In the Spring of 2020 (what seems like a lifetime ago now), my team and I faced a decision—should we continue researching and developing a set of patient education materials amid a global pandemic, or should we pause and evaluate once things had “calmed down?” This thinking seems quaint now, but at the time we were at a crossroads. Ultimately we decided to push forward, researching with patients remotely to gather their feedback on the prototype materials and moving ahead with the project.
After months of testing and preparation, we are thrilled to share the results with you. With help from patients, providers, and staff, we created a set of materials to support patients during their in-person and virtual healthcare experiences, and to help health centers deliver best-in-class contraceptive care. The core materials:
- Welcome booklet to set the tone for the healthcare experience and prepare patients for their appointments
- Decision-making wheel to facilitate conversations between staff and patients on their birth control options
- Series of postcards offering more information about specific methods
- One-pagers that are easily printed on an office computer for patient take-home material or used virtually in telehealth settings
- Mobile-friendly webpage that helps patients make informed choices by filtering birth control methods based on side-effects, benefits, and bleeding changes and to learn more information on each individual method
We worked with an award-winning, human-centered design firm called Smart Design to conduct this work. The project took over 6 months to complete and included research on best practices from the field, focus groups, and 1:1 remote prototype testing with real people. Through this process, we identified that educational materials on contraception should be interactive, welcoming, credible, and respectful in order to resonate well with patients. The content, copy, and design work together to affirm those principles in order to facilitate positive patient experiences.
“The whole approach is asking a lot of questions versus just giving you statements. I like that format better. Makes it more personal. It makes me think.” — Patient
Research and testing
During our research and testing, we spoke to patients, staff, and providers from across the county. We spoke with a large FQHC, a hospital system, a pediatrics practice, and a tribal health center to understand the in-center patient journey and review our prototypes. We facilitated in-person focus groups and conducted 1:1 remote interviews with patients. Our goal was to center the voices and experiences of a diverse group. Patients varied in age, race, cultural background, marital status, and other self-identified factors. Participants were 18-35 years old and used a variety of methods, including withdrawal, condoms, and Fertility Awareness Methods. Some patients were on one method but were interested in switching, while others were not currently using any method of birth control.
Across these conversations, a few key themes emerged. From patients to providers, people wanted materials that emphasized choice, sparked conversations, enabled learning, and helped develop relationships. The patients we spoke to specifically wanted materials that:
- Helped them to have frank conversations about their individual birth control goals and needs
- Made them feel heard and understood regardless of their background, lifestyle, priorities, and birth control awareness
- Gave them the full picture of how methods work, including the possible likes and dislikes with each method
- Helped guide and reassure them in their decision-making
The through-line of these learnings was choice: people wanted to know their options when it came to birth control and feel supported in the choices they made.
Our voice and visuals
The priorities and perspectives of patients and healthcare teams informed the language and visual choices. The copy is conversational and friendly, without being overly medical or too casual. The design is modern and eye-catching, but not overly trendy. Our goal was to create materials that were accessible to people of varying reading levels and could be more easily translated into multiple languages in the future. This meant carefully considering each word choice and avoiding colloquialisms or slang.
Throughout this process we were acutely aware of the spectre of reproductive coercion and took care to ensure that our materials felt transparent and non-coercive. In practice this meant avoiding positive or negative qualifiers like using the words “good” or “bad” to describe methods and even removing exclamation marks in some places. And, as in our training and curriculum, we avoid gendered language.
“I like this info more because it spells it out…what I might like, what I might not like. Explains what I should be looking out for.” — Patient
Meeting the moment and future plans
This is a trying time for all of us. In our personal and professional worlds we face new challenges everyday. Though these times are difficult, at Upstream we are grateful for the opportunity to think creatively about ways to improve our program delivery and support our partners. Printed versions of the materials are offered on laminated and durable paper stock so that materials can be sanitized and long-lasting. The digital versions of the materials are accessible for free by our partners, and our staff will work with you to optimize their use in telehealth settings.
This project is an investment for Upstream and supports our ongoing commitment to centering patients in all that we do. We continue to gather feedback from patients and learn from our healthcare partners on ways to improve and opportunities to consider in the future. We are currently in the process of translating materials into Spanish and have plans to translate into other languages as well. We are also working with our partners to gather more feedback from tribal communities and gender-diverse people. Stay tuned for updates and additions in the months ahead.