In 2023, laws restricting access to essential reproductive and sexual health care have raised new challenges for young people and their futures. Ci3 researchers and designers in collaboration with our faculty partners have sought to understand the impacts of policy changes, identify opportunities to center the perspectives of those impacted, and develop new resources and tools to support health and well-being. We remain committed to using research, community engagement, and design to address the systemic and structural barriers that create disparities in sexual and reproductive health, particularly for young people.
New Research to Understand Perspectives on Abortion Care
Traveling for abortion and navigating care in Illinois
With funding from the Bucksbaum Institute at the University of Chicago, our team is currently exploring the experiences and priorities of patients traveling from out-of-state to seek abortion care in Illinois. We plan to interview 50 participants, oversampling for young people under 18. The study will explore the considerations people are making as they are forced to travel and learn how we can better support patient navigation.
Mapping abortion fund patients in Illinois
With support from the Society of Family Planning, Ci3 is partnering with the Chicago Abortion Fund (CAF) to analyze CAF’s intake database in order to compare travel patterns among CAF grantees for abortion care pre- and post-Dobbs to predicted patterns from the Abortion Access Dashboard. Among other things, the study will focus on travel patterns for young people.
WAVE: Youth Wants, Attitudes, Values, and Expectations (WAVE) around bodily autonomy, gender, and abortion policy
This year, with support from the Funders for Adolescent Science Translation, Ci3 interviewed young people to learn more about their perspectives on policies affecting abortion and gender affirming care in the Midwest. Forty participants between the ages of 14-19 who live in Illinois, Indiana, Iowa, Michigan, Minnesota, Ohio, and Wisconsin were interviewed. Data are being analyzed and will be presented at the Adolescent Health Initiative conference in May.
Participatory Design for Person-centered Contraceptive Counseling
Hello Options in clinics and schools across the United States
Ci3 is excited that Hello Options, a novel contraceptive counseling tool co-designed with young people and clinicians is now available for purchase. With detachable replicas of the 10 most common birth control methods, Hello Options supports information sharing in clinical or educational settings while fitting easily in a white coat pocket or easily stored away in its compact travel case when you’re on the move.
You may have been one of the hundreds of individuals who tested a Hello Options prototype along the way—at an annual meeting of the Society for Family Planning (SFP), the American Public Health Association (APHA), or in our day-to-day work in Chicago. Ci3 is grateful for the combined lived and technical expertise that informed the iterative development Hello Options! If you already purchased and have been using Hello Options, please share your experiences and any feedback you might have with Ci3 as we continue to improve the design. For support with bulk purchases, please contact Tim Parsons at RGS, our manufacturing and commercialization partner, by email at tparsons@resilientgames studios.
In other exciting news, the Chicago Department of Public Health is bringing Hello Options to its school-based sexual health education and STI testing initiative, CHAT, all STI Specialty Clinics, and the Family Connects Chicago postpartum nurse home visiting program. The Hello Options tool will also be distributed to school-based health centers citywide and in other educational settings. The purchase of hundreds of Hello Options tools will support thousands of contraceptive counseling conversations throughout the city. Ci3 and our partners are delighted that Chicagoans will directly benefit from this homegrown tool, co-designed with young people and providers.
Tear Sheets
This year Ci3 introduced an innovative set of educational tear sheets to support contraceptive counseling with Hello Options. Working closely with Ci3 and its clinical partners, young people determined the design criteria essential to print and digital resources about birth control methods and how to use them. The thoughtful articulation of these criteria in the final design were a distinguishing characteristic acknowledged through a Core77 Design for Social Impact Award. Tear sheets are available for download from Hello Greenlight Pro—a website for healthcare providers and sex educators—or explored on Hello Greenlight a website for young people. Sex educators, clinicians, and patients can also leverage another Ci3 tool, Let’s Chat, to spark question-asking about essential sexual and reproductive health topics.
Adolescent experiences with contraceptive side-effects
This new study seeks to build upon the Hello Options contraceptive counseling tear sheets to develop additional resources to help adolescents successfully navigate side effects. We are conducting in-depth interviews and a design workshop with adolescents to explore experiences with side effects and inform resources.
Game Design & Game Play to Enhance Health Outcomes and Career Interest
Game Design & Game Play to Enhance Health Outcomes and Career Interest
Hexacago Health Academy (HHA)
Hexacago Health Academy is a five-year study funded by the NIH Science Education Partnership Award (SEPA) to develop and test programming that can increase student interest in health careers and STEM subjects. During summer 2023, we recruited 8 Chicagoland teachers to receive training on and then implement a curriculum leveraging game play and game design to enhance systems thinking and engage students in STEM.
Partnership with Chicago Public Schools and Chicago Department of Health
We are pleased to announced that we received a grant from the Funders for Adolescent Science Translation to distribute three of our most popular youth-co-designed board games in Chicago public schools and other public health settings. Babytown, Smokestacks, and Hearsay are educational games prototyped during our first Hexacago summer camp in 2014, refined by Ci3’s team of designers and researchers, and evaluated and play tested by students and educators alike. In the summer of 2023, Youth Fellows Nehemiah James, Lucy Pizza, and Tej Shah worked together to balance the game mechanics, update the rules, and produce video tutorials to support the implementation of these educational games in classroom settings.
Step Up
Funded by the National Institutes of Health, Step Up is a digital bystander intervention game for high school students to understand the importance of diversity in STEM while mitigating bias and harassment via bystander intervention. In partnership with The Ohio State University and Resilient Games Studio, Ci3 researchers conducted story circles, a narrative-based research method, with members of the Youth Council to continue creating content for the game and provide feedback on the animation. Across six chapters, the game aims to teach young people from marginalized backgrounds about STEM careers, as well as teaching them about the bystander effect through mini-games. Throughout the year, we hosted playtests with teachers and students to help improve the game before recruitment for research. The game will next be evaluated with larger communities.
New Publications and Resources
A recent study explores pharmacists' experiences dispensing misoprostol and readiness to dispense mifepristone. We found nearly all pharmacists would feel ready to dispense mifepristone with some basic training and most challenges would stem from individual or institutional refusals, supporting the FDA’s rule challenge allowing pharmacist dispensing.
Our team also just published results from a qualitative study exploring abortion method preference among Illinois patients after insurance expansion. Participants cited complex and personal preferences influencing their method selection; when cost barriers were reduced, preferences centered physical or emotional experiences, setting, effectiveness and timing. As abortion access is increasingly restricted, many patients may still highly value a choice between medication and procedural abortion when possible.
In a co-authored editorial, Lee Hasselbacher discusses the potential impact of Dobbs on adolescents in particular and calls for more outreach to understand and elevate the perspectives of young people in the post-Dobbs landscape.
A recent paper features the prototyping design process we used to develop Let's Chat, a web app intervention co-designed with adolescents and clinicians to spark question-asking about sexual and reproductive health topics.
In a paper co-authored with colleagues at Ibis Reproductive Health and the National Health Law Program, Lee Hasselbacher argues that advocates might turn to the Hyde Amendment to preserve a minimum level of access to abortion in states with extreme bans.
This year, the youth style guide was created with young people as a resource for providers, organizations, and schools to understand how to more successfully engage young people regarding sexual and reproductive health resources and services in marketing campaigns, materials, and channels.
In tandem with a study team leady by Jade Pagkas-Bather, MD, Ci3 created a zine that showcases different methods of antiretroviral uptake among young Black sexual minority men (YBSMM). Multiple studies indicate that Black men are less likely to use PrEP and be virally suppressed. This study examined YBSMM preferences for Antiretroviral (ARV) procurement.
Youth Summer Fellow, Tej Shah, alongside Ci3 staff created a youth resource guide based upon needs found during the WAVE study. This guide, available on the website, provides information on voting and abortion in the Midwest with a youth audience in mind.
Our speculative worldbuilding toolkit is now available for partners who may be interested in engaging with youth using this approach. Ci3 conducted workshops with our Youth Advisory Council to create speculative design projects for a radical imagination-based future museum that would hold an artifact that would help them and their community to achieve daily joys. The toolkit provides an overview of the workshops and describes the methodology we used to further youth-focused equity work. By sharing our methods and approach to speculative worldbuilding rooted in radical hope, Ci3 hopes other youth-engaged groups might draw inspiration and help other young people to reimagine possible futures rooted in joy, love, and acceptance.
Presentations
Ci3 presented at a number of scientific conferences across the United States this year.
In March, Amanda Geppert co-led a workshop—“Designing with and for Adolescents to Optimize Sexual and Reproductive Health” — with experts from Emory University, Indiana University, University of Illinois Chicago School of Public Health, and Power to Decide at the Society for Adolescent Health and Medicine (SAHM) Annual Meeting in Chicago.
“Co-designing optimal sexual and reproductive health experiences with and for adolescents,” a case-based workshop led by Amanda Geppert was attended by more than 50 sexual health educators, policy makers and program managers at the FactForward Summer Institute in Charleston, South Carolina, in June.
In July, Amanda Geppert was a panelist for “Designing innovative adolescent-friendly sexual health services,” with experts from Child Trends and Fact Forward during the HHS Office of Population Affairs Title X Grantee Conference in Baltimore, Maryland.
In October, Amanda Geppert and Julia Rochlin, former Ci3 intern, presented a case study—“Let’s Chat! Prototyping productive frictions and radically restructuring adolescent sexual health counseling interactions” — in the Mediated Bodies and Embodiment Session at the Ethnographic Praxis in Industry (EPIC) Annual Conference.
At the Society for Family Planning (SFP) Annual Meeting scientific poster session in Seattle, Washington, Amanda Geppert presented, “Using participatory design to create adolescent-centered contraceptive counseling tear sheets to support exploration, decision-making, and use.”
Ailea Stites presented at the NIH SciEd 2023 Annual Conference in a plenary session called “Utilizing Partnerships for Multimedia Production” and led a breakout session entitled “Game Design for Systems Thinking,” where they presented on our game-based methods for youth engagement in STEM and research design, including several youth-designed paper prototypes of educational board games around STEM and health topics. We were also able to bring Alaa Mohamed, one of our Hexacago Health Academy peer mentors!
Madeline Quasebarth presented research findings with a poster presentation; “Illinois patient preferences around abortion method prior to 11 weeks’ gestation” at the 47th National Abortion Federation Conference in March.
Vanya Manthena will be presenting findings from Youth WAVE study at the Adolescent Health Initiative 2024 Conference on Adolescent Health. The poster presentation is titled “Adolescent reactions to abortion and gender affirming care policies and desired healthcare resources.”
Ci3 Collaborations with Fellows and Students
Homecoming
Ci3 is supporting medical student Tecora Turner, who was selected as a Society of Family Planning Emerging Scholar and funded for her research project: Homecoming. This study seeks to understand how restrictive abortion and gender affirming care policies are affecting where medical students from the South are planning on applying for residentcy.
EC4UC
Sophie Knifton, a UChicago undergraduate student and student researcher at Ci3, is conducting a survey on UChicago student’s desires and understandings of emergency contraceptives. The research will be used to help better understand the need for emergency contraceptive vending machines on campus. Ci3 staff are working with Sophie to help create and implement the survey.
Hello Options resources
OB/GYN Fellow, Dr. Eryn Wanyonyi, is partnering with Ci3 on our study exploring adolescent experiences navigating side effects to supplement Hello Options resources. She will be bringing her medical and theater expertise to both the interviews and design workshops and serve as a medical advisor for Hello Options.
TRAVIL
Medical student Kristen Chalmers and OB/GYN Resident Jessyca Judge are working with Julie Chor and the Ci3 research team on our qualitative study examining experiences of people traveling from out of state to receive abortion care in Illinois.
Mapping IL travel of abortion fund grantees
OB/GYN Fellow, Dr. Jocelyn Washer, is working with Ci3 to explore the travel patterns of Chicago Abortion Fund grantees pre and post Dobbs.
PHARMACIST DISPENSING OF MIFEPRISTONE
Medical student Meron Ferketa worked alongside Lee Hasselbacher to explore pharmacist readiness to dispense mifepristone and served as lead author for our recent publication on the findings.
summer fellows
With support from the Funders for Adolescent Science Translation, three Youth Advisory Council alums—Tej Shah, Lucy Pizza, and Nehemiah James -- joined Ci3 as Youth Fellows over the summer of 2023 to produce tutorial videos and other game curriculum support materials for our health games and tools.