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Case Studies

Pediatric Asthma

How might we re-imagine pediatric asthma care in Baltimore?

Project Overview

The prevalence of pediatric asthma in Baltimore City has been estimated to be twice the national average. In partnership with healthcare professionals at JHCC Pediatric Pulmonary Asthma Clinic, parents of children with asthma, and other community stakeholders, MICA’s Center for Social Design worked to better understand the barriers in pediatric asthma control and develop design prototypes with the ultimate goal of improving outpatient pediatric asthma care.

Process

We began our research with the following question in mind: How might we improve outpatient care for pediatric asthma in Baltimore?

Research

Our research process began by doing various readings that helped contextualize pediatric asthma in Baltimore and helped give the team a sense of existing interventions. In addition to the readings, all team members were asked to participate in community engagement activities related to pediatric asthma. The last phase of research was conducting interviews with various kinds of stakeholders to gain direct knowledge from those involved about their experiences with outpatient care for pediatric asthma care in Baltimore.

We talked to:

  • 3 doctors, 1 nurse
  • 3 social workers
  • 2 community advocates
  • 10 caregivers
  • 2 adolescent asthma patients

Synthesis

We Identified several key themes from the information we gathered through the research phase and paired those themes with some key insights:

  1. Success relies on team effort. Medical providers tend to only engage caregivers in conversations about asthma, leaving the child out of the conversation.
  2. What happens at home matters. Knowing about the patient’s home life not only builds trust and collaboration between provider and caregiver, but also allows the provider to give better healthcare advice for patients.
  3. Being a caregiver is hard work. Providers may not always know what the caregiver’s support systems are like, and that may affect the quality of trust and collaboration between provider and caregiver.

Ideation

As part of our ideation phase, we conducted a brainstorming session with providers and caregivers to come up with possible interventions based on our insights.  Our prompts included:

  • How might we shift asthma education from instruction to a conversation?
  • How might we help providers understand the lives of their patients and their families?
  • How might we create opportunities for caregivers to share their needs with providers?

The goal of this brainstorming session was to be ambitious and not afraid to think outside the box. Focused on having quantity over quality, we filled five boards with a variety of ideas and proceeded to vote on our favorite ones. Having stakeholders involved at this stage of the process allowed us to check-in and get a better understanding of the kinds of interventions they were most interested in.

Prototyping

After our ideation session, we took a closer look at the ideas with the most votes and created lo-fi prototypes of what those interventions could look like.

We identified the prototypes that best addressed our key insights and worked on further developing them. During our final shareback session, providers and caregivers were able to interact and give their feedback about the prototypes.

Through this shareback session, we were able to gain a lot of understanding about how our prototypes could be used and we were able to further develop the prototypes into the following forms:

  1. All About Me! Asthma Activity Sheet
    For this idea, young patients, with the help of their caregiver, work on a fun activity sheet in the waiting room about themselves, their homes, family, and what they know about their asthma care. The completed sheet can be handed to the provider to review during the appointment. This allows the provider to get a better sense of the life of the patient outside the clinic, as well as what the patient knows about their own asthma care.
  2. Conversation Starter Pack for Pediatric Asthma Care
    This prototype is to encourage more personal conversations between patients, caregivers, and providers. Providers can start a fun conversation with their pediatric patients by pulling a card from the Conversation Starter Pack and caregivers are encouraged to join the conversation. This prototype is made to help providers connect better with their patients/caregivers and build a foundation for collaboration. 
  3. What's Your Ideal Support System? Worksheet
    In our research, we heard that support systems are really important for caregivers. However, not everyone has access to strong support networks. The "What's Your Ideal Support System?"  worksheet allows a social worker to have a conversation with the caregiver regarding their current and ideal support systems, giving the social worker an opportunity to share resources that might help bridge the caregiver’s needs.

Learn more about each of the prototypes here.

Implement & Iterate

You can find a link to download and print each of the prototypes here to use in your own setting:

Articles & Publications

Project Team

MICA Center for Social Design: Franki Abraham, Katie Mancher, Delaney Todd, Kimmy Tsai, Amanda Velez-Cortes, Maddie Wolf, Christina Yoo

Johns Hopkins Children's Hospital: Mandeep Jassal, Hilary Heslep, Christy Sadreameli, Helen Hughes, Arlene Butz, Cassie Lewis-Land, Kate Bosley

Graduate Teaching Intern

Ashley Eberhart

Project Lead

Becky Slogeris

Toxic Tour with Glen Ross exploring environmental racism in Baltimore. + Enlarge
Mapping asthma rates and resources in Baltimore. + Enlarge
Ideas from shareback session with caregivers and pediatric asthma providers. + Enlarge
Initial prototypes of tools for caregivers and providers. + Enlarge
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