Designed Shock: A Card Game to Improve Cultural Awareness and Empathy

Library Student Mini Grant Award Year: 2017-2018The purpose of this project is to create a card game that will improve the cultural awareness and cultural empathy of students and more generally of any person entering a new community, a new setting, or starting a new experience. Each card has a prompt. The student is to pick a card a day and do the prompt, then the student is encouraged to jot down notes on the card or in a journal, and to share her experience with fellow travelers. The student would use the deck of cards before, during, and after her experience to become more aware of cultural values, beliefs, and perceptions, and will hopefully be more open minded towards other cultures.https://deepblue.lib.umich.edu/bitstream/2027.42/142874/1/Coulentianos, Marianna_MiniGrant2018.pdfDescription of Coulentianos, Marianna_MiniGrant2018.pdf : Presentatio

The Use of Prototypes to Engage Stakeholders in Low- and Middle-Income Countries During the Early Phases of Design

Human-centered design processes have been leveraged to help advance solutions to the world’s most pressing problems. Early and frequent engagement with stakeholders is a key activity of early-stage human-centered design processes that leads to better alignment of product requirements with the needs of stakeholders and the context of the artifact. There are many tools to support early stakeholder engagement. A subset of methods includes the use of prototypes – tangible manifestations of design ideas. However, prototypes are underutilized in early design activities to engage stakeholders, notably during cross-cultural design in Low and Middle-Income Countries (LMICs). In such contexts, prototypes have the potential to bridge contextual and cultural differences, which is especially critical when designing for LMICs where many proposed solutions have failed to meet people’s needs. To investigate the roles of prototypes to engage stakeholders in LMICs, I used both qualitative and quantitative research methods emphasizing both engineering design and economics theory and methods. Specifically, I conducted an interview-based study with industry practitioners and investigated two prototype-based stakeholder engagement methods in practice in LMICs. I conducted semi-structured interviews focused on the use of prototypes to engage stakeholders in early design stages with 24 medical device design practitioners from multinational and global health companies. Practitioners described the types of stakeholders, prototypes, and settings leveraged during front-end design and the associations of engagement strategies, stakeholders, prototypes, and/or settings. I further studied the practices of global health design practitioners working on medical devices for use in LMICs and described their approaches to tackle stakeholder remoteness, explore the environment of use, bridge cultural gaps, adjust the engagement activities to stakeholders, and work with limited resources. My analysis of requirements elicitation interviews with 36 healthcare practitioners from two hospitals in Ghana revealed participant preferences when viewing three, one, or no prototypes. The findings indicate that stakeholders preferred interviews with prototypes and in the absence of a prototype, stakeholders referenced existing or imaginative devices as a frame of reference. I investigated the preferences for, willingness to pay for, and usage of a novel tool for electronic-waste recycling with 105 workers in North-Eastern Thailand. Workers were assigned to one of two conjoint experiments that leveraged different prototype forms. Workers further completed baseline and endline surveys and participated in a Becker-Degroot-Marschak auction experiment. The results showed that the prototype form used in the conjoint experiment affected the valuation of product features. One-month evaluation of usage revealed that participants who received the new tool decreased their injury rates and increased productivity. This research provides new insights into the practices and teachings of prototype usage for stakeholder engagement during early design stages, contributes to the developing body of literature that recognizes the unique design constraints associated with designing for LMICs, and advances approaches for promoting more inclusive design practices. The description of the types of stakeholders, prototypes, settings, and strategies leveraged by industry practitioners when engaging stakeholders in LMICs are potentially transferable to, and can have a broader impact on, other contexts in which prototypes are used to engage stakeholders. Furthermore, both applied studies illustrate the effect of using different numbers of prototypes and different prototype forms on the outcomes of the two commonly used stakeholder engagement methods – interviewing and conjoint analysis. The applied studies provide examples of stakeholder engagement methods with prototypes in LMIC settings in practice.PHDDesign ScienceUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/162996/1/mjcoul_1.pd

Defining and characterizing task-shifting medical devices

Abstract Background Task shifting could help address limited human resources available for the delivery of quality health care services in low-resource settings. However, the role of medical devices in supporting task shifting is not fully understood. This study aimed to 1) define “task-shifting medical devices” and 2) identify product characteristics to guide the design and development of task-shifting medical devices. A three-part survey questionnaire comprising open-ended, rank-ordering, and multiple-choice questions was disseminated to healthcare professionals worldwide. The survey included questions to capture stakeholders’ general understanding of and preferences for task shifting in medicine and public health, and questions to define task-shifting medical devices and identify desirable product characteristics of task-shifting medical devices. Results Task-shifting medical devices were defined by respondents as “devices that can be used by a less specialized health worker”. Aside from safe and effective, both essential characteristics for medical devices, easy to use was the most cited product characteristic for a task-shifting medical device. Responses also emphasized the importance of task-shifting medical devices to enable local agency, such as peer-to-peer training and local maintenance. Several additional frequently mentioned attributes included low cost, contextually appropriate, maintainable, capable of using an alternative power source, easy to understand, easy to learn, reusable, and easy to manage throughout its use cycle. Conclusion This study defines and characterizes task-shifting medical devices based on healthcare professionals’ responses. Ease of use was identified as the most important characteristic that defines a task-shifting medical device, alongside safe and effective, and was strongly associated with enabling peer-to-peer training and maintainability. The findings from this study can be used to inform technology product profiles for medical devices used by lower-level cadres of healthcare workers in low-resource settings.http://deepblue.lib.umich.edu/bitstream/2027.42/173689/1/12992_2021_Article_684.pd

Pathways to building a Living Lab in a cross-country technology-driven field trial in the Global South

Increasing access to modern energy in the Global South necessitates human-centred approaches. The authors will share their experience implementing a Living Lab with Country Partners in East Africa, where human-centered and participatory methods were trialed

Evaluation of open-ended, clustering, and discrete choice methods for user requirements development in a low-income country context

High quality user requirements are positively correlated with successful design outcomes, but engaging stakeholders within low-income contexts can present financial and time-related challenges to product developers from non-local industrial and academic institutions with limited knowledge of the context. Existing literature provides guidance for engaging stakeholders during the early stages of product design in high-income country contexts, but few studies have examined the effectiveness of these methods in low-income country contexts. This study evaluated three user requirements elicitation and prioritization methods including open-ended, clustering, and discrete choice. Ghanaian healthcare delivery stakeholders with varying types of expertise, years of experience, and from various types of healthcare facilities were recruited to allow for diversity of responses. Participants included physicians (n = 10), nurses/midwives (n = 16), biomedical technicians (n = 14), and public health officers (n = 7). A hypothetical mechanical device for managing and treating postpartum hemorrhage was chosen to characterize each method's ability to elicit and prioritize user requirements. The open-ended method captured general requirements of a design concept, yet resulted in predominantly generic requirements. The results from the open-ended method were used to inform the clustering and discrete choice methods. The clustering and discrete choice methods were useful for inferring in-depth user requirements and eliciting stakeholder priorities. The clustering method revealed that usability and affordability were high-priority requirements among all four stakeholder groups. An individual difference scaling analysis was performed using the clustering method outcomes, which indirectly identified ease-of-use, availability, and effectiveness as the priority user requirements categories. Stakeholders ranked ease-of-use as the highest-priority user requirement, followed by performance, cost, and place-of-origin requirements, using the discrete choice method. Given the significance of the ease-of-use requirement, an analytical framework based on sub-requirements was developed for quantifying stakeholder needs. Lastly, the relative merits of the three elicitation approaches and their implications for use with different stakeholder groups were examined

Product representations in conjoint analysis in an LMIC setting: Comparing attribute valuation when three-dimensional physical prototypes are shown versus two-dimensional renderings

Conjoint experiments (CEs) provide designers with insights into consumer preferences and are one of several user-based design approaches aimed at meeting users’ needs. Traditional CEs require participants to evaluate products based on two-dimensional (2D) visual representations or written lists of attributes. Evidence suggests that product representations can affect how participants perceive attributes, an effect that might be exacerbated in a Low- and Middle-Income Country setting where CEs have seldom been studied.This study examined how physical three-dimensional (3D) prototypes and 2D renderings with written specifications of attribute profiles generated differences in estimated utilities of a CE about a hypothetical new tool for electronic-waste recycling, among workers in North-Eastern Thailand. Two independent CEs were performed with each representation form. Ninety participants across both experiments each ranked three sets of five alternative tool concept solutions from most to least preferred. The results of the conjoint analysis guided the design of a tool optimized for user preferences, which was then distributed to half of the sample through a Becker-DeGroot-Marschak auction experiment. One month after the auction, participants completed an endline survey.The results point toward potential differences in relative importance of different product attributes based on product representation. Price was found to have no significant impact on the valuation of tools in either experiment. The differences in relative importance of product attributes may have been explained by the limitations of 2D renderings for conveying sizes.Further research is needed to understand the impact of product representation on preferences in this context. We recommend careful consideration for product representations – specifically, how well the representations convey all product attributes being evaluated – in CEs. Using a combination of 2D renderings and 3D product features might have satisfied both the speed and low-cost advantages of renderings while enabling participants to have a better sense of product features