Philadelphia has been experiencing a spike in recent years in sexually-transmitted infections, specifically HIV and Syphilis. The head of the Department of Public Health decided to try a different approach to help address this problem. After attending a conference about design thinking in healthcare, she sought help from design thinking professionals (including myself). You can read a report from Philly’s Health Department on this issue here. There’s a long, complicated history of the Dept. of Public Health and how it relates to individuals and influences widespread negative views by the public of the organization. The CDC and local health department’s responses to the AIDS epidemic has been widely condemned as being inept and extremely delayed. This is still top of mind for many community groups working with at-risk youth, who interface with the Health Department in a variety of ways. And yet, the Department of Public Health has a mission to address potential risks to the health of an entire community. Because of this they must follow up with individuals with particular diagnoses, such as HIV and syphilis.
Recently, Syphilis in particular has become an illness that affects men who sleep with men (MSM). MSM has become the preferred acronym of this group, due to the fact that the term “gay” is more often used by older white men. Men who sleep with men may also sleep with women, and may or may not identify as gay or homosexual. In addressing the AIDS crisis in the late 1980s through the 1990s, regional health departments learned to work with gay-focused organizations. As cultural forces and sexual identities have evolved since then, this strategy now doesn’t account for men who sleep with men, who do not identify as gay or out, and use mobile apps to find partners.
Our main goal was to start to understand the needs and mindset of the target audience for this project. The young men that are at most risk of HIV and syphilis often don’t spend a lot of time in Center City or around hubs of historical health intervention for gay men in Philadelphia. They may have a major distrust of the Health Department staff (for good reason), and may be struggling with homelessness, drug addiction, abuse at home, and other issues.
- Future Backwards
- Empathy Maps
- App mock-up
- Communication Roadmap
Through my own network I knew Melinda and she asked me about design thinking professionals she might be able to work with. I recommended my friend and former colleague Rob Peagler as the lead designer for this project. Rob in turn hired me to be a second designer on the project to provide additional thinking, research, and support.
It’s hard to do this project justice here, so what I am providing is incomplete and I intend to add to it at a later time. This project brought me back to the mantra I picked up in design school which is, “Who is the user, and what do they want?” I used this as a guide in the first part of the project, when just being in touch with the user in this case, the individual who may be at risk that the Health Department wants to have access to, was a big challenge. These individuals often experience organizations wanting access to them, or giving them things (tokens, gift cards, phone credit) for filling out surveys. They are used to being in a transactional relationship. Rob and I carefully considered how to take a different approach. Once we were able to meet and talk with people in this group, it was clear that all they wanted were to be treated by the Health Department as real and valued people. In our initial report-back to the Health Department, higher-ups were surprised, sometimes shocked at the portrait of these men that we were able to paint, because it involved taking trips, going to conferences, being a part of book groups. In the eyes of at least some people in the Health Department, their target audience are living squalid, miserable lives. I think showing a different view of this group initially was super valuable on our part, and lead to further opportunities for Rob and I to work on this problem.