IXD Social Design
Faith Kaufman, Sydney Choi, Junyu Huang
There are 68,000 veterans with opioid-use disorders, representing about 13% of all veterans currently taking opioids.
Problem space
U.S. veterans diagnosed with chronic pain by the Veteran’s Administration (VA) are becoming addicted at unprecedented rates. About 60 percent of those returning from deployments in the Middle East, and 50 percent of older veterans suffer from chronic pain, according to Veterans Affairs officials. That’s compared to about 30 percent of Americans nationwide.
Veterans face a double-edged threat: Untreated chronic pain can increase the risk of suicide, but poorly managed opioid regimens can also be fatal. Veterans are twice as likely to die from accidental opioid overdoses than non-veterans, according to a 2011 study of the VA system.
Stakeholder model
In the graph below, we looked at all the stakeholders who might be involved in the system. We listed out all different members under each role.
In the model below, we analyzed how they interacted with each other and the value flows among them.
Selected approach and rationale
Inspired by commercials for risks of smoking, we explored further to think about how addiction itself can be valuable. Such commercials are effective in that it increased a fear and awareness to the audience by showing them how smoking could terribly harm people’s health. Similarly, we think that addicts can be an excellent educational resource in opioid addiction as they have gone through all the problems, challenges, and pains that other people could not understand.
Ideation
We first generated 20+ social design scenarios where different stakeholders can participate to help prevent opioid addiction. Then we looked further at some potential ideas.
- Medium for Opioid Addiction: Recovering veterans share everyday stories about fighting against opioid addiction
- Buddy System Communication: Veterans that have just gotten home are matched with one veteran who has recovered from opioid addiction and that they would stay in-touch with
- VR Opioid: Veterans can develop an empathy by experiencing the addiction in virtual reality
- Veterans Speed Dating: Newly returned veterans have “speed dating” with addictive veterans to learn how addiction has affected their life
Envisioning Co-Design Session
(Design scope: How might we leverage the value of addicts to prevent opioid addiction?)
A co-design session, otherwise known as participatory design is an approach to designing that involves all stakeholders to utilize their expertise and ensure the result fulfills their needs. The main differentiating factor between a co-design session and traditional design, or big-ego design, is traditional design only uses one person (the designer) to create a solution for the users.
Version I.
Goal: To learn about the best way to create a platform that can be seamlessly integrated into the VA and hospital’s current health care plan that provides young veterans support to prevent opioid addiction.
Participants
- VA Policy Makers — Recovery Program
- Recovered veterans
- Family of recovering veterans
- Recovering veterans
- Family of veterans who overdosed
- Young veterans
Context
- VA Conference Room
- Saturday morning
Materials
- Tables and chairs
- White boards
- Journey map templates
- Markers and post-its
- Voting stickers
- Lunch + snacks
- Cards pre-written out
- Prototyping tools
Part One: Narrate Experience
Knowledge hunt
This allows people to share thoughts, feelings, and attitudes towards the sensitive topic in a safe and comfortable environment.
Journey mapping
Stakeholders will map their journey to share their story. Not only is storytelling a part of army culture already, but it provides an opportunity for other stakeholders to gain compassion and empathy for the other stakeholders as people detail their challenges.
Part Two: Create Activities
Open card sorting
This is an activity in which participants work to discover effective means of communication for newly returning veterans to speak with veterans on the path to recovery from opioid addiction. After compiling a group of ideas, the participants will then categorize the solutions.
Show and tell
Each group is to present their ideas and get feedback
Iterating design
After obtaining feedback, we ask all groups to iterate their ideas according to the feedback from show and tell
Part Three: Prioritize Activities
Close card sorting
Groups will decide on their best ideas for how newly returning veterans will meet with addicted veterans.
Evaluation
Participants will prioritize the designs using the easy/hard x longterm/short-term evaluation grid. This helps both the participants and designers to identify the aspirational attributes of ideas
Part Four: Contextualize Activities
Experience prototyping
The participants are to create a rapid-prototype of the experience each group has proposed from card sorting
Speed dating
This is an opportunity for the stakeholders to connect further and shares the ideas they have come up with in their own group. As they meet, they can experience the rapid-prototype and provide feedback.
Co-design session Poster
Possible Solutions
- VR experience — helps veterans develop an empathy by experiencing the addiction in virtual reality
- Buddy System Communication — veterans that have just gotten home are matched with one veteran who has recovered from opioid addiction and that they would stay in-touch with
- Medium for Opioid Addiction — recovering veterans share everyday stories about fighting against opioid addiction
Final Solution and Storyboard
Main goal: An app presented at the hospital provided by the VA that connects returning veterans with veterans that are currently addicted but on the road to recovery.
Our solution is one in which the VA provides newly returning veterans a connection initiating mobile application that educates them on the risks of opioids and allows them to meet and connect with a recovering veteran. The recovering veterans are currently addicted to opioids, however are on a path to recovery with the help of the VA. We plan to make meeting with newly returning veterans a part of their treatment plan as an opportunity for the veteran to impart their wisdom, experience and a chance to bond with a fellow veteran. The mobile application will have a list a available veterans which the newly returning veteran can choose from based on his or her profile. Once a match is made, the app will coordinate a meeting place and time for the two veterans to connect. After completing the meeting, the newly returning veteran can continue with his treatment plan at the VA.
Feedback on Version I.
After receiving feedback from our peers and professors, we realized that the co-design session was too centered around human-computer interaction learning practices. Additionally, our peers suggested that we incorporate the speed dating idea into one of the activities for the co-design session to allow newly returning veterans and recovering veterans to collaborate and ideate for other veterans with similar situations.
Taking our feedback into account, we started prototyping a new activity that involves the veterans getting up and moving around to make the experience more immersive and involved.
Activity 1
Activity 2
Activity 3
Re-framing Co-Design Session
After finalizing our ideas for the co-design session, we wanted to run it by someone representing the audience of our pitch. Since Faith’s dad works for the VA, we were able to get in touch with Dr. Shannon Miller, who works for the VA Outpatient Detoxification Service, is Medical Director of the Dual Diagnosis & Sobriety Plus Clinics, is Program Director of the Addiction Medicine Research Fellowship, and is Director of the Addiction-related Services. He works at the VAMC Cincinnati. He informed us over email that “have a very active (and growing) Opioid Overdose Education and Naloxone Distribution program here at the CVAMC — one of the first in the VA system. We have published several research papers on the subject and would have interest in exploring such collaborations.” We figured that he would be the perfect person to consult with.
Interview with Dr. Shannon Miller
We ran our ideas by Dr. Miller and he thought the idea to intervene in the VA system right when the veteran gets to the VA would be great as a means of prevention.
Quotes and insights
He informed us of the vesting process which is the first step when a veteran checks into the VA. It’s basically when they ask them questions like “Do you have insurance? Can you pay?” After listening to our proposed solution, he believed that it would be a great time to stage our intervention.
He sent us the following brochures that are given to patients during the Vesting stage when they are prescribed opioids.
He believed that our solution could either accompany or replace the brochures.
We also discussed the digital component of our solution — having ipads for registration. While the VA he works in — the CVAMC — does not have this, he noted that other VA’s do.
But he mentioned the following.
“The Opioid Overdose Education and Naloxone Distribution program here at the CVAMC is one of the first in the VA system. The VA is a leader nationally in OOEND.”
In order to stay true to the claim, we feel that ipads can be a solid way to guarantee that the VA stay on the cutting edge of OOEND.
Feedback on our idea
We asked for his feedback and if there were any roadblocks he could anticipate to our design.
He noted that if you can require the user to fill out the form before closing the app that would help.
In order to get the VA onboard, he noted that if it can take the smallest amount of time and energy required, then that would be beneficial. We noted this when writing our script for the pitch.
Screens
After getting the go-ahead from Dr. Miller on our solution, we mocked up screens of what the solution would look like.
We figured it would be best to explain our solution first in the pitch, and then go into how the co-design session can help us make the design of the solution better since we are designing with the stakeholders of veterans that have just returned home and veterans that are recovering from addiction.
Final Co-Design Session
From there, we go into the co-design session, which has evolved a lot throughout the process.
Context
After talking to Skip, we figured that it would be best to set the co-design session at Boulder Crest Retreat. ““Boulder Crest Retreat is the nation’s first privately-funded rural wellness center dedicated exclusively to combat veterans and their families.”“The Retreat is open to combat veterans (defined as anyone who deployed to a war zone) from any generation and conflict.”
We don’t want being in the environment of the VA to change the way that the veterans connect. Since part of the solution is getting the different veterans to come together and meet in a place that’s not the VA, we figured that we could add value to the co-design session by simulating the kind of interaction that we are trying to initiate with the solution.
Stages
There are three stages to the session.
- Divide
- Bond
- Brainstorm
At this stage of the process, we digitized our ideas of how to illustrate how the activity would work.
Stage 1: Divide
The aim of the first activity is to divide our two groups of stakeholders (veterans recovering from addiction and veterans who have just returned home and haven’t started opioids) into their respective groups.
The activity begins with all the veterans mixing up and then coming together in a line.
We say statements such as:
- “If you have ever self prescribed a medication due to insufficient pain relief take a step forward.”
- “If you have never taken opioids, take a step back.”
What this does is split them into two lines. The two groups are on the two sides of the room.
Stage 2: Bond
From there, we have them come together so that the veteran that is recovering can speak of his experiences with addiction to the other stakeholder. We tell them to match up with the veteran directly across from them and then sit down at a table with their new buddy.
It initiates the kind of conversation our app tries to do in our intervention.
From there, we hand them a retrospective timeline to spark the conversation and get them to hone in on issue areas in the process. They should be at the VA since that is the only stage before the second stage, when addiction was at its worst.
Stage 3: Brainstorm
Finally, we have the teams determine how to solve these issues to prevent addiction even before it begins — at the VA.
This would help us figure out the following questions we have for how to make the solution better:
- What information do they need to find a better match?
- Where would they want to meet up?
- What would they want to do? (e.g. grab coffee)
- How long would they want to stay in touch?
Second iteration of solution and storyboard
We digitized our storyboard from earlier, tying in the ipad which had been missing in the previous iteration. It now ties in perfectly with our solution.
Values
The co-design session is valuable for the following reasons:
- Collaboration from multiple perspectives
- Mimics the type of interaction that our solution would create
- Educational to the public
Reflection
What We Learned
We learned about how to set our own constraints when given an abstract prompt. Additionally, we learned what a co-design session is, and how to design one utilizing the interaction design principles that we accumulated during the semester.
What Were We Challenged By
Our main challenge was in creating the co-design session, we had a hard time choosing activities that would initiate the right kind of involvement of the stakeholders. For a while, our activities were basically having the veterans do HCI with card-sorting and paper prototyping activities. Though we wanted to involve them and put them into the role of a designer, this was not the way to do it. We struggled for a while but eventually landed on activities that created the right type of interactions.
What Did We Do Well
We did a great job of responding to feedback and critique. When told we were doing something incorrectly, we would drop it, and start over without abandoning constraints on the solution that we had already set for ourselves.
Our team also worked together really well!
What Would We Do Differently
During critique, Karen talked about how the tone of your pitch is a form of design as well. If given another stab at the project, we would incorporate more story-telling into the pitch and consider what tone we wanted to take while presenting.
