Essential elements of co-design

Ayoung man with a black beard and hair is talking to someone across a table with coloured paper and pens. We need elements of co-design.Co-design in an academic context is part of participatory action research, or PAR. It’s used to understand, inform and change the design of policies, programs and services. But what are the essential elements of co-design? As we know, community engagement or consultation is not the same as co-design. Including diverse stakeholder and user perspectives is essential for developing best practice.

Gabrielle Brand and her team have identified five core co-design principles in the field of health education. Briefly they are: inclusive, respectful, participative, iterative and outcomes focused. These principles apply in other fields too. 

Core co-design principles 

Inclusive: Involve key industry stakeholders and consumers from the initial proposal design. That includes the development and framing of learning focus to final educational outcome and delivery.

Respectful: Health care consumers are considered “experts by experience”. All input is equally valued in design, development and delivery of education.

Participative: The research process is open, responsive and empathetic in co-creating education. It generates new understandings of health and healthcare experiences.

Iterative: A cyclic, collaborative process that takes time. It embraces movement towards a shared education vision. It includes the risk of failure.

Outcomes focused: The focus is on achieving a shared educational outcome co-created during the co-design process.

Brand and her team used conversational interviews transcribed verbatim for analysis. An organic iterative approach to data analysis developed shared understandings. Artefacts were also used in the process for eliciting sensory triggers for participants and for developing vignettes. 

The article details part of a vignette to explain how it was used with learners. It’s based on a mother of an adult son with a psychosocial condition. Members of the research team benefited from knowing they had valuable and legitimate expertise on a research project. 

Title of the article is, A research approach for co-designing education with healthcare consumers. It has a mental health education focus, but the methods are applicable in other fields. 

One of the issues with co-design and PAR is passing ethics approval processes. When an ethics committee labels particular groups as ‘vulnerable’ they apply different approval criteria. However, including the voices of a broad range of people involves the participation of vulnerable groups. 

The end result of this kind of research is to “transform hierarchical health care relationships towards a more humanistic model of care”. 

From the abstract

Context: Community and consumer involvement in health professions education (HPE) is of growing interest among researchers and educators. It prepares health care graduates to effectively learn from, and collaborate with, people with lived experience of health issues. 

Approach: We describe the background to our work with health care consumers including the five core principles for successful co-design and how to apply them as a research approach in HPE.

We used arts and humanities-based teaching methodologies including engagement, meaning-making and translational education strategies. This illustrates how this research approach has been applied to reframe mental health education and practice in Australia. Furthermore, we share some reflective insights on the opportunities and challenges inherent in using a co-design research approach in HPE.

Conclusions: For the consumer voice to be embedded across HPE, there needs to be a collective commitment to curriculum redesign. This paper advances our understandings of the educational research potential of working with health care consumers to co-design rich and authentic learning experiences in HPE.

Co-design research approaches that partner with and legitimise health care consumers as experts by experience may better align education and health professional practice with consumers’ actual needs, an important first step in transforming hierarchical health care relationships towards more humanistic models of care.

Assoc Prof Gabrielle Brand is based at Monash University Peninsula Campus.

Health professional education research

Two New Zealand researchers in health science say it is time to apply universal design principles to health education research. They take the universal design principles that originated in architecture and translate them to universal design for research.

The researchers use the The three pillars of universal design for learning (UDL) as the means to crosswalk from architecture to research. The aim is to embrace and enact diversity in research design. This, of course, means engagement with people most often excluded from health education research. 

The title of the article is,  Designing for justice: How universal design theory could bolster health professional education research.

 

Wayfinding system audit checklist

Front cover of the wayfinding systems audit checklist.Wayfinding is often considered as just signage instead of site or building legibility. A wayfinding system involves buildings, open space, lighting, and landmarks. It’s about providing consistent clues to help people navigate indoor and outdoor spaces. Wayfinding should be integrated into the design process in the early stages instead of being added as an afterthought. To help designers, the CRC for Construction Innovation has devised a wayfinding system audit checklist.

The Wayfinding Systems Audit checklist provides guidance for designing wayfinding systems. There is a mix of Australian Standards, thoughtful design, and end user convenience. It includes:

      • The application of tactile ground surface indicators (TGSI)
      • Signage and graphic communication
      • Auditory communication
      • Maps

The audit checklist supports the Wayfinding Design Guidelines also produced by the CRC. The many photographs illustrate key points.

Some basic principles

Provide frequent directional cues throughout the space, particularly at decision points along journeys in both directions.

The design of decision points must be logical, rational and obvious to a sighted user, ensuring the directional cues relate directly to a building or landscape space. Ensure sequencing and that the priority and grouping of message signs is unambiguous.

Design and implement a ‘naming protocol’ by choosing a theme for segregating places and spaces. Use names and symbols easily remembered by users from diverse cultural backgrounds. 

Consider incorporating information in multiple languages or incorporating pictograms when devising a naming protocol.

Ensure the physical placement, installation and illumination of signage is suitable for all users.

Published in 2007 by the CRC for Construction Innovation, supported by the Queensland Government. The CRC came to an end in 2009. The Australian Standard for Wayfinding (AS1428.4.2) was updated in 2018.

The Victorian Department of Health also has a useful wayfinding checklist for hospitals and health facilities. 

Audit also in previous post
https://universaldesignaustralia.net.au/systems-audit-for-wayfinding/

Model for ICT Procurement

Two open laptops facing each other with stylised bodies coming out of the screens to shake hands. Model policy ICT procurement. Accessibility and inclusion begins with procurement for any project. Often a scope of works is done by a non-expert to get the expert.  But if the scope isn’t targeted correctly, the consultants are committed to sticking to the scope in the contract. So, the consultants are “doing the thing right” but not necessarily “doing the right thing” for the intended outcome. Consequently, staff involved in procurement activities need to understand access and inclusion basics. That means co-designing of the scope of works to include accessibility requirements. 

The G20 Global Smart Cities Alliance  has a webinar and a model policy on their website about ICT Accessibility procurement. It states:

“Procurement policies are a critical lever in increasing accessibility. They set out the expectation, standards and criteria for how goods and services will be purchased, and through this the city can ensure the acquisition of universal designed products and services to safeguard the equitable development and participation of all.”

A procurement policy or code of conduct can: 

      • clearly document and ensure compliance with national legislation on accessibility and procurement, or
      • define a clear approach for ensuring inclusive and accessible services that demonstrates alignment with globally recognized standards, even if national legislation does not exist.

While the focus of the advice is on ICT procurement, the principles are applicable to other types of procurement. 

Model Policy

The model policy set out on this website looks very wordy and not an easy read. It’s aimed at city planners and policy makers in the context of smart cities. However, it does set out processes for tendering and contract management. It also includes a section on training, awareness and capacity building for all stakeholders. 

The model policy is worded in policy-speak so that cities and local government can copy and paste sections. The website has various Standards in an annexe and includes Definitions and policy references. 

The references include the UK Government policy and guide on accessible technology, and another from Chicago. Also included is the G3ict discussion guide for accessibility in public sector procurement. 

The model policy is available in English, Spanish and Japanese. A five minute video with James Thurston explains.

Karen Tamley, “The adoption of a policy like this is going really help your city to make sure that accessibility is part of your DNA”.

Tourism Accessibility Guides: Good examples

A heritage building in Scotland at night with nice lighting from the windows. Accessibility guides like this encourage more visitors.
One of the attractions from the Visit England website

According to the Visit England website, 63% of tourism businesses do not promote their access provisions for visitors. Yet 95% of visitors with access requirements look for this information before deciding to visit. The website also has advice and help for creating and publishing accessibility guides. It includes sections on photography, and how to create a location map and video guide. 

The Visit England website also has a link to a video and three good examples of tourism accessibility guides:

Self-catering example

The self-catering example has an easy to read webpage setting out where there is level access, and access to bedrooms. Under the hearing tab it explains the TVs have subtitles and a hearing loop. 

Under the vision tab it explains colour contrast, large print and Easy Read formats. They have non-allergenic bedding and a portable hoist. 

There is a three-minute video explaining the importance of this information and how businesses benefit. 

Restaurant example

The restaurant example explains they are a family run business and similarly to the self-catering example they cover level access, hearing and vision. They cater for a variety of diets and assistance dogs are welcome. 

Visitor attraction example

The example is based on a whisky distillery with a guided tour, a shop, restaurant and tasting experience. Visitors can check out level access, and provisions for hearing and vision.

The example guides are a good start, but would be enhanced by more photographs of the rooms and spaces. See previous post on The Kelpies for another good example of a guide for ALL visitors. This one is in the form of an access statement and includes several photographs to aid visitors.

Is your pub accessible?

Picture from front cover of the booklet showing two pubs and a man who is blind using his smartphone to order food. Is your beer accessible?The British Beer & Pub Association has a straightforward booklet of advice and good case studies for accessibility. It dispels a lot of myths, and many of the adaptations are simple, such as easy to read menus. It covers physical, sensory and cognitive issues that potential customers might have. So joke-type symbols for toilets are not a good idea, as well as understanding that not all disabilities are visible. Excellent resource for any food and beverage venue. As is often the case, it is not rocket science or costly, just thoughtful.

The title of the publication is An Open Welcome: Making your pub accessible for customers. “Pubs are places where everyone is welcome. It’s where family, friends and colleagues come together and where tourists to the country feel they will see the true, welcoming Britain”. 

 

Health, the digital divide and rural dwellers

A timber barn in a rural setting. Looks like it is on a farm. Health and digital divide. In the land of access and inclusion, the focus is usually on the built environment and services. But there is also virtual access and inclusion to consider. The pandemic has highlighted a lack of equitable access to the internet and therefore access to health services. This is particularly the case for rural dwellers. The issues of health, the digital divide and rural dwellers is discussed in a report from the US.

The context of the report is the social determinants of health and the digital divide. Broadband access and digital literacy are key for connecting to services such as employment, education and health services. While broadband infrastructure and computer hardware are necessary, true equitable access also requires focus on digital literacy and proficiency. However, there are other issues related to poor health outcomes. 

According to the report, rural residents are subject to additional social determinants including physician shortages, persistent poverty, and food insecurity. Excessive travel times, inadequate transportation options, environmental exposures are also problematic. And broadband internet services that are often poor quality, unaffordable, or unavailable. 

“Super-determinants” of health are poor transportation, lack of broadband access, and living with a disability. That’s because they cause disadvantage across other areas of life. 

The title of the report is Underfunded Infrastructure Impact on Health Equity. The study focuses on north America, but Australian rural dwellers share many of the same issues.

People are looking at bright orange pumpkins piled in rows in a field on a farmThe report recommends engagement and involvement by community members. Community health workers live and work in vulnerable communities, and they understand the real lives of people. Consequently, community health workers should lead community involvement in coming up with solutions. 

The report explains the social determinants of health, the cost of inequity, and the need for digital literacy training. 

Four key findings in the report

      1. Households with consistent broadband have increased health literacy, greater access to clinical and social services, make better informed healthcare choices, and stay closer connected to support systems of friends and family.
      2. A holistic approach led by health advocates from the local community has the best chance of improving health outcomes and successfully overcoming barriers caused by social determinants.
      3. Strategies for reaching vulnerable populations should center on community health workers (CHWs) who are trusted and respected members of that population. CHWs have an ability to better understand the reality of
        how people live and the obstacles that keep them from success.
      4. Program leadership should include meaningful representation from local community organizations with valuable experience in health equity and extensive community networks.

Readability and colour choices

Colour contrasts can be deceiving because we are subject to optical illusions. The video below shows how two different shades of grey are actually the same. That’s why you can’t rely on judging contrast by eye. Fortunately there are colour checkers to help with colour choices especially for websites. And why do you need colour contrast checkers? Because more than 8% of the population has colour vision deficiency (colour blindness). 

A semi-trailer is stuck under a bridge with the warning "low bridge" in upper case. Colour choice is one factor in readability. Others include using sentence case. Using upper case or capitals does not convey important messages more urgently. The image shows that using upper case to indicate a low bridge did not stop a truck driver from driving under it. Upper case is harder to read because the shape of the words are unfamiliar. 

The most accessible websites are those that have an Easy Read option.  A good example is the My Allied Health Space. At the top of the home page is the symbol for Easy Read and this is where you click to turn it on

Screenshot of Allied Health Space standard format.
My Allied Health Space home page with option for Easy Read at the top of the page
Screenshot my allied health space in easy read format.
My Allied Health Space with Easy Read option turned on

Thanks to Dr Em Bould, Senior Research Fellow at Monash University for the inspiration for this post. Dr Bould has great advice on this topic based on research. 

Co-creation for train station design

Artist view of a station pod showing the clock tower and a sheltered entry. Co-creation for train station design.
Impression of station pod from 7N Architects

Design Council in the UK is extending its experience in co-creation for train station design. Co-creation or co-design is the new buzz-word in access and inclusion. A large cross section of people had a say in the process of designing a station.

Network Rail want to build on the legacy of Great British railway stations to create the transport hubs of the future. Railway stations are an integral part of a community and can offer more than a platform and a train. That’s why they are including a community or retail space. 

Design Council and Network Rail ran a national engagement exercise called ‘ThinkStation’. They spoke to more than 320 people representing a cross section of people and ran eleven workshops. Nine priorities were identified for the next generation of railway stations:

      • Support existing and new communities in their local area
      • Reflect and embody local character and heritage
      • Provide consistent quality of space and service
      • Establish connections with and between town centres and/or high streets
      • Celebrate and improve the quality of green spaces and open spaces and/or provide access to them
      • Be welcoming and facilitate inclusive travel
      • Support and better integrate cross-modal transport 
      • Help to address climate change 
      • Ensure longevity by accommodating changes of use, capacity and trends

Co-creation engagement process

The engagement process covered three key areas:

      • Environment and sustainability
      • Inclusion and accessibility
      • Community and enterprise

Just over half of survey respondents said they feel welcome and safe when using their local station. More importantly, 86% said difficult interchanges sometimes prevented them from taking the train. 

Proposed train station designs

A standard pod design evolved from the engagement process. A video on the webpage explains.

Aerial view of the proposed station pod design.
Photo by 7N Architects

The pod design has sheltered waiting areas and facilities such as baby change and accessible toilets. The signage is easy to use and lighting is designed to make people feel safe. A tall clock tower is the station landmark and the first step in wayfinding.  

The illustrations are very helpful in visualising the project. The project is now complete and the full report published

An older woman is writing something on a wall chart alongside others.

 

 

 

 

 

Designing and reorganising transport hubs: A framework

Inside Kings Cross Railway Station in UK showing two floors with shops inside a giant atrium.Seamless transitions between walking, cycling and public transport are important for the environment, inclusion and for reducing traffic congestion. The MATCH-UP project in Europe developed a method to assess how policies are measuring up and creating design solutions. The method and background to the project are presented in an article published in Sustainability.

The aim of the method is to support designers and decision-makers who need to re-organise existing transport hubs and plan new ones. This detailed document is good for anyone in transport planning and transport policy, sustainability, accessibility and universal design in the built environment. Accessibility and universal design are embedded in all aspects and not listed at the bottom as an afterthought. 

The title of the article is, Assessing the Performance of Modal Interchange for Ensuring Seamless and Sustainable Mobility in European Cities.  

 

Accessible Pedestrian Signals

A street with a pedestrian crossing in a city. Accessible pedestrian signals.Accessible pedestrian signals are evolving. Audible crossing signals devised for people with low vision are a signal for all of us that it’s safe to cross the road.  And now we have the “guiding sound corridor” which gives increased guidance to reach the other side more easily. As soon as a pedestrian activates the signal, the guiding sound corridor emits at both ends of the crossing. Then they just have to follow the sound to cross the street. It gives greater safety and independence because the signal ensures they are going in the right direction.  

An article in the Inclusive City Maker blog explains the system. From a city planner perspective, this kind of device can encourage more walking for people with low vision and their companions.

How does it work?

The blog post explains that a guiding sound corridor needs to have 3 elements to be perfectly efficient:

      1. Poles with the accessible pedestrian signals (APS) need to be located face to face, on the same side of the crossing.
      2. The broadcast emitted by the audible pedestrian signals need to be led towards the crossing,
      3. Activation of the APS needs to be simultaneous –  both sides of the crossing are synchronized and paired.

A pole with a pedestrian signal button and instructions. A video on the blog site illustrates how it works.

Workplaces: Lessons from the pandemic

Graphic showing a laptop computer screen with coloured squares each with a face of a person. Workplaces: lessons from the pandemic.The pandemic has shown that workplaces can be almost anywhere. People who previously experienced physical barriers to workplaces found working online from home a blessing. But that doesn’t mean employers and managers don’t have to worry about accessibility and inclusion any more. Hybrid working where some staff are onsite and others online is where there are a few problems to solve. G3ict has some workplace lessons from the pandemic to share. 

Creating an inclusive workplace means catering for equity and accessibility in physical and virtual spaces. Platforms such as Zoom evolved quickly and now include automatic captioning for meetings and webinars. But there are additional things to consider in hybrid settings where some participants are online and others are in the conference room. 

Many conference rooms now include technology to accommodate hybrid meetings, but there is more to do. We need protocols around seating, placement of a sign language interpreter, captioning and the ability to use the “chat” function.  

Including people with disability – some tips

Including people with disability – and you might not know they have one – requires an approach that allows for equity and dignity. For example, a person should not have to ask for captioning to be enabled. If they have to ask they probably won’t because they don’t want to be singled out. If the captioning is clear, and AI captioning can be patchy, it’s good when sound is distorted or digitised. 

Not everyone will be viewing on a large screen, so presentation slides should allow for this. Large text with good colour contrast will ensure a higher level of readability for all. Not all vision conditions can be solved with glasses so it help people with low vision too.

Head and shoulders of James Thurston. He is wearing a light blue shirt and glasses and smiling to the camera.
James Thurston

The G3ict blog post discusses other details such as workplace furniture and products. Even fabric textures, patterns and colour contrasts can affect some people.  As the blog says:

“There is no handbook on how to create a fully accessible hybrid workplace, but engaging staff from a cross-disability perspective for ideas and product testing on both the physical and virtual side is critically important.”

“Set-backs in your plans should not be seen as failures but rather learning opportunities to move you towards a workplace that is accessible, inclusive and functional for everyone because truly hitting a “reset button” is not a singular action but a journey we must all be on together.”

When home is the workplace

A woman is sitting at a dining table typing on her laptop. When home is the workplace.Computers and internet provided the opportunity for some people to occasionally work from home. That was pre-Covid-19 when Home was still Home. But now Home is the workplace as well as home. It’s also been a place for education, long day care, and a place to stay safe. For some, home is all four at once: workplace, school, childcare centre and safe haven. Open spaces have taken on an increased value as a means of escape from the same four walls. But not everyone has easy access to open space, public or private.

Our homes were never designed for any of this. Not on a long-term basis anyway. Then there are the institutional homes – the aged care industry has not fared well in providing a sense of home for its residents. So we need a complete re-think about what it means to be “going to work at home”. 

A paper from Ireland looks at the impact of the pandemic on everyday lives and the need to adapt the built environment. The authors argue that: 

“There is now a key opportunity to implement universal design, to allow the best possible use of space, to enable everyone to live, work and socialise safely and equally.”

The authors discuss issues related to the public realm, housing design, and green infrastructure, and access for people with disability. They conclude that the pause mode caused by Covid-19 gives an opportunity to improve the lives of city dwellers. 

The title of the paper is, The impact of Covid-19 on our relationship with the built environment. 

From the abstract:

This article aims to explore the impact that the Covid-19 pandemic has had on the built environment in Ireland. It considers how our homes might suit the future needs of all citizens, particularly the needs of the most vulnerable members of society.

The growth in ‘working from home’ has highlighted architectural issues such as space within the home and the local community, as well as the importance of public and private open space. Covid-19 has exposed the most vulnerable, and the nursing home model is under scrutiny and will need to be addressed. 

The Covid-19 pandemic offers the potential for architects to provide a vision of a built environment that addresses biosecurity issues, accessibility and climate change. Architects need to re-purpose towns, villages, and urban areas, and develop new housing typologies which will integrate living and working within the one dwelling, and promote a sense of community in local neighbourhoods. Adaptable, flexible buildings alongside usable and accessible public spaces are necessary to meet change.

Access Statement for The Kelpies in Scotland

Giant silver coloured horse head sculptures depicting mythical Kelpies in a new parkland. Visitors can see the access statement for the Kelpies for information before their visit. The Kelpies are 30 metre-high horse-head sculptures in a new parkland area near Falkirk, Scotland. The project connects 16 communities in the council area and the Clyde Canal. The sculptures attract many visitors to The Helix site and the whole project was designed with access and inclusion in mind. This is apparent in the Access Statement for the Kelpies – a good guide for all visitors.

The Access Statement for The Helix and the Kelpie sculptures uses and plain language and lots of photos. The photos show key places such as car parking, the visitor centre, playground, café and toilets. Visitors can hire manual wheelchairs and dog bowls are provided for assistance dogs. 

The Access Statement is not an overarching policy document. It is a visitor guide that includes information about the level of access visitors can expect. One of the best examples of visitor access information – makes it good for everyone.

There is more information about this destination and how to get there on the Accessible Travel Online Scotland website. Accessible Travel Scotland also has an accessible travel hub.

The video below provides more information about The Kelpies, the largest public artworks in Scotland. It explains the story behind the sculptures and their construction. 

There is more information on travel and tourism on this  website. 

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