Stanford Health ++:
ERA (Empowering Relationships Among the Aging Population)
Awarded the Best Stanford Emergency Medicine International Power in Hands Solution
Introduction:
This project was started at the health hackathon hosted by Stanford University, Health++ 2019. This event hosted over 450 engineers, designers, business experts, and healthcare professionals from all over the world to ideate, design, and build in the space of healthcare.
My team tackled the issue of social isolation in older women from low and middle-income countries, a project pitched by Stanford Emergency Medicine International (SEMI). We designed and presented the app ERA (Elder Relationship Assistant), a phone-based solution to increase social connectedness. We were awarded the SEMI Power in Hands Solution Award and the opportunity to continue working on our idea through a prize of $1,000. From there we have further investigated the efficacy of our design through conceptual designing while receiving mentorship from Noora Health.
Role:
User Research
Visual Design
User Experience Design
Duration:
October 2019 - April 2020
Tools:
Figma - High Fidelity Prototyping
Challenge:
Problem: With the decline of the extended family model, more elderly adults are living on their own. This issue has set off the social isolation epidemic, leading to decreased support and increased isolation of older adults.
Goal: A way to increase social connectedness for older women by fostering thoughtful connections through shared interests, in an effort to improve physical and mental well-being.
Background Research:
Target User
Our design focused on older women living in the United States who are able to access a smartphone or tablet. From our initial research, we decided to narrow the scope of our design to older women 60+ years old.
Initial Survey
We started off collecting data through an initial questionnaire to better understand how people self-reported levels of loneliness, social interactions, and happiness. We also included questions to get a sense of technology usage and preferences when it comes to online platforms. Our survey consisted of statements that would be rated on a scale of 1 to 7 depending on how closely they agreed with them. We used both printed versions of the questionnaire as well as posting a similar set of questions (excluding the technology questions to avoid bias) on Reddit. This set the grounds for our approach to our deep dive into social isolation in older adults and technology-based solutions.
Qualitative Research
To understand more about how social isolation impacts older adults we spent some time gathering research. Some of our key findings were as follows:
Impact of Social Isolation:
Impact: A report from the National Academies of Sciences, Engineering, and Medicine (NASEM), concluded that one-third of adults 45 and older feel lonely and nearly one-fourth of adults 65 and older are considered socially isolated.
Health Risks: According to the CDC, adults aged 50 and older have higher health risks perpetuated by social isolation including, premature death, heart disease, and dementia.
Connectedness: NASEM recommends that people at risk of social isolation and loneliness, be connected to community resources.
Perpetrators of Social Isolation:
Living Alone
Loss of contact with friends and family
Limited with a disability or illness
Societal barriers
Transportation Challenges
Absence of social opportunities
A gap in technology understanding
Competitive Analysis
Key Take-Aways:
Prioritize offline interactions to facilitate in-person connections rather than just virtual encounters.
Emphasis on friendships, specifically helping older women build a community with one another.
Focus on ease of use, through a clear and simple app interface fostering learnability and memorability.
User interviews:
We conducted interviews with older adults in the East Bay to learn about their interests, routines, social lives, and experience with loneliness. We also gathered information from a diverse group of stakeholders.
Stakeholders:
College students volunteering in nursing homes
Mental Health Specialist from UCSF
Professionals from a health-education venture
Interview Insights:
Some of the key insights from our interviews that helped shape our problem framing included:
Some reported feeling overwhelmed at some point using technology but were perceptive to using technology-based platforms if they are easy to learn to use and purposeful
Most were looking to add companionship that aligned with their interests and regular activities that they enjoy
Having the ability to have a community and feel included as part of something was something important they were looking for.
When it comes to online platforms many agreed they wanted a space that was more geared toward them.
Areas of Opportunity:
After synthesizing our user interview data the recurring themes that emerged from our target user population included:
Accessibility: Keeping limitations and usability as a priority in our design
Lifestyle:
Creating opportunities to socialize that fit interests and daily routines.
Community:
Building a sense of community and purpose through meaningful encounters
How Might We Question:
Based on these findings we narrowed the scope of our problem by creating the following “How Might We?” question:
How might we facilitate finding meaningful social connections for older women?
Ideation:
To begin to find the best approach to our HMW question we focused our efforts on generating ideas from our background research and interviews.
Body-storming:
Our team started by playing a game created by Dr. Evie Kalmar at UCSF designed after the “Game of Life” to teach people about how aging changes how social connections and isolation look. The game uses situation cards that dictate good and bad developments through life such as gaining a social connection. This progression is slowed down if a player acquires a disability further down the line, which is simulated through physical props like having to wear vision-distorting glasses throughout the game. As we played it put into perspective the journey and situations that people encounter as they age, and served as an empathy-building exercise for our team.
Brainstorming:
To consolidate our findings from our user interview insights and background research we had brainstorming sessions where we organized our notes into categories through virtual sticky notes. The three categories were: problem, needs, and ideas to better serve our conversation around feasibility, cost, accessibility, and impact of potential solutions. .
From these exercises, we concluded that the best approach moving forward was an app-based platform that aimed to help address some of the key needs we identified.
Prototyping:
The initial prototype of our app-based platform displayed 6 of the most common activities that represented users and were designed to randomly match them to another local user. However, the issue that we came across with this approach was that it was not personalized enough for users, there was still a gap in making social connections. Below is the first prototype of the information hierarchy and user journey.
Leveraging from our initial idea, we shifted to focus on features that would combine proximity-based matches, messaging, local event postings, and interest-based community groups in one platform. Our approach aims to simplify social media by providing only relevant features for the user base and prioritizing accessibility and ease of use.
Final Design:
The initial prototype of our app-based platform displayed 6 of the most common activities that represented users and were designed to randomly match them to another local user. However, the issue that we came across with this approach was that it was not personalized enough for users, there was still a gap in making social connections. Below is the first prototype of the information hierarchy and user journey.
Why ERA?
The Name:
We wanted every aspect of our app to be filled with intention, out of this came the name ERA, an acronym for its purpose: Empowering meaningful Relationships for the Aging population. The word era in its archaic definition means an event marking the beginning of a new and distinct period of time. This definition captures the intention behind ERA, introducing people to a new period of social connections.
The Logo:
The design of the logo was made to resemble a flower made out of pink circles. Each circle represents an individual and the collection of them symbolizes a connected community. The color of pink flowers represents grace and happiness, while an open flower was intended to symbolize the blooming relationships we hope to help foster.
Accessibility Considerations:
Moving forward with the redesign of our initial prototype of ERA, we wanted to ensure that it was accessible to our user group so we prioritized the following design considerations:
Guided onboarding, to make sure that users did not feel confused when signing up for ERA.
Icons are accompanied by clear text labels to communicate their purpose
Simple visual design to make the app feel guided in itself through daily use
Accessible navigation is used on each screen to serve as clear points of action to prevent users from feeling stuck.
“Help” smart feature across every page that provides voice or text guidance when users need assistance
Integrating Adobe Color Accessibility Tool to ensure that the color palette for the app is not conflicting for any user
Onboarding:
Highlights:
• Large cards and outlines to avoid finer motor interactions
•Bright, bold, colorblind and low vision friendly color palette
• In built voice assistant on each screen as alternate navigation
• Progressive disclosure to prevent distribution of attention
• Easy access to settings for customization and privacy control
Accessible Help
Integrated smart voice assistant to answer questions, access settings, customize font sizes or activate the inbuilt screen reader. This feature would ideally be available across all the pages of the app to provide quick and easy assistance when needed.
Profile:
The Basics: Name, age, location related information as an introduction
Interests Finding commonalities and potential activities to do together
Self Summary: Can disclose a lot about how someone thinks and navigates life
Values: Highlights which traits people identify with and value most
Deeper Connection: Finding common ground through sharing compassionate insights
Favorite Pictures: Place to share any other things that may catch others interest.
Compatibility Check: Establishing expectations and aligning personal values
Future Steps:
In order to make this service accessible to those without smartphones, we intend to develop voice user interface and text service alternatives to this app. Our team has investigated a variety of alternative implementations, including a low-data-consumption (for countries with slower network speeds) and a no-data, phone-and-text-based service (for remote areas with limited to no service). In the future the user testing data from users with visual and aural impairments, could expand the scope to focus on inclusion and accessibility when it comes to online-platforms.