Final Summative Project – Designem.co.nz

Final Summative Document for Design for Social Impact

This is the final submission for my Design for social impact class.

You can download a PDF of this document by clicking the link: Improving Access To AUT Health And Wellbeing Services or view it below.

Improving Access To AUT Health And Wellbeing Services Acknowledgement page

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Introduction For our Post Graduate class Design for Social Impact, we were given the task to create a solution to improve access to the AUT Health and Wellbeing Services on Campus. Part of this project was to investigate and discover what barriers currently exist that prevent students from accessing the services and create workable solutions to negate these. At the start of this project we were working with a number of hunches, due in part to having spent time at AUT as a Student ourselves. We designed questions built upon these hunches so that we could take them to the students, using the intercept interview method to generate conversation and discover the real source of what is causing this issue. Purpose of this work The aim of this work is to uncover the key reasons students are not accessing a free service that is available to all enrolled AUT students. From the information we gathered from this process we were able to brainstorm ideas to promote the Health and Wellbeing service at AUT in a way that took into account the needs of the students and the service. Through the design process, we can create a catalyst of possibilities that open up ideas to create greater awareness of the Health and Wellbeing services at AUT and ensure that all students who require the assistance know that they are entitled to use it, and also how to use the service.

To design a solution that would genuinely fit the purpose of improving access to the Health and Wellbeing services at AUT we had to meet and talk with several groups of people who represent a stake in the interest of the services. To ensure we worked on a solution that was more than hunches and previous bias we used an approach based on the ThinkPlace© Four Voice Model to observe, immerse, and engage to ensure we would develop a narrative that reflected the issues facing AUT students, while keeping in mind the needs of the service itself. Voice of Intent The driver behind this project is the design team from ThinkPlace© many of the design practices and thought processes used have been based entirely on the lessons learned in class. ThinkPlace© Staff Rose, Leonie, Stephen. Voice of Expertise The holders of the in-depth knowledge on the topic. ThinkPlace© Staff Rose, Leonie, Stephen. Staff at the Health and Wellbeing Centre. Voice of Experience Those who attend AUT, the students who have experience of the service, and those who had no awareness of the service. We spoke to AUT students. Voice of Design Our Design team. The ideas generated were a collaboration of our design team, Ning, Emily, and our other classmates during brainstorming.

The process and methods undertaken Intent Sessions In our groups, we talked with ThinkPlace Staff to discuss the design problem, from the intent, scope, and outline what our project would encompass. Stakeholder Sessions We meet with the Stakeholders from the Health and Wellbeing Centre at AUT, where they spoke to us about how their services work, and the current issues of access to the services from their perspective. Designing the Questions Based on the conversations with the Stakeholders and ours initial assumptions we crafted the questions we would be using to interview Students. Intercept Interviews Working in pairs, we interviewed Students on the AUT campus. We met with Students in the Hikuwai Plaza, the postgraduate kitchen and the Refuel dining room. We spoke to a variety of students, such as those undertaking their undergraduate degree, postgraduate students, and international students. Speaking with First Years I surveyed a group of first-year students to ask them how much they knew about the Health and Wellbeing Services at AUT. Visiting the Health Centre We visited the Health Centre and Wellbeing Service at AUT to experience how Students might come to the service for the first time. Insight mining As a group, we spent time writing insights from our interviews on to post-it notes, where we grouped and arranged them in different ways to pick apart key insights. Synthesis findings Using the insights discovered during the interview process, we generated many design solutions and created a prototype. Testing Prototypes Sessions with post-it notes to unpack insights, gathering feedback on the prototypes and using this feedback to refine our ideas. Stakeholder Walkthrough Those who were involved in in the Intent Session, previous workshops, and were at the Stakeholder meetings were walked through our design thinking process, the insights gathered from our intercept interviews and how we used these insights to generate design solutions.

Understanding the perspectives A vital part of the design process is speaking directly to the people who the Service is designed for. Speaking with the AUT students provides us with key insights to the issues surrounding the accessibility of the Health and Wellbeing Services

Who we listened to Under Graduates Post Graduates International Stakeholder I guess I knew about the Doctors but I never thought about it, maybe I just needed a reminder. I never knew about the services when I was doing my degree; it would have made a lot of difference if I had known about it. Having English as a second language can feel like a barrier to asking for help. We know we need a better website. Under Graduates Post Graduates International Stakeholder My Lecturer told me about the service and took me over there. I might have been told about the Health Centre at Orientation, but I forgot about it by the time I needed it. I wouldn’t want anyone to know I was going to talk to a councillor or going to a doctor; I like that the clinic is private. We don’t want to use Social Media to reach students.

Key Messages From the completed interviews, we worked as a group to identify key messages in what we heard. We organised these into three distinct groups and wrote them on to different coloured Post-it notes; these groups were: Positive comments, negative comments, and key values. Once written, we separated the different interview subject’s narrative. Clustering the various groups together meant that it was easier to determine immerging themes. These themes are the first step towards reframing the issues of Access to the Health and Wellbeing Services at AUT. This method of making sense of what we learned leads to greater understanding as we examine our insights from our data, focusing in on the points that are actionable and specific. This often requires taking an intuitive leap from what we learned, to the opportunities this research has created. Key messages from Students Orientation Overwhelming Family Influence Not talking about it Feeling scared about going Thinking it’s only for when sick Unsure about how good it was Uni-Prep doing a good job Went for free condoms Lecturer told them about the service English as a Second Language Needs more than six sessions Hard to get an appointment Not a good first impression Hard to find the centre Previous knowledge of therapy helpful Large majority unaware of service

What we heard from Students The AUT campus is populated with a diverse student base which encompasses an age range from school leaver to mature student. These students come from many different backgrounds, each with unique needs. We set out to talk to a range of students that represent the entire student body to discover the reasons why they were not taking advantage of the free health services available. Our interviews with international students revealed that many females felt nervous about going to the Doctor, or Service. I feel scared about going to the Doctor; I don’t want anyone else to see me going and wonder why I am going there. A key insight we discovered from this was the need for the Health and Wellbeing Centre to be a visible Service that is known to all students but also to maintain the privacy of location so that these students can access them. “My Mum made me sign up for the Doctors the first week I was here; I moved up from Hamilton so needed a Doctor. If she hadn’t made me do it, I’m not sure I would have thought about it.” A theme we noticed running throughout the interview process was that students did not know that: A) There was a Health Centre on campus, and B) That this was a free service available to AUT Students. I can’t remember if we learned about the Doctors during orientation, maybe we did, but yeah, I don’t know. This was a common theme from the feedback we received. That although we heard directly from the Stakeholders that the Health Centre is a topic covered, and although there is information regarding the Services on the AUT website, and in printed material, students are not recalling learning about it during their orientation. A common thread we saw develop was that students are not talking to each other about their health and wellbeing needs. Students are also not practising word of mouth about the free health care that is available. When asked of an interview subject why they did not tell a friend they considered in need of help about the free services they responded: I guess maybe I should, I never really thought about it. I’ve been using the doctors but I never thought I needed to see a councillor, but yeah, maybe I should tell my friend about it. This key insight leads us to hypothesise that while some students may be aware of the services they may have forgotten about them by the time they find themselves in a situation where they might need to seek them out.

Making sense of what we heard This section is how we probed deeper and unpacked the insights gathered from the interviews. We do this by examining these insights and asking ourselves ‘What does this mean?’

Out of sight, out of mind A trending insight we noticed was the invisibility of the Health and Wellbeing Centre. Students seem to forget about the service if they have only been told about it once or twice. Part of the problem we are solving for is how to ensure that the Health and Wellbeing Centre sticks in the student's mind, so that if or when they might need to access this service they will remember that it’s there for them. We were surprised by the sheer volume of students that no matter how long they had been attending AUT, had little to no awareness of the service. Some of the main insights we picked to become our focal point include the culture of AUT not discussing mental wellbeing or talk therapy, that for some students looking after their mental fitness is not a priority, or an issue that they believe they will ever face, and they're generally not awareness of the service or the fact this is free of charge to all AUT Students. We were also surprised to find out that many of our interview participants had very little understanding of how to take care of their mental health, or awareness of their peer's mental health needs. This could in part be due to the emotional maturity of young students, and/or because despite that the stigma surrounding Mental Health is dissolving; this is still a taboo subject for many AUT students. For some students, while they may have learned about the Health Centre during orientation, the knowledge of this has been forgotten, for many due to not having needed the service in the first few months of study, and the overwhelming nature of adjusting to university life. It will be game-changing if we're able to ensure that every single AUT student were aware of the free services provided for them so that they feel supported and valued by the university.

Speculation and Solutions The students that attend AUT university may have come from many diverse backgrounds, however one fact remains the same for everyone: They all have equal right to access the free service provided by the university, and they all have at some point a health need that will require a professional.

Principles for designing solutions This project highlighted some critical aspects surrounding the reasons why students may not be accessing the Health and Wellbeing service at AUT. While each student's needs are unique, one main point stood out. The problem that reoccurred time and again was that the Service is almost invisible to the majority of students. Workshopping design solutions When tackling a problem such as accessing the Health and Wellbeing Service, we needed to keep an open mind when brainstorming potential solutions. By not locking ourselves into one idea, we open our selves up to many different avenues of reframing the problem. We practised the ThinkPlace Design SystemTM in which we expanded our design thinking before narrowing to a workable solution. Reframing the problem From the research we conducted talking to students, we were able to unpack the influences affecting access to the Health and Wellbeing Services. We have utilised the method to innovate by breaking the routine and looking at the problem in a new way, creating a radically new perspective as referred to in the book Design, When Everybody Designs by Ezio Manzini. Working together The issues surrounding access is multifaceted, approaching design solutions as part of a team increases the likelihood and success of creating a viable solution. We worked together with the entire Design for Social Impact class, generating solutions based upon our ‘How might we’ question, which meant that we had a larger pool of ideas.

How might we … Taking into account the information we gathered during the interview stage, the meetings with the stakeholders and subsequent insight mining process, we generated as many solutions as possible for our how might we statement. We used open-ended focused statements to craft our solutions around. We had many insights to generate our how might we statements, with one emerging theme that ran throughout all those we spoke to: The Health and Wellbeing Centre is an invisible service at AUT. Although students are given material about this free service at orientation, the knowledge gets lost in the overwhelming amount of information given to them. During their adjustment period at university knowledge regarding what they are entitled to may be forgotten, which led to our how might we statement: How might we make information about the health centre more memorable so that it is easy to recall or access when needed?

Emerging ideas During our ideation workshop, we wrote our how we might question onto a large post-it note and asked our class to think of as many design solutions as possible. We asked them to be as creative as possible because you never know when you might say something that sparks a fantastic idea. Even the most ridiculous remark can lead to the perfect solution. The idea behind our question: How might we make information about the health centre more memorable so that it is easy to recall or access when needed? Is based on the insight that although many students have at some point been advised of the services, by the time they might need to use them, they have forgotten about their existence. No idea too silly As a firm believer that solutions should not be limited by what seems feasible, we approached ideation by generating as many ideas as possible. Even the suggestion of an AUT Zoo could spin our concepts in a workable successful direction, such as having dogs visit AUT for pet patting. For this to be a viable idea, we could work in collaboration with the SPCA or Service Dog training who are wishing to socialise their puppies before service training. Expanding the idea Once we had a wall full of ideas, we expanded on this by asking ourselves what this idea might achieve in terms of student engagement with the Health and Wellbeing centre. For example, pet patting at the centre could improve student morale, and be used as a tool to entice students to the service where they could be engaged in conversation with the staff. The result would be a memorable and rewarding experience which ensures they will recall the Health and Wellbeing Centre AND remember that it exists.

Refining the prototype Once we generated as many ideas as possible, we use a graphic scale to work out how viable the ideas where on a scale between high confidence of value and success, to low confidence of value and success. Arranging the concepts in such a visual manner makes it easy to narrow down to the ideas that have the highest chances of working. Our group developed the concept of vinyl stickers. I focused on creating calls to action stickers that would work in an unobtrusive yet visible way to remind students where the Health and Wellbeing Centre is and what services they provide. This concept links to the insight that the service needs to remain unobtrusive so that it can be confidentially accessed, and still a known available service. Prototype development When developing a prototype, there should be a strong emphasis on creating a human-centred approach. This is where we create a solution either alongside the user or seek feedback from those who would be using the product. This method of empathetic design gives our design idea a higher chance of success. Using the method of failing fast makes it easier and more affordable to test your assumptions, learning early and often. With each idea, there might be parts that fail, but they’re might be aspects that work well. Making our prototypes Working with the insight we learned during our interview collection; I was able to use my skills as a graphic designer to quickly mock-up our first iteration of the call to action stickers. With critical messages such as there being a lack of public knowledge about the Health and Wellbeing Centre, and little visibility of the services existence, coupled with the feedback that students are not talking about health needs to each other, we were able to develop a message that is informed by what we heard from the AUT students.

Testing the prototype An essential step in ensuring the success of a human-centred design solution is testing the prototype by getting feedback from our target audience. To achieve this I placed printed versions of the call to action stickers around campus. To gather the information, I prepared a questionnaire so that we can ask ourselves “What am I hearing?” “What does this mean?” and then, “What are we going to change, scale, up/remove?” Once our prototype call to action stickers had been in place for several days we set out to intercept students and gather feedback. Some evidence of them working was achieved by stationing ourselves in a corridor when we had the stickers fixed to the automatic opening doors. In this location, we were able to observe students reading the information on the prototypes. We were also able to gather insight in testing the location of the stickers, such as where we can, and cannot place them, as the Security Guards removed some from next to the elevator within minutes of them being placed.

Refining the solution Based on the feedback gathered from user testing, we discovered that although the call to action stickers was well received, they were still in need of improvement. We heard that they were ‘too wordy’ and that having too much type on a circle was hard to read. We also heard that they needed to be brighter so that they were more eye-catching. Students liked the placement of the prototype, having them on the automatic opening doors ensured that any student who was passing though read the call to action. Feedback I was pleased to see included in our feedback the suggestion of providing these call to action stickers in different languages. This was an idea we wanted to implement, but in the interest of testing fast created our intimal prototypes in English only. As indicated in the feedback I reduced the amount of overall text and increased the size of the main message. Stakeholder walkthrough The final step of our design solution was to create a ‘walkthrough’ of the design process for the stakeholders. Using this method, the service provider can follow the threads of design intent by seeing first-hand how we discovered the insights that informed the final design. Including the Stakeholders in this process ensures that they feel valued in the process and gives them a chance to provide meaningful feedback.

Conclusion While the AUT student body is made up of a diverse group the needs remain the same. Everyone requires access to health care, and although we were not surprised to find our hunch that many students are unaware of the service, most students can be reached in the same manner.

Conclusion We believe that the call to action stickers will have a high success rate for creating awareness of the Health and Wellbeing Centre; however they will work well as part as a more extensive campaign. In Conclusion During the research data collection, we discovered that many AUT students were unaware of the existence of the Health and Wellbeing Centre, and of those who knew it existed a smaller percentage understood that this service was free. Many of these students would have been told of this service during orientation; however, this knowledge is susceptible to being forgotten with the information overload of transitioning to university. An insight we learned during research informed us that many students do not talk about mental health with each other and that just because one student is aware of this service does not follow suit that they will pass this information on. While brainstorming our design solution, we practised empathetic product design, taking into account that the service did not want to use social media to reach students. While there are many different factors to students accessing health services, the visibility of its presence is a solvable issue. By placing the call to action stickers in areas of the campus where students move to and from class provides the student with frequent reminders that this free service is available to them, while the service can remain in a location that ensures the patient's privacy. Looking forward Looking to the future, we discovered that relying on orientation alone is not enough to ensure that students retain good access to the Health and Wellbeing Centre. Creating a call to action stickers is a great resource, one that will work well as part of larger campaign. In the future, the Health and Wellbeing Centre might like to consider creating Wellbeing events that generate conversation with students, increasing engagement which in turn increases the likelihood of the service staying in their mind if they find themselves in a situation where they need to access the Centre. This report has begun to create conversations surrounding the barriers to students accessing the Health and Wellbeing Service. The next task will be to continue this effort with the stakeholders working to create greater visibility of such a valuable university student resource.

Resources During the creation of the document, several academic resources were consulted. Bibliography Urin ‘Design, When Everybody Designs : An Introduction to Design for Social Innovation’. n.d. http://eds.a.ebscohost.com.ezproxy.aut.ac.nz/eds/ebookviewer/ebook/bmxlYmtfXzk2MT A0NF9fQU41?sid=2b0cf378-2cf5-4398-ab69-5582f7b84ea5@sdc-v- sessmgr02&vid=0&format=EK&rid=1. ‘Exploring Respectful Design Directions for Indigenous Communities’. 2013. 2013 International Conference on Culture and Computing, Culture and Computing (Culture Computing), 2013 International Conference on, Culturecomputing, 131. https://doi.org/10.1109/CultureComputing.2013.31. McDonagh, D. C. 2006. ‘Empathic Design : Emerging Design Research Methodologies’. Postma, Carolien, Kristina Lauche, and Pieter Jan Stappers. 2012. ‘Social Theory as a Thinking Tool for Empathic Design’. Design Issues 28 (1): 30–49. https://doi.org/10.1162/DESI_a_00122. ThinkPlaceTM Resources How to have an Empathy Conversation – Working with millennials Analysis and Synthesis Process Guide Begging in Wellington – An exploration into our community’s issue The Family 100 Project – Demonstrating the complexities of being poor; an empathy tool