Developing Interventions for Underserved At-risk Populations Using Mobile Technology

Designing solutions for underserved, at-risk populations can present unique challenges, especially when using mobile technology. The design team for HealthTea, a mobile health app, approached this problem with collaborative design thinking. Their work demonstrates unique strategies for improving engagement, privacy, and trust in new mobile health tools.

As part of a pilot study, the HealthTea app was designed to reduce health disparities and facilitate human papillomavirus (HPV) vaccination in specific communities. In particular, the study was aimed at men between the ages of 18-26 who were having sex with other men (MSM). The app sought to address known barriers to vaccination among young MSM and to serve as a bridge between the virtual community and an MSM-affirming health center.

This pilot intervention study, funded by the National Institutes of Health, National Institute of Allergy and Infectious Disease, was led by principal investigator, Holly B Fontenot, PhD, RN/NP, and her team, which included Chokdee Rutirasiri, VP Experience Strategy and Research at MadPow [see source]

Using a design thinking approach, the design team was able to (1) develop a deep understanding of the wants, challenges, barriers, and unmet needs of the community; and (2) co-design with community members. This collaborative approach led to more innovative strategies for increasing engagement with the app while reducing harm and unintended consequences.

Three Key Takeaways from a Design Thinking Approach

1. Co-design your content strategy 
   Health content is often perceived as dry, boring, and TL;DR (“too long; didn’t read”). To address this challenge, the HealthTea team worked directly with members of the MSM community to co-design communication strategies that resonated with the community.
   
   Their collaboration focused on content for recruiting MSM community members to participate in the design phases of the larger project. The team recruited on MSM-focused dating apps, and therefore the content strategy leveraged humor and imagery. (See screenshots). By co-designing with their audience, the team was able to present critical healthcare information in a more familiar, fun, and engaging way.
   
   
    
2. Be a good host
   Iconic designer Charles Eames once said, "The role of the designer is that of a very good, thoughtful host anticipating the needs of his guests.” The HealthTea team took this heart and added such a host to the HealthTea app.  To build trust and engagement, the host was someone who community members could identify with. The host was a real person, a nurse at the clinic where community members could get HPV vaccinations. The host welcomed and directed users in short videos throughout the app experience. These short videos used the app's branded humor and were intentionally shot using an iPhone. The deliberate use of the iPhone was intended to keep the video in a fidelity that users can relate to (note these videos were created long before TikTok videos were popular/viral). Like a good designer, the host was designed to anticipate and address user needs while fostering a familiar, engaging, and trusted experience.
   
   
    
3. Think more holistically about user privacy
   Privacy is more than policy, protocol, and terms of usage. The MSM community’s concerns about personal privacy and general lack of trust in the healthcare industry made traditional engagement difficult.
   
   Backed by research, the team identified a design principle critical to building a trusted relationship with the community: The HealthTea app was intentionally designed not to 'out' someone who had downloaded it to their mobile device. To address this, the name of the app and the corresponding home screen icon did not indicate its connection to the MSM community. (see home screen image). The branding of the app remained engaging without revealing the lifestyle or identity of those using it.
   
   

The HealthTea project illustrates several strategies for designing health solutions for underserved, at-risk communities. Using co-design and Design Thinking practices, the design team worked to facilitate HPV vaccination within the MSM community. Their collaborative approach led to more innovative strategies for reducing harm and increasing engagement with the HealthTea app.

Mobile technology solutions, particularly for healthcare, need to resonate with their intended audience. A Design Thinking approach can help you understand and create a deeper connection with your audience– and in doing so, build trust, mitigate risk, and increase engagement with the people you are trying to help.

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Source:
Mobile App Strategy to Facilitate Human Papillomavirus Vaccination Among Young Men Who Have Sex with Men: Pilot Intervention Study https://www.jmir.org/2020/11/e22878