Dalberg Design’s partnership with the Pima County Health Department on the Advancing Health Literacy (AHL) program in Tucson, Arizona, has been recognized by the Core77 Design Awards 2024. It is the second year in a row that Dalberg has received this honor under the Design for Social Impact category for their human-centered design work. The award is the result of a deep collaboration with the Pima County Health Department and a coalition of local nonprofits in Tucson, funded by a grant from the Federal Office of Minority Health.

“The COVID-19 pandemic exposed deep inequities in our health system; so it was a true privilege to be able to partner with Dr. [Theresa] Cullen and the team at the Pima County Health Department and MHC Healthcare to rebuild trust within underserved immigrant communities in Tucson,” said Robert Fabricant, Dalberg Design’s Founding Partner. “This project offered a unique opportunity to center equity issues both in how we engaged the community as collaborators as well as in the solutions we piloted together.” 

With a goal to boost community access to health services and address cultural challenges faced by immigrant communities in navigating the healthcare system, the project reflects Dalberg’s growing practice in the U.S. and global commitment to bridge health equity gaps through a community-centered approach. Conducted in 2022–23, the AHL program focused on building trust and improving health literacy and experience for Latina/x/o communities and medical practitioners in Tucson, which shares the longest border with Mexico of any county in the U.S.

The project’s human-centered design process aimed to understand challenges and lived experiences of underserved Latina/x/o communities in the region and identify and map opportunities for intervention. Our collaborative process centered on the lived experience of diverse community members struggling to navigate the complex U.S. health system. They were brought to the table to co-design approaches that would better meet their needs. Dalberg Design worked with the AHL team and local partners to translate ideas that emerged from the community into pilot preparation and planning of two distinct interventions. These interventions were implemented by a broad network of community-based organizations including MHC Healthcare, Literacy Connects, Portable Practical Educational Preparation, and the YMCA.

The focus of the pilots was to strengthen engagement of communities with health practitioners and increase their capacity to navigate the health system to meet the critical health needs of both documented and undocumented Latina/x/o families. 

• Community Pilot: Deployed by partners in adult literacy and education, this pilot aimed to help clients better navigate the local healthcare ecosystem through a series of in-person and virtual workshops, augmented by WhatsApp groups for follow-up support. 
• Clinical Pilot: Focused on improving the clinical experience for both clients and practitioners, the partners trained promotoras (community health workers) to engage with patients in pre- and post-visit activities and throughout their clinical visits to close existing gaps and boost engagement and trust.

Through the program, Dalberg Design took a participatory approach, collaborating with primary clients, community members, and clinical staff to map their ecosystems using various tools and techniques and generate promising, innovative solutions. The success of this project is tied to the quality, diversity, and reach of Dalberg’s participant pool. When calling on participants from underserved and underrepresented communities to talk about personal experiences in healthcare, it was important to set a fair compensation model. A significant portion of the grant budget was utilized to compensate participants at $100 per hour for their time (including travel), which could be spent on a range of goods and services of their choice, while making sure their federal benefits were not at risk. This innovative model proved to be far more equitable than the typical way that participants are compensated for contributing their knowledge and lived experience in public health research.

While the analysis from measurement and evaluation partners is awaited, initial data and testimonials show positive impact from both pilots, with immediate improvements in patient trust and communication within clinics. Full-time positions for promotoras have been expanded within the local health system to sustain and institutionalize the outcomes from the AHL pilot. A human-centered design course has also been added to the learning management system, available to all clinical staff.

• Read more: Runner Up, Design for Social Impact Award, Core77 Design Awards 2024
• To know more about designing for health equity, tune into this podcast featuring Dalberg Design’s Founding Partner Robert Fabricant and Adriane Ackerman who led the AHL program from the Pima County Health Department: Design Lab Podcast with Bon Ku