How a new design process helps communities create their own health programs

It would appear that, by definition, social services and community health programs help the neighborhoods in which they operate.

But talk to community leaders on the ground, like Adair Mosley, CEO of Pillsbury United Communities in Minneapolis, and it becomes clear that while there is no lack of intention, designing services that truly reflect the needs of the community is a challenge. .

“Typically, social services are normative in nature, rooted in pride,” says Mosley, whose group serves underrated populations across town. “Whether it’s funding or a law, a service rarely gets to the heart of the problem. It’s about asking the right questions, and in social services, we often get the wrong answer, because we don’t listen.

By placing human-centered design practices at the center of a new way of creating local programs and initiatives, a large-scale pilot project wants to change the way communities design their own futures. A national effort funded by the Robert Wood Johnson Foundation that began last fall, Raising Places gives $ 60,000 to six different communities to help develop programs that support healthy childhoods.

One of the Raising Places Laboratories, organized by the Greater Hudson Promise Neighborhood group in Hudson, New York.

This initiative differs from the nonprofit organization’s usual programming because of its process. Using an engagement program designed by Chicago-based Greater Good Studio, a socially oriented design practice, community feedback doesn’t start with solutions, but with understanding the issues.

Comprised of a series of labs, prototyping sessions, and community discussions, the nine-month process is built around the idea that better understanding, better engagement and, ultimately, community-led design and not by experts create lasting and effective solutions.

Reflecting a larger shift in the health community that recognizes how health and community development are intertwined – that your zip code may play as or more a role than your genetic code – Raising Places is taking the next step logical and asks the community to diagnose their own challenges.

In August, Raising Places selected six groups from a pool of 156 interested community organizations: Mosley’s Group in North Minneapolis, Minnesota; Bighorn Valley Health Center on the Crow Reservation in southeastern Montana; Greater Hudson Promise District in Hudson, New York; The Rural Health Foundation of North Wilkesboro, North Carolina; Southern Market Community Action Network (SOMCAN) in San Francisco; and SBCC, Thrive LA in Wilmington, a community near the ports of the Port of Los Angeles.

Although the circumstances and areas of interest, ranging from access to healthy food to police-community interaction and air quality differ from group to group, all said that the program developed by Greater Good led to more in-depth information.

Community Improvement Concepts of Valley of the Chiefs in Montana

The idea for Greater Good stems from her experience with nonprofits, local governments, and what she calls mission-driven organizations. Grants for these tend to be restrictive, and while it is great when a nonprofit gets money to pursue a project or program that is right for them, the community often ends up adjusting their programs to match funding guidelines, stifling innovation.

“Designers have a unique power, but we often ignore it,” says Sara Cantor Aye, co-founder of the studio with her husband, George. “We try to share this power as much as we can.”

The Ayes came up with a different way of providing solutions: start with a better understanding of the problem, and ultimately end with a better solution. The Raising Places program and grant give communities the luxury of time and the opportunity to discuss and debate what they need most and implement a program based on community wisdom, not observations. exterior.

Each community has an organizer, a local service agency that facilitates events, or labs, and a design team made up of other organizations and local leaders. The groups began with a launch lab that brought the team together to focus on areas of research, which then led to weeks of observation, immersion, and discussion of the root causes and goals of framing. Then, a think tank helped the groups synthesize the results, brainstorm and create prototypes.

Finally, once the local teams have completed the 12 weeks of prototyping and iteration they are currently engaged in, they will hold the Action Lab in February, where they will review and evaluate the prototypes, and develop a plan to go. forward. Throughout the process, Greater Good Studio offers technical support and advice.

“We intend not to prescribe what has to come out of the process,” said Katie Wehr, senior program manager at the Robert Wood Johnson Foundation. “By funding a process rather than a specific intervention, we empower the people living and working in each community to shape the results and ultimately own them.

A suggestion from a participant of the South of Market Community Action Network

While many of the community leaders involved have already used some variations of human-centered design, or design thinking, in their work, they have found value in the Raising Places process.

Colleen Mooney, Executive Director of CCSC, Thrive LA, the organizing organization working in Los Angeles, has always made meaningful community engagement part of its process. A 42-year veteran of the group, who has raised children herself while on welfare, she has a more personal connection to the organization’s mission, helping residents gain economic stability. She finds that the lab process, especially reviewing prototypes, has given Thrive the tools to do what they already do, just better and in more depth.

“We didn’t really have concrete contact with the residents, and they didn’t have the ability to think deeply about how best to invest their time and money,” she says. “The core value of human-centered design is to have an open mind and be prepared to make others say your idea sucks. It is important.”

In North Wilkesboro, North Carolina, the Health Foundation has dedicated decades to improving rural health, helping fund helipads for remote hospitals and expanding dialysis treatments. According to Executive Director Heather Murphy, the foundation has long believed that “health is more than a doctor’s visit,” focusing on the social determinants of well-being and how to make lasting improvements. Childhood obesity, a problem with interrelated causes, has long been a central concern. The Raising Places grant allowed the group to do a better job of involving more voices in the discussion.

“People can be the architects of their own solutions, if only they’re invited to the table,” she says. “We understood that not everyone who needed to be at the table was at the table, and that people had strong opinions and community ownership, wanted to be part of the solution, but didn’t know how. “

This sense of empowerment is especially true for marginalized or ignored groups.

Dr Megkian Doyle, of the Bighorn Valley Health Center in southeast Montana, an organization that serves a large Native American population, says the community has been “over-surveyed and over-surveyed”, feeling they have given information. with little action or change in return. Raising Places helped them expand their community reach, leading to longer term relationships and difficult, but necessary conversations.

“It allowed us to listen to people we don’t usually listen to,” says Doyle. “Usually in Native American communities, people will ask the elders. We also went to ordinary parents, people who used drugs, and asked them about topics they had never been interviewed about before.

Recently, the Montana Raising Places team created a garden sign featuring the silhouette of people raising a teepee that they use to promote events and activities. The idea, says Doyle, is to want people to see that everyone is doing it together.

As Raising Places enters the final stages, testing ideas before turning the research into concrete ideas, organizers have expressed optimism about the results. Mosley says the North Minneapolis community is currently evaluating more than a dozen concepts and has heard from hundreds of neighbors throughout the process. Everything that comes to life will be representative of northern Minneapolis, he thinks.

“Human-centered design is rooted in humility. Start with the simple question of knowing what you need.

“We rarely have a funder who will fund the process,” he says. “That’s what is so exciting about this work. This funds a fair solution for the community and it saves money by starting to meet the needs that the community wishes to meet.

After the six groups hold their final meeting, the Robert Wood Johnson Foundation will host a national meeting in April, bringing together organizations and experts in politics and philanthropy to learn lessons from the program.

Mooney from Los Angeles said she wanted to see if this part of the process helps groups connect with funders who can help them continue their work, so that Raising Places can both support the work it does. started out while refining a better model of community engagement.

Heather Murphy of Wilkesboro is hopeful that Raising Places can show other communities a better way to envision their own brighter futures.

“Product designers discovered a long time ago that you could give a product to someone, they would tell you what they did and didn’t like about it, and you could make it better,” she says. “Why should the systems in our communities, those who care for our children and families, be any different? ”


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Abdul J. Gaspar