Bedsider: Re-Branding Birth control

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Presentation about re-branding birth control and human-centered design delivered at The Big Redux DC on April 30, 2011.

Presentation about re-branding birth control and human-centered design delivered at The Big Redux DC on April 30, 2011.

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  • Good morning. I’m so happy to be here.\n\nI’m LS, and I’m the Senior Director of Digital Media at The NC and if you thought we’d be talking about sex today, well, you’re right! In fact, we’ll be talking about better sex. And this comes as a surprise to me too. But I’m jumping ahead.\n\nBefore we get to better sex, let’s first talk about what the bleep is going on out there...\n
  • The United States has a significant problem with unplanned pregnancy, especially among young single people in their 20s. Seven in ten pregnancies to single women aged 18 to 29 are unplanned. 7 in 10!\n\nThis is the case even though--according to a report called the Fog Zone--most people think pregnancies should be planned\nAND\nMost people also say it’s important to them to avoid pregnancy in their lives right now\nBUT\nAmong those having sex and not trying to get pregnant:\n19% use no contraception at all and 24% use it inconsistently. [Intentions don’t match behavior]\nAND\nAmong those who say it’s very important to avoid pregnancy now, 34% say it’s likely they’ll have unprotected sex in near future\n\n\n
  • With this as the landscape The National Campaign in the late summer of 2008 enlisted the help of the innovation and design firm, IDEO, and started to look closely at the reasons that people weren’t getting BC right so we could reduce the number of unplanned pregnancies. What were the reasons--beyond cost and access to BC--for the failure? \n\nWe went looking to reduce unplanned pregnancy; but we came back with stories about better sex.\n
  • The task of reducing unplanned preg is a pretty daunting problem. How do you change the behavior in the face of one of the most powerful biological urges on the planet? \n\nWe started by taking a look at what's what’s out there now. And the state of sexual health and behavior change is not pretty. If you pick up a few flyers at the local clinic--the people they show look like going to dentist or buying a pre-owned car. \n\nWhat does this any of this have to do with sex? The answer is: Not very much at all.\n\n[Why do the people with vaginitis look so happy?]\n
  • This is a web site to help women find Emergency Contraception. Instead, it looks like she's searching for a lower rate on car insurance? And it’s BEIGE. \n
  • The problem is sex isn't science, but we keep attacking the issue with squeaky clean, very de-sexualized logic. Sex is emotional. It’s carnal. It’s intense. It’s funny. Yet none of these things are reflected in the tone of the behavior change work that’s out there.\n\nWe quickly realized we needed to create design solutions that matched the subject matter and we needed to adopt a tone that wouldn’t be so easy to dismiss.\n
  • Working with our partners at IDEO we employed human-centered design to get at the right tone.\n\nFor those of you who aren’t familiar, human-centered design is pretty much exactly what it sounds like—it’s a design process that puts real human needs, desires, especially latent desires—at the center, first and foremost. \n\nTo step into the lives of these young women, IDEO did intense, in-home interviews. For our initial research, we spoke to 15 women and 3 men in 3 states, plus 3 experts in the field. And the stories we heard were incredible. We went into it thinking that the people we would meet would be shy talking about such an intimate subject with total strangers, but not so. Given a safe forum, these women were more than happy to tell us everything. And beyond that, they were desperate for information. They were asking US questions, as if we were the experts. It became abundantly clear, really quickly, that they had nowhere to go to be able to talk about this stuff and ask questions safely. (So, insight number one out of these interviews...is...) \n
  • Education comes at the wrong time, in the wrong context, if it happens at all.\n\nThink about when you had sex ed. In the U.S., many get it at 12 or 13. And that’s if they were lucky and had sex ed, which certainly isn’t a guarantee in the U.S.\n\nThat’s like learning to drive in a classroom setting at 10, and getting the keys to the car at 17 and being asked to drive.\n
  • In the heat of the moment, all bets are off. \n\nWhen it comes to getting it on, your brain turns off. And that’s the fun part. We don’t actually want to mess with that-- Because that’s what we all crave, to lose ourselves in passion. But that’s not so good when it comes to protecting yourself. \n\nBrianna, who we’d recruited specifically because she was so hyper vigilant and adamant about birth control told us a story about going to Mexico on a vacation, getting drunk, and having unprotected sex. In that drunken moment, she just wanted to get busy.\n\nAlso a great example of how alcohol plays a HUGE role. To be totally blunt, people love to get drunk and get it on. [an ode to Dan] And if you don’t believe me, ask yourself. So many of us use “I was drunk” as an excuse to do whatever the heck we really want to do. It’s really easy to pass judgement-- oh they should have been more careful--until you get honest with yourself and feel some empathy for the people you’re designing for.\n
  • Booty trumps Jesus. We weren’t being anti-religious with this insight-- we were simply telling it like it is.\n\nWe heard an amazing story from a woman who was a Sunday school teacher. Had a child out of wedlock, then taught abstinence at her church, using herself as a cautionary tale. But she had a secret she was keeping from the congregation-- she was still unmarried and pregnant again. And we’re like, how did this happen to you? How did this happen while you’re teaching kids to do the exact opposite? \n\nAnd she’s came back to us with this great quote. She said, “When you’re in heat like a bunny, you just have to have it.”\n
  • Then there’s the total lack of feedback.\n\nWhat happens when you get BC right? That’s right: nothin’. This is a BIG challenge--one that’s not faced by some other issues like weight loss. How might we build in systems of feedback?\n\nLarry: Without feedback, it’s harder to stick with it. In the next few months we will be working on instituting rewards for getting it right--that “way to go” when you have done what you said you wanted to do and stayed on your birth control. And as your needs change over time Bedsider is by your side.\n\n
  • This is a tiny fraction of the stuff we learned—it was endlessly fascinating. And complicated. So we knew we couldn’t just design messaging to raise awareness, or give people better tools to remember to take their BC—we had to create a system that would support women every step of the way. \n\n
  • Because we know behavior change is a journey—it’s not fixed in time. And there are all these little points along the way that either buoy you up and help you stick with your plan, or push you down and nudge you off course.\n\nPreparation: This issue is out there, maybe I should pay attention\nInitiation: Taking action, making an appointment, choosing a method\nThird phase that so often gets forgotten, Maintenance: Actually sticking with the plan\n
  • We use a number of theoretical models to guide our development. \n\n- The Stages of Change model gets us thinking about the Preparation to action stage and how we reinforce a good action\n- The Health Belief Model gets us thinking about Perceived barriers and improving self-efficacy so that people gain confidence in using their method\n- And we look to Behavioral Economics and it’s talk of hot and cold states as well as biases like Optimism Bias– the tendency to be over-optimistic about the outcome of actions like when you think it’s ok just this once to have unprotected sex, because what’s the likelihood...\n- We are also inspired by people like Dan Ariely and his work with irrational behavior, and BJ Fogg and his systematic approach to change.\n\nSo, using these models we attack the perceived barriers for using BC. Bedsider will provide information to people that will give them confidence that they can get and stay on BC. We’ll empathize with women who experience side effects and display videos of women who have successfully dealt with side effects. We show that there are other women “just like you” using BC and overcoming whatever barriers exist.\n\n
  • With Bedsider, we’ve tried to address the real issues and hurdles that women face at every stage, and give them tools they can actually use to stick with their plans to not get pregnant before they’re ready. So, part of it is education, for sure. But it’s education in a voice that makes sense and comes from the POV of the women we’re speaking to—they’re not really interested in birth control, they’re interested in having better sex. Every piece we created—and continue to create as the system evolves—has to keep this in mind.\n\n
  • Here’s one view of the Bedsider home page. Looks and sounds a lot different than everything else that’s out there. \n\nYou can see at the bottom, kind of cut off, the link to real stories, where you can compare methods by watching videos of real women, telling both the good and the bad. So you’re able to choose a method by identifying with a real person, not a medical object.\n
  • Speaking of medical objects, this is a shot of the method explorer. Our goal was to demystify the objects. What does a cervical cap look like? Nobody actually knows! Size comparisons. Tactile, roll over. Different ways to compare. Like party ready (where you can sort by methods that allow you to drink and forget it, nothing to fumble with), STI prevention, or “Do me now”: hot sex any, time anywhere. (No worry about heat of the moment.)\n
  • You’ll notice throughout all of this that the tone is friendly and a bit tongue in cheek. Other aspects of the system you not seeing here are things like Frisky Friday emails, which is like a weekly email newsletter advice column on better sex. Or our Fact or Fiction videos, which are really funny animated videos that debunk the birth control myths that people actually believe. So lots of funny things, lots of sex positive things.\n\nFinding that right tone wasn’t an accident. It was something we prototyped and tested with the women who helped us create Bedsider. We knew that Bedsider needed to be sex-positive, and come from the POV of birth control as a means to better sex, but how sexy? How funny? How authoritative? By prototyping the tone, we found out that too sexy is slutty and not trustworthy. Too funny, also not trustworthy. No one wants to take advice from a clown. But too medical, or big sister, is boring and gets tuned out. It was all about striking a balance, and making birth control relatable.\n
  • This is an example of an SMS birth control reminder. This isn’t a message from a robot. It’s a human voice, with a point of view, and it changes every day so it’s not easy to dismiss. It’s relevant to your life instead of being medical.\n\nWe all tune out alarms. Just turn it off.\nTurned out to be viral.\n\n[Anecdote about women who want to answer/interact with messages. Read another message from your phone.]\n\n[And this is a reminder to me to tell you all that Bedsider is not just a website; it’s a mobile platform--and not just for smart phones.]\n
  • It’s great to re-brand birth control and make it more accessible, but in order to change your behavior, you actually need the tools and means to do it. And that's were technology can play such a key role. \n\nHere, I want to stress how important Agile development is to what we do. Agile allowed us to extend those interviews that IDEO did at the beginning into the development process. We implemented quickly, failed fast, and revised--with the participation of our audience. And we did everything from from gathering users in formal settings to sending out emails to using usertesting.com.\n
  • And we are still failing (sometimes). \n\nWe built our own text messaging platform after considering other vendors like Distributive Networks and Voxiva. We felt that it was important for brand recognition that we obtain our own vanity short code (you can text “MyBC” to 42411) and that we have a customized CMS. \n\nThe challenge we have run into is that mobile networks are not set up for fail-proof delivery. Put another way: there is high tolerance for dropped messages. [We, on the other hand, have a higher tolerance for the website going down because many people have a daily experience of Bedsider through mobile.] Also, individual carriers have their own bottle necks and rules. \n\nBut we want reminders to arrive on time! It’s a constant challenge. [importance of reminders arriving on time]\n
  • We have been running a pilot evaluation with three Planned Parenthood clinics in South Florida. Starting last June we recruited 750 women with whom we’ll follow up four time over the course of a year.\n\nAt this point in the evaluation, we’ve heard both from the clinic staff who introduced Bedsider to patients and from the patients themselves at a one-month follow-up. I’d like to read a bit from the report.\n\nWhen asked what they thought was Bedsider’s best feature or tool, four respondents mentioned the birth control text message reminders, five mentioned the ability to interact with all the birth control methods on one page, and three mentioned the site’s honesty, humor and “in your face” tone. 2 As one Medical Assistant stated: “It’s a very appealing site, and that’s what we liked about it”. \nShe explained that they used to give patients pamphlets, but they prefer getting information in “their style, for their generation” – online.\nRespondents were also asked if they had recommendations for encouraging women to enroll in and use the site. Their responses are summarized below:\nCreate a marketing plan that includes both direct marketing to women through print and television advertisements and indirect marketing through health care providers.\nBuild Bedsider’s existing relationship with Planned Parenthood to take advantage of Planned Parenthood’s established connections with schools and community groups.\nProvide more information about Bedsider on the posters, without complicating their simple design.\nContinue to provide youth-friendly incentives. Both the messages and designs (slim fit, color) of the t-shirts were applauded as very appropriate for the target audience. \n\n
  • And here are some of the evaluation results from the participants themselves--users of Bedsider.\n\nBreakup by race/ethinicity\nWhat drives use--the people who use it most do so because they think it’s fun; second most--good information.\n
  • Here, you see which parts of Bedsider people use most-- reminders at the top\n\nAnd their beliefs about Bedsider’s affect on their own lives: 79% say that they try harder to avoid unprotected sex and that they are more careful with their birth control method\n\nNon-users of Bedsider were worse at keeping their appointments. And users of Bedsider show a knowledge gain of 6% compared to non-users.\n
  • Big launch in November along with debut of social marketing--a PSA campaign done in partnership with the Ad Council that may affect social norms. Like the social norm that it is somehow easier to have sex than to talk about how to have sex responsibly. Hopefully, the PSA campaign will make it easier to talk about birth control and Bedsider will have a roll in making BC easy to use--maybe even fun--because we are doing it in a way that uses real language to connect to real people.\n\n\n
  • ...for an effect like this.\n\n\n
  • Thank you.\n

Transcript

  • 1. Re-branding Birth Control The Big Redux DC 2011 Lawrence Swiader, The National Campaign to Prevent Teen and Unplanned PregnancyThe National Campaign to Prevent Teen and Unplanned Pregnancy
  • 2. What the %$#& is going on out there?The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 3. We needed help. Call in the troops!The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 4. ToneThe National Campaign to Prevent Teen and Unplanned Pregnancy
  • 5. The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 6. Sex isnt science.The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 7. Human centered- design.The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 8. A few insights Education comes at the wrong time, in the wrong context. (If it happens at all.)The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 9. A few insights In the heat of the moment, all bets areThe National Campaign to Prevent Teen and Unplanned Pregnancy
  • 10. A few insights Booty trumps Jesus.The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 11. A few insights And then there’s the total lack ofThe National Campaign to Prevent Teen and Unplanned Pregnancy
  • 12. It had to be a system.The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 13. Preparation Initiation Maintenance PHASE ONE PHASE TWO PHASE THREE Loyalty Services Awareness Driver WebsiteThe National Campaign to Prevent Teen and Unplanned Pregnancy
  • 14. Theoretical models. Real women. (And why it’s important to have a theory to test.)The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 15. The birth of Bedsider.The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 16. The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 17. The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 18. Prototyping tone and rebranding birth control.The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 19. The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 20. Awareness isn’t enough. You’ve got to have the right tools. And an agile approach.The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 21. No room for error. Stressing mobile networks that were not set up for fail-proof delivery.The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 22. Best of all, it works.The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 23. Results. ! !The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 24. Results. ! !The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 25. So what’s next?The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 26. The National Campaign to Prevent Teen and Unplanned Pregnancy
  • 27. Thank you. Larry Swiader lswiader@thenc.orgThe National Campaign to Prevent Teen and Unplanned Pregnancy