August 2018 - March 2019
Context
In South Texas, The Rio Grande Valley (RGV) is home to some of the worst statistics regarding the determinants of health in the US.
30.7% of adults in the RGV are diabetic as compared to 12.3% nationwide
The region is ranked the most overweight and obese regions in America with 36.9% of the adult population being physically inactive and 44.9% considered obese
52% of the RGV is considered a food desert
32.6%- 38.8% of residents live under the poverty line
While a tremendous amount of money goes into clinical care (i.e. medical technology, hospitals, insurance, etc.), comparatively, only a minor fraction goes into health prevention (public health).
Most resources go to the rescue team trying to save people from drowning in the river, but there should be more focus upstream, keeping people from falling in the first place. Image Source
The Organization & My Role
Hermana Luna is a nonprofit organization whose mission is to provide health education, support local sustainable food production and access in lower socioeconomic areas, and empower communities to advocate for systemic change in the food production practices. While the team is extremely well versed in gardening, nutrition, and mental health, they want their programs to evoke authentic community buy-in, and have the ability to scale.
I was brought on as a Human-Centered Design consultant to help strategize their services by facilitating and participating in the research, ideation, prototyping, and initial implementation phases. The team is composed of the two founders, an attorney and a psychotherapist, and myself.
Research
Objectives
While there are many complexities in tackling the public health crisis in the RGV, our major objectives during our research were to:
Learn from the successes, struggles, insights of already established public health organizations to help accelerate Hermana Luna’s learning curve
Empathize with our target population by understanding their daily lives and their views and behaviors within health, sustainability, and community.
Stakeholder Interviews
We conducted twelve interviews; six with community members and six with experts/organizations.
Community Members: The community members we chose had either made a switch to plant-based diets or had shown interest in wanting to change but had not made any significant changes.
Experts/Organizations: The experts/ organizations ranged from The Food Bank of the Rio Grande Valley to the North Shoal Creek Community Garden to the statewide public health and wellness nonprofit It’s Time Texas.
Analogous Inspiration
Knowing that behavior change and community building were going to be important aspects within our initiatives, we found similar examples in how super churches, The Civil Rights movement, and large business organizations are able to use habits to motivate and evoke a culture shift. Examples were found in The Power of Habit by Charles Duhig.
Synthesis
As we completed our interviews, we met as a group three different times to unpack what we learned to avoid losing our initial impressions. Our first affinity diagram was organized with key insights from each interviewee.
Yellow Notes = Interviewee Purple Notes = general information Green Note = Barriers
It gradually evolved into clusters of four different themes:
Healthy Community Building
Individual Barriers
Macro Barriers
Organization Setup
Yellow Notes = Themes Peach Notes = Insight Statements Orange Notes = Sub-themes
Key Insights
We repeatedly heard the importance of supporting community leaders. Community leaders can provide a consistent source of support that an organization cannot. They also better understand the community’s dynamics and can, therefore, garner the support of the community more organically. We also learned about the many details of how to best strategize for community-led initiatives.
The economic and geographical barriers of living in a food desert were confirmed in our interviews with community members. We did find that poor mental health and a lack of routines were common struggles when it came to making healthy behavior changes. Hispanic culture is very family and community-oriented, however, the assimilation to a more individualistic American lifestyle can be isolating, and hard to build routines with a lack of support.
Lack of collaboration between other nonprofit and public health organizations was another pattern that we noticed. There doesn’t seem to be an effective platform for organizations to communicate and there also seems to be an underlying sentiment of competition among nonprofits for having the most impact and funding.
These findings allowed us to create three focused POV statements. Dealing with the multifaceted systematic issue of public health, we believed that we needed to ideate from multiple different directions in order to keep POV statements focused enough for tangible ideation sessions.
Ideation
With these statements in hand, we were ready to brainstorm on possible prototypes. For the ideation session, we recruited more creative brain power by inviting friends and colleagues from similar and different backgrounds to inspire divergent thinking.
Using the Three-Brain Warm-up before our session and refraining from any criticism until after, we entertained ideas that may be near impossible for our team to pull off. But its this type of empathetic optimism that’s needed if we ever want to achieve equitable systemic change.
Prototype
We decided to test co-creating an educational curriculum with community members to see if it would increase community buy-in. Knowing it would take more time and coordination than if Hermana Luna would have done it on their own, we hypothesized the process would elicit community members to become health promoters within their communities.
We partnered with Hope Family Health Center to work with their psychotherapy clients to create a curriculum for a community garden event for the entire client base as well as the local community.
Our goal for this prototype was to test the client’s experience of organizing the event through the co-creative process and if they would had a desire to continue doing this work after the event was finished.
Co-creative curriculum planning with clients
Garden tour with education on the plant’s health benefits that can be grown at home
Plant-based cooking demonstration
Activity that teaches the different health properties of the different plants from the garden
One of the clients who helped us organize this event has taken the initiative of learning more about nutrition and has been educating other social service organizations as well as his community. This is exactly the kind of result the organization was looking for.
Next Steps
The combination of the event’s success, the feedback from the clients, and the insights gained from the research solidified the direction of Hermana Luna’s organizational strategy. They decided to revamp their website so they can provide consulting services for other social service organizations as well as building a library of educational videos so they can scale the development of upstream health promoters in other communities.
Reflection
Although my role as a design consultant was focused on new program design, I would have liked to spend more time helping with organizational management to clearly define their future goals, create a strategic plan, and develop a timeline to achieve them (an example of this can be seen in the TEDxMcAllen case study). Hermana Luna has gained a lot of traction within the RGV, but there are a few key organizational milestones that the organization needs in order and scale its impact.
Looking more closely at the design process, I would like to take more time to refine the research questions/methodologies for future projects. I would have loved to do more prototypes with the organization, however, the realities of working on this part-time as well as the geographical distance made it difficult for me and the founders to meet up after our first prototype. Reflecting on this, I will be better prepared to step into a design project with a more experienced project management skillset within the design process.