User research & product design with vulnerable populations

Bionic
Bionic
Jul 2, 2019 · 5 min read

Article originally published on Medium by Zoe Fuller-Young

Throughout my career as an Experience Strategist and Product Manager, I’ve conducted user research and designed products with vulnerable populations and haven’t found many resources or playbooks as guides. This article is a starter set of my lessons learned to support those doing similar work.

Defining “Vulnerable”

What is the definition of a “vulnerable population”? It depends on who you ask, of course. Federal regulators define it broadly as pregnant women, children, and prisoners.

Researches define it broadly as well; a disadvantaged sub-segment of society.

As user researchers & product designers, it is useful to have a slightly more detailed definition given that we are still writing our industry standards around ethics and so we can raise a flag early and often to recognize when we should treat our users with special care. Here’s a working definition: A population that experiences disadvantages, discrimination, or stress related to economic, racial, gender, sexual orientation, health (mental or physical), religious, ethnic, or criminal (incarceration) status.

Lessons Learned

These lessons learned are based on my experience as a tech consultant; my job is to understand the full breadth of people’s needs as they engage with services, honing in on specific opportunities to leverage tech to improve user experience.

I have personally conducted user research with three types of vulnerable population: Veterans suffering from behavioral health challenges (USA -national), young adults transitioning out of youth care centers (South Africa), and applicants during enrollment and eligibility of public benefits (USA -state).

Challenge 1: Contextual inquiry can be too invasive.

County service center where 13 computers have one purpose: provide access to an online application for food, nutrition, and health benefits.

One of the most common research approaches is direct observation. The famous Doug Dietz, who learned Design Thinking at the Stanford d-school, used observation of children at play to create his seminal “adventure series”that enabled children to receive MRI scans without anesthetic they had previously needed to quell their fears because he made the experience seem like a fun adventure. It’s a great example of applied insight.

Yet, for a vulnerable population like applicants for food & nutrition assistance who are afraid they won’t be able to feed their family that evening, asking to observe them use the online application form may feel invasive; it can slow the process, add to anxiety, and create greater issues like awareness of their Personal Identifiable Information (PII) being compromised.

What to do: Talk to folks who are as close to your user as you can get. For our research into the experience of applying for public benefits, we spoke with Customer Service Representatives and Caseworkers; they work in county service centers and quite literally sit next to applicants while they fill out their forms. These folks know the users intimately and often came from similar communities, therefore understanding the emotional experience of applicants before and after their online experience based on their authentic relationships, over time, in that specific context.

Challenge 2: Tech access can be minimal (which is hard when you’re there to design a tech product!).

Young person in Cape Town showing me which apps she can use without having data.

When you are a tech consultant or working for a nonprofit that has funding for a program requiring an “innovative solution,” you’re looking for a tech solution. When you have a hammer, everything looks like a nail. This is challenging when working with a population like youth in the global south. Even if your users have a cell phones, they may not be able to afford data or they frequently lose battery throughout the day (ahem, thanks YouTube!).

What to do: Spend time during your research to understand the exact access limitations (i.e., can they afford data but often use it up with video chat?) and research how they meet their needs outside of tech (i.e., do they get information from a family member or institution?). If your solution must be tech-based, then explore options for a public-private partnership to enable greater access. For example, many carriers in emerging economies offer unlimited WhatsApp or Facebook access with their basic plans. Consider what service design improvements you might be able to make to in-person processes that may not require technology at all. Many complex challenges require systems thinking and a combination of process and technology solutions that are part of a service delivery experience.

For some additional information on this challenge, see my summary report on working with youth in Cape Town here.

Challenge 3: Anticipating your “savior complex.”

The savior (or messiah) complex is defined as:

“A psychological construct which makes a person feel the need to save other people. This person has a strong tendency to seek people who desperately need help and to assist them, often sacrificing their own needs for these people.” [Psychology Today]

When you are working with a vulnerable population, chances are they have experience with some “saviors” who have swooped in assuming s/he can “save them.” This can result in skepticism (low expectations), optimism (high expectations), or anywhere in between. (I’m sure my psychologist mother would suggest a few others.) It’s also important to note that this is an inherently disrespectful and emotionally violent, even if inadvertent, approach. Check your biases and enter into the work with humility. People are experts on their own contexts and often a co-design approach is best, where a user researcher & product designer plays the role of amplifying community knowledge and wisdom.

For example, Veterans who we interviewed about creating a tool to ease the transition to civilian life were extremely skeptical that the tool would ever actually be built or that it would actually work. Much of this was based on their lived experience of multiple agencies not effectively supporting them during their transition.

What to do: Conducting user research with Veterans during this project meant conducting interview acrobatics! Not only did we need to carefully construct our questions, we also brought someone trustworthy with us. For Veterans, we learned that a chaplain was considered a consistently trustworthy individual in military culture, and we ended up using “the chaplain” as our app persona. Do enough user research to understand the cultural context in which you’re operating, and tune your design process accordingly.

Closing

Please send me your thoughts! I’d like to create a much longer list of lessons learned and how-tos related to working with various types of vulnerable populations so that we can make more and better products and services.

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