PPJ semester3 by Qin Lu

New me, between us

: Design Innovation and Service Design Semester 3 | Summer 2018 QIN LU ĺ?˘ć˛

OVERVIEW This is a ten-week individual design research project conducted by Qin Lu during the 3rd semester of Design Innovation and Service Design programme in Glasgow School of Art. The focus of this project is to challenge social stigma toward menopausal women to promote their wellbeing. In this project, I was playing the role of a designer and trying to explore a complex topic â&#x20AC;&#x153;Menopauseâ&#x20AC;? under the contexts of Sociology, Medical Science and Psychology.

Following I will show you how I did the project step by step. :)

Image source: https://thepsychologist.bps.org.uk/volume-24/edition-5/menopause

page

DEVELOP

DEFINE

DISCOVER

week

:DELIVER

w01

Research Proposal Contextual Understanding Online Survey

2 4 6

w02

Literature Review Desk Research

8 10

w03

Interviews Case Studies

15 20

w04

Research Analysis Insights

22 24

w05

1st Interim Review Insights Articulation

27 28

w06 w07

Concepts

w08

2nd Interim Review Design Proposal

33 34

w09

User Testing

Commnunication

w10

Conclusion

DISCOVER Research Proposal

: What is social stigma? ‘exists when elements of labelling, stereotyping, separating, status loss, and discrimination co-occur in a power situation that allows these processes to unfold.’

Initial research question:

How can millennials challenge social stigma surrounding menopausal women to promote their wellbeing?

Why millennials? As the leader of the future world, millennials have abilities and responsibility to say “no” to existing social stigma, especially those also relevant with themselves.

Issue(s) Menopause is a normal, natural event, defined as the final menstrual period (FMP). As same as the research question, I am interested in the social attitudes toward female menopause. In public perspectives, the menopausal woman is a marginalized, even demonized, figure in much of Western society. Actually, as a natural and normal physical process, every woman should have a better experience during this midlife period.

Objective(s) By doing this project, I hope to diminish public stigma on this group. Moreover, trying to understand them and provide them the proper careness. During the menopause, women are suffered from both physical and psychological illness, they are fragile, unconfident and helpless. Although the medical help can release the physical pain, the mental problem caused by social discriminate and cultural restrict.

NHS.uk. (2018). Menopause. [online] Available at: https://www.nhs.uk/conditions/menopause/ Flaviamenopausa.it. (2018). Menopausa - Flaviamenopausa.it. [online] Available at: http://www.flaviamenopausa.it/Menopausa

Innovation Social attitudes around menopause need to shift toward valuing the experience and maturity that comes with ageing. The reality is that this will inevitably reduce the menopausal distress women experience. The case studies I am using are “end the mental health stigam” and “challenging cultural stereotype”, they are both concentrate on the marginalized groups, and trying to shift the social attuitudes to be more positive and empathic.

Deliverables I wish to deliver a more comfortable and safe method for menopausal women to help them spend this period. Because from the perspectives of “outside” and “inside” groups, the negative attitudes impact menopausal women to treat this process properly. I think it is necessary and valuable for menopausal women and the other young women who haven’t experienced this event. In order to achieve this, I am planning by helping women treat being old more properly, diminishing publics stigma on this event/group or establishing a more specific health care system.

Ethical Considerations Under the context of my project, I will do many interviews and questionnaires with my stakeholders to gather their opinions. Firstly, before I start my research, I will informed my participants the aims, methods and risks, and ask them read the consent ensure they totally understand it. Then, I will assure that all of my participants in this project are volunteers. The data and insights I gathered all will be confidentiality and anonymity and only be used for the university study purpose. During the research process, I will be respectful to the participants and ensure their mental and physical comfort and safe. Moreover, I will ensure the integrity and quality of all the data and result I collected in the field research. For some people, some of my questions might be very personal. Thus, during the research process, I should concern about their emotional status and pause the interview anytime when they feel uncomfortable. Here are five key points I was considering:

Aim & risks imformed

Vounteer participant

Confidentiality and anonymity

Being respect

Integrity and quality

DISCOVER Contextual Understanding

Overview of menopause Biologically, menopause is when a woman stops having periods and is no longer able to get pregnant naturally as a woman's oestrogen levels decline. This is a natural transition and not brought on by any type of medical or surgical treatment. Changing another words, it is a natural part of ageing event which every woman would experience gradually by these three stages (Perimenopause, Menopause, Postmenopause) during 45-55 years old. For ageing women, menopause is a significant transition from both biological and social perspective.

Climacteric

Period fertile

Premenopause

Postmenopause

Period senile

Menopause

45-55 years of age

Symptoms According to my researches, 80% women would bothered by both physical and psychological symptoms during this process. Which can last between 2 to 10 years depends on individuals. Most physical symptoms are caused by changes in hormone levels in the body, and they are very personal symptoms. Women need to bear the discomfort and embarrassment of these symptoms alone. However, psychological illnesses, such as irritability, depression and memory loss, can also affect the social relationship between menopausal women and people around them, such as their family members, friends, and colleagues. Women during this transition could be hard to control their emotion and act extremely emotional.

LONG-TERM

High risk of weak bones Lack of energy Cancer risks

Hair loss

Weight gain PHYSICAL

Chills

Depression Poor concentration

Frequent toilets

Anxiety

Difficulty sleeping

Memory loss Low mood irritability Grumpy

Night sweats

Headache

Social relationships influenced.

Hot flushes Skin irritation SHORT-TERM

Handbook. (2018). Manage My Menopause. [online] Available at: https://www.managemymenopause.co.uk/handbook/ nhs.uk. (2018). Menopause Symptoms. [online] Available at: https://www.nhs.uk/conditions/menopause/symptoms/

PSYCHOLOGICAL

DISCOVER Online Survey

â&#x20AC;&#x153;What do you think about menopause?â&#x20AC;? In order to gather public'sâ&#x20AC;&#x2122; opinions on menopause, I conducted an online survey. Then I received 20 feedbacks from both millennials and menopausal women. From their answers, I found that most millennials would associate menopause with their mothers, and treat it as a horrible thing. However, it is an indelible fact that young women will enter this period in a few decades, and young men will face their menopausal wives in the future. Although people do not consider too many things that are far away from themselves and haven't happened yet. When people define menopausal women in this way, will they be able to pass their menopause smoothly in the future? Moreover, part of these negative descriptions also come from some mid-life women who is experiencing menopause. How can they get along with menopause if they remain so fearful and unacceptable?

mother

loss of femininity

illness

sensitive

bad-tempered

change of life emotionally unstable

terrified

end of fertility

ugly

grumpiness wrinkle irritable midlife crisis depression

ageing

moody

getting fat

monster

weird

being uncomfortable 6

lack of sexuality unsexy

Reflection

To be honest, at the very beginning of this project. I realized there will inevitably be some conflict with our parents in my generation, but these unpleasant experiences we don't want to see. I aimed focus on the relationship between teenagers and their mothers, how can I get them closer? Then I interviewed some teenagers about the way they getting with their family members, especially their mothers. Then, I found our mothers are becoming ageing with many emotional changes, which lead me to focus on this body transition - MENOPAUSE.

Considering this topic is quite private at present, I decided to start dig from the online resources and literature reviews. After a deeper research on menopause, I was shocked by the whole society attitudes towards menopause. They are very negative, compared with death, they two are both natural events happened in the different stage of life. People have a much deeper understanding of death. They prepare for it and accept it as an inevitable phenomenon in life. Nevertheless, people rarely talk about menopause and regard it as a curse. Why?

DISCOVER Literature Review

FACTS about menopause: Following is some facts I learnt from literatura reviews: • Each woman’s menopause is unique. • Women often felt unable to share their experience and felt foolish asking for help. • Younger and premenopausal women may have more negative attitudes because they have less knowledge of the menopausal transition. • Women are now working to later in life than in the past. • 87% would rather treat symptoms naturally than take medication.

Influencing factors of a woman’s quality of life during menopause. Women’s experience of living through the menopausal period is dramatically affected by sociocultural factors. The most relevant factors influencing a woman’s quality of life during the menopause transition appear to be: Persaonl factors:

previous emotional and physical health

experience of stressful life events

Social factor:

Educational factor:

social situation

beliefs about menopause

Cultural factor:

culture about female ageing

For all women, leaving the reproductive years marks both an important change and a window for growth. Regardless of differences in how it is experienced, the menopausal transition can provide an important focus, a time that can be used to reassess one’s health, lifestyle and goals.

World Health Organization (2007). Women, Ageing and Health: A Framework for Action. Focus on gender. Lee, M., Kim, J., Park, M., Yang, J., Ko, Y., Ko, S. and Joe, S. (2010). Factors Influencing the Severity of Menopause Symptoms in Korean Post-menopausal Women. Journal of Korean Medical Science, 25(5), p.758.

Where does these social stigma come from? I was curious about why social attitudes towards this group of women and this natural transition are so negative. Thus I conducted a series research on it. From the researches, I found that there are 3 phases of social stigma on menopausal women: The way menopause is demonised in the media, it is a result of the medical view of menopause, which has in turn been shaped by the negative cultural view of ageing women, creating a circular influence that continually reinforces the perception of menopause as a miserable time for all women.

The media depicted: demonised

The medical view: still disease

The public views: taboo subject

(Circlar of social stigma on menopausal women)

Pope, M. (2017) Attitudes toward Menopause. Master of Science Thesis. ARIZONA STATE UNIVERSITY

DISCOVER Desk Research

: “Diverse sociocultural differences can affect a woman’s

experience of menopause and her view of menopause treatments, as well as her overall health and well-being.

”

Examples of contrasting views:

A natural event.

A medical condition.

Medical view in different cultures First of all, from the medical point of view, menopause is a disease with cultural differences. A study found that Asian women report much lower rates of menopause-related symptoms than Western women. This is possibly linked to diet (soy!), but prevailing thought suggests that it may be the result of Asian attitudes towards aging. Social status in Asian cultures often increases with age, and positive attitudes about menopause and aging are common. In some young idolizing western countries, menopause means physical aging and the decline of female characteristics. Once women enter menopause, they will be sentenced to death of youth. So they will do their best to seek medical help, through medication and some surgical cosmetic surgery to delay aging. In addition, some of the symptoms brought about by changes in the body of menopausal women are also the medical view that menopause is a cause of disease. However, in some other eastern countries, such as Japan, menopause is treated as “renewal years” and “energy.” Thus, most Japanese would treat it as a natural event. How your culture sees you, treats you, and talks about you dictates how you live in that culture. Culture is our mirror, and if we see withered crones in the glass, we feel useless and disposable. If, however, we see energy and renewal — well, what does that feel like?

North American Menopause Society. (2010). Clinical Care Recommendations. Chapter 1: Menopause Lisa, R. (2018). Alone in a Crowd: The Hidden Landscape of Menopause. Avis, N. and Crawford, S. (2007). Cultural Differences in Symptoms and Attitudes toward Menopause.

(An example from media view)

Media view There is an example of the menopause in media view, a news of an interview shows that Ben Broadbent, the deputy governor of the Bank of England, describes the UK economy was in a â&#x20AC;&#x153;menopausalâ&#x20AC;? phase after passing its productive peak. It is totally inappropriate that using this language publicly. From here, we can imagine how people who do not have any experience and knowledge of menopause would treat menopause? When the whole society is shrouded in such stigma, the media reports further confirm such stigma. How can we face up to menopause and encourage women to accept it?

Anna Isaac (2018). Bank of England deputy warns UK economy entering 'menopausal' phase. [online] The Telegraph. Available at: https://www.telegraph.co.uk/business/2018/05/15/menopausal-uk-economy-risks-once-in-a-century-slump-warns-deputy/

DISCOVER Desk Research

Public view Does everyone learn about menopause from the media or medical point of view? In order to find out the source of individual stereotypes about menopause, I did some interviews about where people's perceptions of menopause came from. Then I mapped out peopleâ&#x20AC;&#x2122;s knowledge of menopause from different stages of human life: Childhood: People little known about menopause in childhood, and a few vague sources of knowledge may be from animated cartoons and storybooks. Adolescence: When children enter puberty, they are greatly influenced by their families, they gain the knowledge and understanding of menopause at this stage. The performance of family members in menopause would largely construct the basic understanding of children to menopause. Moreover, media rendering will deepen their understanding of menopause at this stage. Adulthood: People's awareness of menopause at this stage slowly deepens through GP and some public media and materials. Menopause: Before women entirly enter menopause, most of them still lack the understanding of menopause, even when they are already menopausal and show the symptoms associated with menopause, they do not know that they are in menopause. On the one hand, they will seek medical help to release some of their physical symptoms at this stage. On the other hand, communication is very important for them to help their psychological changes. Talking with other menopausal women makes them realize that they are not alone in this transition and that sharing experiences is an important way for them to acquire menopausal knowledge. However, as this topic is still a taboo subject in the society, people not allowed talking in public. Therefore, the dialogue on menopause is still limited to menopausal women. Interestingly, millennials learn a lot from their family, but they rarely have formal communication with family members. Old age: After menopause, women (including their husbands) reach a peak in their knowledge of menopause. After that, women no longer have symptoms of menopause. With the passing of menopause, the knowledge of menopause gradually decreases with age.

DISCOVER Interviews, Literature review “Millennials learn a lot about menopause and aging from their families and, depending on what they witnessed at home. ” ( Madeline R. Vann, 2012).

“I certainly never heard my own mum speak about it. I do like the idea of talking with other ladies who have been through it.”

“ I learnt the knowledge about menopause from the daily conversations and television programmes. ”

(Angela Milby, 47)

(Catherine, 53)

(Zoe, 23)

Stages

Childhood

Adolescence

“I decided to write this blog post to share my experience as I’ve found that it’s still a fairly taboo subject here in prudish Ireland. ”

Adulthood

PEAK

Menopause Others’ sharing

Old age

Media Printed materials

Menopausal knowledge from:

Family Animation stories.

NONE

It is important that teenagers during adolescence and women experiencing menopause interact at a certain stage. The stereotypes of adolescents are formed at this stage, and women are experiencing and struggling with it. Can this interaction bring some positive changes?

(Individual menopausal knowledge) Madeline R., V. (2012). What You Can Learn From Your Mother's Menopause. [online] EverydayHealth.com. Available at: https://www.everydayhealth.com/menopause/what-you-can-learn-from-your-mothers-menopause.aspx

Supervision

During this week, I had the first meeting with my supervisor, Mafalda. After I introduced my project with her, we started by rephrasing my research question, as my previous one is quite ambiguous and not exactly fit with my research purpose. From this, I realized that an accurate, clear and appropriate research question is very important for a research project. It can guide us alway keep clear in the next broad research process.

Reflection

Next, I was informed the following design theories that I would use in my project. By further researching to understand each theory, I had deeper realization of my project in the academic level.

During this stage of desk research and literature review. I had deeper understanding on where does the social stigma toward menopause come from and how does people learn the knowledge about menopause. I also found that the understanding of menopause and social attitudes are different under different cultural backgrounds. Based on what I see and feel in my own cultural context, I can only represent the opinions of a part of a cultural group.

1) Critical Design: it is an awareness to make people think about something. It is more of an attitude than anything else, a position rather than a method. 2) Design Activism: it is a method to make people do something. It uses design thinking to create products, environments, solutions or services that enhance quality of life for the other 99%. 3) Social design: a design project under a social context. 4) Transformation design: a design project about change. 5) Human-centred design: Itis a design and management framework that develops solutions to problems by involving the human perspective in all steps of the problem-solving process. 6) Ethnographic visualized: Data may tell you what the trends are, but ethnography is a tool for figuring out WHY those trends are happening. 7) Context mapping: It is an approach to design in which designers use peopleâ&#x20AC;&#x2122;s everyday lives to inform and inspire themselves for ideation.

Then, I realized that the design about menopause was not as simple as I thought at first. My supervisor also suggested me to consider narrow the research focus down to one specific cultural background, such as Asian culture, which I am more familiar with. However, I think the negative social attitudes toward menopausal women do not exist only in a certain sociocultural context, but also in both East and West cultures. Although there may be some different phenomenon under the influence of different cultural beliefs, culture is not the main reason for the social stigma of menopause. I believe there must be some common element which could lead to the social stigma.

DEFINE Interviews, Literature review

“How are women dealing with their menopause currently?” By combining the data from both interview and an online blog named ”my second spring” where menopausal women share their menopause stories, I gathered 9 women’s stories, they are age from 44 to 55 and respectively from Ireland, UK, Australia, New Zealand, China, Canada. Through analyzing these stories, I found that their management of menopause mainly are pharmacological and non-pharmacological. Among these methods, pharmacological therapy and lifestyle modification are the choices of women in most countries, as they have the initiative. However, they cannot control the social support which they need, they can only wait for help and passive acceptance.

Pharmacological

Non-pharmacological Lifestyle modifications

HRT

(Hormone replacement therapy) “I was getting fed up and eventually decided to try HRT. The symptoms eased but I hated it.” (Karin, 47, UK)

“I didn’t want to go on HRT.” (Noelette, 58, Canada)

Supplement “I started taking a variety of supplements and experimented with some botanical herbs and magnesium” (Jet, 56, Ireland) “Taking supplements have helped my tiredness and given me more energy.” (Aisling, 52, Australia)

Exercise

Herbal medicine “My GP didn’t suggest me take any HRT as it might bring some side effects, she suggested me to try some traditional Chinese medicine. Compared with HRT, it works slower but safer.” (Yin, 48, China)

“At present I'm keeping positive by doing yoga and meditating” (Jet, 56, Ireland )

Social support:

Dispelling misconceptions

Social interaction

Diet

“I tried to improve my diet (less sugar, less coffee and less wine, more vegetable and fish protein, more vegetables)” (Robyn, 48, New Zealand )

Prfessional advices

NHS.uk. (2018). Pat's story. [online] Available at: https://www.nhs.uk/conditions/menopause/pats-story/ Mysecondspring.ie. (n.d.). Womens Stories | My Second Spring. [online] Available at: https://mysecondspring.ie/womens-stories

“I feel like my life’s over. It marks the end of being young and attractive and fertile.” (Pat, 44, UK ) “A wonderful, supportive and understanding husband was essential.” (Karin, 47, UK )

“I visited my GP, and I just wanted information about what was happening to me and how I could manage it.” (Pat, 44, UK )

DEFINE Interviews

: Preparing for interview I had some deeply interview with both menopausal women as the target group and millennials as emerging group. Before I talked with them, I highlighted the key methodology of interview that ensure me gain the most valuable insights and opinions from conversations with them.

Menopauseal women

Millennials

Target group(women between 45-55): • How did you recognize the first symptoms of menopause? • Do you want to gain more knowledge about menopause? • Where do you gain your information from? In what way do these help you? • What is the worst aspect of going through menopause? • How do you normally deal with your menopause symptoms? (Pharmacologically and Non-pharmacologically?) • Do you feel comfortable talking your menopause with others? WHY? • Do you think going through menopause affected your relationships with your children or close teenagers? In what way? • Do you feel you are understood and cared for by them?

Emerging group (people between 10-24): • What’s your opinion on menopause? • Why do you have this opinion on this issue? • Are you afraid of that? (target on your family/friends or on yourself) • How much do you know about menopause? Where did you gain this from? • Anybody you have touched with are experiencing menopause? Eg: Your mother?teacher? • Do you want to get more knowledge about this group of people/ this issue?

Insights from interview From the interviews, I found there are some gaps between menopausal women and millennials about menopause. First of all, in many families, the menopause of the mother and the puberty of children mostly occur in the same period. Both sides were emotionally unstable and irritable at this time. The generation gap between the two generations has become broader. Secondly, although menopausal women express a willingness to talk to their families about their menopause, they are also expect understanding and support from family members for empathic needs. However, for millennials, they seldom hear their mothers talk about it with themselves. Thirdly, menopausal women gain more menopausal knowledge by sharing experiences and feelings with other menopausal women. But millennials has no way to acquire relevant knowledge. Therefore, for them, there is a misunderstanding of menopause caused by lacking of knowledge.

Menopausal women

Millennials (as family members)

“ My children were teenagers during my menopause. It was a fairly potent mix. I still don't know who was more responsible for the moodiness, them or me. ” (Noelette, 53)

“ It is important to my

Generational gaps

“ I would like to share my menopausal experiences with people whom I trust and love with to get their understanding.” (Yin, 48)

Communicational gaps

“So helpful to talk to others women at all different stages of life. Helped to see the positive side of this time of my life and the future! ” (Chan, 46)

Educational gaps

menopausal mom if I understanding her feelings and stand by her side when she was experiencing this transition. ” (Emma, 20)

“

I never heard a peep from my mother about menopause. It’s as if it didn’t exist.” (Amy, 22)

“ I know it is a natural event in the life, but it is inevitable that I would discriminate against it.” (Mocha, 24)

Generational gap From the interviews, I gathered many gaps between menopausal women and adolescent millennials. Then, I did further research on this two generations during these two transitions. First of all, they both are natural transition period lasting around 10 years but happened on the different stage of lifespan. They would experience changes from physical, psychological and social behavior. A noticeable similarity in their social behaviour change is that their identity building. During menopause, woman’s identity is challenged by body changes and social attitudes. For teenagers, during this period, they are searching for a new identity to been grown up.

VS Adolescent millennials

Menopausal women

Teenager years: 10-24 years of age

Women: 45-55 years of age

Defination

transitional stage of physical and A psychological development that generally occurs during the period from puberty to legal adulthood.

The natural transition period in most women's lives when menstrual periods stop permanently, and they are no longer able to bear children.

Physical changes

• Rapid increase in height and weight. • Changes in circulatory and respiratory systems. • Body composition. • Primary sex characteristics are changes directly related to sexual.

Hot flushes, Night sweats, Difficulty sleeping, Headaches, High risk of weak bones, Cancer risk, tiredness and weight gain ...

Psychological & Emotional changes

Unpredictable moods, More sensitive to other’s emotions, More self-conscious

Low mood, Anxiety, Irritability, Lack of energy, Memory & concentration problems, feeling worried, preoccupied, nervous, or panicky. et,.

Ages

Social behaviour

Searching for identity, Seeking more independence and responsibility, Spend less time with family and more time with friends, Influenced more by friends, Having more arguments with parents, Looking for new experiences, Thinking more abstractly and to question different points of view.

Lower self-esteem, demoralised with a drop in confidence; Productivity at work was reduced; Identity challenged.

Healthyfamiliesbc.ca. (2018). Social and Emotional Changes in Adolescence | Healthy Families BC. Brunet, pharmacists affiliated. (2018). Adolescence: a period of changes. Sawyer, S., Azzopardi, P., Wickremarathne, D. and Patton, G. (2018). The age of adolescence. The Lancet Child & Adolescent Health, 2(3), pp.223-228. Www2.le.ac.uk. (2018). Workplace menopause study finds ‘women feel they need to cope alone’ — University of Leicester.

Reflection

As this topic is relatively secret in many societies, inviting women to talk with me about menopause is a challenge, especially for unfamiliar women. So I chose to talk to young people first, and most people would mention the experiences of their mothers or other menopausal elders. Then I would ask them if their elders are willing to accept interviews. By doing this way, I can get more potential interviews. Then I realized later that I would not be able to understand the views of women who were reluctant to share their menopausal experiences. So I found a workshop called "menopause cafe" in University of Leicester, where many menopausal women come to share and talk with others. I decided to go and try to communicate with more menopausal women. Unfortunately, for my own reasons, I missed the workshop. Then I had to go back to desk research and try to find the communities and blogs for menopausal women online. By combining two kinds of research methods, I have further confirmed my conjecture and hypothesis.

My challenge

After the desk researches and field researches, I generated many insights which would guide me in the following steps. However, at this stage, I got stuck. As a foreign culture background student here, I felt that it's hard for me to understand some words. It is not that I do not understand the meaning of words, but that we regard it from different perspectives in my culture. For example, the word of “identity”. I totally understand it under the context of menopausal transition from the conversation. I know every need own identity. But in my culture, we wouldn't say that “building identity”. We believe that own identity is not built by doing anything. It is changed in the course of long-term behavior change or position change. The same term as "identity" in Western culture, in Chinese culture we would think of as labeling you. It is the outward label, rather than the inner self.

DEFINE Case Studies

Menopause café Inspired by the format of Death Cafes, a similar non-profit gathering to encourage people to talk about a previously forbidden subject, Menopause cafe was developed by Rachel Weiss, who launched the first Menopause Cafe in June 2017 in Perth, central Scotland. It welcomes all genders and all ages people come together to share their stories, experiences and questions about menopause. This is an initial step of bringing “M” word to public space to encourage people talk about it. Additionally, it is not just a support group for menopausal women, it’s opening up conversations about the third stage in women’s lives, who am I if I’m not fertile or don’t look like a stereotypical sexy woman? The key value of this case is to provide people an opportunity to talk menopause with others, and this is also the requirement of menopausal women and some of their family member.

“I hope hearing about The Menopause Café will encourage people to start their own conversations with family, friends and colleagues. I’d love to see it become an everyday topic of conversation.” (Rachel Weiss, Orgniser of Menopause Café, 2017)

Kirker, A. (2017). Women share their menopause experiences as new cafe lets people open up over a cuppa - Sunday Post. Available at: https://www.sundaypost.com/fp/finally-lets-talk-about-lifes-changes/

Menopause attitudes in India When the expectation of growing older is positive in a culture, the physiological/psychological symptoms seem less or are just not there. The common perception is that Western cultures treats older women as if they were less valuable members of society. However, in India, women who were veiled and secluded before menopause, could now “come downstairs from their women’s quarters to where the men talked and drank home brew” and could publicly visit and joke with men after menopause. Moreover, older women in India do enjoy a measure of respect as the senior member of the family, this is another reason Indian women would look forward menopause. Once women get better identities after menopause than before, they would no longer be negative for menopause.

“Although women always remain subservient to men, older women in India do enjoy a measure of respect as the senior member of the family. ” (Pekker,M. 2013)

Pekker, M. and profile, V. (2013). Indian women and menopause. Available at: http://menopause-aid.blogspot.com/2013/07/indian-women-and-menopause.html

DEFINE Research Analysis

Woman changes during menopause Based on all the previous research, I mapped out the changes women experience during menopause from three level. Firstly, the most obvious thing is physical change. This is also the most accessible change for menopausal women, whose physical symptoms can be alleviated by medication or exercise and diet. Secondly, physical changes can lead to psychological changes. This kind of change usually brings about the interpersonal relationship which affects the menopausal women, and leads to many negative effects. The source of negative attitudes towards menopause is largely due to these effects. However, the effective communication with others is a good coping strategy. Thirdly, the key reason for women's fear of menopause is the change of role. Inevitably, after menopause, women lose their attractiveness as a result of physical changes and ageing, especially in youth-idolizing society, which is unacceptable. I think the hardest part for menopausal women are the neither physical changes making them feel uncomfortable, nor the psychological changes making them irritable, but the role changes. How to transfer from previous role to a new one?

Changes Social statu changed. Self-identity changed. From young to ageing. Social relationship influenced. Social behavior changed. Body structure changes. Uncomfortable symptoms.

Coping strategy Role change

Mental changes

Physical changes

Rebuidling self-identity. Effective commnunication with others. Medical help. Lifestyle modification.

Identity building In order to figure out what make an identity to help menopausal women rebuild after-menopausal identity. I mapped out the methods from five sessions. From my understanding, building identity need opportunities to reflect on the past, focus on the present, and envision the future. However, specific methods may vary among people of different ages and cultures, which was also confirmed in my further research. .

My future, my personal dreams and goals.

On who I am becomingmy emerging values, attitudes, beliefs, morals.

n ar

My family and personal history.

My emerging interests and concerns.

Building identity

Self-respect as well as respect and appreciation for others.

nnet Co

My talents, abilities, and skills.

elo Dev p

Refle ct

Envision

My emerging sense of identity with positive role models (peer and adult role models)

Figes, K. (2004). Kate Figes: When menopause meets adolescence. the Guardian. Available at: https://www.theguardian.com/books/2004/jun/14/booksonhealth.lifeandhealth

DEFINE Insights Reframing

Insight 1: Communication Cross-generational communication is the key to breaking down the stigma.

â&#x20AC;&#x153;I think telling your daughter about the menopause is the second most important conversation you should have with her, after the facts of life, because communication is key to breaking down the stigma.â&#x20AC;? (Linda Barker, 2014)

I JUST WANT TO TALK! Walsh, J. (2014). Linda Barker, fabulous at 52: 'Menopause made me stronger'. Express.co.uk. Available at: https://www.express.co.uk/life-style/health/459743/Linda-Barker-on-how-menopause-made-her-life-better

Insight 2: Transition Both generation go through a transition.

â&#x20AC;&#x153;I now find that my menopause coincides with my daughter's adolescence. We now have so much more in common with one another as women, even though we are at opposite ends of the menstrual spectrum.â&#x20AC;? (Kate Figes, 2004)

SO MANY CHANGES! Figes, K. (2004). Kate Figes: When menopause meets adolescence. the Guardian. Available at: https://www.theguardian.com/books/2004/jun/14/booksonhealth.lifeandhealth

Insight 3: Identity Menopausal woman’s identity is challenged.

“It’s opening up conversations about the third stage in women’s lives, who am I if I’m not fertile or don’t look like a stereotypical sexy woman?” (Rachel Weiss, 2018)

WHO AM I? Brooks, L. (2018). Welcome to the Menopause Cafe: 'Now I know I'm not alone. I'm not going mad'. the Guardian.

1st Interim Review

Reflection

During this stage, we had the first interim review. I received many valuable feedback from tutors and peers. Firstly, as I had done a lot of research, I was expected to have stronger position and attitude to show my ideas by using these evidences. Secondly, I was suggested to gather story from the other side of menopause, to see what happens after menopause to compare with before. To figure out the reason why the elder generations never talked about it but they are still fine, and why they need the communication? The answer from my side is that the menopausal women’s well being influenced by many elements. Until about 100 years ago, there was very little medical information on the menopause and many believed that the menopause was a sign of women’s hysteria. Thus, for the older generation of women, it is too shame to communicate with others about their menopause. They never talked about it doesn't mean they had never experienced discomfort and changes. Thirdly, don’t treat this transition isolatedly, but put it in the whole lifespan to compare the physical changes in different stages and the social attitudes toward each period. And there were much more suggestions I received, they all gave me different perspectives on this project. It helped me to see my blind area when I was working independently, so that I could continually think about design research more critically.

After the interim review, I paused to look at my existing researches to analyze all the points and insights from previous research to narrow down the direction. When I looked at all the data from the different areas all point to one direction, I can say that my insights are what I can use for the next phase of idea development. They are what menopausal women’s needs and the changes the whole society should make.

DEVELOP Insights Articulation

Opportunity Based on the 3 insights I gathered, I was starting thinking what if we encourage mothers talk with their young children about menopause during their menopause to educate them about this natural transition and also get them know each other better during this special period. Moreover, millennials also experience the transition and have need of role change through identity building. So, I think the opportunity of this project could be providing a channel to let people talk about menopause. In order to educate both generations, to diminish generational gap, to help people during transition cope with their changes, to promote menopausal women’s wellbeing, let’s talk about menopause between generations to help menpusal women re-building their identity.

Opportunity

Insights

Cross-generational communication is key to break down the stigma.

Both generations go through transitions.

Menopausal woman’s identity is challenged.

Let’s talk about menopause between generations to help menopausal women re-building their identity.

Inspiration: Arranged! The Arranged Marriage Board Game This is a good example of playing game to change social behaviour and that is the aim of my project. It exposes the culture of arranged marriage culture in Pakistan. Under this popular culture, many girls are forced or emotionally blackmailed into marrying someone their family chooses for them. This card game starts by acknowledging that there is a problem, and to have a conversation about it. In the game playing setting, it provides a platform for people to be able to discuss these issues in a very lighthearted setting. Thus, I decided to use a game based approach to encourage dialogue.

Nashra Balagamwala. (2018). Arranged!. [online] Available at: http://nashra.co/#/arranged/

DEVELOP Concepts

Concept 1: identity swap card game • Key insights: Empathic needs; Building identity; Communication channel. • What if question: What if ... we create a method for cross generations to encourage people talk in a family setting, and experience the other identity. • Concept description: (More details at Page 31) An identity switch game through swapping the role challenge cards in a family setting. The function of this game card as same as the sticky note, you can write down their feelings or challenges then leave it for anyone you want to talk with. • Reason for the idea: This game can bridge the channel between two generations to discuss about their own trouble during the transition by a more acceptable way. • Feedback from tutors: It might be a good way to encourage the communication between family members, but it might not be a good way to promote menopausal wellbeing as your proposal. You should consider this project to be more about different generations coming together that just within the family core. The intergenerational conversation can happen inside the family core, but a project that focuses only on family is more difficult to expand to inter-generations. This is relevant with the variety of family concepts that we can observe in the world. For example, imagine women that have very close friends and that are almost like mother/aunt figures for their friends’ children. These are also relationships worthwhile to include in your project. Hence, you should focus more on generational-relationships.

What?

An identity switch game through swapping the role challenge cards.

When?

Given as a gift in a special day as a ritual. Play with one family memebers when you want to share your feelings.

Where? It It It It

is very portable and easy to play. can be used in own home for closing family members. can be carried out during the family trip. can be also deliver to someone you want to talk with but living far away.

How to play?

what if...

I want ...

what if...

I want ...

Assigning

Swaping

Conducting

Reporting

By writing down my feelings and the things Iâ&#x20AC;&#x2122;m experiencing to ask the other person to finish a task.

Giving the game card to the person you want to share with.

The person who recieve the card and then finishing the task he/she is asked to do.

Recording the results on the back side of the card and return it.

Concept 2: An educational board game • Key insights: Educational purpose; Tigger a dialogue; Identity building. • What if question: What if … we provide an lighthearted environment to encourage generations sitting down to talk about the menopausal knowledge and the coping strategy of identity challenge? • Concept description: This is a board game for multiple players playing together, just follow a easy rule to take cards and pair them off. They are paired by the information of menopause, such as: menopausal symptom pairs the coping strategy, social stigma toward menopause pairs the the fact about menopause. Another part is helping people to building their identity through thinking a method. • Reason for the idea: This game is not limited in any specific family structure, but suitable for both cross generations and peers. Through playing the game to educate people the basic menopausal information less likely cause the embarrassing or uncomfortable. • Feedback: Cross generational dialogue could be helpful for diminish generational gap and social stigma which caused by lack of communication.

2nd Interim Review

In the second interim review, asI didn’t really well prepared for it, I missed a lot of evidences in the presentation. In fact, I had enough researches to support my insights, but I did not expressed it very clearly. Plus, public speaking always makes me extremely nervous especially when I think I am not good enough. It is conceivable that I got a lot of negative feedback. Except the lacking of evidences, in the idea communication part, I failed on storytelling. Thus, the audiences couldn’t really understand what is that. After the interim review, I reordered all the stuffs, tried to make them list in a more logical way. By doing this, I felt that I was much clearer about my project.

Reflection

I finally understand why we are always asked "why" in every decision making point, why evidence is so important and how to present the project by the clearest way. The way we as designers to present to our project to audiences is very significant as our design language.

After analyzing all the concepts, I chose the “educational board game” as my final idea. Starting by case studies, I read some articles about game design and motivation. I find that game design seems easy, but every step of motivation needs to be considered. I hope the rules of the game are simple, because if the game itself is too complex, the educational purpose may be partially ignored. Then I searched some rules and system from the classic board games. For example, UNO is a very popular board game, its rule is very simple and easy to understand.

DELIVER Design Proposal

NEW ME, BETWWEN US What: It is an educational board game. Who: Design for 2-5 players from different generations.(14+ yrs old). Why: It provides an opportunity to get people from different generations to sit together and start a conversation about menopause by playing game in a relaxed atmosphere. I hope that this will trigger communication between players and help both millennials and adults to gain a basic understanding of menopause through the cards information. Moreover, in the identity building phase, menopausal women are encouraged to explore their new identity through a number of tasks and questions from each section. Where: In the future, I imagining that this design can be finally adopted by the public health organizations, such as: NHS, WHO, BMS (British Menopause Society). Then citizen can collect the game boards free from public places, such as hospitals, supermarkets or clinics. How to play: Starting by taking cards from each deck of cards, then start from one players. If this player has any pair of matching red and blue cards, then pair them and put them away. If this player does not have any pair of matching cards, he can lay down any one of the challenge card, and ask other player to pair with opportunity. If pairs with any other player’s opportunity card, next player’s turn. If there is no any player have paired opportunity card, then this play enters the self help section*. *Identity building cycle: The player turns the “identity building cycle ”. Then try to answer the challenge from the perspective of the selected section. Basically, it is a cards matching game by pairing the challenge with opportunity about knowledge of menopause. Additionally, the self-help part runs by think the way to build identity from different perspectives.

Why card game? Firstly, from the case study I mentioned earlier, it is a good method to force participants to confront the secret subject they might never talk about. Secondly, I have interviewed some millennials about their opinions and experiences about playing board games with the other generations. The result shows, most people had the experience of playing board games with their elders and their elders are also happy to play with them. Besides, players are relaxed when playing games. Thirdly, I did the literature research, then I found that playing card games is an excellent way to teach patience, concentration, and academics. Moreover, most card games promote memorization, matching and pattern recognition. They are also a way to improve family relationships, which is one of the most important benefits of game play between generations. It provides a great opportunity for interaction between generations.

Cratty, R. (2018). The benefits of playing card games. [online] Honeycreekschool.org.

35 23

DELIVER User Testing

User testing In order to test my final idea”New me, between us”, I invited people from different age bracket to join the workshop. Before that, I made some draft cards and the original identity building cycle. Following are some key points I received from this workshop that I should further think about: • The way to promote this game. • What kind of situation, people would play it? • Identity building tasks/questions might be different from different gender, age and culture. • How to ensure players read the information on cards? • Whether the game would be endless, how to control playing time? • What is the motivation for winner? • How to avoid disputes in dialogue?

23 37

DELIVER Preparing:

Every player pick 4 cards (2 blue, 2 red).

Social stigm Ba d a: Fact: situ

ation: Fact

Let’s talk about menopause!

IA Fact:

Fact:

ial is Menopa n: Socuse stigralnatural tio : is a natua ma situa pause that Ba d Menoevent woman woman yevery Me

nopever that experie twould aus g maye etra nce during eventhe durin n rienc me end of nsition is d expe of k44-55. al wo woul wo man’ 5.aer. paus ed ris nc s life. Meno increas 44-5 ca an rian have an d ova st brea

Player 1

Player 3

Player 2

Player 4

D Fact:

(Next player)

After menopause, women are more likely be labled as “wisdom”.

C Fact:

Bad situation:

Yes, pair: C

(Next player)

Menopausal women may have an increased risk of breast and ovarian cancer.

Still no pair: Enters the self-help stage.

c fle e R

yo fut ur ure .

En vis

r Lea

Identity building

ur y yo mil l fa and na . o y rs or r pe hist younts, , e tal lities s. abi skill and

pe yo dr rsour ea n m al s.

Connect

ur . yo oals g

your emerging interests and concerns.

Then try to answer the challenge from the perspective of the selected section.

g: in m co e b ing morals e ar erg iefs u l yo r em be s o u wh yo ude on tit t a

appreciation for others.

The player turns the “identity building cycle ”.

with your emerging sense of identity with positive role models.

Lays down any one of the challenge card, and ask other player to pair with opportunity.

Bad situation:

Menopausal women may have an increased risk of breast and ovarian cancer.

No pair:

Menopause itself is not associated with an increased risk of developing cancer. However, the rates of many cancers do increase with age.

Menopause is the signal of women ageing.

re s

Social stigma:

lf-

Social stigm Ba d a: Fact: situatio n: F

act Meno Meno M : trans pausa Menopausepause is a natural enition is the endhaofvea olpwo men ma woma event that everyan woman use n’salife. assrea y breast inc o se itsek would experience during an dincovaciated ris d w lfofis 44-55. deve rearia se dn can itce h r. not H lo ma oweve ping risk an ny o can r, the cance f cers ra r. te w it h a do inc s of ge. rea se

Dev elop

of a, woman wom ’s life. -55. duri an opause ed Menop ng labl After men likely be aus hav an al wo me e n may are mor “wisdoem”. increa as breast and ova sed risk of rian can cer.

Fact:

ral: natuct a n: Mene is atio an Meno paus op y wom evdensitu ause Socia ever g l stigma: t eventBwathat may durin rienc ould th at e isena na of ever risk tu . would expe expe wom 5. ral 44-5 ncer sal Menop rien se d yause w caom transit ea ion is ce opau 44 cr the ian du end -5 ar ofria an Men an in ov5. ngwoman’s life. d have st an brea

Pair:

Fact H Men : Social stigm even a:opau wou t th se is at ld Fact: ev a natu Ba dexsitu Menopause pe er transit ion riati y wom ral the end en 44 is enon: ce

opportunity cards

From one player.

Let’s talk about menopause!

challenge cards

Start:

: Menop Menop Menop transit Menopause ause is a natural ausalionauis the endhav assowo me se n ofeaan event that every woman may ’scilife. rea breast inc ate itse incr sed drisk lf would experience during and de ovaea send w ithofis not ria can 44-55. How velopi ri ceran man ev ng sk . y ca er, th canc of ncer e ra er. w it s do tes of h ag incr ease e.

va lu e

Game Instruction

Social stigma:

Fact:

Menopause is the signal of women ageing.

After menopause, women are more likely be labled as “wisdom”.

Fact: Menopaus event tha e is a natural t wo uld exp every wo man erience during 44-55.

Social stigma:

Fact:

Menopause marks the end of a woman’s reproductive powers.

Menopause also means no more limited by period.

Choose one challenge card in the table to pair one of remaining opportunity card and give a reason.

Fact:

(After several rounds)

Fact of symptom:

Treatment:

80% women during menopause would be bothered by some symptoms such as: hot flushes, night sweat.

HRT (Hormone Replacement Therapy) is a treatment used to relieve symptoms of the menopause.

Bad situation:

Fact:

Menopausal women may have an increased risk of breast and ovarian cancer.

Menopause itself is not associated with an increased risk of developing cancer. However, the rates of many cancers do increase with age.

ral I e is a natu an Meno paus ever y wom Fact g : event that rience durin would expe Men 44-55. opause is a natural event that would exp every woman erience during 44-55.

There is no more challenge card.

Let’s talk about menopause!

challenge cards

Social stigma:

Fact:

Menopause transition is the end of a woman’s life.

Menopause is a natural event that every woman would experience during 44-55.

Continuely pair the challenge card with opportunity card.

(Paired cards)

If there is no any match, takes one more challenge card from deck.

Let’s talk about menopause!

opportunity cards

There is no winner at the end of the game, the aim of this game is to build dialogue between generations.

DELIVER Game Prototyping

Game cards: Two kinds of cards in total: Challenge cards: Fact of symptoms; Social stigma; Bad situation. Opportunity cards: Facts, Management, Coping strategy. By taking cards from two deck of cards separately, each player has different cards and they can share the information in the card with others by exchanging cards or pair with others. In this phase, I hope to educate players from different ages and genders all know the basic information of menopause. This may avoid some social stigma and misunderstanding between generations. For middle-aged women, it can also help them prepare for menopause early.

Packaging:

Game cards:

All the cards and cycle map can put in the box, it is portable and cheap. Thus, the cost of one box of the game cards is very low and can be largely printed and free distribute to publics.

By turning the arrow to choose one section for self help. Thinking about a detailed idea to build identity under the section and giving a reason, which aims to trigger the thinking and conversation.

Conclusion

Actually, this is my first individual research design project. It was really a big challenge for me, I have to make decisions alone. Unlike in the previous team setting project, once I made mistake there would not be anyone to tell me. For me, the most valuable ideas are generated from the group discussion, I love work as a team to free communicate with teammates. This is not a problem solving project, the social stigma still exists even everyone know the knowledge about menopause in the future. I am hopeful that by discussing the stigma and misunderstandings of menopause, the society might start to realise how flawed these bias are and eventually promoting menopausal womenâ&#x20AC;&#x2122;s wellbeing. I also believe that this game will provide women with creative ways to avoid their fears of being ageing as well as empower them to not be afraid to pursue a new identity after menopause. Talking about the final outcome, I know the menopausal information on the cards about their bad situation, therapy and management might not be exactly correct. The role Iâ&#x20AC;&#x2122;m in the project is as a designer to provide menopausal women, public and some organizations a way to release the social stigma. If this game can be promoted in the future, it will still need to be calibrated by experts in medicine, sociology and related fields.

The end.

I have to say, during this one year programme in GSA, I learnt a lot not just the professional skills but also the exotic culture and behaviours. I enjoyed living and studying in Glasgow. Next, I want to say... Thanks to the staffs and students in GSA who have offered me support. Thanks to our tutors of Design Innovation, Elio, Brain, Iain, Lorenz for providing us many perspectives during the projects, and encouraging us to explore more possibilities. And special thanks to my supervisor Mafalda for guiding me and giving me many professional suggestions during semester 3. Thanks...