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Michelle N. Eakin, Ph.D.1 Casey Thompson,2 Emilie Gilde2 MPP Becky Slogeris, MA3 Denise Brown, MA3 Smile Indias, MA3 Johns Hopkins University School of Medicine; 2 Maryland Institute College of Art 3 Baltimore City Health Department 1



In Fall 2016, an interdisciplinary team of undergraduate and graduate students at the Center for Social Design at Maryland Institute College of Art (MICA) collaborated with Baltimore City Health Department’s Tobacco Free Baltimore initiative to address the impact of smoke exposure in the home. Utilizing a human-centered, collaborative and design-driven approach, the team met with health professionals to better understand of the problem, interviewed families to gain new insights, and facilitated design workshops to generate ideas and prototypes. The research and brainstorming resulted in HealthiAir, a pop-up event that supports families in creating smoke-free comfort zones in their homes, identifying practical ways to get started, and connecting to the resources they need.

• Six community events have been conducted with 65 residents • School • Preschool • Substance use treatment center • Public housing development • Senior center

The Center for Social Design utilizes a human-centered and collaborative design process to understand social problems, identify opportunities for intervention, generate ideas, and make tools that support positive change. Our goal is to shift relationships between people and people, and people and institutions. Our process includes six interwoven phases: 1. Translate / Frame: Students organized existing scientific data and research associated with smoke free homes. They facilitated discussions and created visualizations to better understand key data and research and to appropriately scope the engagement to accentuate target behavior and outcomes.

Objective To use the human-centered design process to develop a culturally appropriate and evidence-based intervention that reduces secondhand smoke exposure, implements home smoking bans, and improves engagement in smoking cessation resources.

About HealthiAir HealthiAir believes that if we ease the pathway to creating smoke-free comfort zones and engage people where they are on their journey, every home and family in Baltimore will breathe happy and healthy. We accomplish this by constantly reflecting back on our core values. OUR DESIGN PRINCIPLES: Honor stories and experiences Respect the personal and lived experiences that are shared and allow them to inform our design process with integrity.

Acknowledge the reality of addiction Be empathetic in our language and careful in our approach to address smoking without blaming or shaming behaviors.

Engage the whole person Connect with all aspects of the people we design with (physical, mental, emotional, social) while being mindful of their individual needs.

Ease the pathway Create interventions that don’t recreate stress while allowing families the agency to take action on their own terms. Do no harm, add no stress.

Make knowledge actionable Inform with solid facts and data but also translate information in a way that is relatable and approachable to motivate effective change.


2. Research: Students worked to understand the culture and context of the problem by understanding the culture and context of people. They talked to, observed, and learned from Baltimore families and healthcare professionals to locate needs and assets. 3. Synthesize: Students compiled observations and research findings. They created visualizations of key research and looked for common themes and insights in order to identify appropriate opportunities for intervention. 4. Ideate: In collaboration with stakeholders, students generated as many ideas as possible to address barriers to creating smoke free homes. 5. Prototype: Students developed tangible representations of the ideas. Through feedback and testing, they arrived at the HealthiAir pop-up event intervention. 6. Test / Implement: In partnership with Baltimore City Health Department, students piloted HealthiAir in multiple contexts (schools, community centers, and apartment buildings) and collected feedback. The pilots helped identify important design tweaks to make before officially launching HealthiAir.

• 10 residents requested follow up services for smoking cessation • One smoking cessation group was initiated to help attendees receive support and counseling. QUALITATIVE FEEDBACK SHOWED 1. High satisfaction with the program “A little empowered to talk to others. I feel equipped with knowledge to share”

“It’s a very helpful program”

2. Desire to recommend program to others “It would give smokers a reason to quit smoking”

“Would recommend program to my husband to get him to quit smoking”

3. Healthiair is unique from other tobacco programs “It got me thinking about steps, like the pro/con about smoking. I hadn't thought about them”

“It made me feel different. We laughed.”

4. Addressed them individually “My favorite was the group sharing”

“I feel good about making changes in my household”

Conclusion • Our community-academic partnership to engage residents led to the development of a culturally appropriate event that helps families set up home smoking bans. • Using design principles helped tailor a program to the target population's specific needs. • This adaptation process resulted in a program that feels unique and approachable to attendees. • Furthermore, the program was developed to be an engagement event to link residents with smoking cessation resources • Next steps should focus on community engagement and success in linking residents to services as appropriate to further evaluate the efficacy.

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