NALOXGO
Illustrating the importance of carriage considerations and target audience input in medical product design. A case study in re-designing take home naloxone kits for college campuses.
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Design for Health: Innovation Studio (OCADu); major research project
TEAM
graphics, research, report writing
ROLE
photoshop, illustrator, indesign, zotero, social media, limesurvey, canva
tools
CHALLENGE
Post-secondary students consume substances recreationally at a higher rate than the general population, yet few carry naloxone. As fentanyl is increasingly adulterated into other substances, these students are likewise increasingly likely to be subject or witness to opioid poisoning.
Solution
While NaloxGo is a conceptual product, it’s also a case study; it was developed as we investigated the barriers to naloxone kit uptake among post-secondary students and similarly aged lay-persons.
We found that the most significant barrier to both uptake and carriage was the size and bulk of most standard naloxone kits. Thus, we designed NaloxGo: a compact and carryable naloxone kit based on the input and needs of students, for use by anyone involved in or in proximity to recreational substance use.
KEY FEATURES
Easily carried (in your bag, as your bag, in your pocket, on your belt, etc)
Multiple colour options for visibilty or discretion
Drug testing resources provided
Pockets for extra personal items
i.e., bank cards, bandages, test strips, etc
ADDITIONAL FEATURES
Anti-slip adjustable (and removeable) strap
Reflective logo to spot in the dark
Instructions for use printed on inner lid
no more unfolding extra sheets of paper in point 2 font size
Prototyping &
dESIGN REQUIREMENTS
Our prototypes designs test out our design requirements in different ways. The design requirements, as determined during the research process (explained below) are:
Multiple appearance options for either discretion or visibility
Inclusion of drug testing resources
Instill use confidence in laypersons
Intranasal applicator
Ergonomic size (compact)
Quick + efficient access to contents
The Materials prototype (right/below) is effectively the final design for NaloxGo.
Similarly, many other of our prototype designs contain elements that had direct influence on the iterative process and development the final design, such as the strap-based kit. Others had more subtle influence, like the mini-case kit design. View both below.
Though NaloxGo is ultimately a research case study, we also constructed rough prototypes out of pizza boxes and dollar store materials as a means to further investigate affordances the structure, shape and function might provide.
PROCESS
Literature review
area a. the opioid crisis
Opioids
Stigma
Intersectional Considerations
Harm Reduction and Naloxone
area B. ADJACENT DESIGN
Emergency Communication Design
Design in Stigmatized Healthcare fields
Carrying Behaviour
Target Audience
Subject Matter Expert Interviews
SMEs from fields of
harm reduction
health design
public health
These interviews informed us of how to direct our literature review, as well as how to proceed with our primary research; later interviews provided us with expert feedback and points of view on our research results and design prototypes.
SuRVEY
Through OCADu and social media channels, we conducted a survey that investigated carrying behaviour, naloxone kit awareness, and naloxone kit design preferences.
Respondents: 58 English-speaking students between the ages of 18-34, living in Canada.
Survey findings made it clear that more research into item carriage was necessary.
Figure 1. Over three quarters of respondents reported that on a typical day, they avoid carrying items larger than pocket-size.
Comparatively, only 8 respondents reported that they carry any type of emergency kit.
Figure 2. Self-reported items can provide some insight into the limits of daily-carried items for students (such as a slim phone, carried by all respondents, versus a larger waterbottle, which was the 4th most reportedly carried item, by 21 respondents).
Figure 3. Respondents’ explanations of why they do not typically carry a naloxone kit suggest; a) a lack of awareness or understanding of what naloxone and opioid overdose are, and b) some barriers to uptake are item bulk and confidence.
USER PERSONAS & JOURNEY MAPS
In lieu of a R&D workshop with student participants (which was not feasible due to compounding pandemic issues and restrictions), we created several user personas of students, as well as empathy and journey maps for each. Below is an illustrated graphic medicine example of a persona’s journey equipped with a standard naloxone kit.
impact & reflectionS
NaloxGo is valuable as a case study in naloxone kit design. Our research revealed a need for further investigation into item carrying behaviour and habits, particularly for first aid/emergency kits and other medical items. In addition, our data is for student populations, and further study is needed to confirm if it can be extrapolated to general populations.
Another design direction that arose from NaloxGo is developing drug testing resources and awareness. An easily sortable online database of testing locations and information, facts about different substances, and other such resources.
Similarly, students and recreational substance use is another area for future research that could elucidate how to increase naloxone training attendance, carriage, and awareness.
Concerns
As its visibility inevitably draws attention, the main reactions to the concept of a brightly coloured THN kit were:
Approval of NaloxGo as a means to confront the stigma of substance-use disorders
Apprehension that this approach minimizes the seriousness of the opioid epidemic, either via
Trivialization of opioid poisoning response, resulting in exacerbated stigma towards substance-use disorders,
or
Encouragement of substance use
RE: Trivialization of harm reduction
During the design process, I was in the first camp of concern. I feared that an aesthetically-considered design would commodify naloxone, patronize end users and PWUO, and make light of the deaths we are trying to prevent. However, the feedback from harm reduction experts and critique sessions was that it’s much more imperative to “get naloxone into as many hands as possible”, rather than worrying about trivialization. Normalization among lay persons is the goal because it will save lives.
RE: encouragement of substance use
Research shows that harm reduction and reducing stigma is not correlated with increased substance use. To receive a naloxone kit, one first must receive training; individuals are not seeking out THN kits while being unaware of the potential harm of substances. Our hope is that our target demographic will pick up THN kits up because they are aware of the harms.
incorporating feedback
These concerns make it clear that when sharing our design, we needed to simultaneously to dispel misconceptions. We put together an info and facts package to share during our grad exhibition, and almost every person who spoke with us said that they learned something new or that their entire perception of the opioid epidemic had changed with a few simple facts.