face to face in a therapy session.

She also explains that inside there is also a book called “My Story” that has stories of people just like her she can read, and blank pages where she encourages her to write down her story, and to record her thoughts or feelings each day in the “My Story”.

She describes how to take the medication and tells her that the instructions and info about the medication is on the bottom of the box if she ever needs it.

Jane thinks to herself, “my this is different. I hope I can keep up with it all this”, but is uplifted a bit that she is not just being sent home alone with a bottle of pills. ”


This activity was followed up by a short questionnaire regarding the accuracy of the scene, if there was anything that would make the concept more relevant, or more simple, if there was anything missing, and what might you do to improve up it if you could do anything.

The answers were group based, and was a very enlightening discussion.

One woman – age 54 – described the scenario as being seemingly accurate, but definitely hopeful that the Dr. would guide her through the process of using this “thing” because there really was not much direction in the prototype. Rather intentionally actually, a choice made by myself to try to be very clear yet still have a sense of discovery.

Another man – age 47 – thought it was an “interesting” idea, that the postcard was nice, but really the action of taking each pill out of the box, ripping it off of the card and taking it with you was a bit unrealistic and tedious.

My sessions are so far being held in a medical facility where you are not even allowed to bring in your phone, but one man was nice enough to go out to a cafeteria and fill out his scenario there.

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So with what I observed, listened too, and got in hopefully honest writing was that I need more focused content.

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What I came out of my session was this:
People WANT to tell their story. Affirmations are nice, but the content needs to be packaged more familiar, and the actual content needs to better encourage a few key items.

  • The idea that they are not alone.
  • That they are not weird.
  • That other people share their same story.
  • That the idea of being “normal” is such a stretch perhaps it is more of an acceptance that not being normal is really ok.
  • People rely on their medications, and switch meds a lot until they find the one that works for them.

GOING FORWARD:
The box is staying. The innards are changing a bit, but really just becoming more robust around the narrative listed above. I am now moving forward with the “notebook” kit rather than the advent calendar approach, which I believe will gain me more access to be able to provide guided content, as well as it being a much more familiar and portable solution for people who may need to have their medications with them on the go. I am now focussing on a 2 week solution rather than a one week solution.

The week is moving fast, I just got my second round of just feedback, no scenarios, from a few new people that I will share next time, and hopefully have more people to comment on the actual included narrative of the item, as well as the construction – next week.

 

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TippingPoint: Doughnuts & Beers | Smoke & Mirrors

We finished last week by testing low-fidelity wires with one group of strangers to elicit feedback on our overall idea, as well as to understand emotional responses to different scenarios and tones.  We learned a lot from that test and we wanted to continue to test these screens with a few more individuals to gain even more perspective.

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2 of the screens we tested

Beer & Doughnuts

Our first stop was the University of Texas campus.  We arrived at a sunny picnic table on the north side of campus armed with a box of doughnuts to be used as compensation for people’s time and opinions.  We set up camp, wrote “Free Donuts:  Help With Design Research” on the box and put on our best smiles in an attempt to lure people to our table.  We quickly realized that offering free doughnuts doesn’t get nearly the response that offering free beer does (our tactic from last week)… despite that lesson learned, we were finally able find two college students willing to sit with us and give us their opinions.

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Free Doughnuts… Anybody??
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Yay, participants!

Our major takeaway from this set of tests was the need for our messaging to be tailored to the person using the service.  The two girls we spoke with were both 20 years old and did not drink or go to bars, so the series of screens we showed them aimed at an audience that spends too much money going out to bars wasn’t applicable to them, so it elicited negative feedback.  They also did not have credit cards or debt so they got stuck on the idea of using a service to pay off credit cards.  This was useful in its own right, and got us thinking about different ways we might tailor the communications and how we might be able to test that.

Later that afternoon went to a nearby bar to find more participants.  Not surprisingly, offering beer worked like a charm and we quickly found four participants eager to share their opinions.

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Sam with a test subject

A lot of what we heard echoed our first round of tests:

  • People enjoy a playful tone and a relatable voice
  • They want messages to be short and sweet
  •  They want to be able to customize the characters
  • They want to know specific dollar amounts (not just percentages)

We also heard some new feedback:

  • People want some sort of option to turn off the messages, especially if they do not currently have enough money to pay towards their credit card or savings
  • They want clear language telling them where their money is actually going
  • They would like us to push the funny character voices even further (fun!)

Smoke & Mirrors

In addition to these tests, we also reached out to our AC4D network, and were able to find three alumni friends willing to let us pilot a “smoke & mirrors” version of the service with them.  This involves a hacked together process of using their bank account alerts to send them an email every time they make a purchase over $1.00, and then setting up their email to forward those alerts to us so we can then send them a text message asking if they want to contribute money to their credit card or savings.  Make sense?  See below:

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flow diagram: smoke & mirrors

Our goal for this method of testing is to determine:

  • What it feels like to receive a message
  • With what frequency people prefer to get messaged
  • What tone is most effective
  • How much money a person using this service might save/put towards debt

After one week of sending & receiving messages, we had our first follow-up interview today.  The participant told us that she really enjoyed receiving our messages and preferred when the messages were more playful and personal as opposed to cold and professional.  It was her opinion that about one message a day would be a good frequency and any more than that might get annoying.  She wants us to keep it fresh and “keep the wins coming.” This means we will need to figure out ways to keep the reminders from becoming stale;  learning about our users to personalize messages, upping the ante, using variable reward structures, and helping people track their progress might be some methods we can use to keep the thrill alive.

The Next 7 Days

This coming week we will be continuing the “smoke & mirrors” testing with our alumni volunteers focusing more on testing different tones.  We will also be doing a series of Scenario Validation tests which we are currently recruiting volunteers for.  Please feel free to share the link above with your networks or if you or anyone you know fits the bill please don’t hesitate to contact us.

Tune in next week for more testing fun!

 

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Mental Healthcare in Rural Texas: Interaction design for the people, by the people – that have no idea what the people need

It’s true. I would imagine the majority of projects that an Interaction Designer works on are for people they may have never met, and have no idea what their users need or the processes they take to meet their needs. This could be true from anything as simple as re-constructing a bus system app if the Interaction Designer has never ridden a bus, or as complex as attempting to create, through design, a solution to the wicked problem of access to mental health care in rural America.

The latter of the two examples is what I am focusing on, and have been for the past 16 weeks or so.

This initial blog post is the beginning of a series of stories. Intended to serve as an overview of the backlog of all the travel, research, data synthesis, and real user scenarios (names changed) that I have gathered and now currently processing out design ideas. We will identify the key players, the where, when and how they go about meeting their needs. As well as the obstacles and challenges both the patient and the caregivers face in their journey through the difficult process of both access and care.

There is a lot to catch up on, so let’s start from the beginning.

I began my research focusing solely on access to general healthcare in rural America.

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I was drawn to subject this initially because of my own upbringing in extreme rural Texas. Where the nearest hospital you could visit for anything more than vaccinations or stitches on your knee after falling out of a tree per say, was about an hour away. During my contextual inquiry, where I went to a rural Texas town, investigated their medical facilities, and interviewed both physicians, caregivers, and patients, interviewing and observing them in the environments where they lived and worked; I actually realized a larger problem than access to general healthcare was access to mental healthcare. And in rural Texas, as well as the rest of the rural United States, access to mental health care facilities I found to be tedious, illusive, and sometimes non-existent.

For most of us access to a therapist is relatively simple. The person reading this, myself included, may know a handful of psychiatrist or psychologist that can be accessed for an appointment during their lunch hour. In extreme rural areas however where the majority of the people are either on Medicare, Medicaid, or fall between the coverage gap of not being poor enough to qualify for Medicaid, and not being old enough to qualify for Medicare, are directed to privatized mental health centers. These centers are few and far between and operate on grants, donations, and the kindness of wealthy philanthropist to provide therapy and medication to those in need.

However, there is a catch. In order for the center to pay for the visit and the medication the patient has to actually be physically present in the facility AND rather than being able to speak directly in person to a therapist, the diagnosis is done via teleconference. This means that the patient must drive, sometimes up to 3 hours to visit the center (walk ins welcome) and talk to a TV screen.

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This in and of itself is barrier number 1.

I had the opportunity to interview a caseworker that had just retired from one of these centers and from that interview a number of insights were gained as well as some very compelling stories. She was able to give me information about the patterns she witnessed in her 14 years of service.

That there is a stigma around seeking help for mental health issues, most likely shared throughout many societies but specifically in an area where “everyone knows everyone’s business”. There is a perception that you should be able to suck it up and it really takes loosing it all and hitting rock bottom for individuals to seek help. This generally happens when their personal support system has been tapped out. They feel alone and the final option is to drive, once again, to a clinic far away to speak to a psychologist via teleconference.

Another issue in very rural areas is access to technology. During the course of my research I personally had zero cell phone service, and admittedly drawing from assumptions, many of the homes in the sparsely populated areas looked as if they did not have running water let alone wifi.

And then there is the glaring isolation. Homes in the areas I visited are sometimes miles apart. There are “towns” I put in quotes, that really are just a few households spread out on a large piece of land. Some having populations of just 100ish people.

A number of publications I found had done intense research on this very topic, thus validating that this is not just a personal problem it is a problem that affects society as a whole. One paper entitle “Mental Health in Rural America” illustrates the shocking statistics that were uncovered in their research.

[excerpt]”In a review of studies investigating the prevalence of psychiatric disorders in rural primary care settings, Sears and colleagues (2003) found that 34 to 41 percent of patients had a mental health disorder. Additionally, results of studies of seriously mentally ill individuals indicate that rural residents have poorer outcomes (e.g., reliance on inpatient services, increased symptom severity) when compared to urban residents, especially if there are co-occurring substance abuse issues (Fisher, Owen & Cuffel, 1996; Rost et al., 1998).

One striking difference between rural and urban populations is the higher rate of suicide in rural communities, which has been a consistent trend for more than a decade (New Freedom Commission Subcommittee on Rural Issues; NFC-SRI, 2004; Institute of Medicine, 2002; Stack, 1982; Wagenfeld et al., 1994). Specifically, the suicide rate for older adult (elderly) males and Native American youth in rural populations is significantly higher than in urban populations (Eberhardt, Ingram & Makuc, 2001).

Adults suffering from depression, who live in rural areas, tend to make more suicide attempts than their urban counterparts (Rost et al., 1998).”

This is a real problem.

So after weeks of contextual inquiry, transcription, secondary research gathering and synthesizing out all this data I could, I then began developing some insights into what this all meant. There are some serious problem opportunities that could be addressed.

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Questions I asked myself along the way:

  • How can a center stay connected to their patients and monitor their mental state and medication regimen after they walk out that door?
  • How can any tracking or monitoring of a patient be performed without seeming clinical or cold?
  • How can a support system be established for patients that are isolated?
  • How can technology be taken out of the picture and a program still work?
  • How can I actually get a patient in this environment in a particular mindset to even care about following and participating in a program?

I went through a series of many many brain dumps of potential scenarios, at least a hundred design ideas. I concept mapped, and process flow diagramed a few I thought were potentially viable. Threw those out and started over again. I did storyboard after storyboard attempting to validate through real life scenarios of how some of these ideas would play out, and finally landed on one over arching theme.

What I am currently iterating on is a Patient Journey Kit that utilizes Fed-Ex or the postal service rather than a smart phone or a computer.

This kit will be packaged with their medication, and seeks to guide the patient through the process of self-recovery week by week.

I would like to include:

  • Real stories from real people expressing their experience, a new story each day/week that hopefully identifies to the patient that they are not alone. And what they might be feeling is not shameful or wrong.
  • An encouraging progress tracker, that provides information about how the patient may be feeling taking their medication, so there are no surprises and empowers the patient to be aware of their mental state.
  • A tear out and mail back interactive questionnaire that does not feel like a questionnaire but more like a personal check-in. It will be mailed to their caseworker, pre-posted with the name of the caseworker and address pre-filled for the patient’s ease of use.

I currently have about 6 iterations of how this could possibly play out, and how the system logistics could actually work.

Next steps include more sketching, more scenarios, and narrowing down to at least three rough working prototypes to test with both therapist and patients this week.

I am very excited about this project moving forward. The following post will include status updates of testing results, iteration prototypes, and new insights I gather along the way.

I would like to hear from you! All information is valuable so if there is an opinion or comment that anyone would like to share to benefit or critique the project I encourage any and all feedback.

Thank you!

 

 

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CapMetro Re-design Wrap Up

For quarter two, our Design Methods class has been focusing on rapid ideation and iteration for a redesign of the Capital Metro mobile app. For those of you who don’t know, Capital Metro is Austin’s public transportation system.

To kick this project off, we completely immersed ourselves in the current app in order to formulate a thorough understanding of the current experience of using the app and identify the key areas where it breaks down.

The Problems

There are a number of things that cause frustration while using this app, but the attributes that cause the most frustration is the navigation, different menu items take you to the same place, and in some flows, it’s difficult to find your way back.
Here’s a concept model of the app as it currently is in order to illustrate its complexity and more clearly identify the breakdowns:
 
CURRENT-ConceptMap-CapMetro

 

With these breakdowns noted I created a new, “ideal” concept map:
 
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With this in mind, I chose to focus on the following:

1. Get a step by step itinerary based on my desired destination from my current location
2. Identifying a stop near me and easily understand if the bus I need will pass through

And so we begin…

Like I said earlier, this class is about rapid ideation and iteration. We started with an initial set of wireframes, user tested them and then made edits based on the results from testing. This process of make, test, iterate went on for six weeks.

Overview-iteration

User testing allows us to assess the usability of the product. In this class, we used Think Aloud Protocol, a method of testing where you ask the participant to think out loud as they are going through the flow of the product to complete a specific task. It allows you, the designer, to gain insight into the thought process a person uses to complete a task rather than just focusing on the completion of the task. This way you can pinpoint where adjustments to the design are needed.

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Evolution of the Trip Planner

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Evolution of Home Page
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Evolution of the Trip Experience

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Iteration 7: Trip Planner

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What I learned

Think aloud protocol works.
People catch on and it’s a great opportunity to step out of your designer tunnel vision and see the design through their eyes. It immediately becomes clear where there are wholes in your design.

Make it difficult, make it real, make it almost impossible.
When user testing, you must be careful about how you craft the scenarios. It’s easy to make a scenario that may not be real enough but works well with what you’ve designed. This won’t tell you what you need to know to move your design forward.

Carefully consider the order of your flows.
It became very clear that it only takes one flow for a user to begin to learn your application and then begin to expect certain results. With this in mind, it’s important to order your flows strategically.

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CapMetro App Iteration 6: Defining and Refining

The latest iteration of the CapMetro App was intended to reduce the number of physical clicks that it would take a user to get from point A to point B, purchase a ticket, or add money to their “wallet”, and get on their bus.

Other smaller functions such as saving to favorites, finding help info were taken into consideration but not the primary function of this iteration.

Below is the revised concept map for this version of the flow:

Cap Metro Concept Map - Support Process

And below are the pre-critiqued wires of the consolidated journey:

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3-01And below is the post critiqued in class revisions to the wires:

20141210_214335After both critique and user testing the results were mixed both positive and negative.

My user tests did not seem to have an issue with being immediately presented with the idea of getting to a particular location from the location they were currently, via gps.

The critique however pointed out that someone, at some point may want to not always use their current location to get from A to B, and might not realize that by clicking the “Plan a Trip” button on the navigation that option actually appears.

My user test questions then were to specific. The task posed was get from where you are to this destination. This was not an open ended question and from this the task seemed rather obvious and was generally successful.

The next steps are to actually take into consideration these open ended questions. What if a user wants to perform a certain task that I do not have the option for? And this is the process of iteration.

Honestly 7 iterations is really not enough to get to the ultimate flow for the user. Testing and re-testing is really the key. Getting the wires in front of real people and knowing what questions to ask or to NOT ask might actually be the key.

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