It’s getting real!

In the last few months I’ve managed to organise and run 3 participatory design workshops – 2 with young people (aged 14-17, and 18-25) and 1 with GPs. These workshops had two main aims: to identify barriers and facilitators of implementing a screening tool in general practice for young people; and, to design a prototype.

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Generally they seemed to go pretty well! Overwhelmingly the participants were engaged and excited about the tool (phew!), and, as importantly, they provided many valuable insights and feedback that, at times, challenged assumptions I’d had.

Without me quite being conscious of it, I think I’ve had a vision of the tool that has kept getting bigger and more complex (‘perhaps it could do X’, ‘how cool is it if it could do Y!’) when, in fact, one of biggest messages from both young people and GP was ‘keep it simple’ and, perhaps, ‘stick to the core purpose of the app’ – other functionality is nice to have but isn’t really necessary.

It’s reminded me again that the core purpose isn’t really just about saving time; getting sensitive information efficiently. It’s more than that – it’s more about the technology providing a ‘tickit to talk’ – much in the same way as a dog provides a way for strangers in the park or street to engage with each other. I really love this potential of technology – it’s a tool that is facilitating more meaningful and honest connection; in my case that will in turn, ultimately better health outcomes.

Understandably, one of the biggest concerns for GPs was around risk and managing when and how information came to them (a particular issue if young people were filling it out a day or more before their consultation). I’m hoping we can come up with a solution for this.

Young people were very worried about being judged (e.g. if I say my partner has been violent towards me, will they label/pigeon-hole me). This certainly reflects the research about help-seeking but I think as someone who has worked in the health sector for so long, it’s easy to forget what a huge barrier this is. But the good news is that they respected their GP and recognised that generally they could provide impartial, educated advice and support (even if, they didn’t really realise this includes prevention not just acute health concerns).

They suggested that the language and contextual information of the questions were critical in their use and honesty with it. There is a real need to further involve young people to refine and improve the questions (interestingly, the widely used HEEADSSS assessment which I am planning to use/adapt, doesn’t seem to have been developed with young people’s involvement).

Not surprisingly for digital natives, young people were very quick to suggest future iterations of the tool and how it could be used to complement existing services and create a better experience for young people (e.g. GPS of youth-friendly, bulk-billing clinics; ability to share data with other health professionals). Alas the current government’s electronic health record is a dinosaur in comparison.

It felt good to get out in the real world, talk to real people who are the target audience for my project; a good reminder of what and why this is doing – the potential to make a real difference. My immediate task is to talk with practice staff – from previous research it would be best to minimise the need for them to be involved; they are gatekeepers, but generally don’t have the time nor the interest for additional work (e.g. identifying young patients, describing and giving the tool). It’s a critical piece of the puzzle.

I have a number of concurrent major tasks over the next few months; finalise the final study design (more of that in upcoming posts), write and submit ethics for it, write up a 2 1/2 articles.

Game on!