This paper presents the results of an iterative participatory process to design a smart self-management tool for less-literate people living with diabetes in Pakistan. Initially, interviews and focus groups with sixty-nine people living with diabetes identified issues that they face when self-managing including uncontrollable factors, lack of diabetes awareness, low-tech mobile phones, and poor internet availability. We developed personas grounded in the scoping results and adjusted our PD approach to focus on more tangible design artefacts before running narrative scoping PD sessions. Working from older, illiterate persona, we designed a phone-line delivered Interactive Voice Response (IVR) system. We developed a functional IVR Prototype "Sugar ka Saathi" (Diabetes Companion) with input from a group of 4 Pakistan-based healthcare professionals, to act as a design probe in the PD process. We tested the IVR probe with fifty-seven of the original scoping participants which validated the knowledge transferred by the IVR and its acceptability. Invisible design videos were shown to elaborate the IVR and community concept to thirteen participants through two filmed videos using our existing persona characters from the scoping studies, these videos helped to engage older people with diabetes in PD sessions.
This paper presents a Participatory Design approach focused on applying primarily Verbal Design techniques working alongside illiterate People with Diabetes (PWD) from low socioeconomic groups in Pakistan. After gathering a set of initial findings through classic Participatory Design and encountering several challenges, we discuss the development of our Verbal Design Approach in response which uses Narrative Scoping and Persona along with Invisible Design videos to structure and drive discussion and document design. Preliminary work showed that the approach resonated with our illiterate participants.
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