Nudge Unit, Penn Medicine

World’s 1st behavioral design team embedded within a health system.

De-risked costly Gun Lock interventions to prevent firearm injury.

Role: Design Strategy Intern

Skills: Contextual Inquiry, Mixed methods research, Data Triangulation and thematic analysis, Stakeholder Management, Design principles workshop facilitation, Design Report creation

Location: Philadelphia, US

Timeline: 7 months

Team: Senior Design Strategist, Clinical Research Coordinators, Project Manager

WHAT WAS GOING ON IN THE GUN LOCK PROGRAM?

The Nudge Unit, a team of injury prevention researchers, security, and hospital leadership piloted a program in which security guards offered a cable lock and safety brochure when the gun owner returned to retrieve their firearm after their visit.

The brochure was distributed with a gun lock.

WHY DID THE DESIGN TEAM STEP IN?

Uncover implementation barriers and facilitators

Assess the appropriateness and acceptability of the gun lock program

Identify the beliefs and behaviors of the security guards about gun owner perceptions and interactions.

Design ways to collect self-reported data about gun lock usage from fire-arm owners.

It was imperative to de-risk and test assumptions before making the big investment of expanding and launching a costly lockbox distribution program.

OUTCOME HIGHLIGHTS:

➡️ Research findings and design recommendations were featured in the Washington Post and a high-impact journal.

💡 Conducted a participatory design workshop with stakeholders and strengthened project visions and relationships.

✍️ Redesigned the dialogue script for security guards, brochures, and strategy for recruiting gun owners for gun lock adoption data collection.

💯 Uncovered a tactical and strategic opportunity to expand the gun lock program to hospital employees and visitors without guns through contextaul inquiry with security supervisors.

Why was the study unique?

We were helping an academic team and security professionals to adopt design practices.

Performing research with security professionals who were working in high pressure conditions required agility and nimbleness.

The study involved diverse stakeholders including hospital security supervisors, gun owners, ER physicians and researchers

The method behind the madness

  1. “Line of Sight”

  • Extensive Literature Review

  • Context Canvas Workshop

  • Assumption Mapping 

2. Contextual Inquiry

  • In-depth Interviews with 12 security supervisors at Penn Medicine Hospital

  • Stakeholder interviews with management of similar initiatives

3. Triangulation of Insights

  • Thematic Analysis of In-depth Interviews using NVivo software

  • Leveraged data collected from gun lock distribution logs programs to uncover adoption rates

4. Design recommendations workshop with team and stakeholders

Facilitated ssumption mapping, journey flow diagrams,and brainstorming sessions to uncover design principles and recommendations for program changes.

5. User testing of different lockbox options

Designed a research plan to test the acceptance of cable locks vs gun safes

  • Midway after our contextual inquiry, a major gun policy in the hospital changed

    We adapted our recommendations and design principles in an agile manner with stakeholder collaboration

“AHA” Moments

  • Gap between "academic" hypothesis and real world implementation

    Sitting in the lab, we thought that distributing lockboxes was the best intervention. But, supervisors understood the context better. They were concerned about the weight and logistic barriers of lockbox distribution.

  • I

    Involving stakeholders in the design process is key to implementation

    Including security supervisors, hospital staff, and employees in designing interventions, will improve the chances of implementation success

  • Adoption vs Distribution

    Accepting a gun lock doesn’t ensure that gun owners use it. Uncovering the barriers and drivers to adoption requires interaction with gun owners

  • Education is an ambiguous term in gun safety

    The most frequently used word for gun safety, by security supervisors was “education”. But, what does that mean? Does education translate into desired behavior?

Key takeaways and next steps

  • The security supervisors will be given training to defuse non-compliance with gun safety policies and build empathy in the gun lock distribution process

  • Gun owners will have a say in the kind of gun safety devices they prefer to use, improving rates of adoption

  • The gun lock program if extended beyond visitors, to include employees at the hospital, will increase reach and awareness about gun safety.