In Baltimore, 50 percent of Baltimore middle-schoolers live with a smoker. In 2013, 14 of 17 sleep-related deaths reported secondhand smoke exposure. Significant disparities exist, such as 37.12% of those with income $15,000-$24,999 reported smoking compared to a City average of 21.2% and 25.18% of Black people reported smoking cigarettes vs 18.76% for white people.
In Fall 2016, an interdisciplinary team of undergraduate and graduate students at the Center for Social Design at Maryland Institute College of Art (MICA) collaborated with Baltimore City Health Department’s Tobacco Free Baltimore initiative to address the impact of smoke exposure in the home.
Utilizing a human-centered, collaborative and design-driven approach, the team met with public health professionals to better understand the problem, interviewed families to gain new insights, and facilitated design workshops to generate ideas and prototypes. The research and brainstorming resulted in HealthiAir, a pop-up event that supports families in creating smoke-free comfort zones in their homes, identifying practical ways to get started, and connecting to the resources they need.
Students worked to understand the culture and context of the problem by understanding the culture and context of people. They talked to, observed, and learned from Baltimore families and healthcare professionals to locate needs and assets.
Students compiled observations and research findings. They created visualizations of key research and looked for common themes and insights in order to identify appropriate opportunities for intervention.
In collaboration with stakeholders, students generated as many ideas as possible to address barriers to creating smoke-free homes.
Students developed tangible representations of the ideas. Through feedback and testing, they arrived at the HealthiAir pop-up event intervention.
Test + Implement:
In partnership with Baltimore City Health Department, students piloted HealthiAir in multiple contexts (schools, community centers, and apartment buildings) and collected feedback. The pilots helped identify important design tweaks to make before officially launching HealthiAir.
HealthiAir believes that if we ease the pathway to creating smoke-free comfort zones and engage people where they are on their journey, every home and family in Baltimore will breathe happy and healthy. We accomplish this by constantly reflecting back on our core values:
- Honor stories and experiences: Respect the personal and lived experiences that are shared and allow them to inform our design process with integrity.
- Acknowledge the reality of addiction: Be empathetic in our language and careful in our approach, making sure to address smoking without blaming or shaming behaviors.
- Make knowledge actionable: Inform with solid facts and data but also translate information in a way that is relatable and approachable to motivate effective change.
- Engage the whole person: Connect with all aspects of the people we design with (physical, mental, emotional, social) while being mindful of their individual needs.
- Ease the pathway: Create interventions that don’t recreate stress while allowing families the agency to take action on their own terms. Do no harm, add no stress.
HealthiAir is designed to meets participants where they are on their journey to creating a smoke-free home. For each pop-up event, participants are guided through 5 stages where each stage of HealthiAir features different prompts and activities aligned to the transtheoretical model of health behavior change:
- Sharing Stories (Precontemplation): Creating an open space for participants to share and connect with others about how smoking has affected them on a personal level.
- Exploring the Opportunities (Contemplation): Participants imagine, through drawing or writing, what their ideal smoke-free comfort zone would look like and how it would feel.
- Accepting the Challenge (Preparation): Participants discover the benefits and challenges of creating a smoke-free comfort zone and identifying their first step by signing a family pledge.
- Continuing the Process (Action): Celebrating where participants are in their journey and finding ways to keep themselves on track by creating House Promises, realistic and achievable plans to create and maintain smoke-free comfort zones.
- Supporting the Journey (Maintenance): Connecting participants to additional resources to quit smoking.
During the prototyping and testing phase, Baltimore City Health Department hosted six HealthiAir events with 76 Baltimore residents across various neighborhoods throughout the city. Thirteen people requested follow-up referrals and eight residents joined a smoking cessation treatment group. After the event, HealthiAir participants shared that they felt like they gained new information (“I feel equipped with the knowledge to share”), would recommend the program to others (“I would recommend the program to my husband to get him to quit smoking”), and that HealthiAir was different than other health programs because it involved “group sharing” and “got them thinking about steps to quit.”
Awards & Recognition
Articles & Publications
- Health Design Thinking: Creating Products and Services for Better Health, by Bon Ku and Ellen Lupton
- Using Community-Academic Partnerships and Social Design to Develop and Implement a Smoke-Free Home Intervention, Michelle N. Eakin, Ph.D., Case Thompson, Emilie Gilde, MPP, Becky Slogeris, MA, Denise Shanté Brown, MA, Smile Indias, MA
Design Strategists: Denise Shanté Brown and Smile Indias
Practice-based Studio team: Amanda Buck, Haley Frazier, Mihoshi Fukushima, Jenny Hung, Christy Tang, Naeeme Mohammadi
Project Lead: Becky Slogeris
Partner: Baltimore City Health Department