Equity Framework Design
Design workshops for Health NZ Te Whatu Ora, working to develop a framework aimed at strengthening internal capacity to reach equity goals in public health.
8 min reading time
DURATION
12 weeks · 2024
CLIENT
TEAM
6 student UX designers
TOOLS & SKILLS
secondary research · workshops · UX writing · service design ·
design strategy · Figma
DELIVERABLES
research analysis · workshops · framework · tool prototypes
Project Details
Health NZ Te Whatu Ora identified the need for an Equity Framework to strengthen the internal working capacity of staff at strategy and decision making levels.
CHALLENGE
Health NZ Te Whatu Ora aimed to improve public health equity in Aotearoa NZ empowering their staff to make informed decisions that meet the health requirements of priority population groups. An internal framework document would provide direction for a set of proof-of-concept tools that could be routinely used by staff to assist them in their work. The framework aspired to be contemporary, relevant, contextual and inclusive to align with dynamic requirements in public health.
SOLUTION
Design workshops generate direction for a set of principles, which became the backbone of the framework. The framework was visualised into graphic assets by other members in my team to create reference resources. Further workshops identified potential areas for future relevant tools, which were prototyped as proof-of-concept.
Background Research
DESK RESEARCH
Our project began with desk research that probed into the current context of public health in New Zealand, including some of the formative documents central to health policy. I investigated some of the most recent and relevant documents relating to health equity, such as the Pae Ora (Healthy Futures) Act (2022), Te Pae Tata Interim Health Plan (2022), Pae Tū: Hauora Māori Strategy (2023), Te Mana Ola: The Pacific Health Strategy (2023), and the Women's Health Strategy (2023), among others.
Other research explored health's commitment to the principles of Te Tiriti o Waitangi, particularly with regard to Māori self-determination and effective stewardship. The Critical Treaty Analysis tool was considered valuable for evaluative purposes.
To better understand the role of frameworks and tools in public health, my team and I reviewed several tools already in use by Health NZ. These included Takoha (2022), Te Ara (2019), and HEAT (2008).
Women's Health Strategy (2023)
Te Mana Ola: The Pacific Health Strategy (2023)
Pae Tū: Hauora Māori Strategy (2023)
Te Pae Tata (2022)
SCOPING LITERATURE REVIEW
Myself and one team member co-led a scoping literature review that sought to summarise and synthesise academic and grey literature on health equity. Key terms were used to identify relevant material, which was disseminated among participants of the review group. Those involved summaries of the literature using a structured template format.
Vast quantities of data need to be analysed quickly. Using an analysis approach inspired by affinity mapping, this data was oriented according to its relevance to a set of questions that guided the research. This methodology meant data could be traced back to its source by stakeholders, fortifying its validity and relevance.
STAKEHOLDER ENGAGEMENT
A series of stakeholder engagement interviews were conducted with Health NZ staff. Knowing their experiences and pain points was integral to building a framework with longevity and integrity as the framework being developed was intended for internal use.
Results were drawn from this data by myself and one team member using thematic analysis. These were then integrated with the themes from the scoping literature review, amassing a pool of research to guide the generation of principles for the framework.
Workshop Series
The initial research phase identified three priority areas for workshop engagement with Health NZ employees. 12 participants attended workshops between 60-75 minutes long.
RESOURCE CONSTRAINTS
Workshop participants had limited time available to commit to the design workshops, so efficiency and maximising the time available was crucial. Activities were developed with our research objectives in mind, structured and timeblocked .
SENSITIVE CONTENT
We opted not to record workshop sessions in light of political considerations. Instead, we relied on activity data on our Miro boards and notetaking for reference. We met with participants before the workshops to build rapport and answer their questions. Guidelines and expectations for participants and facilitators of the workshops ensured that environment remained safe and fair for everyone involved.
ACCESSIBILITY
We chose to use Miro for our workshop sessions to foster collaboration as workshops were required to be online. We expected that participants would have varied experience and familiarity with it. An onboarding activity acquainted new users with some of the basic tasks that would be required from them during the workshop and this was sent out ahead of time with a pre-workshop pack.
The Miro onboarding activity was sent out to all participants ahead of the workshop series to prepare them with the basic skills they'd need to be involved. Each participant had their own board for practice.
WORKSHOP 1 / Principles
The framework's content was divided into principles. These are as research-led commitments to achieving health equity that provide direction and structure for the framework. Workshop 1's objective was to draw on the expertise and knowledge base of participants by identifying areas of importance that may have been missing in the literature.
WORKSHOP 2 / Framework
Our second workshop focused on how the framework might best communicate the information that had been gathered and analysed from our background research and workshop 1. Participants engaged in activities that clarified their perceptions and attitudes towards the data.
WORKSHOP 3 / Tools
Our Tools workshop aimed to find sustainable, effective ways of activating the framework. The tools would help Health NZ staff to implement the framework in real, tangible ways. Workshop 3 helped identify what tools were currently working for Health NZ staff and how practical support might help them in their roles to bring about more equitable outcomes in public health.
All workshop activities were built in Miro, accompanied by instructions. PDF versions (above) were emailed ahead of time to participants to give them an alternative to Miro.
Ideation
Our background research and workshops provided us with the content to develop and refine the framework's principles. These would later drive the generation of tool concepts and prototypes.
The framework's principles needed to reflect and stay true to our research findings, while also communicating key messages relating to health equity that would resonate with staff. We made iterative adjustments to the draft principles based on five key criteria (see below) to ensure they aligned with their context and purpose.
Population Health
Active Voice
Inclusive
Accessible
Evidence-Based
Each principle needed to be situated within a population health approach, be written in active voice, use inclusive and approachable language for accessibility, and stay close to the data.
PRINCIPLES
Concepts for principles were developed and refined as products of research, taking the themes from the scoping review and stakeholder engagements as foundational material for workshop resources.
Prototypes
Proof of concept tool prototypes would show how framework might be implemented in tangible ways. Referencing framework principles, we developed concepts for four tools accompanied by interactive Figma prototypes.
EQUITY LEARNING MODULES
I designed a proof-of-concept prototype for a series of learning modules for new employees that would be nested in Health NZ's intranet. The educational onboarding tool, which would be supplemented by in-person check ins, was founded on the idea of introducing the crucial educational content early within an employee’s tenure. Introducing staff to ways that they can reflect on their work with consideration to the needs of priority populations ensures a shared understanding of equity and goals to move towards at organisational level.
Research showed that new employees at Health NZ need to be aware of equity issues in order to make informed decisions within their professional capacities. We found that information was bottle-necked by communication channels in the organisation, resulting in lost opportunities to upskill staff and perform at potential. Educational modules as part of a wider onboarding plan take learners through key considerations in population health, as produced by existing staff with expertise in these areas.
Two pages were designed for the equity learning modules on Health NZ's intranet. They demonstrate the kind of content that research indicated would be most beneficial for Health NZ staff.
WORKSHOP REFERENCE GUIDE
At the time of this project, design workshops were not common practice at Health NZ. They were proven to be beneficial in this setting for generating new ideas and bringing staff together from various parts of the organisation. The structure and objective-driven nature of participatory workshops allowed staff to work together towards a shared goal, guided by collaborative tasks.
Myself and two team members drafted a document outlining UX best practice for design workshops for their continued application at Health NZ in the future.
Reflections
"The prep is most of the work"
Design workshops require careful planning to execute well. Relationships with participants need to be cultivated, which requires work before, during and after the event. Timing estimates should be considered before the workshop. Think about 'what if' scenarios that might eventuate from different activities, or how others might perceive them. There's a lot less chance of 'winging it' when there's many stakeholders involved.
"Be a chameleon"
The prep might be most of the work, but you have to be ready to pivot and change direction without fuss. The unexpected is bound to happen, so adapt to the environment and you'll have a better chance of success. When you expect that things will change, you'll be much better placed to tackle what's thrown your way.
"Empathy is a superpower (!)"
Design is rarely without people, and it's best if you try to relate to them. During this project, we were required to be considerate of many sensitive contexts that were at play. This added an extra layer of complexity, but staying human and bringing kindness first and foremost to each situation made it easier to navigate through the political tensions involved.
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PROGRESS REPORT
This case study focuses on my individual contributions towards this team project.
