July 14, 2021

Co-designing a technology intervention to support the health and development of children

The King County’s 2018-2019 Community Needs Assessment revealed that infants from racially and economically marginalized groups encounter the highest rates of infant mortality and lowest birth weights compared to any other population.

King County has offered developmental screening services and virtual information to help child caregivers address this issue. However, there is growing consensus among healthcare providers and child caregivers that these tools do not adequately respond to diverse cultural, social and economic experiences.

Recognizing that these factors do not act in isolation and collectively impact child development, there is a need to create culturally-responsive and accessible interventions to support this historically underserved group.

To address this need, Julie Kientz, professor and chair of the University of Washington Department of Human Centered Design & Engineering, and Kendra Liljenquist, assistant professor of Pediatrics at the UW School of Medicine, have partnered to develop an advanced, smartphone-based technology that will provide culturally relevant activities and health recommendations to support healthy child development.

“When we began talking about the ways that we could reach families, the idea of using smartphone-based technology came up,” Liljenquist said. “This is a great opportunity to work together and collaborate to craft this new tool that will hopefully make a change for a lot of clinics and families.”

Traditionally, child development screening occurs during in-person clinic visits and the scoring time for screenings have proved to be lengthy and not always widely accessible. These barriers to screening access hold implications for early childhood health, curtailing timely diagnoses and evaluations of child health and development.

“There has been a big push in Washington for universal developmental screening and right now there are a lot of barriers with our current set-up,” Liljenquist said. “This tool will allow us to more readily identify kids and families needing developmental or social support [and] really make a change for a whole generation of kids.”

To develop this technology, the researchers combine their skills and expertise for this interdisciplinary endeavor. Liljenquist’s background in healthcare and child development will inform the design of the technology intervention that Kientz will develop through her background in computer science and human-computer interaction.

“There is this temptation to separate technology and content, but those two must be thought of simultaneously,” Kientz said. “[Liljenquist] and I are coming at this with different research questions from our respective fields, [which] is crucial for interdisciplinary work and important for ensuring a successful research collaboration.”

The researchers are also supported by Akeiylah DeWitt, a Ph.D. student in Human Centered Design & Engineering, with an interest in early childhood and health disparities.

“A main priority of this work is to respond to [child] health needs in a way that’s financially and culturally accessible,” DeWitt said. “Our goal for this project is to support those communities directly by creating a technology that is aware of and responsive to both the barriers to healthcare they face and the relevance of culture in early childhood health. We can only achieve that goal by valuing the community’s voice and offering them leverage in the design decisions we make.”

To ensure that the design of the technology meets all relevant stakeholders’ needs, the researchers are beginning their work with a series of community-driven co-design sessions.

The feedback from these sessions will enhance the researchers’ understanding of how families conceptualize child development and provide essential considerations to inform the design of the intervention tool, ensuring that the developmental screening tool is accessible and culturally-responsive.

“We want families to feel supported by our system, and to have a tailored health experience that is compatible with their expectations for health promotion, so they can continue to use it and fill the gaps in their health needs,” DeWitt said. “We hope that this technology can significantly reduce the disparities in access to child health promotion resources in King County.”

Currently, the researchers are in the preliminary stages of building relationships with different community-based organizations and stakeholders to compile a pool of co-design session participants from racial and ethnic minority backgrounds. These sessions will occur over the summer and will hear stories about early childhood experiences from varied perspectives.

This project is supported by a 2021 pilot research grant from the Population Health Initiative.

“With this funding from the Population Health Initiative, we have a whole set of funding dedicated to working directly with families to get their input on what this tool is actually going to look like,” Liljenquist said. “We’re going to be able to include many more families and community perspectives than we may have been initially.”

Additionally, the funding will enable the researchers to expand their tool to a broader audience.

“One thing with assessment development that doesn’t usually happen is to create an assessment in several different languages at the same time,” Liljenquist said. “With this Population Health Initiative funding, we are going to be able to do these sessions with English, Spanish and Somali-speaking families. That’s going to be great to get a lot of feedback from families of different cultures and with different languages.”

Following the co-design sessions, the research team will utilize their findings to ideate possible interventions to reflect a nuanced understanding of diverse cultural, social and economic experiences.

“One thing that we hope this technology will be able to [provide is] the customization or tailoring that’s needed for different families [with] different needs,” Kientz said. “It’s much harder to create many different paper versions of a tool than it is to adapt using technology to reach different populations.”

From the preliminary data and the development of a novel intervention tool, the researchers aim to support the healthy development of children in King County and beyond to improve population health outcomes.

“I imagine a longevity to what we build: if families benefit from it, the technology can continue to support them even after the project ends,” DeWitt said. “I hope that this work inspires other researchers and designers to adopt population-level perspectives to approach health promotion and create holistic solutions.”