Project Overview
Client: California Regional Centers
Duration: 7/2018-7/2019
Contributions: User Research, Design Strategist, User Interaction Writer
Team: Yvette Portello,Toni Donovan, Kate Jamison-Alward 
I authored a service design providing sexual and reproductive health education in a variety of formats for Planned Parenthood Northern California which was "vendorized," (contracted) and filed within the Regional Center's "vendor" system. It is currently deployed in the following California counties: Del Norte, Siskiyou, Modoc, Humboldt, Trinity, Shasta, Lassen, Mendocino, Tehama, Plumas, Lake, Glenn, Butte, Colusa, Sonoma, Napa, Solano, Contra Costa
Crosshatched lines show where the service is currently provided. Red lines emitting towards the southern end of the state show the potential reach. 
Design Opportunity
My team taught at 62% of schools in the three northernmost counties in California and noticed a majority were not in compliance with California state education mandates (as outlined in the CA Healthy Youth Act). Sexual and reproductive health education is mandated across the state for all students-including students in special day classes- twice before graduating high school. 
With the support of my manager and teaching team, I was allowed to explore this issue, and what it meant in the context of my community.   
Photo by Dids from Pexels
How might we improve access to sexual and reproductive health education in California to include all populations?
Research
Laws are in place to ensure equality. Unequal education indicates systemic inequality. Systemic inequality is wicked. To achieve a dynamic understanding of this issue, I explored pre-existing research, spoke to various stakeholders in the community, and interviewed experts. 
Research Method 1: Naturalistic and Participatory Research
I conducted participant observation within various events and settings. These included: networking events for people who have special needs or their families, networking events with other special needs service providers, transitional housing facilities, behavioral health facilities, local conferences, health fairs, classrooms, training for the Department of Health and Human Services, etc. I mapped out stakeholders to better visualize connections and derived a few findings. 
Tabling at a health fair 2018
Provider networking event 2018
Stakeholders
This stakeholder ties the two largest tertiary stakeholders to primary stakeholders.
Findings
1. There were unmet sexual and reproductive health education needs from school-aged children to adults with special needs. 
2. PPNorCal Health Education Specialists were uniquely positioned to provide this education because of our expertise and resources.
3. California Healthy Youth Act mandates are difficult for many schools and teachers to accomplish alone. 
As requests started to come in for education, I started conducting my literature review and came across some formative key findings.
Research Method 2: Literature Review
I conducted a literature review to learn about education: needs, topics, curricula, tools, and what factors inhibit service provision. I discovered the following key findings:
Some of the curricula included in the literature review. 
Findings
1. This population is 7x more likely to experience sexual abuse than other populations and less than 13% of service providers in North America provide sexual and reproductive health education to populations who have special needs (Vice). This is often tied to lack of funding, coordination, and negative attitudes (World Health Organization). 
2. As according to various curricula and the Sexuality Information and Education Council of the United States, the education provided to this population is only as effective as an educator's ability to adapt the content to the needs of the individual (Siecus). 
As I gained a better understanding of the needs and barriers for providing education for this population, I geared up for a panel interview with Regional Center experts. 
Research Method 3: Networking and Subject Matter Expert Panel Interview
Redwood Coast Regional Center office- where SMEs work relentlessly to provide quality services to people with special needs. Our panel interview was here.
By conducting a panel interview, I aimed to: learn about issues affecting local Regional Center clients, resources needed by Service Coordinators and other professionals, and establish a professional working relationship between the Regional Center and my team. 
From networking and my panel interview with the Redwood Coast Regional Center, I learned:
Findings
1. Professional and non-professional advocates wanted sexual and reproductive health education for people who have special needs. This reflected findings from my literature review (Siecus).
2. The Regional Center wanted to collaborate on a plan with Planned Parenthood Northern California to provide this necessary education. This could bypass systemic barriers within the education system. It could also help adults access this necessary education.
I used these findings and experience to formulate some insights:
Insights
1. People who have special needs were vulnerable not because of their mental, physical or emotional disposition, but because of their occlusion from typical sexual and reproductive health education. This occlusion was symptomatic of unequal treatment, deficient understandings of abilities and dessires, and a lack of dynamic education. 
2. Education is a means of proactive intervention not just to avoid negative consequences, but to ensure positive outcomes. Positive outcomes require adaptable education.  
3. Collaboration improves the quality of education. By incorporating multi-valent stakeholders, we can better identify methods, goals, objectives, and outcomes.
Conceptualization
After our panel interview and further meetings with the Regional Center, it was evident the best way to contract with the Regional Center would be to produce a service design. I derived principles that would structure this design. 
Design Principles​​​​​​​
Photo by Cliff Booth, from Pexels
1.Motivate empathy between PPNorCal staff  and vulnerable populations.  By relating individual stories to statistics, I could leverage our mission of education "that empowers all people."
2. Customize education to an audience or an individual to be effective. In this case, using information obtained through a Release of Information could ensure a wholistic education experience.
3. Create collaborative networks. This can drive greater community impact from the individual to interorganizational scale.
I would need to coordinate, mobilize and motivate my peers within my community and organization while iterating on a service design. To start, mapping out a service blueprint could help better conceptualize various touchpoints before getting into the granular logistics of education. 
Service Blueprint
This service blueprint was approached with an emphasis on systems and collaboration in order to align research findings and design principles with outcomes.
 Planned Parenthood Northern California's Service Design for Accessible Education
This shows, at a high level, the general process required to create a lesson plan specific to the needs of the client. 
Client-Specific Intake
This flow chart combines swim lane visualization to show how each of these steps is connected and sequential. 
The intake process consists of:
1. Negotiate services between Health Education Specialists and Service Coordinator.
2. Develop goals through Release of Information in collaboration with stakeholders and advocates. 
3. Implement education and record progress towards specified goals.
4. Track outcomes, report outcomes, and iterate depending on outcomes. 
Features: Custom Education Design

Goals are specific, measurable, attainable, relevant, and time-bound. The instructional design is dynamic and thereby achievable.
Varied resources are integrated into specific lesson plans.
Features: Release of Information
A Release of Information ensures a collaborative, dynamic, and informed education experience. Shared information is used to select tools, strategies, resources, and understand personal histories. 
Features: Iterative Education
This education model borrows mixed methods applied research from applied behavioral analysis. By combining qualitative and quantitative information in our progress tracking, we are able to apply findings in future iterations of lessons for a group or client. 
Mixed methods and XD applied research and education design
Features: Add-on to the Accessible Service Design
As our services started to garner attention locally, I was contacted by Dr. Laurie Sperry, a leader in the field of inclusive education, Psychiatrist, and Board Certified Behavior Analyst, who has developed a group learning program for people who have special needs in California and Colorado. She offered to help train our education team to facilitate group learning.
I wrote an addendum to our service design with new billing rates and a few other specifications related to group learning. I also developed a guide for internal use that any Planned Parenthood in the state of CA can use to set up and model their services for any Regional Center in CA.
Outcomes & Impact
Planned Parenthood is the largest sexual and reproductive health education provider in the country. California has one of the largest populations in the US. Every Planned Parenthood in California now has a contract on file with every Regional Center in California. (Research finding #1 from the literature review- less than 13% of providers in North America provided this education when I started this service design). 
  
Individualized education and group learning are currently being implemented throughout the PPNorCal region. 


PPNorCal has facilitated group training events for other service providers and specialists to better disseminate awareness and resources throughout Northern Ca.
PPNorCal has built a library of physical and digital resources including books, curricula, educational DVDs, apps and digital content, trainings and certifications for our staff.

A sample of highly specified education material from the accrued library

 

This is an excerpt from my performance evaluation 9/20. Feel free to ask me for any additional documentation such as coordination, writing, or lesson plans related to the service design.
Looking Back and Looking Forward
Takeaways
1. Healthcare and education systems are dynamic and constantly evolving. To appropriately navigate these spaces, it was important to scaffold education services with an ability to adapt to new input. 
2. Systemic opportunities require systemic responses. Collaboration can help provide a larger network for people who have special needs.  
3. Service design has the ability to infuse communities with more equity. The design of these services allowed stakeholders to bypass systems that are reluctant to follow-through or offer education even when it's needed. 
Reflection
"Accessible design is good design. It benefits people who don't have disabilities as well as people who do. Accessibility is all about removing barriers and providing the benefits of technology to everyone."  -Steven Ballmer
Designing for an often occluded 15% of the world's population enables me to design for the remaining 85%. I can connect people to goods, products, services, and technology that create dynamic impact for users and stakeholders alike. This led me to my graduate studies at UW's Master's of Human Computer Interaction and Design program where I learned emerging methods and theory to design with a larger breadth, depth, and impact (see more projects below).

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