Abstract
Marginalized areas are progressively at the center of socially responsive design, which has as its main consideration social impact and are the center of social innovation (Manzini, 2015). We explore the multifaceted challenges and obstacles impeding access to health services related to physical, mental, and sexual domains for adolescents living in marginalized areas. The framework used is administrative burden, operationalized as the function of the learning, compliance and psychological costs perceived by the citizens while dealing with policy implementation (Moynihan, Herd & Harvey, 2015).
This study unfolds within the context of the ProxyYoung project, aimed at approaching adolescents to health services and health literacy by co-designing tools and languages. The rationale is making our final users designers and innovators through a Participatory design approach, peer-promotion and peer-education intervention (Manzini, 2015).
We center on people aged 14-20: their extensive involvement in various formal and informal organizations positions them for timely risk detection and intervention (Spring, Moller & Coons, 2012). We focus on Serchio, (northwest Tuscany) where according to preliminary interviews, a surge in antidepressant prescriptions among adolescents and an under-served network of healthcare facilities necessitate attention.
The analysis of information collected from the adolescents was aimed at answering two research questions:
What are the main learning, compliance and psychological costs perceived by adolescents living marginalized areas?
Is co-design a bottom-up approach capable to reduce administrative burden and increase adolescents’ access to health facilities compared to previous top-down informational approaches?
We developed an action-research path following peer-to-peer and bottom-up approaches with the aim of innovating the actual information tools for adolescents by developing a digital health web application. By employing a qualitative approach nested within an action-research framework (Kemmis, McTaggart & Nixon; 2013), 50 adolescents were involved from local schools in multiple participatory design sessions to co-design the webApp that integrates both language and practices of young people when seeking services or information in health and social care services. After building a thematic analysis to get an empathy map and scenarios of AB experienced in healthcare, we launched the webApp and collected feedback from participants.
The research path is still ongoing, but preliminary results show how availability of a comprehensive digital tool to reach information on services and activities could be fundamental to improve preventive actions and care for the target group. Their participation in the design allowed to use a more effective language and to develop a tool that is recognisable for their peers, especially thanks to peer promotion interventions which deployed gamification techniques for the app’s diffusion. Next steps of this research will:
1) Assess which are the most visited areas of the webAPP
2) sketch the way the app is adopted and used
3) monitor the impact on process and outcome indicators, especially expecting a decrease of antidepressants prescriptions and an increased adolescents’ access to health services