Developing a national harm reduction app to enhance digital support for people with lived experience of substance use.
Background
Digital Lifelines is a portfolio of work funded by the Scottish government which aims to help people with lived experience of substance use (PWLE) through digital inclusion outreach and the development of digital products. In the first stages of the work, the Digital Health & Care Innovation Centre (DHI) was involved in interviewing PWLE on their experience of services that support them, and the challenges and obstacles that they faced. DHI then took over leadership of the programme in 2023. Digital Lifelines recently won an award at Holyrood Connect for our work on digital inclusion.
Need for a national app
In our conversations with services across Scotland, we found that many areas were looking at creating harm reduction apps which can support PWLE by giving helpful information and signposting to relevant services. Based on this, we identified a need for a national harm reduction app.
This would:
Eliminate duplication of effort caused by local councils each trying to create their own services
Focus available resources on creating the best possible app using evidence-based, trauma-informed approaches
Ensure consistency for PWLE, particularly those who might be moving between council areas
However, it was difficult for stakeholders to come together and agree what a national app might look like or how it might function.
Provocative exploration
We developed a set of digital prototypes to explore concepts for the national app in terms of features and functionality. The purpose of this exercise was to use the available research and product development which had already been done through Digital Lifelines to create a set of relevant and provocative ideas which could help focus stakeholder conversations. The scope had to be something which could be achieved using minimal resources for maximum impact, as funding and time were limited.
To understand what PWLE might want from a national app, we carried out:
Background research of work done by Digital Lifelines and other researchers worldwide (but particularly in Scotland) on what PWLE want and how they use digital services
Technical audit of Digital Lifelines products and other relevant services to understand what features and functionality might be important
Review of third-sector reports on digital services aimed at PWLE and their use
From our initial conversations with Digital Lifelines stakeholders, we already knew that professionals were most interested in incorporating RADAR alerts (which warn about dangerous substances in circulation) and having a more complete, easy-to-maintain service directory. We worked with the ALLIANCE to explore how ALISS could be incorporated into the app to reduce effort by having a single, national source of data for service listings.
Once the initial research had been completed, we used Spotify’s Thoughtful Execution framework to map out our background research and previous product development done by others.
By correlating these to various “How might we…?” questions, we were able to clearly see what areas had already been explored through other work. This helped to identify what was already known (or unknown) about what PWLE wanted from digital services and products, and what areas were working well.
From this, we started to develop wireframes showing how these services could be combined into a single app. After obtaining feedback, these were further developed into an annotated walkthrough on Miro (a collaborative workspace) which could be used to support stakeholder discussions.
Focus on By My Side
After reviewing the initial concepts, Digital Lifelines decided to focus on expanding Simon Community’s By My Side app. By My Side was an obvious choice because it was already being developed through Digital Lifelines, it used an evidence-based approach, and it had been co-produced with PWLE. A great deal of work had already been done by Simon Community on tailoring the language and experience to make it as supportive and respectful as possible for PWLE’s needs. This also meant that we could take advantage of Simon Community’s highly engaged co-production group for feedback.
Technically speaking, BMS is a web app built on a CMS (content management system), meaning that it could be integrated with ALISS and continue to be easily updated in future. The original version of the app had been designed primarily for women, a group who tend to be under-catered to harm reduction. Initially, there was some concern that expanding the focus of the app might reduce the available support for women. However, Simon Community’s co-production group indicated that they were happy to see the benefits of the app shared with others.
By My Side had been developed for Simon Community by AND Digital, who rejoined the project to discuss and agree on what new features would be added to prepare the app for national use. Simon Community also had a lot of ideas from their previous work on how they would like to see the service extended. Together, we agreed on three priority areas for development:
Highly prominent display of RADAR alerts, which warn citizens about dangerous batches of drugs in circulation
Functionality that would allow users to personalise their experience of the app by tailoring the content to them (allowing women to continue to find relevant content easily)
Searchable, location-based service directory through integration with ALISS’s service database
One of the challenges we faced was that many PWLE have very low levels of digital literacy and access. They are also (justifiably) wary of sharing their information online. Setting up the ability for users to create accounts would also take more development time. We therefore decided to use content filtering to personalise the app experience rather than having a log-in system for users, as this option was the most technically feasible and the most acceptable to users.
After a period of collaborative development sprints, it’s exciting to see the updated app being rolled out for national use. Hopefully, services and PWLE across Scotland will be able to take advantage of what this has to offer.
What’s next?
From this work, we learned a lot about what services and PWLE want from digital services and got a chance to collaborate with other groups in Scotland to make something that everyone can benefit from. We’re planning to carry these learnings forward into DHI’s other work which aims to help support PWLE. However, we also learned that there was little research which asked open questions about what PWLE want from digital services, rather than starting with a set idea for testing.
In future, we hope to be able to explore these questions more with PWLE communities. We hope that new projects and programmes of work will provide the opportunity for Digital Lifelines to develop By My Side further and identify how the service could be adopted more widely.
Try out the By My Side app: https://bymyside.simonscotland.org/
Authors: Marissa Cummings and Gabriele Rossi are designers and researchers with the Digital Health & Care Innovation Centre
Stay updated on the latest news, events & funding opportunities across the digital health and social care sector!