Aging-in-Place Prototype: Final Report by NS GovLab

Thank You First, we would like to acknowledge that this work took place in Mi’kma’ki, the traditional, unceded territory of the Mi’kmaq people. With this acknowledgement, we recognize that colonialism with violence and unsustainability continues to underly in all of our work even when and where we are actively working to try and lessen the harm. We would also like to acknowledge that we are all relations, human and non-human, including all of our past, present and future ancestors who made it possible for us to be here to do this work. Prototyping requires us to draw on the life experience, knowledge and wisdom of citizen’s to help improve what we do and how we innovate. We would like to take a moment to acknowledge the time and wisdom of the many individuals from the African Nova Scotian community who contributed their ideas, their experiences and helped deepen the learning while we developed and tested this prototype. In particular, a special thank you to Shelley Fashan, the Community Impact Coordinator with Inspiring Communities for the Nova Scotia Network for Social Change (NSN4SC) project who helped connect the project team with seniors and their family in community who were graciously willing to meet with the prototyping team and provide feedback on the tool. As well a very special thank you to Mary Desmond, in the Municipality of the District of Guysborough for sharing her wisdom related to aging-in-place in rural Black communities and for connecting the prototyping team with seniors in Guysborough who also offered invaluable lessons and learning. In addition, we would like to thank Elder Debbie Esian with the Mi’kmaw Native Friendship Centre for her guidance and input into development of this concept and design. Finally we would like to thank the organizations and people working to support seniors with 211, Community Links and Caregivers NS for their invaluable contributions to this prototype.

Table of Contents Thank You

Commonly Used Acronyms

Introduction Prototype background and origins: A timeline Design questions for AIP 2.0 About this report

4 5 7 7

Our Process and Design Contributors The design team Our Technology Vendor: We Us Them

8 9 9

Prototype Description How it works Where you can access it Current resource investment

10 11 13 13

Testing Plan and Learning Framework

Key Observations, Insights and Findings Technology Related Learnings Aging-in-Place and System Related Learnings AIP Prototype Specific Learnings

16 16 18 20

Next Steps and Potential Actions

Appendix A: AIP 2.0 Early Origins

Appendix B: Testing and Learning Plan

Appendix C: Testing Observations, Insights and Findings

Commonly Used Acronyms AIP

Aging-in-Place

ANS

African Nova Scotians

BIPOC

Black, Indigenous and People of Color

F/P/T

Federal/Provincial/Territorial

ISP

Internet Service Provider

PHAC

Public Health Agency of Canada

SNS

Service Nova Scotia

Introduction Nova Scotia is aging. Our demographics are shifting, our communities are evolving and rural parts of our province have populations that are exponentially growing older. By 4

2030 more than one in four Nova Scotians will be over the age of 65. While an aging society is not unique to Nova Scotia, we are among the first jurisdictions in North America to be going through this demographic shift; a shift which will require many sectors to ask critical policy questions about how we might best provide services and support to an older population. It also has public sector bodies grappling with the complexities of reorienting and transforming systems of social support so that we might provide those in a dignified, just and fair manner. In 2018, NS GovLab (the Lab) hosted its first cohort of fellows - a group of individuals from across government, academia, the private and non-profit sectors - to imagine how we might, ● Create a province where people can age at home and stay connected to their community? ● Foster connections across generations and cultures to create resilient communities in Nova Scotia that can adapt to their changing demographics? Prototype background and origins: A timeline Since our inaugural fellowship program in 2018, NS GovLab has worked to deepen understanding about population aging and its impacts on public policy; to build skills in social innovation and has supported fellows and partners in their prototyping efforts through funding, testing assistance, and advice. At the same time, Lab staff have also been engaged in direct development, testing and iteration of prototypes that might help enhance services for older adults, reduce current harms, and build more equitable and fair policy for an aging population. Part of these later efforts have included the Lab’s work to develop an early prototype of a web-based tool called the Aging-in-Place portal (AIP 1.0). The development of AIP 1.0 was informed both by the work of the Route of Aging team formed during the first fellowship and their Working Paper submitted to the government

following the end of their fellowship program (see Appendix A). The AIP 1.0 prototype was also informed by the work undertaken by the Forum of Federal/ Provincial/ Territorial (F/P/T) Ministers Responsible for Seniors at the Public Health Agency of Canada (PHAC) in their guide titled, Thinking about your future? Plan now to age in place which provides a reflective checklist in PDF format structured, influenced and premised on mainstream, Western notions of what “healthy aging-in-place” should look like. For AIP 1.0, the Lab team consulted with Service Nova Scotia’s (SNS) Digital Service Design division to develop an early stage wireframe and website. The team was advised to contract for services, to work with SNS Digital Service on developing a user testing approach and to execute that work collaboratively together. Staff awarded the initial contract to We Us Them, a full-stack Halifax-based developer in the amount of $4,999 for an early build. In May 2019, service designers from Digital Services and Lab staff tested this early prototype with seniors and their families. Following that initial round of testing, attention, energy and capacity to further support experimentation and additional development of AIP 1.0 was low and the work behind AIP 1.0 was shelved. Instead, staff were focused on other priorities like supporting two subsequent cohorts of fellows, increasing the diversity of participants from Black and Indigenous communities, seeking a renewed mandate and funding for the Lab and re-staffing with the departures of key roles supporting the Lab and social innovator’s network. In late 2020, after re-orienting the Lab’s practice and approach throughout the early part of the COVID-19 pandemic and with the addition of new team members, staff once again revisited the initial AIP 1.0 learnings, began to assemble a team of design contributors and picked up prototyping efforts in this space.

Work to conduct inspiration research with Indigenous and Black communities and non-profits engaged in digital equity initiatives was conducted to inform our next steps. In addition, special attention was paid to the context and challenges created by the pandemic for older adults from urban Indigenous and Black communities. In March 2021, NS GovLab engaged the services of a consultant to develop AIP 2.0 adapting and iterating from the first version of the tool. The following shows a high-level timeline of origins and development of current AIP 2.0 tool:

Design questions for AIP 2.0 Inspired and guided by the learnings surfaced by past fellows, user testing and inspiration research in late 2020, Lab staff set out to explore what AIP 2.0 could look like using two key design questions: 1. How might we create an online tool that helps people focus on the services, supports, and plans they may need now and in the future to age in place? 2. How might we use this web-based tool to match users to programs and services by providing content that may be relevant to the user’s self-identified immediate and future needs?

About this report The purpose of this report is to document and share what NS GovLab has learned through its second round of design and prototyping with the AIP 2.0 web-based tool. This report describes the AIP 2.0 prototype, how the content was developed, the intended purpose at the outset of the design process, the Lab’s process for testing and learning, and the results of user testing and inspiration research. The bulk of this report focuses on the team’s learning, observations and insights through our interactions with various potential users. Finally, this document provides recommendations about how this work can move forward and provides a set of discrete and actionable next steps.

Our Process and Design Contributors The NS GovLab process is nonlinear and emergent by nature. Emergence is the process of becoming visible after being concealed; the process of coming into existence or prominence. Figure 1 below shows the Lab’s process at a glance is designed to: ● hold space for contributors to set some initial intentions or questions ● go deep through human-centered research ● help the design team make sense of contextual knowledge and learning ● brainstorm more, be creative, play and mock-up small scale, low-cost prototypes that can be tested with real users with intention. In short, the Lab process is one that invites and even expects failure, u-turns, surprises and uses these learnings as the basis for iteration and change moving forward. While the process may appear linear in many respects it more accurately feels like one is moving through a design squiggle!

Credit: The Process of Design Squiggle by Damien Newman, thedesignsquiggle.com

The design team The core design team for AIP 2.0 was diverse and made up of six multi-generational, cross-cultural contributors. The team included the wisdom and guidance from Indigenous and African Nova Scotian (ANS) elders and community leaders, a creative visual artist, Provincial government policy analysts and researchers, contributors working for non-profits, a social work candidate and folks in the early, mid, later and retired stages of their careers. Each contributor brought to the team skills in community engagement, community outreach, human-centred design, research, social innovation/social change work and collective capacity in anti-racist, decolonial and equity-based approaches.

Core Design Team for AIP prototype from Left to Right: Jenna Andrews, Jocelyn Yerxa, Debbie Eisan, Mo Drescher, Rayna Preston, Shelley Fashan.

Our Technology Vendor: We Us Them AIP 2.0’s technological platform was created by We Us Them, a Halifax-based full stack developer. We Us Them provided the technical programming skills, website hosting, serverspace, and graphic design services to develop a mock-up which then became a higher fidelity prototype website for user testing. 9

Prototype Description AIP 2.0 is a web-based prototype assessment tool focused on activating reflection and thinking about one’s ability to age-in-place while also ensuring ease of access to information about supports, services and programs offered by government or the non-profit sector that can support aging-at-home for as long as possible. A secondary purpose for this prototype is to test how we might move towards a digital self-help strategy for centralizing the provision of information related to supports for older adults and to explore whether a web-based tool like AIP 2.0 might be able to surface and identify potential unmet needs among older adults and those planning for aging-in-place. Using the design questions as a guide, and previous user testing and research, the Lab set out to evolve the first iteration and design of the AIP 1.0 with specific focus and attention on changes intended to: ● Offer culturally responsive content designed specifically with Indigenous and Black seniors’ needs in mind; for example, offering areas of reflection that focus on aging-in-place needs related to community connection, spirituality and faith-based connections, traditional knowledge and medicines and other services, programs that might support healthy aging and eldership in non-White communities. ● Reduce the volume of content and questions that users have to respond to by providing a mechanism so that content is tailored to a self-generated persona/profile (whilst still maintaining privacy). ● Resolve challenges - observed during AIP 1.0 testing - around a lack of clarity among users about whether they should respond for themselves or someone else by providing options that allow the user to tailor the questions for situations where they may be living intergenerationally, or where they may be caring for or looking out for older adults in their family or community. ● Reduce the volume of content by providing the option to self-select only the topics that are most important to them or their loved ones; leaving other areas of reflection for another time. ● Integrate a decision-making approach using branch logic and elimination design that show users only the questions and resources most applicable to them. ● Provide a visual interface that includes more diverse and less ageist imagery focused on seniors thriving and contributing in older age so that all user’s feel welcome.

● Remove language or questions that could be construed as judgemental and ensure that users do not leave feeling as though their current or future capacity to age-in-place does not measure up to some idealized standard. Most importantly, the team was focused on how to use this tool to empower people toward actions that may help them meet their needs while also acknowledging that for many citizens, the individual choices available to them are often constrained by the historical impacts of colonialism, racism, as well as present day challenges such as limited financial resources, the environment they live in and their overall physical health. When re-developing content and the approach, the core design team intentionally tried to avoid language and design elements that might suggest or convey a commonly held assumption; that if people just planned better, they would be able to stay in their homes and communities longer. How it works The following provides a high-level summary of how the AIP 2.0 web-based tool functions. Step 1 A user visits the AIP portal and is greeted by the landing page that says, “Positive Aging. Get connected to services, supports, and programs that can help you and your loved ones age well, safely and comfortably with as much independence as you want.”

Step 2 The user answers a set of personal questions about who they are, how old they are, and any other unique characteristics such as current employment status, whether they belong to an equity group, and their geographic location within Nova Scotia.

Step 3 The user then selects which domains related to aging-in-place are most important to them and their situation at the time. These include: ● ● ● ● ● ● ● ●

Physical Health Mental Health Transportation Home (Neighborhood) Safety Finances and Legal Spiritual Well-Being Identity and Sense of Belonging

Users can choose one or multiple domains and return at a later time to select other options as they see fit. Step 4 The user answers a series of questions related to the domains they have selected. These questions and the response options are focused on getting users to reflect on their lives/the lives of those whom they love. As a user makes their selections, these movements in combination with the answers they provided in the initial interview section, enable the website to filter and sort the most relevant resources for them which are presented at the end of their experience.

Step 5 At the end of the experience, the user receives a Thank-You page with a personalized list of resources for each of the areas of focus they choose which are based on the user’s unique responses. To maintain the user’s anonymity they are provided an option to “Share Resources” by either emailing those resources to themself or someone else.

Where you can access it Currently the AIP 2.0 prototype website can be located on a development server owned by We Us Them at this URL: https://nsgov.weusthem.com/ At the end of the prototyping contract with We Us Them, they will provide the Province with the design, code and development files so that we may host on a government development server or provide such to another partner who may be better suited to house, continuing building, scaling and integrating this work. Current resource investment AIP 1.0 was developed primarily with in-house resources and guidance. $4,999 was paid for the initial wireframe and basic website so that the Lab could engage in initial user testing. In-kind space and staff time to test were provided by SNS’s Digital Services team. Small honoraria in the form of $50 gift cards were provided to seniors who spent time testing the website. AIP 2.0 has involved a more substantial design build. A contract valued at up to $49,999 was issued. At the time of this report, approximately $33,000 had been provided for deliverables received under that contact. Testing with seniors and family members has taken place primarily in ANS communities. Costs related to meeting space rentals, travel to and from community and small honoraria in the form of $50 gift cards have been accrued. The approximate costs related to testing in this phase are about $1400.

Testing Plan and Learning Framework To test the AIP 2.0 prototype the Lab focused on recruiting three key user-types: ● older adults from ANS communities in the Preston Townships and Guysborough County (for both an urban/suburban and rural perspective) and urban Indigenous communities ● family and kin who support older Nova Scotians in these communities ● people who work with organizations that help navigate older Nova Scotians

Through this testing, the team was focused on learning from users and folks working in senior serving organizations, ● How likely older Nova Scotians and their families are to reach out, connect to and find programs and services online to help support aging-in-place/aging-at-home? ● Whether the content developed - both the questions and the resources providedresonate with older Nova Scotians and whether the tool would spark personal reflection and planning while also connecting people to supports in real time? ● Where this tool might be best placed or administered from - government or in community? ● How feasible would it be to maintain a tool like this and keep it up to date? ● Whether the concept of aging-in-place or the supports we think might help resonate with older Nova Scotians living in Black and Indigenous communities?

The testing process was grounded in human-centred design and user-experience (UX) testing methodologies. These were blended to create both an inspiration interview and live UX technology test into one session. Community members were provided a full explanation of our testing process and how the Lab would maintain their anonymity. They were asked to consent to participating in the process and to having their live test of the website video recorded so that other members of the core design and consultant team who could not be there in person could also review the experience, code for data, and contribute to collective sensemaking and analysis of the data. In recognition and thanks for their time each senior or family member in community who tested with the Lab received a $50 gift card. At the time of this report the Lab had invited thirty-two individuals to participate in

testing; twenty-three individuals accepted the invitation. Due to ongoing pandemic challenges we were unable to test with urban Indigenous Elders at this time. The following provides a high-level snapshot of who has provided feedback to-date: Type of Tester

Location

Approximate Age Range

African Nova Scotian Seniors

The Preston Townships

55 - 80 years old

African Nova Scotian Seniors

Guysborough County

60 - 70 years old

Family/Kin Supporting Seniors

The Preston Townships and Guysborough

50 - 60 years old

People working for senior serving organizations

Guysborough, Halifax, Annapolis Valley

A wide range of ages

Original fellowship team who inspired AIP 2.0

Halifax

20-70 years old

Following the testing interviews, a workshop with the core team was held to surface key observations, problems and challenges that users raised - both spoken and unspoken technology challenges. Those findings were systematically documented in a database with more findings from system’s leaders and people working at the point of impact, added overtime. A second workshop with the core design team to further develop key findings, recommendations and potential actions was held. In addition, content revisions, critical changes and tweaks were flagged for the external consultant and next iteration. For more information about the specific questions asked and tools used during this prototyping phase please see Appendix B: Testing and Learning Plan.

Key Observations, Insights and Findings This section of the report outlines the key observations, insights and findings that emerged during prototype testing with seniors’, their families and system navigators. While some of the findings that emerged are useful for improving the architecture, design and content of the AIP 2.0 web-based tool, other findings point to broader system challenges for which AIP 2.0 is not a suitable or well matched solution; in many instances the AIP tool and conversations served as a provocation for many to share more deeply, the challenges and barriers in their lives. Observations, insights and findings in this section should be considered in conjunction with the Key Recommendations and Options for Action in the following section. A full list of observations and findings collected across the various user-testing sessions and via email can be found in Appendix C: Testing Observations, Insights and Findings at the end of this report.

Technology Related Learnings Most senior testers experienced challenges using their internet-enabled devices Lab staff encouraged those testing to bring the device they were most familiar with to test on. Seniors and their family brought a range of different types of smartphones, tablets, laptops and chromebook type devices. In almost every instance, the team observed limited capacity to reconnect to the on-site WiFi, limited knowledge of how to launch a browser and limited understanding of how to perform a Google search to find information or a website that they had heard of. Staff also observed a high degree of dependence on previously saved bookmarks; ones that their family or friends had set up for the senior so that they could return to different places on the internet. This was punctuated, for example, by the number of senior testers who eagerly asked Lab staff to bookmark the AIP 2.0 website so they would be able to come back to the tool even when the team explained the website was only a demo. Another strategy seniors shared was their tendency to simply leave numerous browser tabs open so that they could return to those pages; in many instances testing staff noticed a significant number of tabs already opened on the device as the experience began. Once using the web-based tool, the testing team also observed an almost universal inability to quickly adjust and adapt the settings on the device in order to create a smoother user experience. Performing simple tasks such as using the pinch touch function on touch-screen devices, swipe motions and navigation to browser button options to do things such as increase the size of font quickly or even simply reducing the speed at which the screen on the device would blackout all presented challenges for those with whom we tested. 16

All of these challenges, while relatively simple to overcome in the context of a technology useability test, caused pause among staff. Much of the national research on seniors and technology is often cited as evidence that the majority of the population over 65+ is now using internet-enabled devices. However, the capacity to use and range of capabilities to use these technologies to their fullest abilities vary significantly across those over 65. With the relative push to modernize government services, digitize other public sector supports and put more and more information online, we must be mindful of the impact these policy decisions have on users who have never received technology training, skills building, and who may not be engaging online frequently enough to learn by doing. There is an ubiquitous need for technology and skills to remain relevant and engaged as an older adult in the voluntary sector Many of the seniors NS GovLab staff tested with are very active and engaged community members. A few were retired and working in their second or third careers; many were active in supporting community through the voluntary sector. A key theme that came through their stories was both the need for and daily use of technology to support their efforts. They also expressed that working in this way, with so much technology and little formal training or IT support, can and does often feel overwhelming for them. The amount of “computer work” was already increasing but COVID-19 has amplified the need to be connecting, ‘zooming’, and meeting virtually. This has been especially important to reduce risk of COVID-19 but also to reduce social isolation in their age demographic. It was clear to staff that those who tested AIP 2.0 are managing to get by using the technology they have but many may not be using their technology, devices and software optimally or to its fullest capacity despite their openness to learning. Rural Nova Scotian seniors have a lack of truly affordable high-speed internet options. Access to affordable high-speed internet continues to be a challenge for older Nova Scotians living on a fixed income both living in urban and rural areas of the Province. The physical availability of service for those living in rural communities is also a challenge for so. Currently, monthly service costs depending on the type and number of Internet Service Providers (ISPs) in a local market can range in price from about $60 $150 per month. Most of the folks who tested AIP 2.0 indicated they had internet service in the home while a few received subsidized service through community-based organizations in the short-term. Almost all commented on the high but unavoidable cost of internet while also recognizing it has become an essential service - no different from the need for a 17

home or cell phone, heating source, or food. The team also heard from some of those who tested AIP 2.0, about the poor quality of internet services in rural areas, slow speeds and limited bandwidth at peak times which impacts video connections, and poor mobile data coverage for those using smartphones. Aging-in-Place and System Related Learnings Aging-in-Place as a concept does not resonate well in Nova Scotia’s Black communities. During testing, the Lab began each conversation by asking users what “Aging-in-Place” meant to them. In many instances folks were unsure what the concept meant at face value. A couple felt the notion - as traditionally defined - is focused too narrowly on the negative aspects of growing older such as limited mobility and failing physical health without accounting for the positives that come with growing older like wisdom gained, ability to be a role model and the capacity to support community, family and others. A few also indicated that the language of “Aging-in-Place” was alienating for them; they wondered if it was being used to remind them of their lot in life and perhaps to convey the sense that they should “stay in their place” or that they should “know their place” in society and not deviate from it. Given the historical connotations that notions like “stay in your place” have had and continue to have in Black and Indigenous communities, this was an important and surprising learning. If this tool is to be culturally appropriate, safe and relevant for African Nova Scotian users in particular, the name of the tool and the language used to describe “Aging-in-Place” may need to be reframed to reduce alienation and align intent with perception and need in community . Lack of culturally competent community-based care options While testing, staff heard consistent stories about the lack of culturally competent community-based care and support for an aging population. For example, when ANS seniors living in rural parts of Nova Scotia reach the point where their own homes become too much to care for or where they may be unable to care for their own personal needs, there are no culturally competent care options for them to remain close to their communities. Home care services are generally provided by service providers from outside of the community, those working in care homes are generally not from the community, and there are no long-term care options that keep seniors living in close proximity to their historic communities. 18

There is mistrust of government and support providers and fear that elders will be removed from their homes against their wishes if they reach out for help in rural ANS communities Seniors testing AIP 2.0 also shared that they and people in their communities are fearful of reaching out for basic supports from the public system because reaching out for help can have dire consequences. In the past, asking for support has resulted in the removal of older community members from their homes for “their own safety”. Testers shared stories of elders from historic Black communities who were sent to live in care facilities far away from their family and spiritual communities where the acceptable standard of living, safety and what constitutes ‘living well’ - as defined by predominantly white, upper-middle class system workers - was not able to be met. These stories underscore the lack of consideration of the impacts that lifelong racism have had on one’s ability to afford to maintain the conditions of their property and home as they might wish. The result is that aging community members often fear reaching out for support because they are acutely aware their living conditions are likely to be viewed as substandard and unsafe, which is likely to trigger adult protection’s involvement. In addition to the fear of reaching out, testers also shared there is often a failure to consider the overall benefits of the informal and kinship based supports from community that can help support an individual’s care and independence in their home community. While it is common for ANS seniors to live intergenerationally with other family when they need enhanced support and care, the reality in some rural ANS communities is that many younger family members no longer live at home as they have migrated to find work in larger towns and cities. In these instances, it is often other seniors and community members who are checking in on and supporting seniors living independently with services like grocery delivery, snow removal, and meal preparation. Staff heard community members wonder why the public care system is not more concerned with supporting ANS elders to address the conditions in their homes or provide what is needed to support them to stay in their homes before needs escalate. ANS community members expressed feeling defeated and forgotten about. There is a complex paradox at play in community; on the one hand, ANS seniors view the resources and supports as intrinsically helpful for supporting them to age at home in community AND on the other, the social contract and trust in government and public agencies is fractured. Many elders are willing to go to great lengths to actively avoid accessing the supports because of a fear that they will be judged or worse, removed from their homes and community. In practice, this creates a situation where by the time they or someone on their behalf is willing to reach out, or draw attention to their situation, it is often because their living conditions or health condition has deteriorated so dramatically and the situation is dire. Seniors shared that “help” only comes when the 19

system is looking to place a senior in an institutional setting - often against their wishes. Therein lies the paradox, when ANS seniors have to reach out for help to stay in the home, the situation is often dire and when the situation for an individual is that dire the system response and offer of “help” typically results in the use of the most intensive measures the elder has been trying to avoid; removal from home and placement in long term care. There are significant gaps in the types of resources or supports available to help ANS and Urban Indigenous Nova Scotians age at home in community. As the NS GovLab team built the content to test this prototype, one of the key learnings to emerge was the limited number of publicly funded supports that exist for older Nova Scotians, particularly those who identify as ANS, Indigenous or are living in Guysborough. While it was relatively easy for staff to imagine the various considerations and types of questions we might want to ask folks to reflect on related to aging-in-place, finding supports and services that might offer something helpful to seniors was often very difficult. Naturally the team discovered there were more supports available in Halifax than in Guysborough but regardless of location, when a well matched support, service, or resources was found, staff was quick to discover that most were either oversubscribed, maxed out, or unable to take on new clients. This finding led the team to question how and whether AIP 2.0 usage information might also be used to surface key intelligence about the most prevalent needs among seniors looking to age-in-place and where those gaps in services overlap. AIP Prototype Specific Learnings AIP 2.0 does help users reflect on their aging-in-place needs and plans for the future During testing, seniors indicated the AIP tool was useful for sparking individual reflection on the things one might need to do or consider if they were to be well set up to age-in-place. The content that appeared to generate the most conversation about planning were the sections about advanced care planning/medical directives and preventative screening tests like bone density testing, cancer screening and heart health. Reactions were varied to questions about advanced care/medical directive planning. In some instances, folks did not feel comfortable or willing to reflect on end-of-life care decisions; in other instances they saw the practicality and wisdom in thinking about these decisions now while they are well. Staff learned that within ANS communities advanced planning for end-of-life or aging-in-place is not a common practice. Most ANS seniors do not have the income necessary to pay for the types of

legal documents required to convey advanced care directives. In addition, when it comes to wills and estate planning, lots of rural ANS seniors still do not have clear title to their lands. System navigators who tested AIP 2.0 indicated that the majority of their clients often present for help while in some type of crisis with urgent needs. Whether the client is a family member, caregiver or simply an older adult looking for services, navigators tend to interface with people who are overwhelmed in some capacity either by a new diagnosis, a change in health status, or other life events. For this reason, some of the system testers questioned why they would need to answer personal questions and complete the full interview if, for example, they just needed information about how to obtain assistance with their yard work or snow removal. As a client navigator, they felt there is a segment of the population that will know what they need and may only need help connecting to that specific service. Furthermore, system testers also shared that seniors using navigational services are often more likely to call in real time rather than go online, because they looking for: ● Someone to listen with a friendly and empathetic voice ● Someone to help them prioritize their needs in the face of information and resource overload ● Someone to hand-hold and work through prioritizing their caregiving and other needs. ● A personal or warm connection to peer-supports. They felt like there is a place for a website that helps users reflect on their needs and plan for the future but questioned whether it would be truly accessible for the types of clients they tend to serve if it did not have the ability to meet immediate or urgent needs quickly. AIP 2.0 can help connect some but not all seniors and caregivers to aging-in-place resources. Those who tested felt that AIP 2.0 may represent a part of a communications strategy for informing citizens of what types of support resources exists, but that on its own, as designed, it could never meet all of the varied needs of users that exist. They indicated AIP 2.0 was an improved way to provide information about resources using an online channel for those already thinking about planning for AIP. They felt it would be useful to someone who was already trying to locate relevant local resources online - for example, someone who was engaged in preliminary information seeking around what might be available in certain locations for certain groups of seniors as long as they had some online skills. They did not feel this web-based tool would serve parts of the population with lower 21

literacy, those without internet, devices or technology skills, those who may be in crisis and need immediate supports. Despite this, system testers still felt there was value in tools like this as a way to provide asynchronous information about relevant services and supports online. All of the system navigator users who tested were clear though; a tool like this can never replace the need for in-person or live human-to-human, phone based navigational support services. AIP 2.0 highlighted the inadequacy of the current Government of Nova Scotia website’s capacity to return relevant information on programs, services and supports for seniors. While testing AIP 2.0 a number of seniors and system navigators indicated how difficult it can be to find information about programs and services for seniors specifically on www.novascotia.ca . There is no central place - such as the Department of Seniors and Long-term Care webpage - where links to the variety of different supports from different Departments are located. Users’ felt the AIP 2.0 might represent one way to engage and determine which of the resources that government offers but that this could also be presented and organized for self-navigation on the government’s website. Having both tools, one that can prompt reflection by asking relevant questions to help folks consider their aging-in-place needs and a place where seniors and families can simply access the information about specific programs in a one-stop-shop was also discussed. For example, staff met with Social Development New Brunswick’s Chief Experience Officer and walked through their new website approach and integrated strategy with NB 211. A key feature of their approach on the https://socialsupportsnb.ca website has been to centralize all of the information about services and supports available to seniors in one spot, and to build and add to this website as time goes on. In particular, staff were keen to highlight how they have rolled out these changes: quickly and iteratively. They did not wait to get the list perfect or totally complete before making their new website changes live. Each month they set new goals to improve the presentation of the information or to add new features incrementally. Social Development NB has also made user experience testing a cornerstone of their process. Each time a change or new element is introduced, they test those changes with seniors, families and other users before committing to them. Finally, they have resourced a number of public servants within Social Development NB to lead this project from a content development perspective. These roles work in conjunction with corporate web development roles to deliver on an improved user experience together. Although the website is not perfect, it represents a much better experience to citizens than what is currently on offer in NS.

AIP 2.0 could be administered by government, but is likely better situated with a community-based organization like 211. Staff asked system navigators and seniors where they felt AIP 2.0 was best placed and where they tend to go to find information about services and supports that they trust. The majority of ANS seniors indicated that they tend to connect with individuals or organizations in their local communities when they have a need. Trusted navigators are often those with whom they already have some form of connection or relationship. System navigation and senior organizations who tested were keen to highlight the important role they play in providing these types of informational supports to individuals but interestingly did not jump at the opportunity to explore how they might take on or administer a tool like AIP 2.0. There was significant hesitancy around the idea of having to work to maintain a technological tool, hesitancy in working with technology developers and managing those service contracts - both in terms of finding a quality vendor and in terms of having enough in-house knowledge about the technical requirements to hire well. In addition, a number of respondents were concerned about the amount of time and effort it would require to further develop the substantive content in the tool to ensure it was locally and contextually responsive. They also commented on the level of effort it would take to maintain and evergreen the database over time as the supports and services available through government or community-based organizations change frequently over time. Reflecting on what the GovLab team heard, it is the opinion of staff that Nova Scotia’s 211 service is likely best poised to take on something like AIP 2.0 with its pre-existing geo-coded community resource database, desire to enhance its website offering, and early exploration of how they might create a Directory on Demand function (for which Department of Seniors provided funding in 2019-2020). In addition, NS 211 was the only organization that saw the potential functionality and structure of the AIP 2.0 platform for serving needs beyond those related to aging-in-place. The challenge may lie in supporting 211’s capacity to take this on. Testers were quick to pick up on missing content and user testing quickly demonstrated where existing questions are overly complex and judgemental. Users made a number of recommendations about where and how to enhance the existing content - such as including self-identification categories for Veterans or Francophones and providing the relevant resources at the end of the tool that are dedicated to serving these groups. One tester asked why the questions about whether one needs home care, personal, or nursing care were not included in the physical health domain. NS GovLab staff intended to include a standalone domain called Care in Community that would ask questions and provide information about Continuing Care

programs, direct funding supports, and respite options. Unfortunately, this placeholder appears to have been overlooked during the website build. These are important supports that many Nova Scotians are seeking to help them stay in their homes longer; information about how to connect to these, access them and what the process is, should definitely be included in an AIP web-based tool. Watching how seniors and their families navigated the question content also offered significant insights into the wording and concepts included in the prototype. In particular, questions related to certain health behaviours such as healthy eating, food security and substance use were confusing for most respondents. There were many instances where seniors had to read the question several times to understand what was being asked; in other instances it was clear that questions were perceived as being judgemental and invoked feelings and reactions of guilt/shame (e.g. “yeah yeah I know I am supposed to eat healthy and not smoke”; “Hum…. do I smoke … should I answer truthfully here …. I will if you promise you won’t tell my mother”). If the tool is intended to be about planning, reflection, and action, there is no place for language that is overly complex, preachy or confusing. Users wanted a way to provide feedback to the website owners regarding missing content and missing resources. At the end of the user testing a few people asked whether there was somewhere in the tool that they could provide feedback online. Some had concerns about missing content or questions. Other’s wanted a way to share information about resources they thought would be helpful for folks. They felt this would be one way to help continuously improve the quality of the content and the relevance of the resources that the tool provides.

Next Steps and Potential Actions Public servants in Nova Scotia have been asked to step up, take action and invest in our collective future by solving problems that give Nova Scotians hope, care, dignity and new opportunities for aging well. Our mandate also compels us to listen and respect all Nova Scotians while ensuring government programs and services are inclusive and respectful of all demographic, cultural and ethnic diversities1. Overall prototype testing has revealed that the AIP 2.0 prototype is aligned in purpose, function and intent with the Department of Seniors and Long-term Care’s mandate. It taught us that users find the concept of AIP - a tool able to curate resources of most relevance - useful for some people but that there are also things that could improve the tool, its content and resource list. However, this testing work has also helped confirm that the needs in Nova Scotia related to aging-in-place in Indigenous and Black communities run much deeper than simply providing information and navigational support. While AIP is well aligned and intended to contribute to the current vision laid out by government, we should be cautious about overestimating its potential to have deep and transformative impact. Make no mistake, AIP 2.0 even if more fully developed and scaled, would not on it’s own, be sufficient to address the challenges that many face in trying to stay in their homes well into older age; particularly for older Nova Scotians living in ANS communities across the province. Prototype testing has revealed the complex paradoxes that exist around accessing supports, the impact of systemic racism on how we frame and talk about aging-in-place and the structural challenges with moving the provision of information and publicly funded services to online platforms for older and rural populations. Finally, while NS GovLab has always been an incubator of ideas and potential solutions, staff do not run programs or implement full scale initiatives.This work has been a source of deep intelligence, has generated considerable learnings and a number of potential next steps. The GovLab team is deeply thankful for the generosity of community members who graciously offered their stories, life experiences and opinions in helping us test this prototype. The design team encourages those reading this report to embrace NS GovLab’s principles for working in complexity and social innovation: 1. Be in relationship with people and the planet. 2. Everybody is needed. 3. Discomfort happens; it’s temporary.

4. 5. 6. 7.

Be scrappy, care deeply. Welcome whimsy, creativity and wonder. Co-create the future. Start somewhere, go everywhere.

Hon. Tim Houston, Premier of Nova Scotia. Department of Seniors and Long Term Care, Ministerial Mandate Letter. September 14, 2021. https://novascotia.ca/exec_council/letters-2021/ministerial-mandate-letter-2021-SLTC.pdf

There is no wrong place to start with a complex problem. In GovLab, staff take a systems approach in our prototyping work and we are committed to having the biggest impact possible. We also recognize these changes often start with small steps. It is in this spirit that this report ends by providing our learnings to public, the innovation ecosystem in Nova Scotia, policy folks in government Departments and we encourage anyone with the mandate, resources, energy and creativity to pick up the baton and the work from here. While specific recommendations on potential actions and next steps have been made to Government by the prototyping team, it is also our hope that others might find value in this work. This is why we are sharing our learnings report publicly. In addition, to this report and its Appendices, a copy of the website’s development code is available on GitHub for those who may be interested: https://github.com/SonWUT/AgingInPlace.git If you are interested in learning more, please contact Jocelyn Yerxa, jocelyn.yerxa@novascotia.ca or Rayna Preston, rayna.preston@novascotia.ca.

Appendix A: AIP 2.0 Early Origins In 2018, the Route of Aging team formed during NS GovLab’s first fellowship cohort. The team learned about human-centred design and the design process and developed ideas to test out. They iterated on their concepts and the result of their efforts was a working conceptual paper submitted to government in Fall 2018. Their efforts sparked the early stage considerations and designs for the AIP 2.0 web-based tool. To read more about their learnings and the work that inspired the current version of AIP please visit: Home Sweet Home: A Conceptual Approach to Aging-in-Place

https://dennispilkey.files.wordpress.com/2018/10/ns-govlab-aip-construction-report.pdf For more information about the work undertaken, please contact one of the original group members: Denis Pilkey, dennis@dennispilkey.ca

Appendix B: Testing and Learning Plan End-User Live AIP Test Script and Interview Guide Welcome, Consent and Setup ●

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First of all, I/we want to say thank you so much for agreeing to spend some time with me/us today talking about Aging-in-Place. I am/ We are going to share a little bit about our process today and what you can expect. I am/We are hoping you can spend the next 60 mins with me/us testing out a website. IF TESTING VIRTUALLY / USING LAB IN A BOX: Before we get started how is your sound today? Are you able to hear me/us? How is your video quality? Is the picture clear? Can you easily see me/us? IF TESTING IN PERSON CHECK: Is the font size large enough for you to read the screen. Is the mouse working for you? Today as we test, we will ask you to use a website that has been developed and we will be asking you some questions. I/We want you to know that you are in complete control of the website test today If at anytime you would prefer not to answer a question, please tell us you’d rather not answer and we will move along. If you need to stop please just let us know. If you need us to repeat a question or something isn’t clear, please ask us to repeat. On our end, we are trying to learn from a range of folks today. We would like to take some notes during our test session today as well as record this test so that we can review the information you share with us later on. The recording helps us ensure we understand clearly what you have said and enhances our learning. It also helps just be present in our conversation together right now. Just so you are aware, we will not show this recording to anyone outside our team and the recording and our notes will be held on a secure server in a place that only our team has access to. Once we have completed our analysis, we will delete these recordings permanently. We will only share general insights and information that can not be attributed back to you. All information that you shared with us today will be confidential & only shared within our team. The only limits to this confidentiality would be: - If we suspect harm to a child - We suspect you are going to harm yourself or another person Also we would like to compensate you for your time. We are offering a gift card) in the amount of $50. Provide the card.

Do you have any questions before we get started? <Answer any questions the person has> Do you consent to continuing with this website test? Y/N Do you consent to us recording this session? Y/N

Aging-in-Place, What Supports Are Important To Them and Seeking Help When Circumstances Change 1) When you hear Aging-in-Place, what does that mean to you? Add onto their explanation to ensure that everyone who is testing hears the same message about what AIP means at its most basic level.

Depending on type of tester: a) Have you ever thought about how and where you/you and your partner/your family/your friend would like to age? 2) And when you think Aging-in-Place and about what it means to be connected to a community, what comes to mind? 3) What are some of the most important services or supports that you are using/think you might need in order to age in place in your community of choice? a) What things feel most important to you? b) What about programs or services that are culturally specific or offered in culturally safe/culturally appropriate ways - which supports do you think would be most important for you and your family. Switch terminology depending on which community we are working with - ANS; Indigenous; Newcomer; LGBTQ2I+ Non-racialized etc.. c) And, where would you go to look for services or supports like the ones you mentioned if you needed them? How would you start your search? What would you do? Who would you talk to? 4) In the past when you needed help or support/services quickly - for example, if your health or the health of someone you loved changed relatively fast - how did you get the help you needed in a timely manner? How did you connect to the programs or services that might help? 5) And when you think about the times you have needed to see out programs or services, where do you typically turn for information like this? a) Where do you expect to find reputable information like this? Is the government a trustworthy source? b) Would a government website or office be the first place you turn to, to seek help? Why or why not? c) Explore or prompt around the user’s trust in government - is this strong enough to come to our website in search of this type of information is it their first choice? If not the government then which organizations or places are most trusted?

General Questions: Technology in the Home, Use of Devices and Websites Switching gears slightly, I/we are wondering about the types of technology you may have in your home.

1) Do you have a technology device and internet at home? What types? Which one do you use the most? 2) How do you like your <reference their device> ? 3) What do you typically usually use your <reference their device> for? 4) What was the last thing you did on your <reference their device>? 5) Did you use a website or the internet for that? What about apps? 6) When was the last time you used a website on the internet? 7) How did you find out about that website?

Introduce the AIP Portal Website We’d like to show you a website today that has information about Aging-in-Place. It will ask you a number of questions and is intended to help you narrow down and connect to the programs, services and supports you might like to access. We’d like you to spend some time looking at this website and imagine you are <insert the most relevant scenario for the individual tester based on what we know about their personal situation here>: ● Planning for you and your partners future ● Planning for your future ● Planning with a loved one for their future ● Looking for support you might need right now And just a couple of notes for you: ● This website is still in development which means that not all of the content for all of the area’s of interest have been developed. ● In order to test it out we would ask that you select all of the area’s of focus that feel most important for you ● And that said, we would ask that you also select the Health and Wellness area so that there are few more screens for you to explore. Instructions on How to Test: ● As you are reviewing the website please feel free to move through the website at whatever pace you are comfortable with. ● Please ask lots of questions if you have them and if you would like to narrate or talk out and explain why you are making the selections you are that is also great. ● We would strongly encourage you to point out places on the website where something doesn’t look quite right to you, or sound right, or feel right. ● Things you like about the website and don't like. ● If something is confusing to you; please also share. ● If the website reminds you of a story or experience you have had in the past, please feel free to share. ● All of this feedback is incredibly helpful so that changes can be made.

Questions to potentially ask during Live Website Testing:

1) What is the first area of focus you were drawn to select? And why? 2) What is at least one thing that you feel is really important, and should have been asked, that was not asked? What is one thing that felt really irrelevant? Where you thought, why does this matter or what does this have to do with someone’s ability to age in place? 3) I noticed you did _______________. Can you tell me why? 4) What did you think of the layout of the page, the font, the colours and the pictures? 5) What did you think of the explanations on the website? 6) What did you think of the final steps to get the list of relevant programs and services? What type of information did you think you would receive after going through the website? 7) What level of information would you need at the end of this website in order to take action or make the next step to receive support? Was the information provided at the end of your test sufficient if you wanted to take some next steps?

Using Technology/Websites/Internet to Identify, Discuss, Address and Revisit Challenge, Problem or Need in Your Life 1) Can you think about the last time you had a challenge or problem or needed something like a program or service. Were you able to find what you needed online? a) If so, how did you find what you were looking for? b) If not, why not? Walk us through what happened? 2) When you have had a challenge or a problem or if you need to make a decision about your plans for the future <replace with an example they shared if relevant> do you typically talk to others about it? c) If so, who do you typically talk to and why? d) If not, can you share a little about how you arrive at a decision that is best for you or your family in the moment? 3) When you are searching for information online - how much time would you be willing to spend searching for programs, services or resources that could meet your needs? a) And, if you haven’t found what you are looking for in <use the amount of time they reference in mins/hours/days>, what would be your next steps? What do you do next? b) And, say you find the information that you were looking for online, then what are the next steps that you would take to access that program or service? i) Listen for the steps they take and any challenges they may identify in how they do this: 1) I visit the organization's website if they have one 2) I call; 3) I ask someone else to call or reach out on my behalf? Who might that be? 4) I e-mail the organization; 5) I visit the organization in person to find out more. 31

People Working at the Point of Impact to Navigate Seniors to Support Live AIP Test Script and Interview Tool As a community-based partner who services older adult clients, how might a website like this be useful or not? ○ Would you use this tool ? Why or why not? ○ How would you use this? Would you spend time interacting with the tool before meeting with clients, alongside clients, or on behalf of clients? ○ Which parts of the website did not work for you and why? ○ Which parts of the website did not appeal to you and why?

People at the point of impact feel the tool ○ ○ ○ ○

Asked relevant questions for an aging population Design was intuitive and made sense Navigation was intuitive and made sense’ the design facilitated that? Provided useful information and resources at the right level of detail for them to work with clients to take action ○ felt like it could be helpful overall for their clients ○ is something they would spend time interacting with alongside or on behalf of clients ○ is something they would come back to as their client’s needs change over time. Feasibility of Developing and Maintaining Relevant Content for the Tool Overtime ○ Are the people who administer the AIP portal able to create a relevant and meaningful body of content for the tool overtime? ○ Are there relevant and meaningful services/ supports to be provided in the tool that AIP can connect folks to? ○ Maintaining a body of relevant and meaningful content? ○ What additional content or resources would government be able to offer to this tool? Who is best positioned to maintain and implement the website? Who is best positioned to distribute and use the information from a portal like this? ○ What is the best place/most strategic placement for this prototype in the system within NS? ○ Is this best placed and administered within the Provincial government or outside? If so, where? ○ If the prototype is desirable/feasible/viable, are there other potential key stakeholders who might be willing to take on administration/running it? What do we need to be weary of? Negative implications Feasibility of Integration with Other Websites/Systems What should this website tool be called?

Email Testing Script, Instructions and Google Form Link Dear <Tester’s Name> My name is Rayna Preston and I work with the Department of Seniors and Long-term Care in an office called the NS GovLab. We are a social innovation lab that is dedicated to working on challenges and opportunities related to Nova Scotia’s aging population with a particular focus on supporting rural/remote, African Nova Scotian, and urban Indigenous seniors. Right now we are experimenting with a range of different ways to connect seniors, those who care for them and those that work to support them with resources that can help older adults age in place connected to their communities across Nova Scotia. I received your contact information from <name of person> and <they> indicated you may be well positioned to test out a “prototype” website and provide some useful feedback to us. Below you will find some additional information about the website we have developed and how you can try it out and provide some feedback to us. There is also more information contained in the Google Form/Survey link below about how we plan to use the information that folks provide and how we work to protect your confidentiality. If you have any questions about this request to test out the website or the work of NS GovLab (or something else), please do feel free to reach out to me. Happy to chat by email or by phone; whatever works best for you. My contact information is as follows: Rayna Preston, Data and Evaluation Lead, NS GovLab Department of Seniors and Long-term Care M: 902-220-1801 E: rayna.preston@novascotia.ca

About the Website We have developed a very preliminary concept and website with some content and are hoping to receive critical feedback on this tool from a range of potential users before we invest too much time or resources into moving forward with this concept. The tool uses an online interview approach and some basic logic to match users to a curated list of resources and supports in their community. The tool’s questions and resources are based on how a user’s responds to questions and the selections they make. The website also encourages users to come back to the tool as needs change or as new aging-in-place challenges emerge.

Help Us By Testing this Out To Test the Positive Aging Website just a few instructions to help this go smoothly for you: 1. Go to the following link: https://nsgov.weusthem.com (Note: This is not a live website, it is only available in testing mode at this time; please do not forward the link as a resource to people in your networks yet!). 2. We would be happy to have you test this website as an individual curious for yourself or a loved one you care for; or as someone working in community to support connecting citizens to programs, services and supports (or both!). When presented with the options and questions on the website, choose the one that feels most authentic for your situation. 3. When asked about your geographic location, please select either HRM or Guysborough – as mentioned above this is only in preliminary development – not all of the content is programmed into the tool yet; we are curious if the concept resonates and if so, based on the feedback we receive, we will engage in next steps to further develop the necessary content to cover the rest of the province. For now our small team is focusing our testing efforts in these geographic regions. 4. When asked about what domains or areas related to aging-in-place, that you are interested in, please select all that are relevant for you but, make sure you select Physical Health as this is the only section of questions/content/resources that have been developed for testing at this time. 5. Once you complete the website, please go to this Google Form and respond to the questions to provide feedback : https://forms.gle/t5vzuaw2Dgs5dKiSA. Alternatively, if you would prefer to have a conversation, let me know and I can set up a Zoom or MS Teams call for us to chat. Many thanks in advance for any feedback you can offer.

TESTING/LEARNING FRAMEWORK FOR AIP Questions and Concepts to Test related to the actual prototype platform. Focus is on the prototype itself and it’s desirability, feasibility, viability, design, useability, merit of idea/portal, relevance, potential impact. Overarching Sub-concepts / Key Questions Indicators Who we would test Methods and Tools (link out to Concepts of with the tool identified) Interest To what extent Purpose of AIP Portal ● End-user testers who End-users End-User Live AIP Test Script / is the AIP share examples or Interview Tool ●To what extent does this tool ● range of seniors portal likely to indicate they have and elders living in help spark personal be effective in used similar online community. reflection? How? its People Working at the Point of tools to reflect on ●Is this something you would overarching Impact Live AIP Test their personal/family ● family and friends purpose as a use yourself or with a family or Script/Interview Tool situation OR would who care for tool to assess friend? use this type of tool seniors and elders and support ●To what extent does/would this to do so. who are living in Aging-in-Place tool help spark conversation community. overtime? ● End-users share with others in your life? Does this tool examples of ●To what extent does this/would help: People Working at having/attempting to this be helpful in addressing the Point of Impact have their needs met decisions you/your family ●connect folks online or examples of ● service providers/ need to make? to services/ planning for their community workers supports they ●To what extent does this/would future needs online. who interface and this be helpful in supporting might need in care for lifestyle changes you/your ● End-users can culturally seniors/elders family may want to pursue? quickly identify specific/ ●To what extent would you/your specific needs or appropriate/ family come back to the tool to situations that a tool safe ways? re-explore other needs? like AIP may apply ●spark too. ●Is this something that might be personal and useful for community based collective reflection when 35

planning for the future? ●encourage folks to return and re-explore needs over time, as they change?

partners who service older adult clients?

● End-users share that the website tool they tested: ○ asked relevant questions ○ was intuitive and made sense ○ provided useful information and resources at the right level of detail for them to take action ○ felt like it could be helpful overall ○ is something they would spend time interacting with ○ is something they would come back to as needs change over time.

Usefulness of Content/Content Domains ●What type of resources/content would be useful to see? Government only vs different levels of government vs. mix of community/government/privat e business services/supports. ●Does this/would this connect you to the type of resources you find useful? ●Does this/would this content be inclusive of the circumstances that you/your family find yourself living in/might find yourself living in in the future? ●Do the content domains make ● End-users who sense? Does it capture the express that the tool area’s that feel most important has given them to you as a user, that would something to reflect help you age in place? on / think about in the ●At the end of the tool, what is future. the level of information that users feel they need to receive ● End-users do not for this tool to be useful? Can identify any an organization name be ○ judgemental provided, name of an language/tone; individual, a phone number, an ○ photographic or design elements email, a website?

●What helps people take the next step to access the resources that could help? Design and Useability of Portal Tool ●Is navigation intuitive for users? Does the design facilitate understanding and use? ●Do the graphics hit the mark, overwhelm or underwhelm? ●Diversity and inclusivity of the portal’s design features (both in look and operation)? ●Harmful messages/sub-text coming through in the content that needs a re-think/ re-design?

To what extent is the AIP portal likely to be

Feasibility of Developing and Maintaining Relevant Content for the Tool

that convey a narrative that feels exclusionary to them. People at the point of impact feel the tool ○ asked relevant questions ○ was intuitive and made sense ○ provided useful information and resources at the right level of detail for them to work with clients to take action ○ felt like it could be helpful overall for their clients ○ is something they would spend time interacting with alongside or on behalf of clients ○ is something they would come back to as their client’s needs change over time.

Evidence that there are groups or organizations who

In Community: ●

211

feasible to implement?

●Are the people who administer the AIP portal able to create a relevant and meaningful body of content for the tool overtime? ●Are there relevant and meaningful services/ supports to be provided in the tool that AIP can connect folks to? ●Maintaining a body of relevant and meaningful content? ●What additional content or resources would government be able to offer to this tool?

have capacity - both staff and expertise - to maintain and create new content for a tool like this overtime.

Feasibility of Integration with Other Systems ●The technology to be able to integrate the portal with other similar tools/platforms (e.g. 211 community database) exists?

Evidence that government and other non-profit service providers are introducing new or radically reformed programs and services to respond to aging-in-place needs with cultural safety/ competence/ appropriateness.

Feasibility of the Level of Content Needed ● Feasibility of maintaining an accurate and up-to-date level of content for a resource database output.

Evidence that groups and organizations with capacity are able to work productively with BIPOC communities to apply a decolonial lens to the content development/ maintenance.

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● ●

Canadian Postal Workers Union Special Project Staff Community Links Senior Safety Program staff

In govt: ● ● ●

Continuing Care Service NS and Internal Services Other government departments or branches which provide programs/service s that target an aging or older populations.

Evidence that technological expertise to enable integration with other pre-existing sources of information is in place.

To what extent is the AIP portal likely to be viable in our current government context (e.g. policies, mindsets/norms , regulations, networks, resource flows, etc.)?

Are the privacy mindsets/policies within government a potential barrier to scaling AIP up and out in a govt setting?

To what extent is the AIP likely to be supported or desirable by key stakeholders (e.g. 211 staff; community groups like Community Links etc…)?

Who Should Run/Implement the Portal? ●What is the best place/most strategic placement for this prototype in the system within NS? ●Is this best placed and administered within the Provincial government or outside? If so, where? ●If the prototype is desirable/feasible/viable, are there other potential key stakeholders who might be

Internal Services NSDS Team Members

Are the technical IT requirements of the government a potential barrier to scaling AIP as designed up and out? Is getting this type of support/information online the only viable delivery method? Is online the best channel to meet the purposes above?

willing to take on administration/running it? Questions and Concepts to Learn About or Surface through Prototyping that reveal system challenges, problems that need to shift In other ways could the data be useful? Judging whether the thing is useful and viable and learning about the other things/how else might the information it captures/ if we were to turn in on - in what ways and whom would that be useful Does the tool reveal issues with aging-in-place as a concept? There is some concern that the way we frame aging-in-place around independence and autonomy and its notion that to age in place one must be very physically healthy might be problematic from an indigenous lense. In what ways does the feasibility of developing and maintaining relevant content for the tool show gaps in the current system approach to age in place. Can we use 211 data to inform the content development steps?

Appendix C: Testing Observations, Insights and Findings Black Text = ANS Testers in the Preston Townships

Insight Detail (further details)

Red Text = System Testers and People Working in Navigation Roles

Severity Theme

Potential Solutions

Purple Text = Rural ANS Seniors in Guysborough.

Timing

Challenges Using Technology Among Older NSians Some users brought tablets, or High other tech but then opted to use our laptop in a couple of instances.

Training

app, training, communications, don’t put it on the web for seniors.

One set of mother daughter testers High brought three different pieces of technology with them but did not use any of them; tried to log into the laptop they brought but could not remember the password. They ended up using our laptop and a wireless mouse.

training

app, training, communications, don’t put it on the web for seniors.

Getting to the website; getting the High website up on their device was a challenge for some users. Just following the instructions and navigating to or getting a browser open to use the tool was challenging; staff testing with rural seniors had to handhold to get folks signed onto the Wi-Fi and then to

Training

app, training, communications, if the primary audience is to get seniors using the tool themselves likely not a first line strategy to put it on the web for seniors.

Ownership NSGL Suggested Changes September 8, 2021

Insight Detail (further details)

Severity Theme

Potential Solutions

Timing

get the website loaded up. Users who brought their own device High - had some challenges adapting their settings to enable the website to work as intended when it did not display as it should have. Comfort using the tech was an issue for some.

Training

app, training, communications, don’t put it on the web for seniors.

Rural seniors (in ANS communities High especially) simply do not have access to internet - its too expensive and they can not afford it. They also are less likely to have an internet enabled device because of this. If the tool is internet based those with limited income and less resources will not use this tool/website.

Systemic Challenge

treat internet like other human necessities ensure a set of programs, policies, regulations, agreements to ensure we provide a universal basic access to the net for public services (at a minimum).

Purpose: Meeting Immediate Needs vs. Planning for the Future User questioned why they need to High provide all this info and answer all the questions to get the information they need - for example, I just need some information on getting yard work done/support for this- they want to go from their known need right to the resource for that need.

Design Content

could we go back to exploring meeting needs quickly through an AI chat bot - keywords go in, resources on those keywords come back right away AND also provide a site that gets folks thinking about what they might need to

Ownership NSGL Suggested Changes September 8, 2021

Insight Detail (further details)

Severity Theme

Potential Solutions

Timing

age in place. not all testers understood that the High tool was designed to provoke reflection or understood that it was for folks that are not quite sure what kind of support they might need;

Design Content

being clear about what the tool can do - connect you now and/or help you plan for the future probably needs to be mores explicit or work on how we promo it

Seniors in crisis and caregivers High who support them who are in immediate need of some supports are unlikely to come to a website like this and answer a bunch of questions only to get a huge list of resources - they are already overwhelmed by their situation, all of the information that comes often after a diagnosis and then add on for some technology learning on top of needing to access services quickly; this would just create barriers.

Systemic Challenge

build a site or space that can quickly and easily meet an immediate need to build confidence so folks return for information and planning when they are not under a crisis/immediate need stress. with any web option there must be an in person option as well. web options can not completely replace the need for a caring human to help.

People who are overwhelmed may Observa Design reach out for personal - phone tion Content based services more so than turning to an online tool: Seniors/caregivers tend to call 211 if they need something right away (their website is not user friendly)

If the site could meet a user's need immediately if they were in urgent need of something they might be more inclined when the crisis passes to come back and spend

Ownership NSGL Suggested Changes September 8, 2021

Insight Detail (further details)

Severity Theme

or they call CNS because they need a person to hold their hand to make sense of all the information and what to do next.

Potential Solutions

Timing

Ownership NSGL Suggested Changes September 8, 2021

Now

Developer

more time using the website. This may indicate the need for a chatbot that can connect a user to a specific resource with their keyword search while also maintaining a larger experience for those with time and space to do some planning.

Advanced planning for aging and Observa Systemic dying is not common in rural ANS tion Challenge communities; most don't have the income to pay someone to do it and they may not have clear title to their lands in ANS communities. Aging-in-Place & What this means in ANS communities Aging-in-Place does not hold meaning for users

Medium Design Content

find a meaningful title

Change the title of the website to ... "Positive Aging" and show the following text "This website is intended to help you get connected to the programs, services, supports, that can help you and your loved ones age well with as much independence as possible now and into the future".

Insight Detail (further details)

Severity Theme

Aging-in-Place can have a negative Medium Design connotation - "Place is associated Content with 'stay in place' as an ANS this is relevant.

Potential Solutions

Timing

find a meaningful title

Program

Because you are coming from DOS Observa - I assumed this is only for Seniors tion (65+) but I realize now this is for anyone - we are all aging and might need these supports. The word "aging" needs to be Observa Systemic redefined. I am not old; I am tion Challenge growing and learning and becoming more mature/wiser as the years go on I am not just getting "old". My physical form may become limited in some ways but I am growing and becoming more capable in other ways every single day. Right now, I do more now and work more now than I ever have before.

need to redefine "aging" and "older adults" so that wisdom and maturity are at the centre of what society thinks is to come.

When rural ANS seniors reach a Observa Systemic point in their Aging-in-Place tion Challenge journey where their own homes become too much to care for or we can no longer care for ourself there is no option for us to remain in community nor receive culturally competent care. It does not exist here in rural black communities. We ask for it but it will never happen.

the community is hoping for small scale, kinship focused care for communities; gov't needs to meet needs closer to home.

Ownership NSGL Suggested Changes September 8, 2021

Insight Detail (further details)

Severity Theme

Potential Solutions

Timing

No one is coming to help us / they might remove us from our homes for our safety and send us far away. So, we must be self sufficient and we will avoid reaching out until the situation is dire. Sense of uneasiness around - who Observa will look after me when I can't do tion this myself - right now I am managing within my kinship and brothers and sisters - but I don't have kids here to take care of me. Who would I call - I am called on to help but who would come for me. One tester indicated getting old is Observa related to the head - it's unclear tion whether he meant when the brain is aging or can no longer perform the functions it did - like losing memory/or getting old as a state of mind.

Ownership NSGL Suggested Changes September 8, 2021

Insight Detail (further details)

Severity Theme

Potential Solutions

Timing

Ownership NSGL Suggested Changes September 8, 2021

Application of Website Concept Beyond Aging-in-Place This tech/platform could be used Observa Other systems for more than planning/accessing tion resources for Aging-in-Place. Thinking about all of 211’s COVID-19 information related calls after COVID briefings and updates decision tree that explains various things based on individual circumstances. If we could get a platform in place that operates like a decision tree such as this customized to individuals - that could scale for other needs and/or population groups too.

211 is already planning Now for a Directory on Demand - something that a user builds with resources they select for themselves but they have to know what they are searching for. This DoD it was hoped could replace the Positive Aging Directory (print version) done by DOS. They have had problems with their web based contractor/service provider. The AIP builds on the concept of DOD but takes rather than simple look up uses a decision tree logic to show resources. Give AIP and the vendor relationships over to 211, support a more fulsome build to enhance the functionality of 211's website - use the AIP version to test and scale the model to the rest of

Program

Insight Detail (further details)

Severity Theme

Potential Solutions

Timing

Ownership NSGL Suggested Changes September 8, 2021

211's needs. Social Development NB is creating Observa Other systems a website to centralize the location tion of all government support programs that offer financial or other types of assistance. It has some pre-screening financial calculators which allow people to answer a couple of questions and determine their likelihood of eligibility so they dont waste their time applying for programs their income disqualifies them from.

NS does not have a single place where all support programs for seniors are listed out. We could do better on the basics of website development here. We also don't have any quick self-assessment and financial calculators that let people determine whether they may meet the program requirements/criteria and match a potential user to gov't supports.

Program

UX Feedback on Website/Tool Landing Page and Privacy The Letters on the landing page are High difficult to read

Design Content

re-work the Now typeface/font on landing page Developer

Some users did not see the learn more button

Medium Design Placement

program to discuss Now relevance of learn more whether to take it out or just people what they are

Developer

Change typeface to something with easier readability on internet. The "G" in Aging gave folks some challenge. Remove Learn More button and put subtext for what ppl will find in this tool: "Get connected to services, supports, and programs that

Insight Detail (further details)

Severity Theme

Potential Solutions

Timing

Ownership NSGL Suggested Changes September 8, 2021

there for

Users like the messages in the learn more section

Learn more vs. start - ppl unsure what to click on first or second.

Medium Design Placement

Users felt the purpose/reason Medium Design (messages 6&7) landed with people Placement and suggested they should appear first in the messaging Some users questioned weather all Medium Design the messages needed to be there Placement

At the end of the messages, the Medium Design learn more button kept hitting the Placement button to get another message and didn't know what to do there

can help you and your loved ones age well, safely and comfortably with as much independence as you want. "

program to discuss relevance of learn more whether to take it out or just people what they are there for

Program

program to discuss Now relevance of learn more whether to take it out or just people what they are there for

Developer

program to discuss relevance of learn more whether to take it out or just people what they are there for

Program

program to discuss relevance of learn more whether to take it out or just people what they are there for

Program

program to discuss relevance of learn more whether to take it out or just people what they are

Program

Remove Learn More Button. Keep only the start button.

Insight Detail (further details)

Severity Theme

Potential Solutions

Timing

Ownership NSGL Suggested Changes September 8, 2021

there for Users liked the anonymity in the start message.

Observa tion

People didn't know what meta data Low was

Design Content

bury in the link to privacy. Program to provide wording to developer

Developer

Privacy link - users would use it if it Low was clickable Shorter intro msg and a "start now" Observa Design button seemed clearer to users in tion Content the moment - they got started much more quickly than in other tests with seniors - but many were still not really clear what they were doing, what the purpose was or what they would get at the end of it. Pre-Interview / Personalization Questions The question "Who brought you to the website?" confused folks.

Low

Design Content

reword to help user understand - be more specific

Now

Developer

Remove the text for the question but leave the response options there so the user can just select what makes sense for them. The intent is self-obvious. Also remove the "1 - " that is appearing in front of all the interview questions. Taryn suggested the following text:

Insight Detail (further details)

Severity Theme

Potential Solutions

Timing

Ownership NSGL Suggested Changes September 8, 2021 "Select what applies to you"

Answering the "who are you here for" question incorrectly or by making a mistake selection changes the wording for the rest of the experience if they make a mistake in the selection it was hard for them to understand what was being asked of them.

Design Content

Ensure the question is clear and specific as to whom they are answering for either/or

Often users are thinking of themselves and others when answering the first question which can lead them to be confused in the context for the rest of the experience.

Design Content

ensure the question is clear and specific as to whom they are answering for either/or

Design - Flow

ensure pages load to top

Program

One user commented on liking the graphics Pages don't all load at the top causing users to lose context/place Uncertainty for some users about checking all that apply where the option to do so exists (some missed it and there was a delay/lapse in the functionality of clicking more than one).

Design Content

get options from developer to encourage people they have more than one option to select.

Developer

Fix to ensure page loads to the top of the page (especially on tablets)

Developer

For questions with "Check all that apply" do something that makes it clearer that this is an option. One suggestion was to add a checkbox next to the response options.

Now

Insight Detail (further details)

Severity Theme

Potential Solutions

Under identity some folks asked about other groups - Acadiens are not represented and there are a host of French Language services in NS. Also there are a number of resources for Veterans (although not an identity per se). Folks thought these would be important to add.

Design Content

The mapping of French Language and Veteran services and supports and utilizing the expertise of others in government to build this would be required.

Geographical area was problematic. Users looked for Dartmouth

Design Content

Ask the user to select their county.

Counties are not listed in Alphabetical order which is odd and hard for the user.

Design Placement

Switch the order of presentation of counties to be alphabetical

Some hesitation on working/employment status categories.

Design Content

The employment status categories dont account for volunteerism - I work more now as a volunteer in community than i ever did as a paid employee. This labour is incredibly valuable even though I am not paid for it.

Design Content

The word Access around "other health care providers" created uncertainty

Design Content

Timing

Ownership NSGL Suggested Changes September 8, 2021 Program

Now Developer

Change "geographic area" to County

Developer

Do you work for pay? Y/N Program Include a category for volunteering.

Program clarify - does access Now mean I can access or do I access

Developer

Remove this question entirely.

Insight Detail (further details)

Severity Theme

Potential Solutions

Health care providers - users weren't clear on what this meant

Design Content

clarify - specific to type

When a user indicates they Do not have a primary health care provider in the pre-interview - they still see questions later on that reference "have you spoken to your primary health care provider about screening, bone health, medical histories etc...". Don't show me content that is not relevant to my situation.

Design - Flow

add a trigger that shows a different content that accounts for the context of an individual not having a primary health care provider. re-work the logic behind this.

Timing

Ownership NSGL Suggested Changes September 8, 2021 Program

Program

Domain Selection users did not click on the box in the corner to select topics. They all clicked in the text area

Design Content

The safety topic turns black when it is selected and was confusing because the font and page are also black and white

Design Content

Family/connections was suggested as a content domain for the tool.

Design Content

Transportation is in its own category but basically integral to Physical Health and Mental Health and almost all of the categories. If you can't get out and about, all of

decide whether to leave the check boxes in the top right hand corner use a color

Program Now

Developer make it explicit that this content is in another domain

Program

Design Content

Program

Change the colour of the Safety box or make the checkmark White when toggled on.

Insight Detail (further details)

Severity Theme

Potential Solutions

Timing

Ownership NSGL Suggested Changes September 8, 2021

these domains are impacted. Website Functionality Issues The questions with a "check all that apply" option advance the user down the page upon a single selection. Thank you page at end of tool doesn't always load at the top.

Design - Flow

ensure the page doesn't jump when there is all that apply Developer

Medium Design - Flow

have it load to the top

Now

NSGL staff will look for this in next round of testing nothing to do right now. Ensure the Resource List Loads at the top of the page. Also include the text from the Miro board that was intended to tell the user, you're done ... perhaps place it right under the "Thank You" ...

Developer

Thank you for using the Positive Aging Portal! Here are some resources that are based on your responses to the questions today. As we go about our lives, things may change, and our answers to these questions may change as well. Ongoing reflection can be useful in identifying changes in our needs and what supports might help us. Coming back and checking out the

Insight Detail (further details)

Severity Theme

Potential Solutions

Timing

Ownership NSGL Suggested Changes September 8, 2021 domains in this portal from time to time may be helpful as you continue to think about what you need to age at home and stay connected to your community.

To go back, most users, used the browser back button.

Top of Domain page says Medical Deicions Making above the progress bar

Observa Labelling tion Button/Field

High

The "skip" buttons didn't work as Low folks expected them to work (people expected to see a whole new page or some type of state change in the current page but if you are already on the last question of a squence in a page nothing happens - this cause some folks to stumble over what to do next)

make visible and consider wording on button

Labelling Button/Field

Design - Flow

Now

Developer

Need to make toggling between pages easier and more seamless. Ppl did not use the previous button without prompting.

Developer

Ensure that the text above the progress bar actually matches the section that the person is in and completing. there are a few other sections where this is happening - a mismatch between what the progress bar says.

Now

developer to fix this. Highlight the skip in black to show its been activated.

Developer

Insight Detail (further details) A feedback space - somewhere to write in comments - would be well received

Severity Theme Design Content

Potential Solutions

Timing

nsgovlab team to have a conversation on how best to invite and accept feedback on the tool that protects privacy.

Ownership NSGL Suggested Changes September 8, 2021

Program

Content Issues Questions about healthy food invoked a pause or reflection on how "truthful" one should be; indicating some degree of shame or dissonance between what we do and what we know is healthy.

Design Content

For seniors who are still engaged in self-sufficency/subsitence farming food security is less of an issue within their kinship networks. So long as physical capability is there to raise animals and food there is some security. Planning for the future when this is no longer possible may be necessary if these kinship based structures do not/can not step into continue to provide.

Design Content

The skip meals option - their prefered option wasn't there so they were uncertain to anser yes/no

Design Content

Program we have no content that asks about food self-sufficency and plans for the future is this is something that is currently happening. nor any information around how to enhance food self-sufficency. consider adding content to the tool.

Program clarify and break out into multiple questions where needed

Program

Insight Detail (further details)

Severity Theme

Poorly worded question text around "do you skip meals because you cant afford to eat?"

Design Content

Potential Solutions

Timing

clarify and break out into multiple questions where needed. add just ask people if they want healthy food options and recipes

Ownership NSGL Suggested Changes September 8, 2021

Program

The wording and options in the "tend to eat less healthy" was confusing for users.

Design Content

rework to remove tend and "less healthy"

Users took some time to answer I tend to eat less healthy because ...

Design Content

rework to remove tend and "less healthy"

Program

The Health care provider questions were easily understood - if you have a doctor. If you don't it created a bit of churn as to whether answer No or what option is there if I don't have a doctor

Design Content

program to back to discuss to create more clarity. if you answer no to doctor questions, it still acts as if you have one

Program

I am not sure if people understood the health management systems; wording of the question didn’t allow others to get into considering other technology like life line or meal reminders or Fitbits etc…

Design Content

Program

Users liked the info on the types of Observa preventative screening tests tion Did not witness anyone select that they have routine hearing tests.

Observa tion

revise to be clear

Program

Insight Detail (further details)

Severity Theme

Potential Solutions

In cases where folks are asked are you aware of x or y or z; if they are aware and if they are using them are two different questions. I may be aware of medication reminder tech but I dont need it and wouldnt use it.

Medium Design Content

revise content to be clearer more direct

The cultural identiy question was vague - people of color - east indian / culture didn’t fit everyone.

Design Content

Other testers liked the culturally High safe questions in the tool - it sparked a conversation about the places and spaces where care has not been culturally safe for them in the past and why that prevents folks in ANS from reaching out for supports in the first place and the fears of removal from community.

Accessibility

Substance use questions similar to health eating behaviour questions invoked a level of shame and explanation about use.

Design Content

Questions about end-of-life care were met with mixed response/emotion; which likely indicate their importance. Everything from why would you ask this its irrelevant to this is

Design Content

Timing

Ownership NSGL Suggested Changes September 8, 2021

revise to be clear Program

Program

Insight Detail (further details)

Severity Theme

Potential Solutions

Timing

Ownership NSGL Suggested Changes September 8, 2021

extremely relevant and an excellent planning prompt to get everyone into the space of outlining and documenting their wishes with family should they become incapable of making medical decisions. some conversation around Observa Design home,convalescent and respite tion Content type care while testing the physical health stream suggests that we may be missing content here around LTC and the types of "health related services" that might naturally fit here ... we had envisioned those being in a different domain called Care maybe? we have a blank page for that in our workbook/slide deck but this seems to have gone missing in the build - there is no natural place where the stuff for LTC type services would sit in this tool.

this may need a re-think ; this could be an opportunity to take all of those programs and things people can apply for and stick all the info into one single spot. create a single entry to start the process of applying for multiple things.

program

Resource Lists and the Usefullness of Individual Results The Thank You page met with great Observa response among the first round of tion seniors we tested with. People liked clicking on the websites but had to be directed to

Design - Flow

ensure links look clickable and are visible

Developer

Ensure that website links in the resource list are

Insight Detail (further details)

Severity Theme

Potential Solutions

click on them. They do not look active or may not be visible in pages with a lot of info on them.

in pages with alot of content

Depending on situation of user - the Observa Design resource list could be very very tion Placement long - placing this into a table rather than a large list. Or something with the higher level categories that could be expanded or minimized and opened when needed vs. showing the user -caregivers -everything they might need. Caregivers tend to be overwhelmed by information. They simultaneous have too much info and are unable to make decisions.

consider other formats for the presentation of resources - an option for us to select how they want to see their resources would be ideal - here is a list, here is a table, you can sort it, you can print it (would need to show full phone numbers and simple URLS), you can email it to yourself, you can download and save a PDF etc...

Timing

Ownership NSGL Suggested Changes September 8, 2021 hyperlinked using a differrent colour and underlined

Users were very pleased and felt Observa this information was valuable and a tion few understood it was tailored to their needs. Nobody clicked the read more button at the end of the resource list on their own. Unsure why it is there

High

People wanted a way to save the information

High

Design Placement

Design - Flow

make it visible or decide Now whether that info even needs to be there (the more info stuff)

Developer

give the user multiple Now options to email to themselves or others, to

Developer

Remove the need for Read More...display all relevant info. Scrolling is okay at this point and expected. There was supposed to be a share button that would allow someone to share it to

Insight Detail (further details)

Severity Theme

Potential Solutions

Timing

Ownership NSGL Suggested Changes September 8, 2021

share, print, download

A couple of people selected the "Share Resources" button but nothing happened - no email with attachment was triggered.

Design - Flow

Testers said they want to share their resource list with family and friends - my answers might be helpful for others and I would want to email it to them.

Design - Flow

At the end, no one without being prompted really opened up or looked at the resources on the list at the end.

Labelling Button/Field

A couple folks commented that the screening tests they should go for preventative stuff and the ability to get refurbished hearing aids through DAL was helpful information for them.

Design Content

Their are no vetern's specific resources - they can help with home care for example.

Design Content

People didn't understand at this point it’s the end. Or that they could go in to click more options in the

Labelling Button/Field

their email/or send it to someone, or print to pdf. PLease add this button.

Developer

ensure buttons indicate what happens next

Developer

Insight Detail (further details)

Severity Theme

Potential Solutions

Timing

Ownership NSGL Suggested Changes September 8, 2021

domain selection page if they wanted to. How to get people to visit the website The majority of urban seniors who tested said they would like to receive this information at the community level

Communication/ figure out where it needs Marketing togo and who needs to own the site Program

Wondered if there might be another Observa Communication/ ensure how people will way to communicate it besides tion Marketing learn about it being there email

Program

An easy way to share the fact that this website exists with others

Observa Communication/ ensure how people will tion Marketing learn about it being there

program

Some users thought coming from government was a trusted source

Communication/ ensure how people will Marketing learn about it being there

program

Some users though posters for those who don't use computers

Length of the Tool/Level of Reading/Accessibility People would like to know how it works up front and how long it could take

High

Design - Flow

Program

Progress bar is not helpful. An estimation of time would be better. It's possible more folks might find the bar helpful if the pages loaded at the top. As it loaded, no one could see their progress because it jumped the user

Insight Detail (further details)

Severity Theme

Potential Solutions

Timing

Ownership NSGL Suggested Changes September 8, 2021 down the page.

A lot of reading in this tool at some High points - the choices are quick but how much time does this take someone. People who are overwhelmed already by too much to do/too much information would find this too long.

Design Content

If users had context as to how the system worked, it would help them know why each question is asked and better equipped to answer

Design - Flow

Program

People Who Are Not As Likely to Use This Website Caregivers who are overwhelmed High already - either by the carework they perform or by too much information related to a loved ones new diagnosis etc...

This tool online is not for everyone; very low income seniors would not likely have online accesss or tools. There may be low literacy and this tool is very text based; assumes an ability to read at a specific level

Accessibility

The assumption that technology can save us labour or better connect us than a human interacting with a client on the phone needs further exploration.

Program

broader learning regarding online tools. Its not for everyone.

Program

Insight Detail (further details)

Severity Theme

The level of reading required in this High tool may not meet accessibility standards - you hould connect wth the Accessibility directorate for their perspectives. This would need to be brought down to about a Gr. 7 level. many rural ANS seniors or seniors living in these communities do not have home phones - they have cell phones - usually pay as you go type. cell phone is cheaper than home phone. the general sense is that most are only using those phones for talking not for accessing the internet through mobile data.

Accessibility

Observa Accessibility tion

Potential Solutions

Timing

Ownership NSGL Suggested Changes September 8, 2021

plain language consultant could transform the content once more fully developed. this would be a final step.

Support there may be a need to better understand the specific contextual factors of different device useage among rural, lower income seniors and how they afford/dont afford, maintain basic connection to outside world if they live independently.

People will usually go to govt Observa Accessibility website get lost easily on those tion sites. Within the ANS, people will call central figures - those well connected, those active volunteers who are out in community serving to find the info they might need but asking for help takes a lot. They dont necessarily have computers or internet and People are proud and don't want to ask for support.

Insight Detail (further details)

Severity Theme

Potential Solutions

Timing

Where this type of tool best fits Gov't of NB just launched 211 Observa Other systems during the pandemic. They are tion directing all inquiries about social support programs to 211 and away from government. Rationale is that this is buidling the capacity of 211 through staff training in real time to respond to the need for govt programs and services ; their GovNB also is helping build that database and encouraging collaboration - gov't feeds 211 information directly and 211 feeds back information on needs that go unmet and met back to GovNB and on the types of calls. they use that information to plan next steps and feed that into their web based strategy. I would go to the library to find the things I need. They usually can help connect you to services.

Ownership NSGL Suggested Changes September 8, 2021