Design to Improve the Health Education Experience: Using Participatory Design Methods in Hospitals with Clinicians and Patients

ABSTRACTPoor communication in health is a persistent problem. Transient conversations, extreme time constraints, stress, trauma, clinical factors and the restrictive environment make effective communication between health professionals and patients difficult to achieve. Children, especially, are often positioned as passive participants in the healthcare paradigm. It is hypothesized that providing children with visual health information (well-designed, accurate, age appropriate, and presented in a way that they can understand,) can empower them to take charge of their health and well-being. For visual health education materials to be effective, accurate, and engaging, they need to be designed with input from design practitioners, health experts, and the target audience. However, constraints within the health field, such as restricted access to patients, make this difficult. Furthermore, when children are involved, ethical and practical obstacles can hinder the process. The research presented in this paper navigates the complexities of the health field and presents a realistic participatory design model that responds to the specific challenges associated with designing in a healthcare environment. The efficacy of the approach is demonstrated through successful designs and positive health professional feedback.KEYWORDShealth communication, health education, participatory design, qualitative research, user-centered designINTRODUCTIONGraphics are not generally seen by health authorities as the primary way of communicating information to children (Dowse, 2004), yet it has been shown that picture-based messages are preferred by most people (the "picture superiority effect") (Dowse, 2004; Katz, Kripalani, & Weiss, 2006; Lidwell, Holden, & Butler, 2003). As well as being more accessible, visual materials that are distributed to patients are a permanent source of information (Dowse, 2004; Groves & Fitzgerald, 2010). They can be referred to in the patient's own time, making them less transient than face-to-face verbal communication. The material can be viewed and comprehended at a pace dictated by the patient (Klug Redman, 1993; Purtilo & Haddad, 2002), rather than received by verbal communication which must often be comprehended within time constraints.The literature surrounding visual communication design for children is sparse, with the majority of studies being market-research oriented and commercially driven. While it is important to understand the target audience and their motives, greater importance should be given to children's comprehension of vital health information. It has been demonstrated that young patients are less anxious if they are told what is going to happen to them clearly and honestly. They find it useful to know the order of events (Lloyd & Bor, 2009, 112) and are more interested in concrete information on current experiences rather than possible consequences in the distant future (Rapoza, 2003, 260). It may be argued that children lack the maturity to understand complex health information. Children may be perceived as lacking the knowledge and experience needed to make informed choices (Buckingham, 2011). Furthermore, issues such as low health literacy and age-related cognitive abilities may impact children's comprehension of presented information (Terre, 2009). There are also several psychosocial factors specific to children that may affect their healthcare experience. For instance, child patients are dependent on a parent or guardian in relation to medical care and decision making. This lack of power positions child patients as passive bystanders in the healthcare paradigm (Lambert, Glacken & McCarron, 2010). In addition, the culturally defined power dichotomy that exists between patients and health professionals adds to the passive positioning of the patient. However, by making health information available and accessible, we can empower child patients to take control of their own health, giving them a sense of independence and competence which may foster better health outcomes and psychosocial well-being. …