Co-designing towards better bone health for Singaporeans
Are you healthy? Maybe you think so. Then again, you might look like a picture of wellbeing: healthy skin, healthy hair, healthy organs, and yet be facing a significant and looming problem.
Whether it is good or bad, bone health is invisible. Problems often only reveal themselves when disaster strikes.
In Singapore today (and in many other places) a person with poor bone health usually finds out only when they fall or break a bone. And in a nation with an ageing population this can be a critical first step towards rapidly declining health. A local study reported on by the Ministry of Health found that 27 per cent of Singaporeans who sustained hip fractures died within a year.
Health professionals know what is needed to improve this situation. Early intervention led by increased community awareness, before a person suffers a broken bone, is required to minimise the harm done to Singapore and its people by poor bone health.
But efforts to achieve this change to date have not been broadly successful. It’s time for a different approach.
There have been ongoing local efforts to promote better bone health in Singapore, but the efforts have mostly been disparate, unseen by the broader community and have sometimes overlapped.
To improve this situation, a group of doctors and community health providers formed an alliance, aimed at driving a concerted effort to promote bone health, supported by Amgen and ACCESS Health. The Bone Alliance Singapore wanted to raise awareness about good bone health and to improve outcomes for those at risk of poor bone health.
To deliver on these goals they needed a strategic plan that would examine how the alliance would operate, what it would do and within what timeframe. They needed to kickstart a “how might we” conversation to build an actionable strategic plan for the future.
ThinkPlace joined the project as co-design facilitator to help the new alliance design this plan.
This project made use of ThinkPlace Singapore’s deep experience with co-design for positive impact. In order to be effective, the action plan required the support, and hence ownership, of all stakeholders.
While a co-design process might seem simple, not all co-designs (or co-designers) are created equal. So what matters most in such a project? What does success look like?
For us, success revolves around effectively and productively managing the various voices in the room, balancing differing expectations and interests with sensitivity and creativity to foster meaningful collaboration. Great co-design first secures shared purpose and then unleashes new and creative ways of seeing, imagining and making.
It starts with making sure the right voices are all in the room (or the virtual room right now). ThinkPlace designers worked with Amgen and ACCESS Health to involve doctors, community health providers, people with bone health ailments and others throughout the design process.
Here’s another powerful design fact. Human beings engage with human stories. These can be hugely helpful in both defining the problem space, building the case for change and securing the buy-in to collaboratively innovate.
We started by involving our participants in collecting stories - what did people with bone health ailments go through? Where were the current gaps in the system? What patterns were emerging? With the stories as a backbone, the participants and Alliance members projected forwards and identified various “pillars” that the Alliance could focus on.
During our initial conversation with people who were suffering from bone health ailments, we found out if they could turn back time, they would prefer earlier interventions.
In response, a Life Stage Model for better bone health was proposed and co-designed with these “voices of experience” before being built upon by clinicians and community care providers. This model became a highly-useful framework for the Alliance, allowing members to visualise and map where current initiatives were, where gaps existed and where improvements needed to be made. The model helped ensure that future efforts of the Alliance would be guided by a system-level view, which is holistic, rather than splintered or siloed.
This co-design process allowed an equal voice from each segment of stakeholders, shedding light upon the structural challenges that have been inhibiting collaboration. The process made it easy, even fun, for people of varying backgrounds to chip in their ideas and contribute to the change. People were engaged on their terms, and felt a sense of agency and purpose in the engagements, but also a sense of ownership over the final design
With members of the Alliance, a roadmap was created for the next three years. One of the first initiatives to launch is a bone health ambassadors programme, which is currently being worked on by the Alliance.
Senior Minister of State for Health, Dr Amy Khor, announced during a recent speech that the Health Promotion Board will be working with Osteoporosis Society Singapore, an Alliance member, to train 300 Bone Health Ambassadors. These ambassadors will run educational sessions about healthy bones and fall prevention. Plans have been placed on-hold due to COVID19, but will be restarting soon.
As with bone health itself the full impact will be slow to reveal itself. But greater connection, greater awareness and greater cohesion around services and campaigns will undoubtedly be a good thing for Singapore and its people.