Design and Social Justice Intersect in New Health Literacy Elective

Catherine Oldershaw

At times, reading the list of side effects on a given prescription can feel undeniably similar to reading the fine print on a legal document. The language is obscure, the print is practically illegible, and the form itself raises more questions than answers. In fact, the health industry is so complex that the term health literacy has emerged to describe the ability to find, understand, and use health information and services. A recent national survey found that only ten percent of American adults have all the necessary skills to make informed health decisions. Decisions aside, even the most basic health information is inaccessible to about thirty percent of American adults. 

“I wondered, why is design not at the forefront of this issue?” said Kristin Hughes, professor of the new Health Literacy Course at Carnegie Mellon University’s School of Design. This question led her, and Kevin Progar, a Project Manager from the Regional Health Literacy Coalition, to collaboratively develop a class that gives students the opportunity to comprehend these issues first hand, then design solutions based around those understandings.

“Last year, I spoke at a health literacy conference, and spent the day listening to a number of problems that healthcare professionals and their communities were facing,” said Hughes. “All were passionately committed to change, but many were facing challenges with finding ways to communicate with their patients.

“I knew that I wanted to get CMU students involved, and so I talked to Kevin about my ideas,” she continued. “We ended up spending a good part of the summer planning the course and reaching out to members in the Regional Health Literacy Coalition to ask if they might be interested in mentoring a student team.” 

What resulted was the first offering of a pivotal class: Health Communications for Low Health Literate Adults. This course allows students to rapidly prototype ways to address the specific health literacy challenges for some of the area’s most vulnerable populations.

In order to identify the most at-risk populations, students used findings from a regional survey, then partnered with the Regional Health Literacy Coalition, which actively approaching these issues in the community. From this organization, several constituent groups volunteered to collaborate with student teams. This close working relationship, gave students a platform to help guide their work in the field.

“The course looks at the current and future role that co-created heath communications and services have in shaping conditions for better access to care,” said Hughes. “Students have direct contact with patients and their support network through the RHLC. This partnership has provided students the unique opportunity to understand and respond to the needs of the patients and/or provider.”

For example, Design students Lea Cody and Rachel Reading worked onsite at the Penn Avenue Clubhouse, a workday-centered support community for adults in mental health recovery. Members of the Clubhouse fall anywhere on the spectrum of mental health – meaning the counselors there have to be prepared to address a vast array of needs from anxiety to schizophrenia. Their resources are stretched so thin that psychiatrists are only available to meet a patient once every three months for twenty minutes. So students are using design to leverage this small amount of time to ensure that it can be as efficient and meaningful to patients as possible. 

Understanding context was the key to developing usable materials. The design that Cody and Reading created, support the existing structure at the Clubhouse.

“Before their appointments they go to the Decision Support Center in the building, and do a mental health checkup, updating a form with their ‘Power Statement’, and a list of ‘Personal Medicine’ that they use,” said Cody. “We are creating a toolkit to help them visualize that information, and keep track of their progress from day to day, so they can know when to reach out for help if they notice any unhealthy trends."

Cody added that the success of design relies on testing and then being open-minded to unexpected solutions.

“In our first interaction with the members at the clubhouse, we thought that we had a great set of design research probes and were so excited about getting some great information back,” continued Cody. “While some worked as we expected, others turned out to be confusing for the members, a pain for us to walk them through, and the feedback we got was not useful at all. However we ended up using the forms of information that worked the best, tactile interaction with information and writing in a personal journal, to inform our final project.”

Unlike many other courses, students aren’t focused on creating solutions that meet their own design aesthetic, this course pushes students into the sphere of practical, easy to use solutions that have been co-designed with and for the people who will be using them. Moreover, the course provides an entryway for students to experiment with what it means to work on a critical topic in the emerging field of health literacy.

Often, the field of design focuses so broadly on emerging technologies and futures, that it neglects the more fundamental issues that affect millions of people every day. Courses­–like this one­–are creating ways for School of Design students to address today’s pressing challenges in the area of health and human services.

You can learn more about health literacy and the work being done to improve it at

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Date Published: 
Monday, November 30, 2015
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