This diploma project explores how public health actors in Norway can enable, engage and empower young adults, age group 20-30, to be proactive with their sexual health.

Today preventive health management is a personal responsibility, however there is a disconnection in people's desire to stay healthy and their actual behavior. Our main mission has been to explore a Governmental potential for nudging behavior within the health field, because it is a field that needs solutions for preventive initiatives.Thus, bridging the gap between the public health sector and people's everyday lives, our aim is to increase people's sexual health and wellness, as well as the health sector to be economically sustainable.

We have addressed this human-centered challenge with a holistic approach. Through interviews with experts in different fields we found that sexual health is more than just condoms and contraception, it is the interconnecting aspects of everything from social relations to mental health and biological impulses.

An important challenge with sexual health is the culturally embedded shame and stigma that follows the topic. It is present in our society in different levels, and feeling ashamed about sexuality can stop people from addressing sexual health issues. The topic required a deep understanding of behavior and from close collaboration with the target group, we learned that it is the interactions in our daily life that shape our health and influence our behavior and attitudes.

For public health actors to affect preventive behavior they need to be present and relevant in people's everyday life. Could traits and values from social interactions be brought into a public health service?

Our end result is a set of service guidelines and a service concept that exemplifies how the guidelines could manifest. The result aims to inspire a public health actor to create future health services that meet the real needs of the target group in their daily life. The service 6 om dagen is a health enabling service, present in people's everyday platforms, which not only offers the resources people need to stay sexually healthy but focuses on making these resources relevant to use. 6 om dagen challenges existing health services by promoting sexual health as a positive resource in people's life, equal to how nutrition or physical activity is promoted.

We started this service design project with the intention to explore how public health actors could offer sexual health services that enable, engage and empower young adults to be proactive with their sexual health.

Across Europe, the health care sector struggles to keep costs down. With the expanding elderly generation and rise of chronical diseases the public health care sector can no longer stay sustainable. Today proactive health management is a personal responsibility, however there's a disconnection in peoples desire to stay healthy and their actual behaviour.We therefor found it interesting to explore a Governmental potential for nudging behavior, and to explore within the health field, because it is a field that needs solutions for preventive initiatives. Our main mission has been to bridge the gap between the public health sector and peoples desire to stay healthy.

The preventive stage has a high potential to be explored in relation to behavior influencing design. We believe that as designers we have an advantage of addressing these human-centered challenges with a holistic approach. Our explorative process therefor puts the user in the center, aiming to create ideal services benefiting the users needs, and by using design we can make our findings tangible.

The target group

Choosing to work with a target group of young adults (age 20-30), the existing offerings and and initiatives within sexual health are few.

Sexual health is in a medical perspective often related to youth and sexual education in schools. The gap between adolescence and full adulthood is becoming ever wider in time, this implies that people are in a state where they are single longer or have longer or shorter relationships and thus likely to have more sex partners.

We understood early that prevention and sexual health had many aspects besides the medical, and interviewed people with expert knowledge in different disciplines. We got insights into the wide area of paramaters influencing sexual health and preventive behaviour, as well as insight in to the needs of different actors involved. Through workshops and interviews with the target group we got an understanding of how they experience health services today, and found that there's a gap in how the health sector communicates towards its users, and how the users value interactions in their everyday life.

Our main insights concluded in 4 themes:

1. Health is shaped in people's everyday life, a place health services today are not present.

2. There is a high threshold in using existing health services in preventive situations.

3. To tackle shame and stigma, communication of sexual health needs to shift from focusing on the negative consequences to highlighting the positive aspects.

4. Sexual health is closely interlinked with mental health end general lifestyle. Sexual health offerings should include more than medical resources and information to be proactive.

Exploring interventions

Through our ideation process we explored how proactive health initiatives could be implemented in peoples everyday lives, how they can be relatable, and how values and traits from social interactions can be brought into the service.We constructed a service concept that:

-Connects fragmented offerings in to one service.

- Improves the offerings to enable, engage and empower users proactive behavior.

- Reframes how sexual health is communicated from a public health actor.

Changing how it's talked about

Coping with shame and stigma related to sexual health we looked into existing sources of information that meets the target group as well as looking into how society talks about sexuality. The target group is exposed to glossy images of successfull and perfect people that tell you that sex is great and that popular people with "perfect" bodies have sex, on the other side they are exposed to messages that say that sex is sinful and wrong. Public helath actors focus on negative consequences of sex. The target group don't relate to much of this information. Feeling ashamed about our sexuality can stop us from addressing sexual health issues.

There is a need for relatable information from different people and perspectives in order to empower the target group with competence to act in situations of proactivity in sexual health. We asked ourselves; How can we expect sexual health in the general public to be improved when even public actors only focus on the negative consequenses?

We took inspiration from how public health talk about nutrition and physical activity, promoting health effects of eating healthy, showing inspiring recipes etc. Could this be transferred to sexual health?

Creating guidelines In the process of constructing a service opportunity we created brand experience guidelines, including service personality traits, service principles and an analysis of the needs the service should aim to meet.

6 om dagen(six a day)

Using the guidelines for how public health services can affect proactive sexual health we have identified a service opportunity where these guidelines are manifested. 6 om dagen is a public health service that promotes sexuality and sexual health as a positive part of peoples lives, equal to physical activity or nutrition. By being present in peoples everyday life the service offers resources that engage, enable and empower people to act sexually healthy.

One of the service offerings is "Kiss and tell". Kiss and tell aims to build peoples competence to act by offering a space for relatable conversations of emotional, social and physical themes related to sexual health. To find relatable experiences empowers users to cope with relationship issues, setting boundaries, start difficult conversations, negotiate and talk, which also helps to normalize sexual health. The short format of the stories make them easily accessible and engaging. An other offering is the information webpage which includes promotional as well as disease preventing information. The information is realistic and relevant to people and their everyday interactions, and offer diverse and holistic information about all aspects of sexual health.

Conclusion

The end result and project contribution is a set of guidelines and a service opportunity aimed to inspire public health actors to see the possibilities for enabling, empowering and engaging peoples proactive sexual health. We wish that our process and project itself will be used as a backdrop for a wider discussion about proactive intitiatives. We also wish for public health actors to see the opportunity they have to affect societal change by reframing how they communicate the importance of sexual health in peoples everyday life.