Working with Southwark Council to improve Health & Wellbeing Outcomes
In February 2020, at Comuzi we embarked on a really interesting journey with Southwark Council; a discovery and alpha project exploring the hypothesis that digital technology could improve health and wellbeing outcomes in the borough by empowering residents to make healthier lifestyle changes. We now look back at the project and what we have collectively achieved.
As Mia Peters, Digital Service Design Manager at Southwark made clear at the start, there is evidence showing that digital public health tools such as Couch to 5k appear to have had huge success and are extremely popular, but that it isn’t clear how these national tools and services meet our residents in Southwark specific needs, particularly Southwark’s most deprived communities.
The team wanted to understand how they could maximise the power of digital to engage and support residents, whilst proactively reducing inequality. They wanted to understand needs holistically from a resident viewpoint, particularly those from more deprived backgrounds where the perception is that they might be digitally disengaged; and whether residents saw a role for the council in supporting them.
Framing/Kick Off
A month before lockdown was announced, we spent the first day establishing project foundations, addressing & mitigating risks & highlighting what the council wanted to achieve with this project, a process we call ‘Framing’. We called ourselves the ‘live well’ team.
We also discussed potential ideas & placed them in a parking lot in our living deck.
Ideas are typically assumptious, so it was important as a team to talk through these & revisit them in line with credible research insights, as opposed to moving forward with unvalidated perspectives.
Our challenge question, set at the end of the day was:
‘How might we use research driven insights to inform how we could use digital to deliver impactful health and wellbeing improvements for residents?
Engaging Residents
For our research we carried out two focus group sessions with six residents each spread across the borough, with five subsequent interviews to probe further on our focus group discussions.
We ensured a 50/50 gender split, with at least 50% being from BAME backgrounds & 15% above 65, recruited from across the borough with a focus on more deprived areas such as Peckham. Everyone had multiple unhealthy lifestyle behaviours (drinking alcohol, smoking — not just cigarettes!, overweight, inactive), struggled with their well-being, and many were already living with long term health conditions.
Our discussion topics included:
- What a healthy lifestyle is (mental, physical and sexual health)
- Motivation to make healthy lifestyle changes.
- Residents relationships with location/physical spaces & how that may inspire better behaviour
- Mobile phone usage, usefulness and the feelings associated with phone applications ie texts, social media, etc.
We also enabled Southwark to test a new public health brand to support health improvement in the borough, testing out multiple brand propositions to ascertain what resonated best with residents and inspired action, to be used by the borough to promote relevant public health services. Based on our research, this was the preferred brand:
After analysing the research & compiling our findings, some key insights were:
A key point that cut across everything was people’s mental health and well-being; this was the biggest driver of people’s unhealthy choices, but was also the main motivator to make a change. They wanted to be happier, they wanted to make positive changes to their lifestyle behaviours so they could better manage their lives, but it wasn’t necessarily what your dr would advise first — smokers were more inspired to start eating more fruit and veg or move more to improve their wellbeing. This is a really important message to take back to the public health team — to design solutions that meet people where they are, not where we might want them to be.
Based on these insights, we worked with the council to create design principles that would guide our ideation process, making sure we were creating a service that was tailored to Southwark’s residents and their needs.
Some of these principles were:
“Creating the right support conditions to help people thrive”
“Empowering them to make sustainable change vs short term changes” &
“Understanding that mental health & motivation underpins behavioural change”
Ideation during Covid-19
Working with the council, and a range of national experts, local stakeholders and local residents, we also carried out our first online ideation sessions, as the country had gone into lockdown by this point! Although we had a large number of peeps in the meeting, we were able to lead an extremely interesting set of two three hour sessions, using fun exercises such as Crazy 8’s & Innovation Battlefield to crunch down on two final ideas to prototype in low fidelity:
An online community platform enabling residents to build healthy habits in 30 days.
A mini site offering information on health services, recipes & support groups, signposting them to the right content.
Near the end of this post, I’ve included learnings on navigating online creative sessions and consistent learnings we’re implementing as we continue to operate under the midst of a global health pandemic.
Prototyping
For our low fidelity prototypes, we focused on service advertisements, aiming to test the core value proposition & whether residents actually wanted it. Here’s some notes from This Is Service Design Doing that guided our thought process along with some posters Alex created:
We tested the low fi prototypes with five more residents who hadn’t participated in previous research; we met residents where they felt most digitally comfortable, using whatsapp & google meet to improve accessibility for those who may have been less digitally literate & ease of communication.
Residents were engaged, they saw an important role for the council and wanted a digital — predominantly mobile — first approach to support. Feedback from the residents encouraged us to take the community platform to the next stage & we provided recommendations to improve the council’s current public health offering & signposting so residents have easier access to current health services.
High fidelity prototyping involved:
1. Developing user personas based on low fi test insights
2. Site Maps, user flows, UX strategy blueprints &
3. Loadsssss of design & code.
We took inspiration from various 30 day challenges such as the New York Times 30 day well challenge & Good Housekeeping’s 30 day Mental Health Challenge.
TakeCare Southwark Alpha Prototype
We tested our high fi prototype with 5 residents and here’s some of what we learnt!
Southwark Council are now working to progress this work from a discovery and alpha project to a beta service.
Lessons from conducting remote creative sessions with the council (using our ideation sessions as an example)
We’ve learned a lot of lessons navigating a local government service design project during this pandemic. We took a precautionary approach to remote sessions; staying mindful of accessibility, wellbeing and creativity we successfully completed remote strategy and co-creation sessions with Southwark Residents and Southwark Council’s Public Health Team.
In preparation for the remote sessions we identified two challenges:
- How do we get our audience online, from residents to council staff, as easily as possible?
- How do we creatively interact with people in a digital space?
After speaking to Twitter and looking at various tools we decided to keep things as simple as possible.
Mindful that residents were using mobiles for our sessions & we didn’t know the laptop specs of Council team members we made short preparatory decks for participants with embedded Google Meet links.
Sending this deck out two hours before our ideation sessions for example saved a lot of work in ensuring the 15–20 attendees got online without any trouble.
In adapting our sessions to be remote we chose to use Google Meet and Google Slides, enabling record functionality & screen sharing to large audiences.
When we thought about our requirements to stay creative in a digital space the only thing we really needed, which wasn’t immediately obvious, was a sticky note. When we realised this, we made a yellow text box and added drop shadow.
This made it possible for many participants to contribute their thoughts individually in a communal space. We explored other collaborative uses of Google slides beyond sticky notes for our sessions. We also created a space where participants could simply dot vote on their ideas dragging a dropping shape we created in real time.
Dot voting on digital sticky notes
During our ideation sessions we had two facilitators and assigned roles, with one presenting and the other collecting notes from participants who were only listening in. At regular intervals during the ideation session we asked participants to email in their suggestions so their contributions could be added to the living deck.
This setup was essential in managing the flow of the session especially as we had such a large number of participants.
Timing
A lesson learned was on timings and length of online creative sessions and the types of activities required to keep high engagement. After experimenting with various interval sessions we’ve found we keep teams most engaged over a 50 minute period, anything longer causes screen fatigue.
Breakout Sessions
A limitation if you are choosing to use Google Meet over another provider such as Zoom is that you have to plan for breakout rooms. Our way around this was to schedule another meeting in parallel to our ideation session and provide the link clearly in our presentation and the chat function.
This was an effective method to split the group and have some more detailed discussions about specific ideas we had concepted, but break out rooms are still better.
When coming to the close of each exercise when participants feel they are running out of time to share their feedback we also provided alternative methods to collect their viewpoints. We kept the chat function as an active place where we could capture questions from more silent participants & we encouraged participants to use sticky notes and slides whenever they needed to.
Our biggest lesson is do not overestimate what you can get done in an online session. Timing when you have a big group online can prove challenging especially when talking through ideas. In this setting we found it harder to give cues and our lesson is to timebox every exercise informing the group of the time available before the exercise starts.
We are constantly adapting but this is to ensure we keep the quality of our work high during these times. I am extremely proud of the team and what they have achieved over the last week. I am proud how we are more determined under the circumstances because of how important the project brief is to improving the health and wellbeing of Southwark residents.
Moving forward, our next challenge is how do we maintain energy across remote creative sessions?
We are exploring taking more active breaks, stretching and prioritising tasks which can’t be done outside of a collaborative session.
Special Thanks to Jo & Mia for their amazing passion, dedication & help throughout the process, and for trusting us to continue the project during the current health pandemic.
Many thanks to all the residents for their enthusiasm, their honesty in sharing their lives and working proactively with us to genuinely co-create solutions; and of course Southwark Council for giving us the opportunity to work on this.
Written by Rich & Akil
