Designing For Equity
Creating a visual framework and tool set to promote equitable health outcomes for Māori and Pacific communities in Aotearoa New Zealand.
Public health equity IN NEW ZEALAND
THE CHALLENGE
Public health focuses on the health of the population as a whole. It works to initiate prevention strategies and identifies issues that can affect the larger population in society.
Our capstone project student group worked with Health New Zealand | Te Whatu Ora (National Public Health Service), to develop a framework and conceptualise supporting tools to foster the advancement of equitable public health outcomes for Māori and Pacific peoples in Aotearoa New Zealand. The framework and supporting tools proposal was designed to help internal staff at NPHS frame their thinking in planning, service delivery, commissioning, and review activities.
The goal of this project was for NPHS’ diverse range of internal staff to be able to apply this framework in their specific fields, to ensure population health equity can be promoted at every stage. To achieve this, the framework and tools needed to:
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Promote population level health equity in daily work.
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Be applicable to all priority groups.
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Uphold and honour Te Tiriti o Waitangi.
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Be embedded into the NPHS culture as a way of being.
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Be robust and flexible enough to be used in any context.
My role
Our capstone project group consisted of 6 Victoria University Master of User Experience Design (MUXD) students. I was involved in primary and secondary research processes, conceptualising, and affinity mapping activities. My focuses for this project were the development of our design workshops and the design and writing of the framework
SCOPING REVIEW + Interviews
Process
To gain a deeper understanding of the current NZ public health landscape and current discourse on health equity, our team conducted a scoping review of academic papers and grey literature related to public health, equitable access, Te Tiriti o Waitangi, Mātauranga Māori, disabled communities and equitable experiences in public health. Common data points from the readings were mapped and saved to bring forward as potential framework themes.
Additionally we conducted stakeholder interviews with managers and operational kaimahi with community interaction. This included regional and national teams as well as health equity and research experts. Feedback from these engagements was analysed to uncover themes that had not been identified in the scoping review.
The themes uncovered in the scoping review and interviews were then organised to bring forward to our design workshops with internal NPHS participants.
DESIGN WORKSHOPS
A series of three design workshops were held to facilitate the creation of the public health framework and also to help conceptualise a set of tools that could help in the implementation of the framework. Due to internal factors, it was necessary that the workshops be held online. To meet this challenge, our team developed
interactive Miro workshop "spaces" to help create common places where participants could organise thoughts, whiteboard, and discuss topics with group members.
Additionally, onboarding packets were made to familiarise participants with the overall process of the workshops, as well as the online tools we would be employing on workshop days. We ensured workshops included time for icebreakers and group discussions to help participants feel more comfortable with participation.
Screenshots of the Miro workshop spaces from our first design workshop.
The first of the design workshops focused on getting our participants to evaluate the public health themes gathered from our scoping review and stakeholder interviews, ranking them as more or less relevant and important in terms of improving public health equity. The workshop also focused on letting participants address any gaps in or issues with the presented themes.
The second workshop took the themes deemed most important and relevant from the first workshop, and prompted the participants to organise related themes into groups - an affinity mapping adjacent activity . These groupings were used to build the principles of the final framework.
Finally, our third workshop focused on tool ideation. We prompted participants to identify existing tools used in their work to explore how similar methods could be adapted to support implementation of the framework and principles.
From affinity mapping the results from this workshop, we learned that there is a need for better ways of sharing resources, data and tools across directorates and regions. Face-to face interactions are needed to strengthen work practices in relationship building and learning. We learned that data collection methods need improvement, and needs to be shared back with communities to improve health literacy.
THE FRAMEWORK + TOOL PROPOSAL
SOLUTION
The NPHS public health equity framework features the five principles drafted from the information gathered from our research, stakeholder engagements, and three design workshops. The framework visual references a kauri pod, with five seeds representing the principles created from our workshop exercises. Kauri, whose health is a sign of the well-being of the forest and people, is a metaphor for the framework’s intent.
Through affinity mapping of workshop responses and group ideation sessions, our team created a proposal for tools to support framework implementation within Health NZ.
TOOL CONCEPTS:
Design workshop guide
A workshop learning was that connecting and working together across directorates in NPHS is vital and is most effective when done face-to-face rather than online. Our proposed guide advises NPHS staff on designing and facilitating workshop-type interactions.
Key topics include:
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Encouraging ideation
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Cultural safety and engagement
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Activities for problem solving and ideation
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Analysing results and pattern finding
Kaimahi onboarding
There is a need for basic national training to create shared understanding of NPHS priorities for new and existing kaimahi. Online training was recommended to be accessible, interactive and supported with face-to-face conversations.
Features:
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Active learning modules
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Note-taking sections
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Short educational videos
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Contact details to connect to experts
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Links to relevant information and resources
Data accessibility
NPHS staff agreed that community access to digestible health data supports heath literacy. Access to and data sharing from within communities can help foster empowerment.
Features:
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Simple and clear visualisation of data with short summaries to help bridge language barriers
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Search filter to pinpoint data of interest
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Feedback forms to help communities assist filling in gaps in data