Co-design approach to raise awareness: A case on fertility

Abstract

Since many societies are affected by taboo topics and every society absorbs them in its own way, changing people's beliefs and behaviors on a taboo topic can be challenging. Fertility, as a taboo issue, has been a hot topic for a long time because there is a trend to delay childbearing in most countries, notably among higher educated individuals. Delaying childbearing is a personal choice; however, it should be taken consciously considering its consequences as aging-related social issues. Most people lack sufficient or accurate information about their reproductive health. Due to the social context based on taboos, when behavioral change is desired through design, it should be within the framework of a co-design and participatory approach. Therefore, the current study took women's fertility as a case and aimed to explore how designed material may create awareness and encourage behavior change compared to underdesigned material on a taboo topic. A mixed method approach was taken as methodology. First, an extensive literature review was held on the key areas including fertility awareness, participatory design, and behavior change. The interdisciplinary nature of the study area enabled design, psychology, and medical subjects to merge in this design research study. In light of the literature, the design of the experiment consisted of pre-post surveys, expert interviews, a co-design workshop, and data analyses. The career goals-associated delayed childbearing among higher educated individuals may occur fertility problems. The selected participant group was higher-educated Turkish university students and academicians aged between 18 to 45 years. Firstly, the pre-survey was completed with 153 participants, 106 of whom gave their e-mail addresses to attend the post-survey. The first findings from the pre-survey showed that even highly educated people had insufficient knowledge about their fertility, which is in line with the literature. After the pre-survey, expert interviews were conducted with four experts to get insights and discover unknown facts. In the co-design workshop, both empathy mapping and brainstorming sessions were organized with twelve shareholders to explore the main features of the behavioral change model in regard to fertility potential. With these co-design sessions, a fear-inducing video was designed to motivate people by reminding them of the aging process and describing how to learn about their fertility potential. The experimental group was informed with a fear-inducing video and the control group was informed with a brief text at the beginning of the post-survey. A comparison-based analysis was performed to determine whether the video-informed participants gained awareness of their fertility or not compared to text-informed ones. The findings showed that both groups gained information; however, fertility awareness of the video-informed ones increased significantly as compared to the text-informed ones. This increased awareness can be considered the first step of behavior change on fertility issues. While almost all of the participants of the video-informed group changed their ranking of the most important factor as "ovarian reserve" contrary to their initial rankings, only half of the text-informed group ranked it as the most important. Furthermore, the video-informed group increased their true statement selections by about 70% and decreased false statement selection by 45% according to comparative analysis between their pre- and post-survey responses. In conclusion, this study showed that a designed material was more effective than an underdesigned material in creating awareness and encouraging behavior change on a taboo topic in the case of fertility. While raising awareness and encouraging behavior change, this study embraced a shift from a "designing for them" approach to a "designing with them" approach. Taken together, this thesis can be considered as one of the first studies to contribute to the literature by studying how a designed material can create awareness and encourage behavior change on taboo topics through a co-design approach. Nevertheless, there were some limitations during the study. The Coronavirus pandemic affected the study plan and decreased the sample size of the participants. All meetings were conducted online because of the pandemic. Also, long-term observation and social impact assessment could not be performed because of the short time schedule of the thesis.