The students in UW-Madison’s Master of Design + Innovation (MDI) program were facing a real-world challenge in need of solving.
The client, Wisconsin Institute for Healthy Aging, was not effectively reaching the state’s Black residents who have diabetes. In fact, while an estimated 21 percent of the state’s Black residents are living with diabetes, only about 3 percent were participating in the evidence-based Healthy Living with Diabetes program. Why? And what could be done to improve the participation rate?
The 15 students in MDI’s fall 2021 capstone course took a deeper look. Using a human-centered design process, they engaged with community members to uncover unmet needs and to design meaningful ways to create a more inclusive and effective program.
It all began with a “looking in” day – a deep-dive into racism in health care led by Carola Peterson-Gaines who advocates for BadgerCare and Medicare patients, along with Dr. Susan Passmore who directs the Collaborative Center for Health Equity. The students also learned about diabetes from Dr. Olayinka Shiyanbola, an associate professor of pharmacy whose research focuses on the perception of diabetes and medications in underserved populations.
At the heart of the project’s success are the insightful interviews the students conducted with more than 20 stakeholders. Students met with Black Wisconsinites who have diabetes, caregivers, nurse educators and physicians, as well as facilitators of the self-management program, leaders in the Black community, and community health workers. One group even followed a diabetic meal plan for a week to experience how difficult it is to change their own eating habits.
“What I love about the design thinking process is that it leads students to take a wider look from all dimensions,” said Michelle Kwasny, founding academic director of MDI and instructor for the capstone course. “As they consider more points of view, students develop compassion and a motivation to help – and that’s powerful fuel, especially when working within complex systems like health equity and racism.
MDI student Chris Thompson said that after talking with people with diabetes, he gained an understanding of motivations that go beyond one’s own health.
“It was surprising to learn that most participants felt most satisfied when they were able to help others,’’ Thompson said. “We also learned that it’s critical to match the language around diabetes to the audience and to ensure the dynamic between educator and learner is one of respect; equal footing is key to participants making lasting positive changes.”
The power of social proof was another insight they gained. “We discovered that if Black residents can see their friends and community members having success with the program, the goals will seem more realistic,” says Thompson.
Solutions by Design
Motivated by these insights, Thompson and his team proposed creating a “wrap around” event that pairs a graduation ceremony for those who’ve completed the six-part class with an orientation event for incoming participants, enabling the new cohort to connect with mentors in their community.
“Our vision is that this can compound over time. As the network of graduates builds, we’ll organically see more people in communities becoming more knowledgeable about diabetes self-care, ‘’ Thompson said. “Showcasing success to people just starting out will be an effective way to build that network.”
Building on the importance of social networking, another team proposed moving the learning segments to a podcast series, freeing class time for collaboration and exchange among participants. Another group created a diabetes care package, provided when people are first diagnosed, that contains helpful products and knowledgeable community contacts.
The fourth group tackled the issue of making health care providers aware of the program, proposing a website redesign to add patient resources and an easy way to refer newly diagnosed patients to the program.
“We discovered a gap between diagnosis and enrollment, with no referral system in place, and realized a key stakeholder was being overlooked: health care educators,” said MDI student Emily Phelan. Her group worked with physicians, nurse educators and others to create a better way to refer patients.
Dr. Shiyanbola sees the potential for establishing a referral process through health educators and redesigning the website. She is submitting a grant proposal to examine if these change ideas can improve the reach of the program. “I was impressed with the students’ ability to understand the problem and to use what they learned to inform ways to solve a critical issue for advancing health equity,’’ Shiyanbola said.
Dr. Jane Mahoney, professor of medicine and Chief Medical Officer of the Wisconsin Institute on Healthy Aging, noted that the students’ solutions clearly resulted from careful listening. She cited their engagement with community members, creativity in problem-solving and professionalism. “These design solutions may be quite useful in increasing the reach of the Diabetes Self-Management Program to groups facing disparities,’’ Mahoney added. “I see great value in using design thinking to help deliver better health care and reduce disparities.”
Mondira Saha-Muldowney, who manages the Dissemination and Implementation Launchpad at the Institute for Clinical and Translational Research (ICTR), where Mahoney is director, connected the students with their client. Because her job involves translating research into clinical practice, she attended several of the sessions, advising students at various steps in the process. Their solutions have “huge implications for health care,” she said. “They asked the right kinds of questions. We were very impressed with the quality of the students and their empathy.”
Powered by Design Thinking
Thompson and Phelan are part of the second cohort to complete the year-long MDI program, which incorporates courses from five schools and colleges: Human Ecology, Engineering, Business, Art, and User Experience. The majority of courses are project-based and students can pick their electives based on career paths that may include product design, communication design, user interface and user experience design, and design strategy.
“It’s a hands-on program that encourages students to think, build and learn about the world through experimentation and iteration,’’ said Kwasny.
Phelan said the experience has exceeded her expectations. “I’ve learned about leadership styles and how to work well with people from different backgrounds, ‘’ she said. “I had five years of work experience in consulting and couldn’t think of a better time to do something like this. The interdisciplinary component – seeing design through different lenses – has been huge.”
One of Phelan’s favorite courses involved getting to use the tools in the Wendt engineering “maker space,” ranging from a CNC router to a 3-D printer, to design and build a programmable lamp. “I love that you gain a lot of skills while customizing your learning experience. I’ve gained an entirely new perspective on design,’’ she said. “It’s equipped me with skills that I’ll be able to use forever.” Phelan said she enjoyed working with peers who come from many backgrounds, all with different expertise to contribute.
“I like how intimate the program is – with only 15 people, you really get to develop relationships,’’ said Phelan, age 27. “We have a big age range, some students came straight from undergraduate, and some have had 5, 10, or 20 years of work experience. It’s been wonderful, learning from their experiences, sharing your own, and diversifying your perspective.”
Thompson, who returned nearly 20 years after earning his undergraduate degree from the School of Human Ecology, had pushed for including more human-centered design into his jobs as a product engineer, project manager and product manager, with limited success.
“There aren’t many schools trying to do something like this, and I’m thrilled about this program being in Madison,’’ said Thompson, who learned about MDI through his Human Ecology alumni newsletter and commutes to classes from Milwaukee.
Thompson anticipates the demand for an interdisciplinary design approach will only grow, “as organizations are forced to update to serve a broader, more diverse, and more self-aware population, rather than the traditional way of designing products.”
In a way, the program built on his hybrid undergraduate major, which included engineering classes, and was approved by Joy Dohr, human ecology emerita associate dean of student affairs. “It speaks to the unique nature of Human Ecology that the school helped create this program,’’ Thompson said. “It draws on other parts of the campus to create something that is greater than the sum of its parts.”