Tag: health promotion

design thinkingeducation & learninginnovationsocial media

Disruption by Design

DISRUPT by Paul Woot

Innovation, new thinking, and a change in consciousness can upset the way we see our world and the manner in which we relate to it. This disruption can happen by happenstance or intention encouraging us to consider ways to design change before forces outside our influence change us. 

disrupt |disˈrəpt|

verb [ with obj. ]

interrupt (an event, activity, or process) by causing a disturbance or problem: a rail strike that could disrupt both passenger and freight service.

• drastically alter or destroy the structure of (something): alcohol can disrupt the chromosomes of an unfertilized egg.


disrupter (also disruptor |-tər|)noun

Observing the city I live in, the media I consume, and the way I learn, I can’t help but be amazed at how much of my life has been disrupted over the past few years. I can access nearly everything I need to run my business and do my research from my handheld or a tablet computer. I can hand that tablet or handheld to someone else and allow them to interact with the content on it by using gestural movements, not a keyboard.

If I am engaged in health communications or scholarly research, I look to places like Twitter and blogs as much if not more than I do academic databases. Many of the journals I respect and publish content that counts in fields like public health, such as the Journal of Medical Internet Research, are open access and free to anyone who wants to read them. And these open access publications are becoming leaders in their fields, not just cheap versions of “real” journals. This makes the content of my academic work and that of my many colleagues accessible and much more likely to be used.

If you’re a graphic designer your work has never been more important. Whether websites, infographics, high-quality interpretations of traditional media (for a great example see the re-imagined journal article by my colleague Andrea Yip) the world has become more visual and the weight of good graphic design is heavier than ever. At the same time, tools like easel.ly allow anyone to make an infographic, or WordPress for those who want websites (this one included), and even offers to do a $42 logo as reported in Creative Review.

Want to raise awareness of issues? Grab a film camera and put together a small film like Kony 2012, the most viral success story of any video to date.

Or write a book on an important, if somewhat arcane, topic like the meaning of making and get people from all over the world to invest in it on Kickstarter (that’s what Seung Chan Lim or Slim as he is known did and I invested in this venture with enthusiasm).

Or  charge a mere $5 like comedian Louis C.K. did for a high-quality copy of his recent comedy show filmed at the Beacon Theatre in New York and let your buyers download up to five copies at once for one price.

Or write a book and let your customers determine its price (including free!) like Jon Kolko and his AC4D colleagues have done with Wicked Problems.

This couldn’t have happened five years ago. The production costs were too high, the distribution channels too primitive, and the bandwidth too low. Now, it’s all different and the disruptions are no longer happenstance, but designed.

Harvard professor Clayton Christensen coined the term ‘disruptive innovation‘ which  “describes a process by which a product or service takes root initially in simple applications at the bottom of a market and then relentlessly moves ‘up market’, eventually displacing established competitors.”

Christensen adds:

An innovation that is disruptive allows a whole new population of consumers access to a product or service that was historically only accessible to consumers with a lot of money or a lot of skill.  Characteristics of disruptive businesses, at least in their initial stages, can include:  lower gross margins, smaller target markets, and simpler products and services that may not appear as attractive as existing solutions when compared against traditional performance metrics.

Health promotion and public health are fields ripe for this kind of innovation, so is healthcare. Indeed, movements like those embodied in Patients Like Me, a social network portal aimed at supporting human empowerment in health care.

We are on the cusp of this taking place in health promotion and human services — whether they are governmental, non-profit or social enterprise based. Health promotion is largely about enabling individuals, groups and communities to better adapt to change, support themselves and gain greater control over the social determinants of health. At present, we teach students theory and research, but what about business dynamics or systems thinking or visual methods of presentation or social innovation? These are the tools and strategies that the abovementioned examples used. Many of them also used design.

The same challenge holds true for social work, psychology and education.

These are the fields that are key supports for promoting wellbeing in our community. It is perhaps not surprising that the concept of design is noticeably absent from all of these fields.

That doesn’t need to be the case.

This past week I had the privilege of spending an afternoon with Scott Conti and his staff at the New Design High School in New York City. There I saw students working through everyday problems using design, building business ideas to support themselves and their communities, and applying their various creativities to making a difference in their lives using design as the lens. This environment was where social work, education, psychology and health promotion intersect. Scott — who delivers a great talk on his work as part of TEDX Dumbo — is a health promoter and social innovator. So are his teachers.

None of them were trained for what they do. They have adapted, modified, created and innovated. They disrupted their own patterns of work and learning so that they could better disrupt those around them, for good. They did this by design.

If we are to expect that the fields most connected to social action and the promotion of wellbeing are to contribute to our betterment in the future, they need to change. Disruptive design for programs, services and the ways we fund such things is what is necessary if these fields are to have benefit beyond themselves. Long past are the days when doing good was something that belonged to those with a title (e.g., doctor, health promoter, social worker) or that what we called ourselves (e.g., teacher) meant we did something else unequivocally (e.g., educate). Now we are all teachers, all health promoters, all designers, and all entrepreneurs if we want to be. Some will be better than others and some will be more effective than others, but by disrupting these ideas we can design a better future.


knowledge translationpublic healthsystems thinking

Knowledge Hypocrites: Take Two!

Knowledge Hypocrites: Take Two!.

The link above points to a great post by KMBeing that deserves some re-blogging here. It looks at the issue of hypocrisy in espousing the values of taking knowledge and putting it into practice, without practicing it. It’s worth a read.

There are a lot of professions and practices where we say one thing and mean another. This is something that can apply to health promotion, design, evaluation and social justice work in any guise.

What do the words and ideas mean and what do they mean in practice?

These two concepts are part of reflective practice and also require good communication, the kind that that allows people to find out what the meaning of their words are in the eyes and ears of another. Good communication requires speaking clearly, listening clearly, and clarifying clearly and doing so honestly and openly.

One of the issues with many of knowledge practitioners is that the rhetoric of knowledge translation/mobilization is so seductive. It is so common-sensical and even trendy. But the idea of sharing what we know, building relationships, and working together in true collaboration is much harder when viewed in reality where people have different resources, power structures, perceptions, reflective capacities, skills, knowledge, and time.

Knowledge mobilization is about not just strategy or tactics, but building up a system that supports it all. David Phipps, who wrote the original article looking at these hypocrisies was referring to this by commenting on the fact that there are too few incentives to change the way things are done and so without a top-level strategy to support change and no incentive from the bottom, the system remains the same.

Designing and living a system that works requires living and designing practices that support our values and communication now.

art & designdesign thinking

The Science of Design Thinking

My colleague and design collaborator has proposed a way of viewing design thinking as something akin to a periodic table of elements. Beyond just posing a brilliant way of explicating and organizing the multiple facets of design thinking, Andrea Yip has shown the world that there is much we can learn from science, visualization and how they both apply to design. 

Last weekend a group of design thinkers got together to discuss the concept of design thinking and what it means. The conference, summarized in another post, explored the language of design thinking, the need for visual thinking, and the importance of understanding the context of design and design thinking.

While this was going on in Vancouver, another designer (my colleague, Andrea Yip) was back in Toronto taking these same ideas independently and transforming them into an organizational structure that should create much room for thought among those interested in design thinking. The model she has developed is one not based on areas that are familiar to design — architecture, art, graphic design, business strategy, or engineering — but science.

Designers often speak of a need for multidisciplinarity in their work. While laudable, this commonly refers to the inclusion of multiple perspectives on a design problems from within the broad field of design. It is indeed rare to find such multidisciplinary teams comprised of scientists. Andrea has turned that upside down by proposing a model of design thinking based on the periodic table of elements. The table, shown below, is a first draft, but a highly sophisticated one and something that ought to be taken seriously.

Periodic Table of Design (version 1.0) by Andrea L. Yip on DrawedIt

By using the structure and format of a bedrock of science, Andrea has shown that there are ways of thinking about design that transcend the boundaries that we often unconsciously bind around it. This new model inverses the terms posed by the creative arts or the applied disciplines of engineering or architecture, each that have made enormous contributions to the field, yet all rely on a level of subjectivity, and replaces them with a model based on a more universal language: science.

Science and design are uneasy partners. Some, like Nigel Cross, have pointed to the challenges with the use of terms design science and the science of design, while others, like Buckminster Fuller,  use the term design and science in ways that are open to challenge from those who identify as practicing scientists. Ms Yip, a designer trained in science (biology) and social science (health promotion) fields, sees things in ways that transcend these perspectives to propose using science as a guide to inform the way we understand design.

In doing so, she provides a bridge between the worlds of science, with its emphasis on evidence and strict adherence to protocols, and design, with its flexible, rapidly evolving, yet often non-specific methods. Indeed, Andrea’s blog showcases many examples of how design and fields like health promotion fit together and differ. It is time for both designers and scientists to listen more intently to this conversation.

By using methods, theories, analogies and conceptual models that extend our thinking beyond the realm of conventional design and science, we offer opportunities to make things better — and in doing so shape our world for the greatest benefit for us all.

Andrea’s blog is called Drawed and can be visited at: http://drawedit.wordpress.com/ . She welcomes feedback on her ideas.

And if the Periodic Table of Design is not enough, Andrea’s also developed a prototype set of trading cards based on the table for those more inclined to school-yard forms of collaborating around design that are also up on her blog.

For more dialogue on design thinking, stay tuned to this space and the Twitter feed @d_bracket for the upcoming launch of the Design Thinking Foundations project and corresponding site. And wouldn’t you know? Andrea Yip is the coordinator of that project.

art & designcomplexityemergencehealth promotionpublic health

The Art of Complexity and Public Health


“Art is an intimation of the fundamental reconciliation of contradicting possibilities” – Joel Upton

Without contradiction, there is no art. Art itself is about juxtaposing ideas, tensions, concepts and working with form and space. The artist, whether consciously or not, is balancing contradictions in space, medium and form to challenge themselves and their audience to explore an idea, a feeling, concept or all three.

Engaging with art is about beholding. To behold requires focus, attention and some enthusiasm for the subject matter (knowledge doesn’t hurt much either). It requires time to contemplate the elements above and explore the contradictions and the perspective of the artist and the beholding audience. Health promotion and social change is full of contradictions. For example, how to promote freedom and self-determination while ensuring appropriate regulation to protect those who’s self-determined choices put others at risk? How do we create community and common space while respecting diversity and uniqueness — including those perspectives that don’t support commonly held values?

The list can go on. Art and the art of beholding can offer some ways to address this complexity through contemplative inquiry and learning about perspective and perspective taking.

Claude Monet in painting the Maintee sur la Siene did so from the river in his boat. By being on the river Monet was able to gain a perspective that is fundamentally different than had he painted from the shore, which he also did in other works. To behold Monet’s painting yields insights that cannot be gained by simply passing the image over.

Spending time before the work yields perspectives that cannot be obtained through mere casual observation. One is immune to the overlaying circles, the misty cornering of the Siene, or the fact that nearly all of the painting exists in reflection. When one looks at the painting in the context of others using the same angle and different colour shades, we see that this is a work that is distinct. Searching through the various forms of the work, one sees new layers of possibility and complexity emerge as the tones change, the textures shift and the intensity of the work alters. The version held at the Mead Art Museum at Amherst College, where Professor Upton teaches, is particularly complex in how subtle the reflections and use of colour and texture are parlayed on the canvas.

Learning more about Monet at the time he did this painting, his life, the fact that it wasn’t like he painted it from the water, he DID paint it from the water.

But we might have known that had we not spent the time in contemplation of the painting. Got to know it, and understand it deeply. Submitted ourselves to the work with a level of intimacy that can only be obtained through the act of contemplation and engagement with the art. The longer one beholds the work and sees the various forms within it, the greater the complexity that emerges — qualities unknown or unknowable without the contemplation of the work in depth.

Monet knew that he had to survive, to produce a work of art that was in demand and could sell. He had to survive, but also did art to ensure that people were inspired and challenged. His wrestling with contradiction, his application of knowledge to a medium, and the expression of his creativity through both is what made him one of the most widely renowned impressionist painters who ever lived.

Health promotion is about contradiction. It deals with complexity all the time. How do we inspire change in others and still support self-determination? How can we change a system when that system has no single voice? How do we get individuals to do what we want, yet simultaneously respect what they want?

Health promotion also seeks to respect diversity, but at the same time, what does it do to truly understand this diversity? Do we take the time to get to know the communities it deals with. Really, truly know these communities. Do we give the time to be intimate with them?

My experience is sadly, no. In public health we use focus groups — which were initially designed to focus a research question, not serve as a means of research unto itself — to generalize from a group-think scenario to an entire community and then claim that we know them. Really? Is this beholding? Is this the kind of contemplative inquiry that makes sense for public health.

Could we learn more from artists? Our methods certainly could (see art of public health), but perhaps the way of the artist is also something we could learn more from.

behaviour changedesign thinkinghealth promotionsystems thinking

Design for Social Norms or Social Change?

Social change or social norm?

Designing for how people live is part of good design practice, but what about designing for the way people could be? What does it mean to design for social norms and what role does design have in changing them?

Media scholar and youth researcher danah boyd recently wrote on the need for designers to consider social norms as part of their media creations. The post received a lot of attention in the mediasphere and came on the heels of another interesting post by Keith Sawyer on Chinese social norms and the Tiger Mom phenomenon (that I also wrote on a while back). Returning to boyd’s argument, she makes the case that designers don’t dictate the behaviour of people in the systems they create, the people tthemselves do:

Social norms aren’t designed into the system. They don’t emerge by telling people how they should behave. And they don’t necessarily follow market logic. Social norms emerge as people – dare we say “users” – work out how a technology makes sense and fits into their lives. Social norms take hold as people bring their own personal values and beliefs to a system and help frame how future users can understand the system. And just as “first impressions matter” for social interactions, I cannot underestimate the importance of early adopters. Early adopters configure the technology in critical ways and they play a central role in shaping the social norms that surround a particular system.

What boyd is arguing (using my words and concepts from complexity science) is that emergence and path dependency shape design’s manifestation in the social realm. In technology-oriented systems, the ‘early adopters’ are the ones who set the stage for how the next wave of users interact with the system and boyd points to examples from Friendster about how attempts to control its community helped drive people away from the site (ultimately leading to its demise).

People don’t like to be configured. They don’t like to be forcibly told how they should use a service. They don’t want to be told to behave like the designers intended them to be. Heavy-handed policies don’t make for good behavior; they make for pissed off users.

This doesn’t mean that you can’t or shouldn’t design to encourage certain behaviors. Of course you should. The whole point of design is to help create an environment where people engage in the most fruitful and healthy way possible. But designing a system to encourage the growth of healthy social norms is fundamentally different than coming in and forcefully telling people how they must behave. No one likes being spanked, especially not a crowd of opinionated adults.

The focus here is more on social media and online spaces, but the argument could be made for the same thing in social design. But unlike information technology, which favours a very particular group of people, social design has the potential to intentionally engage specific populations. Using boyd’s argument, one might assert that much of the technology we use from Foursquare to Instagram to the iPhone itself is shaped by the under-40 set of educated, middle class, largely white male hipster knowledge workers as they are typically the earliest visible adopters for such technologies (even if that is changing) .

In this model those with the most power, privilege and social capital at the outset greatly determine what comes next. This might be OK for technology, but is highly problematic for social justice and social inequities. A health promoting social design has the potential to change this by seeding that early adoption cycle with different people with potentially different values to shape outcomes not defined by a narrow set of social groups.

Keith Sawyer’s article points to the social norming around Chinese parenting (as defined through Amy Chua’s Tiger Mom) and how it clashes with a particular type of parenting model that dominates in the United States and our ideas of creativity. In describing his reaction to a recent review of Chua’s book and its contents, Sawyer points to the unease it creates in him when comparing norms and what it means for creativity and innovation:

I ought to be lined up with all of the horrified American parents who hate this book. But I just can’t side with them on this one. Creativity is hard work, and you don’t get creativity without paying your dues. No one magically learns how to play piano or violin (I’m reminded of the old joke: “Do you play the violin?” “I don’t know, I haven’t tried it yet.”) And as Amy Chua points out, there’s nothing like the joy that comes from being able to do something well, knowing that you earned it with hours, months, and years of hard work. As a child, I took piano lessons for eight years, and now thirty years later it’s a major source of joy in my life.

Chua’s parenting is an issue because it doesn’t fit with the dominant social norms, just as the self-esteem-at-all-cost approach that Sawyer rightly exposes as problematic in its own right would be in China.

These are designed systems. Just as we create path dependencies for one set of values, so too can we do the same for others and with other people. The focus on the outcomes of systems rather than their design is problematic if we want change. Starting with design and values at the outset, being conscious of who we invite in and how we engage them and by remaining contemplative about how these systems unfold and the emergent patterns that shape them, designers of all stripes may be better positioned to create social change rather than just for social norms.

design thinkinghealth promotioninnovation

The Design of Health

The Pulse of Health Promotion & Design is Different

Design and health promotion have a great deal in common and enough to complement one another that makes them a great match. However, it is the scale and rhythm of the two that brings them together and keeps them apart.

Although the two fields are distinct, design and health promotion are a natural fit. Health promotion is a field that seeks to address social, environmental and care-related factors that keep people well and reduce the resource gap between those that have good health and those that do not.

Designers seek to develop products — objects, services, structures — that meet the needs of their client and, in the cases of social design, the larger society that they are a part of.

Both fields operate systems thinking environments and consider the opportunities for engagement of wide-scale participation in the creation of their products. But where the two fields differ is where the greatest opportunity for collaboration lies.

Health promoters — and health professionals in general — are not great designers. While they are good at engaging the community in assessing need and opportunity, there is a bias in the sector to looking to what is to inspire what could be. This means drawing on current evidence and spending considerable time defining the issue at hand in the first place in light of this. Health promoters are adept theorists and practitioners, however the theories used are often contested and widely debated — something health promoters embrace. The risk for health promotion is that they will use the solutions already developed or they will get mired in debate over the meaning of potential solutions to come.

Designers on the other hand are great dreamers and doers when it comes to creating things that are novel. Designers are comfortable with working with conflicting information and abductive reasoning to solve problems before them. And then they move on. Design’s focus on the here and now for the product or service gives them focus, but loses the thinking about the wider implications of their product – something that keeps health promotion in debate.

There are exceptions to the examples provided above, but they are exceptions and not the rule.

In a health context, designers systems think about the way their product is established, where health promoters think about the values that underpin that product and the wider implications for its use beyond its creation. Bringing these two fields together provides an opportunity to make health promotion more innovative and action-oriented and design more evidence-based and socially responsive.

The social challenges from chronic disease, environmental threats, social migration, aging populations, economic disparities, and a more globalized, multicultural world require strategies that bring the best ideas to the table, strategies to realize them, and values that make these actions more equitable for everyone. Health promotion + design is one way to achieve this.

complexitysocial systems

What the Slutwalk, Marshall McLuhan and Rebecca Black Have in Common

How famous are you?

The speed at which information is translated into ideas, intentions and actions is now global and nearly instantaneous, which has consequences for collective action.

In the future, everyone will be world-famous for 15 minutes. – Andy Warhol

Andy Warhol‘s oft-quoted phrase from 1968 hinted at a future that Marshall McLuhan saw encaptulated in his famous concept of the global village and the idea that the medium is the message:

The medium is the message – Marshall McLuhan

UK artist Banksy has gone so far to proclaim that in this new social media, always connected, perpetually broadcast media world we will all be anonymous for 15 minutes (see above photo). If true, this has implications that go beyond simply getting ready for fame, but more deeply into the way in which media messages are constructed and construed within a social media landscape. Some cases of how the quick-release created by media this week got me to thinking more about what this might mean for health and creating better communities.

One case is the Internet sensation-of-the-moment Rebecca Black and her widely viewed (which was up to more than 80 million hits as of the time of this writing), parodied, and celebrated video “Friday” . Within the span of two weeks, a 13-year old girl who was largely unknown outside her classmates, friends and family was portrayed as everything from a new talent to a no talent in social and mainstream media circles by pundits, the public and journalists as a whole. One small, yet intricate, act of creating a video and publishing it set off the most talked about musical event since Susan Boyle.

On a matter far more serious, Torontonians — women and men — came out in the thousands to voice their concern over insensitive, negative stereotyping of women in the first ever slutwalk. The website for the organizing team described the instigating issue like this:

As the city’s major protective service, the Toronto Police have perpetuated the myth and stereotype of ‘the slut’, and in doing so have failed us. With sexual assault already a significantly under-reported crime, survivors have now been given even less of a reason to go to the Police, for fear that they could be blamed. Being assaulted isn’t about what you wear; it’s not even about sex; but using a pejorative term to rationalize inexcusable behaviour creates an environment in which it’s okay to blame the victim.

What Marshall McLuhan (add Warhol and Banksy here too), Rebecca Black’s “Friday” (and Susan Boyle’s “I have a dream”), and Slutwalk have in common is that they all gained, retained, and explained themselves through widespread media, intense emotion, and great misunderstanding resulting from the media form.

With McLuhan, the emotion is less (unless confusion counts), but there is still much resonance with his work and celebration of his theories aimed at helping people understand the relationship between media, the messages conveyed, and the cultural reproductions created through them all. While McLuhan’s words are well known, his theories are not, nor has there been much effort to get to know them. I know few who have read his original texts, slightly more who have read secondary accounts of his work in scholarly manuscripts, and most who have done neither or, at best, caught him in his movie cameo in Woody Allen’s Annie Hall.

Rebecca Black has the (mis)fortune to be one of Worhol’s famous people, albiet for more than just 15 minutes. Just as Susan Boyle no longer graces our aural landscape as she did, I suspect Rebecca Black will move closer to what Banksy speaks of within the span of a few weeks with her work to join Double Rainbow and Steven Slater (the JetBlue flight attendent who jumped out of the plane with two beer) as memes that have come and gone.

Slutwalk, I hope, finds a more generous fate. At present it is tied between something of substance (like McLuhan) and celebrity (Black), and is as misunderstood as both. Whereas McLuhan’s work is often overlooked in detail because it is rather dense and challenging, applied without consideration of the manifest ways in which media and messaging intersect, Black’s video is taken up without any thought at all, yet not critically analyzed. (For music fans, I suggest spending an hour with Lady Gaga on her recent visit to Google to see someone who walks the line between McLuhan and Black well, taking the highest art form from both and addresses Black’s fame in answering an audience member’s question).

Reading through the Twitter feeds with #swto and #slutwalk found some cheers, and some questions about what Slutwalk is. Sadly, some of the comments were the (to be expected, I suppose) sexist comments that represent the take-without-thinking approach (Black) from misinformed or misogynist (or both) tweeters. Yet at the same time, there were some who thought about the issue a lot, yet may have been overly analytical about certain aspects of the situation (McLuhan) to the point of making small things into bigger ones. In the latter, there were over-generalized attacks on the police officer who initiated the walk in the first place (and has apologized – the sincerity of which is unknown by me) and the establishment of the police service as a whole.

Neither of these perspectives tell the whole story, but when viewed through the lens of social media, safe ground is harder to find. Nuance is not something that Twitter posts do well. A post by the Toronto Sun shows what would have to be the most stereotypical picture of the “sluts” on its cover (which I see as intentional), with no hint at the diversity of women (and men) who joined the march to specifically highlight that it doesn’t matter what you wear, all women have rights to be who they are and be free from violence. The immediacy of social media and online media, makes this a more complex argument when either the overly simple is favoured and the overly complex is posed as a counter. It is easier to attack someone or to mock them, but harder to understand that person. If we are to design better social systems, understanding is key.

Why write about this here? Because these are the issues we face in health promotion all the time. Poverty, racism, access to health services, mental health and wellness, and education are all issues that are complex. They cannot or will not allow themselves to be understood in simple terms, yet are issues that speak to the wellbeing of society. Slutwalk was about rights and freedoms for more than one half of our population. It was about respecting people for who they are, honouring their sexuality, and educating everyone about the prevalence, consequences and risks associated with unwanted sexual advancement and assault. When it becomes a Rebecca Black Friday issue, it is about things like the salacious use of risque’ language and when it is a McLuhan issue, it takes a library to understand it.

Surely with our amazing tools we can find some middle ground to make the complex accessible, and the simple more sophisticated.

** Photo by fstutzman used under a Creative Commons License from Flickr.