Healthcare

Co-designing Primary Care That Communities Want and Will Use

Fall 2021

Graduate students participating in a workshop with ID's Equitable Healthcare Lab.

Equitable Healthcare Lab, in Collaboration with Rush University College of Nursing and The Community Builders, with Support from the Segal Family Foundation

PROJECT TEAM

Kim Erwin

Associate Professor of Healthcare Design & Design Methods and Equitable Healthcare Lab Director

Santosh Basapur

Assistant Professor, Department of Family & Preventive Medicine, Rush Medical Center and Director of Design, Rush University

Angela Moss

Assistant Dean of Faculty Practice, Rush University

Rose Mabwa

Senior Manager, The Community Builders

Terry Gallagher

Family Nurse Practitioner, Sue Gin Health Center, Oakley Square

CHALLENGE

What would a community-optimized clinic provide to residents?

Primary care is essential to equity, but it’s underused by residents in high hardship communities. Creating community-effective care models — care that residents actually want and will use—is essential to uptake. But what services do residents desire and trust?

APPROACH

We ran 9 co-design workshops with residents of a Section 8 housing complex on Chicago’s West Side. These generative sessions identified local priorities, preferred primary care services, and principles for service delivery. Participants were grouped into 1) parents of young children 2) male teenagers 3) “seasoned citizens” over 55.

OUTCOME

Mental health was the number one priority. Yes, they reported diabetes, mobility issues, chronic pain, etc. But this is not what keeps them up at night. “We need grief counseling. We need anger management.”

Peer-to-peer and group interventions were widely preferred over an individual therapeutic model. Participants highlighted that community members uniquely understand the real-world setting in which they live and struggle. And there is wisdom in their community that should be brought together and shared. They seek help growing themselves, families, community, and they want to avoid solutions that foster dependency on outsiders. Participants then designed a progression of mental health support services that promote self-reliance and localized problem-solving. This approach naturalizes talking about hardship (reducing stigma), shifts power to residents, promotes resiliency and stewardship in the community.