Gustafson&SpruitMetz 6.21.11

7/29/2019 Gustafson&SpruitMetz 6.21.11

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Principles of mHealth Design I:

What are we doing and who are we doing it for?

David Gustafson, [email protected]

Donna Spruijt-Metz, MFA [email protected]
mailto:[email protected]:[email protected]:[email protected]:[email protected]


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Outline

What are you doing? (Scope)

Who are your internal and external customers(and why is it tricky to identify them)?

Why is it important to understand yourcustomers, internal and external?

How do you get into shoes of the customer todevelop systems that best fit the customer?

How do you use the knowledge that you get fromall this?


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How this session works

Take 5

Nuggetology


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Scope

Be creative, open-minded

And PRECISE

(With the option to build on.) Scope will depend on customers


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Identifying the internal customer

Whats an internal customer?If you are an engineer, the health scientist on your

team might be an internal customer (i.e. your owncolleagues and staff)

Your university, tenure committee, department chair,or higher-ups in your business might be your internalcustomers.

Your funders might, in some sense, be internalcustomers

Internal customers might have differentexpectations, needs, desires, timelines andendpoints in mind


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Conflicts between Customers

Is it the most

up-to-date

technology?

!t

Has the

accelerometer in

that cell phone been

validated?

Proof of concepDone!

Promotion =1st AUTHORSHIP

IN JAMA

But I need to be

able to take this

out into the

field and use it

with REAL

PEOPLE!!!

OMG(oodness)!!

TRANSDISCIPLINARY

MOBILE HEALTH

SYSTEMS DYNAMIC

RESEARCH WOW!!


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Identifying the external customer

Lets say we are developing a second skin ofsome type for obesity interventions in urban

inner city Los Angeles youth.

Who is the customer?

Beyond developmental stage (impacts: Cognitivefunction and emotional control, thus learning

styles, acceptability of various functions) Beyond ethnicity (impacts: Approach, acceptable

diet and activity recommendations, language)

Beyond SES (impacts: Everything)


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Identifying the whole customer

EVERYTHING IS A SYSTEM eliminates a lot of discussion (arguments?) about what is

or is not a system.

EVERY SYSTEM IS PART OF LARGER SYSTEMS opens creative solution space by seeking solutions to

achieve bigger ends

EVERY SYSTEM IS MADE UP OF SMALLER SYSTEMS provides a way of considering all aspects of reality

EVERY SYSTEM EXISTS IN PARALLEL WITH OTHERSYSTEMS

is a reminder that independence of systems is an illusion

Dr. Gerry Nadler


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Dan Stokols Early Vision of Socio-

ecological Systems


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Patrick, Intille & Zabinski


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Second Skin in a System

The case of KNOWME


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Your case study


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Why is it important to understand

customers, internal and external?

Assets

Deficits

Perceived (and empirical) needs

Culture

Cognitive & emotional development

Social network, influences, family, environment

What is acceptable? Desirable? Affordable? Can they use it, will they use it, will it motivate

them, whats the hook (points of engagement)


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Your case study

Surprises about your customers that impactdelivery, messaging, technology, displays, data

representation.

(what kids will wear, what they want to hear)eMOTE

(Enhanced Minority health Outcomes Through Entertainment)

H d i h f h


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How do you get into shoes of the

customer to develop systems that

best fit the customer? Community Based Participatory Research (CBPR)

Systems Science: Group Model Building (GMB)

Playtesting

Idea building groups

Focus groups

Nominal group techniques

Walkthroughs


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CBPR Recognizes the community has it own identity Builds on strengths & resources within the community Facilitates collaborative coalition Promotes capacity building (everyone collects data) Emphasizes local relevance of public health problems Recognize and attend to the multiple levers of health

and disease

Involves systems development through iterativeprocesses

Disseminates findings and knowledge gained to allpartners and all partners will be involved in thedissemination process

Involves a long-term process and commitment


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Which Groups Come to the Table?


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Which Issues Get to the Table?


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Birds-eye view of CBPR

Select the community unit of identity

Select your initial partners individuals, representatives oforganizations or both

True dialogue with partners (and others that should be at thetable) before the proposal is written and throughout theprocess

Identification of WHAT, HOW, WHO, WHEN WHAT research question HOW research design WHO who is responsible for what? WHEN - timeline

Sustainability plans from the beginning


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From Systems Science:

Group Model Building

A form of group decision support, involving agroup of stakeholders with a complex problem

Group facilitation

Model building and refinement in publicSimulation of scenarios and options

Extensive facilitated discussion and analysis

Facilitated policy design and decisions


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Nuts and Bolts

Management team (10-20) with aModeling/Facilitation team (2-4)

Four full days over 3-to-4 months

Extensive between meeting work

Rapid prototyping of model with finishedsimulation product

Facilitation of implementation plans


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Group Model Building (GMB)

Group model building is a process in which team members exchangetheir perceptions of a problem and explore such questions as: what

exactly is the problem we face? How did the problematic situation

originate? What might be its underlying causes? How can the problem be

tackled? (Vennix 1996, p. 3)

Group model building, as we intend the phrase, signals the intent toinvolve a relatively large client group in the business of model formulation,

not just conceptualization (Richardson and Andersen, 1995, p. 1)

Why would one want to involve a large

number of people in the modeling process?

Hovmand & White ISSH 2011 Pittsburgh 22


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Reasons for using GMB

Insights come from modeling process Likelihood of implementation Participation as an intervention

Social construction of new realities

Models are only artifacts of that process Changes in mental models of participants

Dignity of risk People should have the opportunity to be involved in designing the

systems that are intended to benefit them

Theory building Grounded theory, synthesis of existing theories from experts

Information source Structure, dynamics, nonlinear relationships, parameters, policies and

interventions



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West End Neighborhood, St. Louis, MO

Residents and community leaders from West End Neighborhood work with researchers and

staff from Washington University and Transtria LLC to build a model to understand social

determinants of childhood obesity and plan new programs and services.



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Example from a causal mapping

exercise focusing neighborhood safety

Sports teams

using park

Playing soccer

Kick ball

teamGetting sports

teams together

Gangs

using park

-

-

Policesearches

Finding dope

Cancelling

program

Connecting to parks

outside community

Condition of parks

Rusting chains-

City maintaining

parks

+

Educational

systemHigh dropout

rate

-

Educational

background

Meaningful

employment

Time on hands,

nothing to do

-

+-

JobsMaintain home

+

Streetcleaning

Crime

Police not

responding+

Policeman on

foot patrol

-

Kids not havingfathers in home

+

Gangs

Parents can't

control kids

Not disciplining

kids

+

+

Community

acitivties

Police+

+

+

Neighborhood

pride

Neighborhood

schools +

Churches comingtogether

+

Vacant houses

and buildings

+

Getting loans to

improve homes

Condition of

buildings

Tearing down

houses

-

+ +

+



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Focus groups

Playtesting



Walkthroughs


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Focus Groups: The Basics..

Facilitated (trained moderator) Group Discussion 8 to 12 homogenous members, who dont know each

other

Audience segmented by level ofuse/exposure/demographics

Rely heavily on open-ended questions and reflections Participants usually paid & fed, sometimes transported Process is audio- or video-taped (with consent) Heavily influenced by group interaction Minimum of 2-4 groups per segment


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Development Process Fact Finding

Review Existing Materials, Literature Review

Identify Possible Audience Segments (SOC, SES strata)

Interview Opinion Leaders (Primary Data)

Convene Expert and Lay Advisory/Review Groups

Exploratory Focus Groups (Primary Data) Individual Interviews

Develop FIRST WHACK

Review by expert and lay groups

Pre-Test

Review and Revise Pilot Test: Expose participants under trial conditions/obtain feedback

Revise

Implement: Evaluate Efficacy/Effectiveness

Post-implementation interviews/Focus groups

Stratify by participants level of change


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Exploratory Focus Groups

Explore target audience experiences,thoughts, feelings, attitudes, fears, conflicts,pros and cons regarding the behavior or issue

Approach audience with blank canvas

Theory-driven Moderator Outlines

Purposeful sampling



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Focus groups

Playtesting



Walkthroughs

How do you use the knowledge that


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How do you use the knowledge that

you get from all this?

This may seem obvious. But it isnt

How will you analyze the data?

Lay out software, mixed models, impact of one setof interviews/playtesting sessions/ etc. on the

next iteration of (game narrative, look, layout,

sensor set, user interface, data display, what

else?) How will you incorporate your findings?

Lay out feedback and iteration plans


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Incorporating Findings

Case study from the simple to the sublime


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And now for something completely

different!

Dave Gustafson!

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Gustafson&SpruitMetz 6.21.11