a symptom-screening kit for polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) affects up to 20% of women in the United Kingdom, yet most women either get diagnosed later than they should, or get misdiagnosed because of the fluctuating nature of the condition’s symptoms.
A four-part initiative has been designed to address key stakeholders within the public health sector, young women, and communities of PCOS patients to begin systematically screening for symptoms earlier in a playful, accessible, and non-invasive way. The components include (1) a service blueprint that showcases the stakeholder phases and activities over time, (2) campaign material that educates the public and conveys relatability to young women in the UK, (3) a symptom-screening kit that is sent to young women by the NHS in the form of a birthday present, (4) and a mock-up of a digital interface for PCOS patient communities after they get diagnosed.
Each part has been tested or validated along the way based on the stakeholder group that it serves. The aim is to incentivize young women to learn about PCOS, and prompt them to go to a doctor for a clinical diagnosis, if the symptoms they learn about resonate with their daily life. The system was designed to address the transferred agency of health, to reach a more diverse demographic of constituents by implementation in the public sector, and to initiate change within the female reproductive health space.
Innovation of products and services that deal with female reproductive healthcare have been historically obstructed from growth due to unfair gender inequality including especially (but not limited to) the realms of user research, science, design, and medicine. Because these industries are siloed in their communication with one another and predominantly gender biased, the resulting policies echo only those interests. For example, public healthcare in the United Kingdom has regulation on clinical products, services, education, and funding, meaning that they typically maintain a closed-loop communication stream between themselves and the lower-tear governing bodies of healthcare — like Clinical Commissioning Groups and Local Trusts, who are primarily run by GPs — thus leaving out the direct input of potential patients and not always understanding what is needed.
To combat this lack of involvement, privatize healthcare markets medical products and services in the consumer sector to bypass the clinical obstacles and to accelerate access to these new ventures (i.e. 23 and Me). While this initiative has an impact, private companies still carry out small and siloed user research. Which means they only serve communities with high socio-economic status and/or a higher educational background.
The three components of Ova — the campaign content, the screening kit, and the proposal for a digital platform — could only function realistically by designing a road map that illustrates the operations of each actor necessary to conduct a product roll out. A service blueprint was co-designed with several stakeholders as each had a variety of insights on their part of the healthcare service process.
The first third of the service blueprint maps out the activities required for a successful campaign for PCOS education. It was influenced by meetings with Service Design tutors, product designers working in hospitals as medical innovators, Reproductive Endocrinologists from Imperial College Hammersmith and St. Mary’s Hospitals, and consultants from industry.
The second third of the service blueprint showcases the user interactions with the product. It portrays the feedback loops of data collection that the subsidiary organizations of the NHS need to document when prepping for funding based on the needs of their communities. The more kits that are sent out, then the more data these subsidiaries have to collect, and then filter back into the Department of Public Health and the NHS based on the efficacy of women getting checked after receiving one.
The last third of the service blueprint is a working section that will be developed further in parallel with the development of the post-diagnosis digital platform. It illustrates the basic continuation of tests, and includes a potential involvement of a charity (or other organization) to be involved with further treatment.
As understood from the online forums, interviews, and discussions with doctors, many individuals are improperly informed about what potential symptoms could be related to, let alone those of PCOS. In order to have any success with a product roll out, there needs to be campaign content that informs the general public about the problem, but also sparks interest in potential users. Inspired by anti-tobacco campaigning and Gardasil vaccination promotions in the United States, a provocative but educational approach was taken to create Ova’s own campaign content.
The campaign material is made up of two main components. The first component is a set of visuals that propose common symptoms as quirky and abrupt questions. They were posted onto Instagram to test how much attention they got, of which seventeen people directly messaged me regarding PCOS, and three agreed to take part in interviews.
Relatability is another successful marketing cue seen in the former campaigns, that engages the target audience to build empathy for the cause because it depicts a protagonist that is similar to them. For the modern UK teen-to-young-woman, a short video was made in a Wes-Anderson-meets-Skins style, and incorporated humor with seriousness. The video depicts an average morning routine that a young woman would carry out. These activities especially call out the normalcy of the symptoms expressed with PCOS, but also the general confusion or frustration that comes with experiencing them. It follows with an explanation of the booklet in the screening kit. It is meant to educate and provoke interest, without taking an overtly clinical stance.
The video additionally aims to promote inclusivity and diversity in its selection of actors and environments, to drive home the point of directly addressing under-served communities. It was iterated upon and validated by Simon Ryninks, a filmmaker and director in London, as well as with three of the six interviewed patients.
* Photos of the real deal coming in July!
After compiling information from the developmental phases, a symptom screening kit was created as a birthday present to be received by the NHS. The kit has less clinical sterility surrounding the process, specifically in its style of branding. It is meant to use visual elements that engage younger audiences, and promote trust within brand identity. Also, a shared personal activity that is usually associated with play is birthdays. Sending content to registered individuals on a specific birthday embeds the roll out within a system that the NHS already has in place, which is to prompt constituents via mail based on their age for other female procedures, like cervical screenings.
The first part of the kit provides information about PCOS and why the NHS is sending the package; the background of PCOS is aligned with the information available on the NHS website. The second section demystifies the superficiality of common symptoms, and relates them back to hormonal imbalances caused by variable communication between the brain and ovaries. The symptom information has been co-designed with and validated by clinical researchers and clinical professionals based on their specific experiences within the public and private sector. The final section of the kit explains what hormones to test for, how and when to swab your saliva, and what to do afterwards. There is a calendar matrix of the three hormones, and three different days that the user will swab their saliva for each. This is because multiple data points will be needed for the GP to see if there were any fluctuations in hormonal levels or if there are consistent spikes (like mentioned previously with LH). It promotes young women to make take responsibility of a portion of this process by having to swab their saliva. The intent is also to encourage users to schedule an appointment with their GP for an accurate clinical diagnosis.
The final part of the roll out is a working design towards a digital platform for patients who have been successfully diagnosed with PCOS to continue learning about the condition, track their tests, communicate with one another about treatment, and potentially collaborate with one another or organizations that would be interested in joining (i.e. charities, gyms, nutritionists, physiotherapists, etc.) a process towards a healthier life by mitigating the symptoms together.
Ova holistically addresses different needs of each stakeholder. The value proposition for the main stakeholder groups are as follows. For healthcare professionals, seeing patients earlier for preventative measures will offset the amount of times that patient would have to be seen in the future for post-operative treatment costs. The NHS has shown dedication to this by increase their budget by 3.4% (£20.5 billion increase over 5 years) to provide for preventative care especially for health inequalities, of which prenatal, maternal, and neonatal health was listed, which PCOS falls under. For women, access to things like Ova empowers women by shifting some of the agency from the industry onto the individual, thus encouraging more responsibility of their health. As PCOS is not often talked about, opening up communication between one another, can help women keep on track with their treatment, since checking in with a doctor becomes less frequent until menopausal age.
Ova is an initial step on the critical path towards more accessible and communicative female reproductive health services. Its multiple facets improve the industry-to-individual communication in a modern and relatable way, encourages user agency of personal health, and removes stakeholder silos by getting more of each involved in feedback loops embedded within the service blueprint. The parameters of time and resources allowed the project to develop to a stage at which digital and physical deliverables are finalized for discussion with industry experts. In parallel, the service blueprint serves as a baseline for how the NHS could to develop this roll out, based on systems already in place for other healthcare services and added activity points for each stakeholder to interact with.
The next steps for this project is to forecast detailed expenditures, and compare short-term and long-term obstacles based on fluctuating budget and resources (i.e. technology, built environment capacity, scientific advancement, etc.). Ova also serves to showcase that medical conditions don’t always need to be addressed in a clinical way. It brands itself as a consumer product with its visual design, and enables a range of citizens to get involved with its light hearted and informative campaign material. At the current stage of this work, I am left with a few questions as I consider accessible healthcare at large. As society develops, specifically within the UK, more advancements in technology and science are flourishing — but who are they serving? Does everyone in our community know that they could benefit from these advancements? And what is being done for long-term preventative engagement of patient agency for their personal health? Further development in the field of healthcare will continue to benefit marginalized groups and conditions with research and design initiatives similar to this.