Information Design and Architecture in Persuasive Pharmacy Space: combating Anti-Microbial Resistance (IDAPPS)

Lead Research Organisation: University of Reading
Department Name: Typography and Graphic Communication

Abstract

Information Design and Architecture in Persuasive Pharmacy Space: combating anti-microbial resistance (IDAPPS)

IDAPPS is an inter-disciplinary project bringing together academics and practitioners in graphic and information design, architecture, ergonomics and human factors, and pharmacy to consider how to support one of the strategic aims of the UK 5-Year Antimicrobial Resistance strategy 2013-18: how to 'improve the knowledge and understanding of antimicrobial resistance'.

IDAPPS introduces 'persuasive space' in thinking about the presentation of information, its situation within an environment, and how users interact with it, in the context of a community pharmacy. Community pharmacies are socially inclusive and convenient, and today play a key role in delivering public health. They are places where people wait for prescriptions to be filled or to see a pharmacist, and offer a persuasive space to raise awareness of the dangers of Anti-Microbial Resistance.

Our inspiration for IDAPPS is work done by Otto and Marie Neurath in the 1930s to raise awareness of and support prevention of tuberculosis (TB). They produced a series of charts with striking and effective images based on consistent and carefully considered principles, for public display in schools and community centres. The Neuraths believed that the space in which the charts were read and used was important for their effective reception and understanding. This aligned with the notion of persuasive space in architecture, in particular a significant seam of work taking place in the 1930s in the early stages of modernism when functionalism came to the fore.

IDAPPs considers this historical context studying graphic and information design in the nineteenth- and early-twentieth century used to tell people about, for example, TB, infection spread, and approaches to hygiene to combat bacterial infection. We use this information to inform ideas for the development of designs for a persuasive pharmacy space, also taking account of user-centred information design projects which patients, families, carers, health professionals and designers work together, and the integrating and participatory principles of human factors and ergonomics.

IDAPPS has been designed to provoke and to generate ideas for future consideration. Through a competition, good practice report, and public exhibition, we anticipate a thriving legacy. A competition to design persuasive pharmacy space will comprise teams of information/graphic designers, architect or built environment professionals or researchers and pharmacy practitioners or researchers. It will result in the development of a winning prototype set up in a pharmacy. A report containing good practice guidelines for persuasive space in community pharmacies will contribute to expanding knowledge on the impact of the built environment and information design on wellbeing and education and will therefore be of interest to a wide variety of organisations. An exhibition will show examples of archival material to show how explanations and descriptions of AMR have been dealt with in the past, and the prototype design solutions.

To enhance feasibility and to add value to the project, we have engaged two project partners who are keen to work with us. Day Lewis is one of the largest independent pharmacy chains in the UK and Europe; its central purpose is 'to help people in the community stay healthy and feel better'. Design Science, a leading science communication design group, will advise on the transformation of scientific fact to understandable information, and will play a key role in the curation and design of the exhibition.

Planned Impact

IDAPPS will contribute improved knowledge and understanding of antimicrobial resistance (AMR) in diverse local communities through Persuasive Pharmacy Space (PPS). IDAPPS beneficiaries are architecture and design practitioners, pharmacy users and workers, organisations who want to raise the profile of the dangers of AMR (especially in the context of the impact of the built environment on well-being and education), and the general public. Through their contacts and networks, our non-academic partners, Day Lewis and Design Science, offer additional opportunities for reach and engagement.

IDAPPS' impact is sought in 3 main ways:
- a Competition that will generate ideas and proposals for persuasive pharmacy space
- a Project Report containing good practice guidelines for developing persuasive spaces in community pharmacies, and that will have considerable reach if our plan to get it distributed by the General Pharmaceutical Council is achieved
- an Exhibition that will draw attention to approaches taken to combating AMR in the past. We are particularly keen to draw attention to the TB and malaria prevention campaigns realised by Otto and Marie Neurath as we have some evidence to suggest the approaches may be relevant today (see, for example, the quote in the Visual Evidence p.1). The Exhibition will display the work of the finalists in the Competition, and the final prototype.

In addition, we will produce papers for non-academic publications in each of the contributing disciplines, and generate impact through the project events and workshop, and social media.

IDAPPS's impact will achieve:
- recognition of the value of persuasive space in community pharmacies as a result of our good practice guidelines arising from the research
- a greater understanding of user needs and perceptions enabling a greater tailoring of pharmacy design experience
- demonstration of the value of well-designed health communication and the environment in which it is situated
- raised profile of explanations and descriptions of AMR produced in the past, and how they are relevant today
- greater understanding by architect and design practitioners of the value of drawing on cross-disciplinary research to enhance practice
- raised profile of research activity within design practice
- expansion of knowledge on the impact of the built environment on wellbeing and education
- raised profile and reach of our project partners, Day Lewis and Design Science
- reactions to the innovative outputs emerging from the Ideas Lab and Competition
 
Title Towards the persuasive pharmacy 
Description This digital exhibition shows the stages of the IDAPPS project. It is divided into the following sections: Pharmacy space and space to inform; Looking back; Our competition; 5 ideas; In place. 
Type Of Art Artistic/Creative Exhibition 
Year Produced 2018 
Impact This digital exhibition has drawn attention to the integration of archival research with design-led methods, which has helped to raise the profile of the Otto and Marie Neurath Isotype Collection at the University of Reading. 
URL https://amrpharmacy.org/exhibition/
 
Description The research demonstrated the benefits of user-centred approaches to design, including the engagement of the public with research, and the advice and contribution of providers of information. Positive feedback about our explanations of drug-resistant infection has demonstrated the relevance and significance of the design of such information. The research confirmed that community pharmacies both in the UK and in Rwanda are convenient, socially inclusive locations to distribute information about AMR. It confirmed that pharmacists and pharmacy workers are both willing to be involved and have a key role to play in engaging people with information about antimicrobial resistance but established that they have limited time to do so.
Exploitation Route The co-design method / Ideas Lab and competition has proved an excellent way of working.
Use of material in archives and collections to inform thinking about a contemporary issue.

Integrating designers / design thinking at the start of a public health communication project. Philip Howard, Consultant Antimicrobial Pharmacist: 'IDAPPS has made me totally rethink how we communicate messages around AMR to the public and healthcare professionals. Inclusion of a designer on project will become the norm where budgetary constraints allow. Where funds are tight, I will apply the principles I have learned.'

Partnerships - with the Commonwealth Pharmacy Association, the Rwandan Community Pharmacists Union and Public Health England - formed as result of the project have said that they are committed to working with designers and, as relevant, including discussion of user-centred design in training.
Sectors Education

Healthcare

URL https://amrpharmacy.org/
 
Description The research has had impact on the global health communication challenge of antimicrobial resistance (AMR), in the context of community pharmacies in the UK and in Rwanda. It has influenced organisations, including Public Health England, the Commonwealth Pharmacy Association and the Rwandan Community Pharmacists' Association, by demonstrating the benefit of user-centred design. Prototype solutions installed in and used in community pharmacies raised public awareness of AMR and antibiotic resistance. The research demonstrated the benefits of user-centred approaches to design, including the engagement of the public with research, and the advice and contribution of providers of information. Positive feedback about our explanations of drug resistant infection has demonstrated the relevance and significant of the presentation and form of information. The research confirmed that community pharmacies both in the UK and in Rwanda are socially inclusive, convenient locations for information about AMR; and that pharmacists and pharmacy workers are both willing to be involved and have a key role to play in engaging people with information about antimicrobial resistance but they have limited time to do so.
First Year Of Impact 2019
Sector Healthcare
Impact Types Societal

Policy & public services

 
Description IDAPPS research led to the integration of user-centred co-design in Public Health England's Anti-Microbial Stewardship (AMS) intervention in community pharmacies. This comprised an e-learning package and an antibiotic checklist that aimed to increase pharmacy staff's capability, opportunity and motivation to provide self-care and adherence advice to people collecting antibiotics.
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Influenced training of practitioners or researchers
Impact The antibiotic checklist was piloted in Gloucestershire. A member of pharmacy staff involved remarked after using the antibiotic checklist: The conversations I had with patients were much more effective and meaningful. The success of the pilot has resulted in modified AMS interventions being scaled-up for implementation across community pharmacies in Wales, Northern Ireland, the South West, South, North West and East Midlands of England.
 
Description University of Reading GCRF Strategic Fund, Building Equitable Partnerships
Amount £48,252 (GBP)
Organisation University of Reading 
Sector Academic/University
Country United Kingdom
Start 11/2018 
End 07/2019
 
Description Commonwealth Pharmacy Association collaboration in Rwanda 
Organisation Commonwealth Pharmacists Association
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution The Commonwealth Pharmacists Association was a partner in the Beat Bad Microbes project, so were part of the research team. We worked together to produce a report about antibiotic usage in Rwanda, to the co-design workshops and to the user-review of the resources that emerged from the project.
Collaborator Contribution The CPA worked with us on the dissemination of the Beat Bad Microbes resources. They organised and webinar to launch the Beat Bad Microbes in Rwanda, and made downloadable versions of these available on their website (see below)
Impact The disciplines involved: design; pharmacy; bio-science A paper about the work has been accepted for publication in Information Design Journal
Start Year 2018
 
Description IDAPPS Ideas Lab 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Other audiences
Results and Impact The IDAPPS Ideas Lab was a two-day workshop where cross-disciplinary teams worked together on ideas for communicating information about antimicrobial resistance in community pharmacies. The teams shared their ideas with pharmacy users and obtained feedback; they worked with pharmacists and pharmacy workers and visited a local pharmacy to make sure that the ideas were relevant and useful. At the end of the Ideas Lab the teams went away to develop their ideas into prototypes for consideration in the IDAPPS competition
Year(s) Of Engagement Activity 2018
URL https://amrpharmacy.org
 
Description Invited talk: 'Beat Bad Microbes: designing to make a difference to communicating information about antibiotic resistance' at Rwandan Community Pharmacists Union National Conference in Kigali 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Third sector organisations
Results and Impact The talk raised the profile of the Beat Bad Microbes work in Rwanda. It was well-received by audience members including the Rwanda Health Minister who is keen to find a way to continue the work.
Year(s) Of Engagement Activity 2019
 
Description Pharmacy conference talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Keynote talk: 'Designing messages with meaning: the role of information design' at the Health Sciences Research & Pharmacy Practice Conference, 'Designing healthcare: fostering inter-disciplinarity and co-design for quality, April 2021

Intended purpose was to raise profile of information design in successful health communication. The discussion led to requests for more information about the work in the UK and in Rwanda.
Year(s) Of Engagement Activity 2021
 
Description Q Community, Co-production SIG, webinar 'Beat Bad Microbes: designing to make a difference to communicating information about AMR'. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact This webinar aimed to draw attention to the role that design thinking and co-design can play in the making of innovative solutions to communicating information about AMR and antibiotic resistance. The talk was illustrated with examples of project work in the UK and in Rwanda.
Year(s) Of Engagement Activity 2019
URL https://q.health.org.uk/event/beat-bad-bugs-cross-disciplinary-collaboration-to-create-and-spread-me...
 
Description Uppsala Health Summit engagement 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Keynote presentation:
Uppsala Health Summit, 'Managing antimicrobial resistance through behavior change' Designing to make a difference to communicating about AMR. March 2021
The talk generated interested from pharmacy academics and practitioners who had not considered the role of information design in getting messages across about antimicrobial resistance.
Year(s) Of Engagement Activity 2021