gustafson&spruitmetz 6.21.11
TRANSCRIPT
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Principles of mHealth Design I:
What are we doing and who are we doing it for?
David Gustafson, [email protected]
Donna Spruijt-Metz, MFA [email protected]
mailto:[email protected]:[email protected]:[email protected]:[email protected] -
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Outline
What are you doing? (Scope)
Who are your internal and external customers(and why is it tricky to identify them)?
Why is it important to understand yourcustomers, internal and external?
How do you get into shoes of the customer todevelop systems that best fit the customer?
How do you use the knowledge that you get fromall this?
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How this session works
Take 5
Nuggetology
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Scope
Be creative, open-minded
And PRECISE
(With the option to build on.) Scope will depend on customers
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Identifying the internal customer
Whats an internal customer?If you are an engineer, the health scientist on your
team might be an internal customer (i.e. your owncolleagues and staff)
Your university, tenure committee, department chair,or higher-ups in your business might be your internalcustomers.
Your funders might, in some sense, be internalcustomers
Internal customers might have differentexpectations, needs, desires, timelines andendpoints in mind
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Conflicts between Customers
Is it the most
up-to-date
technology?
!t
Has the
accelerometer in
that cell phone been
validated?
Proof of concepDone!
Promotion =1st AUTHORSHIP
IN JAMA
But I need to be
able to take this
out into the
field and use it
with REAL
PEOPLE!!!
OMG(oodness)!!
TRANSDISCIPLINARY
MOBILE HEALTH
SYSTEMS DYNAMIC
RESEARCH WOW!!
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Identifying the external customer
Lets say we are developing a second skin ofsome type for obesity interventions in urban
inner city Los Angeles youth.
Who is the customer?
Beyond developmental stage (impacts: Cognitivefunction and emotional control, thus learning
styles, acceptability of various functions) Beyond ethnicity (impacts: Approach, acceptable
diet and activity recommendations, language)
Beyond SES (impacts: Everything)
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Identifying the whole customer
EVERYTHING IS A SYSTEM eliminates a lot of discussion (arguments?) about what is
or is not a system.
EVERY SYSTEM IS PART OF LARGER SYSTEMS opens creative solution space by seeking solutions to
achieve bigger ends
EVERY SYSTEM IS MADE UP OF SMALLER SYSTEMS provides a way of considering all aspects of reality
EVERY SYSTEM EXISTS IN PARALLEL WITH OTHERSYSTEMS
is a reminder that independence of systems is an illusion
Dr. Gerry Nadler
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Dan Stokols Early Vision of Socio-
ecological Systems
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Patrick, Intille & Zabinski
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Second Skin in a System
The case of KNOWME
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Your case study
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Why is it important to understand
customers, internal and external?
Assets
Deficits
Perceived (and empirical) needs
Culture
Cognitive & emotional development
Social network, influences, family, environment
What is acceptable? Desirable? Affordable? Can they use it, will they use it, will it motivate
them, whats the hook (points of engagement)
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Your case study
Surprises about your customers that impactdelivery, messaging, technology, displays, data
representation.
(what kids will wear, what they want to hear)eMOTE
(Enhanced Minority health Outcomes Through Entertainment)
H d i h f h
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How do you get into shoes of the
customer to develop systems that
best fit the customer? Community Based Participatory Research (CBPR)
Systems Science: Group Model Building (GMB)
Playtesting
Idea building groups
Focus groups
Nominal group techniques
Walkthroughs
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CBPR Recognizes the community has it own identity Builds on strengths & resources within the community Facilitates collaborative coalition Promotes capacity building (everyone collects data) Emphasizes local relevance of public health problems Recognize and attend to the multiple levers of health
and disease
Involves systems development through iterativeprocesses
Disseminates findings and knowledge gained to allpartners and all partners will be involved in thedissemination process
Involves a long-term process and commitment
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Which Groups Come to the Table?
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Which Issues Get to the Table?
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Birds-eye view of CBPR
Select the community unit of identity
Select your initial partners individuals, representatives oforganizations or both
True dialogue with partners (and others that should be at thetable) before the proposal is written and throughout theprocess
Identification of WHAT, HOW, WHO, WHEN WHAT research question HOW research design WHO who is responsible for what? WHEN - timeline
Sustainability plans from the beginning
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From Systems Science:
Group Model Building
A form of group decision support, involving agroup of stakeholders with a complex problem
Group facilitation
Model building and refinement in publicSimulation of scenarios and options
Extensive facilitated discussion and analysis
Facilitated policy design and decisions
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Nuts and Bolts
Management team (10-20) with aModeling/Facilitation team (2-4)
Four full days over 3-to-4 months
Extensive between meeting work
Rapid prototyping of model with finishedsimulation product
Facilitation of implementation plans
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Group Model Building (GMB)
Group model building is a process in which team members exchangetheir perceptions of a problem and explore such questions as: what
exactly is the problem we face? How did the problematic situation
originate? What might be its underlying causes? How can the problem be
tackled? (Vennix 1996, p. 3)
Group model building, as we intend the phrase, signals the intent toinvolve a relatively large client group in the business of model formulation,
not just conceptualization (Richardson and Andersen, 1995, p. 1)
Why would one want to involve a large
number of people in the modeling process?
Hovmand & White ISSH 2011 Pittsburgh 22
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Reasons for using GMB
Insights come from modeling process Likelihood of implementation Participation as an intervention
Social construction of new realities
Models are only artifacts of that process Changes in mental models of participants
Dignity of risk People should have the opportunity to be involved in designing the
systems that are intended to benefit them
Theory building Grounded theory, synthesis of existing theories from experts
Information source Structure, dynamics, nonlinear relationships, parameters, policies and
interventions
Hovmand & White ISSH 2011 Pittsburgh 23
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West End Neighborhood, St. Louis, MO
Residents and community leaders from West End Neighborhood work with researchers and
staff from Washington University and Transtria LLC to build a model to understand social
determinants of childhood obesity and plan new programs and services.
Hovmand & White ISSH 2011 Pittsburgh 24
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Example from a causal mapping
exercise focusing neighborhood safety
Sports teams
using park
Playing soccer
Kick ball
teamGetting sports
teams together
Gangs
using park
-
-
Policesearches
Finding dope
Cancelling
program
Connecting to parks
outside community
Condition of parks
Rusting chains-
City maintaining
parks
+
Educational
systemHigh dropout
rate
-
Educational
background
Meaningful
employment
Time on hands,
nothing to do
-
+-
JobsMaintain home
+
Streetcleaning
Crime
Police not
responding+
Policeman on
foot patrol
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Kids not havingfathers in home
+
Gangs
Parents can't
control kids
Not disciplining
kids
+
+
Community
acitivties
Police+
+
+
Neighborhood
pride
Neighborhood
schools +
Churches comingtogether
+
Vacant houses
and buildings
+
Getting loans to
improve homes
Condition of
buildings
Tearing down
houses
-
+ +
+
How do you get into shoes of the
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How do you get into shoes of the
customer to develop systems that
best fit the customer? Community Based Participatory Research (CBPR)
Systems Science: Group Model Building (GMB)
Focus groups
Playtesting
Idea building groups
Nominal group techniques
Walkthroughs
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Focus Groups: The Basics..
Facilitated (trained moderator) Group Discussion 8 to 12 homogenous members, who dont know each
other
Audience segmented by level ofuse/exposure/demographics
Rely heavily on open-ended questions and reflections Participants usually paid & fed, sometimes transported Process is audio- or video-taped (with consent) Heavily influenced by group interaction Minimum of 2-4 groups per segment
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Development Process Fact Finding
Review Existing Materials, Literature Review
Identify Possible Audience Segments (SOC, SES strata)
Interview Opinion Leaders (Primary Data)
Convene Expert and Lay Advisory/Review Groups
Exploratory Focus Groups (Primary Data) Individual Interviews
Develop FIRST WHACK
Review by expert and lay groups
Pre-Test
Review and Revise Pilot Test: Expose participants under trial conditions/obtain feedback
Revise
Implement: Evaluate Efficacy/Effectiveness
Post-implementation interviews/Focus groups
Stratify by participants level of change
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Exploratory Focus Groups
Explore target audience experiences,thoughts, feelings, attitudes, fears, conflicts,pros and cons regarding the behavior or issue
Approach audience with blank canvas
Theory-driven Moderator Outlines
Purposeful sampling
How do you get into shoes of the
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How do you get into shoes of the
customer to develop systems that
best fit the customer? Community Based Participatory Research (CBPR)
Systems Science: Group Model Building (GMB)
Focus groups
Playtesting
Idea building groups
Nominal group techniques
Walkthroughs
How do you use the knowledge that
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How do you use the knowledge that
you get from all this?
This may seem obvious. But it isnt
How will you analyze the data?
Lay out software, mixed models, impact of one setof interviews/playtesting sessions/ etc. on the
next iteration of (game narrative, look, layout,
sensor set, user interface, data display, what
else?) How will you incorporate your findings?
Lay out feedback and iteration plans
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Incorporating Findings
Case study from the simple to the sublime
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And now for something completely
different!
Dave Gustafson!