It’s About Navigation
In this blog, we share what worked well (and indeed what did not) about the 12-month long social prescribing pilot we designed and delivered in Kings Heath, in the form of the 7 citizen engagement “tools” that participants rated the most impactful. We also try and share “why” and “where next” in this post.
High impact engagement tools and % of Members Who Rated Them “Good” or “Excellent”
When we were invited to design the service model, we started with the hypothesis that the people referred to us would desire, first and foremost, to “be heard”. That meant no assumptions; no methodology; no silver bullets; and absolutely no “here’s one we made earlier!”
When You Expect 40 members and 60 turn up – it’s like huh-ho?
We also agreed, as much as possible, that any interventions we co-designed should be more “social” than “medical” in nature. There was just pure endeavour to listen and learn. The main research question we posed to Members during the evaluation was “would you recommend the Happy Hub to your friends or family?” A score of over 72% would have been excellent. Over the course of the pilot responses scored around 81%. This was borne out by the consistently strong attendance throughout the pilot, which ran for 12 months from March 2018.
During one particular month, around 40 Members confirmed their attendance then more than 60 people actually attended (including children, friends, family members). This caused us great concern at first. We had to face the question of whether we were inadvertently creating new layers of dependency in the cohort.
There is no way of knowing for sure what’s going to work and what isn’t
When we explored the data in more depth, we found Members were actually bringing their friends and family with them because they felt they would either benefit or contribute. Often both. The power of “word of mouth” was creating a positive multiplier effect in terms of engagement and attendance. One such “uninvited” person turned up “on behalf” of his sister who had been hospitalised. He had picked up the postcards when he went round to check on her house, and, as he put it, “something inside me told me to come along.”
There was no way of knowing, before implementation, what was going to work and what wasn’t. The results were both surprising and heartwarming. The upshot of this approach was that we spent a lot of time gathering data and playing it back over and over to make sense of it all. Remember these were people whose doctors believed a medical appointment was not the right solution for what ailed them.
What Members Told Us Worked Well
1. Wellbeing Journal
The journal was designed to act as a self-help monitoring tool, whereby members could track their wellbeing journey in a way that made sense for them. We distributed 50 copies and one of the Members turned Maker (Chantelle) stepped up as the peer to peer lead for navigating the process. Bullet journals have become increasingly popular over the past few years.
Our design contains specially formulated psychometric exercises that support and encourage positive thinking and sustained behaviour change. In particular, the journal focuses on the user’s relationship with food; physical activity; forward planning of wellbeing goals and emotional resilience.
2. Health Bar Cookbook and Recipe Cards
This was the biggest and best surprise. Education and support with behaviour change concerning nutrition, diet and increased physical activity was always a key component of the service. This was facilitated through 1-1s and group sessions. We also provided a lunch featuring fresh samples of dishes that illustrated the nutrition themes discussed on event days.
Many of the members were keen to try these ideas at home and therefore asked for recipes and detailed guidance on preparation. They asked, what’s the best cooking oil to use? Is there a substitute ingredient for people who suffer from allergies? In engaging this way, we found they were mostly concerned about their long term medical conditions and wellbeing goals.
This gave birth to the popular recipe cards with accompanying nutritional and information. Over time, so many recipe cards become a book. So we’re now working on producing a cookbook resource, which we will also make available digitally.
When all is said and done and we haven’t been able to connect with a Member in any given cycle, we send a personalised postcard. It’s interesting in this so-called “digital era” how many Members really appreciated the tangibility of an old fashioned envelope coming through the post.
The postcards contained a personalised message which served to promote the notion of a membership arrangement over that of a reminder to attend. In terms of impact, on 9 occasions during the pilot, it was the postcard that finally prompted the Member to come along to the first of their many visits to the Hub.
4. Pledge Card
Pledge cards were a “spin-off” from the wellbeing journal. We were 7 months into the delivery and Members were constantly asking “how can I help and/or get involved?” We noticed that “interest groups’ were forming organically around the wellbeing themes. So people were bringing each other gifts like gluten-free bread; books; packets of seeds; or ingredients they had grown in their gardens or allotments.
We thought it would be a good idea to try and capture this activity in the form of pledges and have people share their experience through storytelling. And so the Pledge Card was born. Its design expands on some of the more effective psychometric content in the Bullet Journal. They are non-prescriptive in that pledgers are free to choose to from categories or opt for a pledge entirely of their own making.
5. Makers’ Newsletter
We quickly discovered that the Makers needed a different dataset to maintain engagement. How to keep track of this ever-changing picture of which Members were planning to attend a workshop and what conversations they would like to see there. There was a little bit of “why can’t the members settle for one thing or another?” However, life in the community is a messy affair when viewed through a more structured lens. Things are constantly changing. This part of the equation, therefore, called for a new kind of “peer to peer” thinking and courageous flexibility about the provision on offer.
Members and Makers were equal partners, not the respective source of problems and neatly matched solutions. The Makers’ Newsletter ensured all contributors were well informed of the topics and timings for talks and discussions. The Newsletter also served as the means through parties who could not attend the events on the day remained informed about the ongoing wellbeing conversations.
6. Wellbeing Voucher
The wellbeing voucher was proof that we could match the requirements of Member to a Maker and measure two important things about the transaction. One it took place and two both parties were happy.
On the occasions where the voucher worked best, it served as an incentive to connect Members to vetted Makers who could address specific wellbeing needs. In this scenario, the requirements were defined by the Member and the service acted as an “honest broker”. This built trust and provided work for the local community, whilst offering special rates and discounts.
The answer to this question is literally “back to where it all started“. Around this time last year, we attended a hack that ran over two days at STEAMhouse, an amazing social innovation Lab run by Birmingham University. Along with a group of tech organisations; artists; medics and patients we explored design ideas for improving the experience of patients attending community rehab services.
We became part of a team that looked into the psychological factors and personal ecology of people who had a high risk of not attending their medical appointments. That’s very much where it all started for us. We were able to take the thinking from that event and use it to inform and shape the design of the pilot.
We think there is a strong potential for increased workability; scaleable reduction of over-dependence on statutory services, and a lot more surprises yet to be discovered. We have been actively exploring the digitisation of these outputs in partnership with STEAMhouse Labs and, with the support of local system partners, hope to further test and develop in “pop-up” spaces across the city. Most of all, we hope to encounter more Happy Hubbers in the process. Find out more here <STEAMhouse>