Co-designing primary care that communities want and will use
In collaboration with Rush University College of Nursing and The Community Builders, with support from the Segal Family Foundation.
Kim Erwin
Director, Equitable Healthcare Lab; Associate Professor of Healthcare Design and Design Methods
Santosh Basapur
Assistant Professor, Department of Family Medicine, Rush Medical College
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.
