1. The use of creative research methods for the development of technologies to support older people to live independently
Nikki Holliday
Senior Researcher
Faculty of Health and Life Sciences
Coventry University
ICT4HOP| 14 – 16 August 2017

2. Background Psychology Health Design & Technology Institute
Faculty of Health and Life Sciences
Presentation is the journey of my research from traditional social science to design influenced research methods
Psychology – training in traditional social science research methods
HDTI – commercial research
CTEHR – still commercial research but focus on more academic projects, has allowed more space to explore new methods and evidence for them

3. Background Psychology Health Design & Technology Institute
Faculty of Health and Life Sciences
Presentation is the journey of my research from traditional social science to design influenced research methods
Psychology – training in traditional social science research methods
HDTI – commercial research
CTEHR – still commercial research but focus on more academic projects, has allowed more space to explore new methods and evidence for them
© Coventry University

4. Background Psychology Health Design & Technology Institute
Faculty of Health and Life Sciences
Presentation is the journey of my research from traditional social science to design influenced research methods
Psychology – training in traditional social science research methods
HDTI – commercial research
CTEHR – still commercial research but focus on more academic projects, has allowed more space to explore new methods and evidence for them

5. Creative methodologies
Research methodologies influenced by the design paradigm, which harnesses the “collective creativity” and expert knowledge that users, patients and other stakeholders have with regards to the development of products and services to address their problems and match their needs. Includes, but is not limited to, methodologies and tools that use approaches such as co-creation (any act of collective creativity) and co- design (collective creativity applied to the whole span of a design process – Sanders and Stappers, 2008)

6. Tools
As well as multiple stakeholders, creative methods encourage the use of a wide rnage of tools with which to collect data, and also to present data and questions to ppts.
Helps ppts to understand concepts:
METAPHORS
2D/3D PROTOTYPES
Not just relying on verbal conversation and turn taking
Examples – ppl who don’t have English as a first language, deaf lady from COMODAL groups
From: Sanders and Stappers (2012)

7. Tools – existing technologies
Refer to case study 3
Web app = app
Utilising existing tech in a different way, or a new combination, or with a new group of people
Can be used to both prototype (demonstrating) and repurpose (demonstrating and creating data)

8. COMODAL COnsumer MODels for Assisted Living (COMODAL)
Technology Strategy Board/Innovate UK funded
Supporting the development of a consumer market for ALT
Gain an in-depth understanding of barriers to market development
Creation of consumer led business models developed through collaboration with potential consumers of assistive technology, industry, and third sector stakeholders
WP1 – explore barriers and enablers to assistive technology purchase and use – traditional social science methods
WP2 – explore ‘ideal’ customer journey… how to engage older people with business and tech speak?
The move to creative methods
The COMODAL – Consumer Models for Assisted Living Project – aims to support the development of a consumer market for electronic and digital assistive technology and services by:
Gaining an in-depth understanding of barriers to market development
Creation of consumer led business models developed through collaboration with potential consumers of electronic assistive technology – younger older people, and industry and third sector stake holders.
The first phase of the research, which sought to find out what younger older people currently know about assistive technology and current barriers and enablers to purchase, utilised a more traditional approach – focus groups.
The focus groups collected rich, saturated data which allowed us to plan the second phase of the research – exploring the ideal consumer journey when purchasing electronic assistive technology.
We wanted to design and plan the ideal consumer journey, so we needed to take a service design approach. Because of this, traditional approaches just weren’t going to give us the data we needed. Also, because awareness of assistive technology is quite low – as we found in the first round of focus groups – we needed to give participants as much help as possible when asking them to consider a consumer journey they might not have even thought was possible to them.
Because of this, we utilised a co-creation approach, using a bus journey as a visual metaphor for the consumer journey, breaking up each stage into a bus stop – so identifying a need was one bus stop, seeking information was another bus stop, etc.
© Coventry University
Holliday, Ward & Fielden (2015)

9. The move to creative methods
The COMODAL – Consumer Models for Assisted Living Project – aims to support the development of a consumer market for electronic and digital assistive technology and services by:
Gaining an in-depth understanding of barriers to market development
Creation of consumer led business models developed through collaboration with potential consumers of electronic assistive technology – younger older people, and industry and third sector stake holders.
The first phase of the research, which sought to find out what younger older people currently know about assistive technology and current barriers and enablers to purchase, utilised a more traditional approach – focus groups.
The focus groups collected rich, saturated data which allowed us to plan the second phase of the research – exploring the ideal consumer journey when purchasing electronic assistive technology.
We wanted to design and plan the ideal consumer journey, so we needed to take a service design approach. Because of this, traditional approaches just weren’t going to give us the data we needed. Also, because awareness of assistive technology is quite low – as we found in the first round of focus groups – we needed to give participants as much help as possible when asking them to consider a consumer journey they might not have even thought was possible to them.
Because of this, we utilised a co-creation approach, using a bus journey as a visual metaphor for the consumer journey, breaking up each stage into a bus stop – so identifying a need was one bus stop, seeking information was another bus stop, etc.

10. Just two cocreation sessions were held with potential users:
So now for a project where we had a fully creative approach, using cocreation with a variety of stakeholders to design a new consumer focused technology service to support older or vulnerable people to live independently by using sensor and mobile technology to connect family, friends and informal neighbourhoods, and enable them to support their loved ones more easily.
Just two cocreation sessions were held with potential users:
Users – older people and their carers
Designers – product, graphic, technology
Researchers – as facilitators
Stakeholders – technology, industry, third sector
Holliday, Magee & Walker-Clarke (2015)

11. WarmNeigbourhoods
Innovate UK – Delivering Assisted Living Lifestyles at Scale (dallas) programme
Aim – develop a consumer service which could be used to support older/vulnerable people living at home and help their friends and family more easily support them
Co-creation workshops and rapid prototyping
USE OF CREATIVE METHOD AND EXISTING TECH
So now for a project where we had a fully creative approach, using cocreation with a variety of stakeholders to design a new consumer focused technology service to support older or vulnerable people to live independently by using sensor and mobile technology to connect family, friends and informal neighbourhoods, and enable them to support their loved ones more easily.
Just two cocreation sessions were held with potential users:
Users – older people and their carers
Designers – product, graphic, technology
Researchers – as facilitators
Stakeholders – technology, industry, third sector
2D illustrations were used to summarise service concepts in between the two cocreation session, and existing sensor technology was used to rapidly prototype a working service.
Within two sessions we had a prototype service which we could implement as a test pilot with 12 families.
The inclusion of users produced original and innovative ideas which met peoples needs, and the use of commercial stakeholders allowed us to make these ideas feasible.
The service is now out for commercialisation.
Holliday et al 2016; Ward et al 2014; Ward et al 2015

12. USE OF CREATIVE METHOD AND EXISTING TECH
So now for a project where we had a fully creative approach, using cocreation with a variety of stakeholders to design a new consumer focused technology service to support older or vulnerable people to live independently by using sensor and mobile technology to connect family, friends and informal neighbourhoods, and enable them to support their loved ones more easily.
Just two cocreation sessions were held with potential users:
Users – older people and their carers
Designers – product, graphic, technology
Researchers – as facilitators
Stakeholders – technology, industry, third sector
2D illustrations were used to summarise service concepts in between the two cocreation session, and existing sensor technology was used to rapidly prototype a working service.
Within two sessions we had a prototype service which we could implement as a test pilot with 12 families.
The inclusion of users produced original and innovative ideas which met peoples needs, and the use of commercial stakeholders allowed us to make these ideas feasible.
The service is now out for commercialisation.

13. Reflections: why creative methods?
Feasible solutions which are realised sooner
Everyone can be creative
Creative methods are more inclusive – do not rely on verbal or written expression
Preserves anonymity
Allows engagement with new technologies and concepts through prototyping and hands on experience
Does not have to ‘overdesign’ – focus can be on using existing technology, not reinventing the wheel
Not always suitable – sensitive subjects, not always appropriate to include stakeholders in same group, requires high level of facilitation
Feasible solutions, realised sooner
Although the end result from the Abianco study was positive, resulting in a product that went to market, we reflect that if it had adopted a cocreation methodology, the ferrule development solution would have been realised sooner, with investment in the walking stick handle being suspended earlier, thus saving time and money.
Rather than creative methods increasing the timescale and costs of a project – a criticism which is often levied at creative methods – by placing users, designers, and researchers together, a feasible solution which meets user needs could have been realised sooner.
Can everyone be creative?
In our experience it is possible to stimulate latent creativity and encourage users to seek novel solutions to everyday problems.
There may be an element of self-selection – following good ethical practice, the nature of any creative session is made explicit in the process of recruiting – its therefore feasible that those who volunteer are naturally more creative. This could introduce bias into the project.
However, I would argued that as long as the participants are relevant to the project in hand then they should be given the opportunity to unleash their creativity.
In my experience however, I would dispute the notion of bias, participants tend to express their concerns about NOT BEING ABLE TO CONTRIBUTE CREATIVELY, but are interested in contributing to the project generally… these participants have still been able to provide very much meaningful contributions, particularly when 2D illustrations and 3D modelling are used to help visualise their ideas during the process.
Are creative methods inclusive?
It has been my experience that creative methods are more inclusive than traditional social science methods.
There is no turn-taking in creative data collection methods – they can shout out ideas, jot ideas down on post-it notes at their own pace.
So, earlier I mentioned the example of participants who had hearing impairment, or a lady whose first language wasn’t English – they had time to sit back and digest the task, ask for further clarification on the question in hand, and feedback in a way that suited them.
That creative methods are more inclusive is of particular use for researchers and designers working with assistive technology, who are likely to be approaching people who may have disabilities which are better accommodated by creative methods.
Does cocreation overdesign?
Some authors have argued that the presence of designers in creative sessions can lead to over designing. I would argue as long as you have facilitators with the right skills, then this is not an issue.
In the WarmNeighbourhoods example, we developed a storyboard which helped to explain the concept we wished to address, whilst keeping use of technology within the story as generic as possible. So the designer used their skills to create a visual of the concept we were working with, whilst avoiding designing the solution prior to the cocreation session.
This allowed participants to engage with the concept, whilst allowing them freedom to redesign and repurpose existing technologies according their thoughts, wants, and needs.
Can creative methods help preserve anonymity?
Another reflection from me and my colleagues is that creative methods have the opportunity to offer a further level of anonymity to participants than traditional methods – and can reduce the chances of group influence.
Participants have a high level of anonymity afforded to them in any project dissemination, for example, you use pseudonyms instead of the participants’ real names in project reports, presentations, etc… however during the data collection process itself, participants may feel inhibited from disclosing ALL their thoughts and experiences to other participants and the facilitator.
The variety of tools used in cocreation means that participants can write down thoughts and ideas rather than verbalise them to a group, e.g. by adding a surreptitious post it note on the wall.
That the participants are able to provide data away from the gaze of the facilitator may also reduce chances of interviewer influence.
This is of course anecdotal and warrants further investigation into the group and facilitator dynamics involved in creative methods.
Holliday, Magee & Walker-Clarke (2015)

14. Evidence – previous research
COMODAL project demonstrated that consumers are willing to purchase commercial technologies to support their health and independence if they are thought to be good value and will make a difference to their lives (COMODAL, 2015)
Assisted Living Technology (ALT) is sometimes research and developed within the medical research paradigm, however this is not necessarily the most suitable paradigm for development, particularly of commercial products.
Development of commercial ALT is more aligned with commercial product development practices, or the design research paradigm which includes creative methodologies (Bruseberg & McDonagh-Philp, 2002; Sanders and Stappers, 2012
Where health and design meet – for the academic researcher there exists a divergence between design and health paradigms and methodologies, and those wishing to bridge the divide do so in the absence of specific guidance or tailored methodologies (Chamberlain et al, 2015)
Current research has explored the extent of design practice as applied to health research (e.g. Chamberlain et al, 2015), and the value of participatory design for health research in general (Macaulay et al, 2011), however, there is currently no knowledge synthesis or comprehensive guidelines specifically regarding the development of eALT which would be of use to both design and health researchers, and commercial stakeholders.
They were my reflections, but what is the evidence?
Coming from a traditional social science approach, although I can see these methods working in the particular projects I have used them in, I am aware that other researchers will be asking “where is the evidence for these methods?”
“Why should I use these methods rather than traditional social science methods?”

15. Evidence – Systematic Review
Links between health and design subjects are getting stronger (Sanders and Stappers, 2008), and product development (including eALT development) is becoming a more knowledge-intensive, companies recognising the contribution universities can make to the product development process (Vogel, 2008; Sanders and Stappers, 2008).
Aim – to bridge the divide between health research and design research with regards the design and development of digital Assisted Living Technology
What value and benefits do creative, design-inspired methods hold for the development of new health and independence technologies?
Produce recommendations for design and health researchers, and commercial stakeholders
Holliday et al, in press

16. Multistakeholder approach; builds trust within teams; breaks down power structures; improves understanding
Variety of expression mediums – design, writing, speaking, acting; low effort; challenges remain for some (e.g. sensory/cognitive impairments, mental health problems, chronic illness
Generation of rich data to support product development to match user need; may produce fragmented data
Familiarity of creative materials important; unclear whether hi- or lo-fidelity prototypes are preferable
Creative tools useful for explaining tech to older people; jargon should be avoided – agree on mutually understandable terms
Holliday et al, in press

17. Conclusions
All methods have their place, but consider the benefits of creative methods
Existing technologies can be repurposed – avoid reinventing the wheel
Existing technologies can be used to prototype new products and services
Benefits of creative methodologies for the development of digital Assisted Living Technology needs to be explored further
There will still of course be a role for traditional social science methods, but creative methods are useful for
Holliday et al, in press

18. Questions

19. References
Bruseberg, A. & McDonagh-Philp, D. (2002) Focus groups to support the industrial/product designer: a review based on the current literature and designers’ feedback. Applied Ergonomics, 33(1),
Chamberlain, P. et al (2015) The state of art and design in health: an expert-led review of the art of design theory and practice in health and social care. Sheffield: Sheffield Hallam University.
COMODAL Project references: see
Holliday, N., Magee, P., Walker-Clarke, A. (2015) Reflections on creative methodologies for health technology research, and the iterative process between research and design. In: Proceedings o the 3rd European Conference on Design4Health. University of Sheffield, 13-16th July 2015.
Holliday, N., Ward, G. & Fielden, S. (2015) Understanding younger older consumers’ needs in a changing healthcare market – supporting and developing the consumer market for electronic assisted living technologies. International Journal of Consumer Studies, 39,
Holliday, N., Ward, G., Awang, D. & Harson, D. (2015) Understanding younger older consumers’ needs in a changing assisted living market. International Journal of Consumer Studies, 39(4),
Holliday, N., Ward, G., Awang, D. (2016) Co-creating well-being: the WarmNeighbourhoods experience. Proceedings of Well-being, Birmingham: Birmingham City University, 5th – 6th September 2016.
Holliday, N., Moody, L., Ward, G. (in press) Electronic Assisted Living Technology: Interim systematic review results – the evidence for creative methodologies. Accepted for publication in: Association for the Advancement of Assistive Technology in Europe (AAATE) Congress 2017, Sheffield: University of Sheffield, 11th – 15th September 2017.
Jagosh, J., Macauly, A.C., Pluye, P. et al (2012) Uncovering the benefits of participatory research: implications of a realist review for health research and practice. Millbank Quarterly. 90,
Sanders, E.B-N. and Stappers, P.J. (2008) Co-creation and the new landscapes of design. CoDesign 4(1), 5-18.
Sanders , E.B-N. and Stappers, P.J. (2012) Convivial toolbox: generative research for the front-end of design. Amsteram: BIS.
Vogel, C.M. (2008) The live well collaboeative: a new model for universities and companies to work together to meet the needs of 50+ consumers, Topics in Stroke Rehabilitation, 15(2),
Ward, G., Holliday, N., Awang, D. & Harson, D. (2014) Technology and informal care networks: Creative approaches to user led service design for the WarmNeighbourhoods AroundMe service. Interdisciplinary Studies Journal, 3(4),
Ward, G., Holliday, N., Awang, D. & Harson, D. (2015) Creative approaches to service design: using co-creation to develop a consumer focused assistive technology service. Technology and Disability, 27, 5-15.
Ward, G., Fielden, S., Muir, H., Holliday, N. & Urwin, G. (2016) Developing the assistive technology consumer market for people aged fifty to seventy. Ageing and Society, 37(50),