Let's Chat! Prototyping, Productive Frictions, and Radically Restructuring Adolescent Sexual Health Counseling Interactions

This case study examines the use of iterative prototyping to raise concerns important to adolescents and healthcare providers in the participatory design of an intervention to spark open and nonjudgmental sexual and reproductive health discussions. It describes how designers in an interdisciplinary, academic research center used prototyping to engage adolescents and clinicians as co-designers in formative research. Prototypes were created, tested, and refined in focus groups, intercept interviews, semi-structured interviews, and workshops. Varied in content and form, prototypes caused friction—generating key questions, revealing conflicting perspectives and power dynamics, driving exploration, and design. These frictions radiated from a primary tension—the difference between how sexual and reproductive health care is currently delivered and the kinds of care young people desire and need. The resultant intervention radically restructured the adolescent sexual health counseling interaction, empowering adolescents to set the agenda, overcome issues of hierarchy and mistrust, and enhance engagement in their own healthcare.