Baltimore City Health Department: Designing with Youth, Part I

How might we increase access to STI testing and normalize testing for Baltimore youth (15-24) through sustainable structural change?


Project in a Nutshell
Co-designing with youth to decrease STI infection rates in Baltimore City.

Summary
With funding from a 3-year CDC grant, the Johns Hopkins Center for Child and Community Health Research, Baltimore City Health Department, and the Center for Social Design at Maryland Institute College of Art have been working collaboratively to design, implement, and test design solutions to increase access to STI testing and normalize STI testing for Baltimore youth. Through additional collaboration with  collaboration with UChoose Youth Advisory Council and Wide Angle Media we explored youth attitudes toward STI testing and testing clinics, synthesized findings, and co-designed interventions with youth to test on youth audiences.

Challenge
Baltimore youth aged 15-24 experience an infection rate of chlamydia and gonorrhea that is more than three times the national average (CDC, 2015). In Baltimore City, the highest rates of chlamydia and gonorrhea are found among young black females between the ages of 15 and 19. A decade of research in Baltimore has shown that individual-level STD risk factors and behaviors alone do not explain increased risk for STDs experienced by specific groups. This suggests that larger social determinants of health are at play and that successful interventions will require structural-level change.

Project Team
Matt Barr, Jaynie Chartrand, Maria Isabel Garcia-Diaz, Devika Menon, Patricia Natalie, Rachel Serra, Irina Wong, and Molly Reddy with Faculty Advisor Becky Slogeris.

Process
Throughout the first semester, our team spent time mapping our own testing journeys, learning from experts in the field, reading case studies, facilitating ideation workshops with youth and adults, prototyping ideas, and presenting them to stakeholders for feedback. We also spent time co-designing with youth to identify their ideal STI testing experience– information delivery, location, access, staff, and space design.

 

Insight
Despite the high availability of options, the fear and anxiety about what happens during the testing process, how to navigate it, and potential outcomes can prevent youth from accessing these resources. So we asked, how might we create transparency around the testing process to reduce fear and anxiety in patients?

 

 

Icon design by: Devika Menon

Design Principles
Serve as allies to Baltimore Youth. Prioritize youth voices, and let them inform our design process. Normalize STI Testing; incorporate sex-positive thinking and destigmatize the process of STI testing. Rethink the negative connotations of STI testing and leverage them to discover bright spots. Make interventions sustainable and structural; design for the long term and be realistic with resource constraints.

Proposed Interventions
I worked with a classmate to develop the initial mockup for a web-based application that would replace paper sexual health history forms in a format that youth feel comfortable using. Additionally, the forms would include personal interest questions that would serve as rapport-builders between doctors and patients. This grew into Tap It, Test It, a group effort to design a web-based application that accompanies youth throughout their entire testing journey.

App prototype design by: Rachel Serra

The Results
During our final presentation of fall semester 2016 we collected input from community members, youth, and partners on what they liked about the 12 different prototypes we presented and the potential barriers to implementation. Based upon their input the development and implementation of final interventions continued during spring semester and can be read about soon on this blog!

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