The Charity Digital Toolkit

Despite great progress made in the past 10 years or more, digital skills and strategy are still in short supply in the voluntary sector. To help to address this (and following her report on the state and implications of this shortfall last month), Zoe Amar and the Skills Platform have put together the Charity Digital Toolkit:

Building on the success of The Charity Social Media Toolkit, we decided to take a similar approach in giving charities a grounding in fundamentals by sharing expert advice, inspirational case studies and tips and tricks, but we wanted to tackle weighty topics, going in-depth where needed and asking big, challenging questions about what it takes to make digital work. We encourage you to use this toolkit to help your charity take the next step in its journey with digital.”

– from the Introduction, Charity Digital Toolkit

Each chapter provides insight from a range of contributors into different areas of digital trends and know-how, and I was happy to contribute a case study about how my charity, Diabetes UK, introduced Agile working in a very pragmatic way, through development projects such as our main website and – the featured case study – our online Know Your Risk test for the risk of Type 2 diabetes:

  • Foreword – from Martha Lane Fox
  • Chapter 1: What is digital? – from Zoe Amar
  • Chapter 2: Digital leadership – from Louise Macdonald and Simon Hopkins
  • Chapter 3: Digital audience and strategy – from Katie Taylor and Zoe Amar
  • Chapter 4: Digital channels – from Mandy Johnson, Donna Moore, Dave Evans and Jarrah Hemmant
  • Chapter 5: Measuring success – from Clare Bamberger and Matt Collins
  • Chapter 6: Digital fundraising – from Steve Armstrong
  • Chapter 7: Digital governance and risk – from Brian Shortern and Sarah Atkinson
  • Chapter 8: Digital service delivery – from me
  • Chapter 9: Digital behaviour and the future – from Beth Kanter and Paul de Gregorio
  • Chapter 10: Digital skills development – from Jo Wolfe.

The more I reflect on our online Know Your Risk project and our Agile approach to delivering this service through digital, the more I can see that the best way to achieve the digital skills that lead to digital transformation or maturity, and a more effective voluntary sector, is through doing – taking a hands-on approach and involving people across teams throughout your projects and activities.

I would love to hear any thoughts you have on this, or what you’ve tried that has or hasn’t worked, in any area of digital skills for non-profits.

2016 highlights – summer – I *did* walk 500 miles

Summer 2016
– the 1 Million Step Challenge

When I was two months in to the three-month 1 Million Step fundraising challenge that my charity, Diabetes UK, launched this summer, I blogged about my progress on the charity’s blog site and shared some tips with my fellow walkers.

I’m proud to say I did complete the challenge, though it took me an extra week or so to do it! And thanks to the generosity of my family and friends, I raised £230 – 115% of my target.

What it was like to take part

I found it interesting that, even though I had already been tracking my steps for nearly three years, and had taken part in other walking challenges in that time, something about this particular challenge really motivated me to reach the overall target of 1 million steps.It was a significant challenge, since the average UK adult is said to walk only 5,000 steps a day, and my average tended to be 7-8,000 a day.

It was a significant challenge, since the average UK adult is said to walk only 5,000 steps a day, and my average tended to be 7-8,000 a day.

Since I started step tracking in November 2013 it has motivated me to walk more than I ever did before. I find myself taking the long way around where possible, and trying to walk rather than hop on a bus or tube – to the extent that 2014 was the last year that I bought an annual season ticket and from 2015 I started walking as much as possible.

Both my Dad and his Mum had Type 2 diabetes and I know that a combination of this family history of the condition, plus our ethnicity (South Asian on that side of my family) as well as my age and gender mean that I’m at increased risk of developing the condition myself. Those are the factors I can’t change. But the factors I do have control over are my weight and waist size, so making walking part of my day seemed like a good way of reducing my risk of Type 2.

Despite all the health benefits, it can still be hard to make sure you walk 10,000 steps a day, and my average tends to be closer to 7,000. So, seeking some extra motivation, I was really happy when we at Diabetes UK launched our new 1 Million Step Challenge this summer. More cause to walk, while also fundraising for a good cause.

It takes me about 10,000 steps to cover five miles. 10,000 x 100 = 1,000,000 steps, which = five miles x 100, which = 500 miles. Hence “I will walk 500 miles” became my earworm for the summer. (Sorry for passing it on to you too.)

I had a combination of different motivations and practical steps to keep me going towards 1 million. See if any of them could work for you.

I found these practical steps helped:

  • Walk for my whole lunchbreak – and schedule these walks into my calendar so that they’re less likely to get sidelined.Combine it with reading if I’m somewhere safe to walk while reading, like a park.
  • Combine it with reading if I’m somewhere safe to walk while reading, like a park.Can also combine it with writing, if inspiration strikes – I wrote some notes for this blog post while walking in the park.
  • Can also combine it with writing, if inspiration strikes – I wrote some notes for this blog post while walking in the park.I love taking photos and Instagramming, so walking gives me more opportunities to do that.
  • I love taking photos and Instagramming, so walking gives me more opportunities to do that.I’m interested in architecture and the city I live in (London) – and there are always new places to discover.
  • I’m interested in architecture and the city I live in (London) – and there are always new places to discover.If your job permits, try having meetings while walking – a Walk-and-Talk, for those who remember The West Wing – though I must admit, I haven’t tried that one myself yet.
  • If your job permits, try having meetings while walking – a Walk-and-Talk, for those who remember The West Wing – though I must admit, I haven’t tried that one myself yet.
  • Make friends with other Fitbit/fitness tracker users – apparently on average Fitbit users walk an extra 1,000 steps a day for every Fitbit friend they have.

And I had various things to motivate me:

  • The challenge itself provided motivation – to complete a big personal goal – especially one that you have shared with lots of people.
  • Staying healthy, for me and for my family – including improving my chances of avoiding Type 2 diabetes.
  • Fundraising in memory of my Dad, for a good cause and a charity which not only employs me but has helped my family and so many others affected by all types of diabetes.
  • It’s a nice little reward when you get a 1m Step Challenge or Fitbit badge for doing a lot of steps in a day or reaching the latest equivalent distance – such as the Great Wall of China – and it helps you push on towards the next milestone.
  • And it spurs you on when you see how well other participants and Fitbit friends are doing, through the 1 Million Step Challenge website, the Fitbit app and social media.

It was so nice seeing people sharing their steps and milestones on social media. How do you motivate yourself or make walking – or any physical activity – part of your day? Please share your suggestions and experiences in the blog comments, on social media with the hashtag #1millionsteps. It would be great to hear from you.

What it was like behind the scenes

Although we don’t have a formal innovation team or group at Diabetes UK, in recent years we have tried to come up with new ways of providing support and services, and new ways of fundraising to make it possible.

Back in 2013 our then Events Fundraising Manager, Mark Fox, came up with Swim 22, a fundraising challenge where participants swim 22 miles – the equivalent to a Channel crossing – across three months in the relative comfort of their local pool.

Swim 22 has been a great success. Taking the Agile approach that I had introduced, we started with a minimum viable product in 2013 on our main website without agency involvement. Building on the success of the first year, in 2014 we worked with our agency Manifesto to build dedicated sign-up forms, a distance tracker and shareable content such as progress badges, all based on the Acquia platform.

For the 1 Million Step challenge, we were able to go from a moment of inspiration early in 2016, for an event that wasn’t even in our original plans for the year, to build and launch for 1 July. This included registration and recording functionality along with progress badges – again all through Agile, taking the decision to launch with a minimum viable product based on the Swim 22 platform and requiring very little adaptation.

It allowed us to launch another effective fundraising product, supporting our prevention and healthy lifestyle message – with minimal budget and with our comms focused online and therefore with relatively low costs. We have been able to tap into the fitness tracking trend of the past few years, provide a mass participation fundraising event with a low barrier to entry than some sporting events – requiring no specialist equipment other than a pedometer and no facilities other than a place to walk.

Despite a fairly low barrier to entry, all along I have been conscious that despite the simplicity of the concept, the step target could be offputting for people who are less able to walk, so as part of our review and plans for development, I will be advocating different levels of target reflecting different levels of ability and achievement – in the hope of starting and encouraging more people to take their first steps to positive behaviour change.

 

2016 highlights – winter – ‘100 things I wish I’d known about living with diabetes’

While most reviews of 2016 have understandably been dominated by negativity, I thought I’d look back ón some of my professional highlights from the year.

Winter 2016
– 100 things I wish I’d known about living with diabetes

After about nine months’ work, including one pilot run in November 2015, we launched our campaign, ‘100 things I wish I’d know about living with diabetes’, on 15 February 2016.

Crowdsourcing content

It centred around a free book of 100 tips about diabetes that we crowdsourced from people living with the condition. We asked people from our networks and at our events, but the highest proportion of tips came from supporters online. There’s a well-established diabetes online community, which Diabetes UK is an active part of, and we knew they could be relied upon to share some great tips.

But the majority of people in the online community have Type 1 diabetes or are parents of people with Type 1 and we wanted to make sure that all types of diabetes were represented in the tips – or at least the two main types. So I made sure we asked all our email subscribers for their tips too, as I knew we would be able to draw on a wider range of experiences – and again, they didn’t let us down, providing the majority of the tips that made it into the book.

Choosing 100 tips for the book

We were lucky enough to receive more than the 100 we wanted for the book – well over 1,000 in fact. Some were variations on the same tip from several different people. To try to make sure the tips would be useful and suitable to the widest range of people affected by diabetes, the final 100 were selected by our Clinical team and a panel of people living with the condition, with our Brand team facilitating and curating the selections to ensure balance.

We finally managed to whittle down to 100 for the book but selected extra tips that would be used on social media, in follow-up email journeys, in our membership magazine and in other channels. We also enlisted some of the contributors to take part the TV ads we were filming at the turn of the year, to be broadcast from 15 February.

Emails for ongoing engagement

As well as being a key source of tips, we used email to keep in touch with everyone who submitted tips, including extra comms for the selected contributors to keep them posted throughout the months-long process before the book and the campaign launched.

We also planned and created tailored email journeys for five different audience groups, for people who ordered the book and opted in to further email comms.

Testing through a pilot

Our agency, Arthur, suggested a pilot campaign, more limited in content and geographical scope but a way of testing that all of the ad formats, tracking, forms and processes were working.

Initially, I wasn’t entirely convinced this would be worthwhile because it wasn’t a completely representative pilot, and because of the limited time between pilot and full roll-out (made even shorter by the Christmas break) we wouldn’t have much time to evaluate and make improvements. We didn’t run any of the social media marketing – paid or organic – at this stage, and nor did we have the TV ad campaign to promote the book. We did have a plan B ready for social media in case people ordering the book started to share images, share the link to the order form, etc, but we didn’t need to activate it.

In the end, the pilot did prove to be really useful because it helped us iron out any final issues with the mechanics and processes for ordering the books (including SMS for callback orders, straightforward phone orders, and orders through an online form).

It also helped us to check that the triggered email journeys were working and to tweak some of the content in the emails to improve them for the full UK-wide campaign in February.

And it told us that print ads in consumer magazines were way more effective than digital display ads, so we could adjust the media placement for the main roll-out.

But one thing the pilot didn’t prepare us for was quite how much a TV ad campaign, launching in primetime, would increase responses.

An overwhelming response

It was planned to be a four-week TV ad campaign, and with even the most optimistic estimates from our agency, based on outperforming top campaigns with other similar clients, we did a single print-run of the books we felt would comfortably cover the demand and leave a buffer of extra copies.

The pilot, with its more limited reach, followed the expected pattern.

When the TV ad launched during a primetime ITV soap on Monday 15 February, we saw unprecedented demand and took enough orders in the first week to use up all remaining stock.

This meant another print run, a curtailing of the TV ad campaign by about half, and acceleration of redeveloping the order form to include a PDF ebook option (which was orginally planned for the very end of the campaign).

Meeting a genuine need with authentic content

As well as the TV ads, the success of the campaign was also thanks to the authenticity of the crowdsourced content – real, often surprising, tips about living with a lifelong condition, all by people living with that condition themselves – and the genuine usefulness of the tips.

It got a great reaction on social media and elsewhere, with countless positive comments (some of which are captured in this Storify), higher-than-average engagement rates with our follow-up emails (helped by being very tailored to the different audience groups), and very few complaints, even when there were delays because of needing such a rapid reprint. We even spotted a copy on sale on eBay at one point!

It’s a campaign that I was proud to lead the digital comms for, one that I worked on in some form during pretty much every day in the nine months or so leading up to the full launch and which in recent months I’ve also spent time evaluating and planning next steps for.

I was also proud when the campaign won a Gold award and two Bronze awards at the DMA Awards in the autumn.

Diabetes UK won gold for the best healthcare campaign .

We also won two bronze awards, for best integrated campaign and best customer acquisition campaign.

An Agile approach

I’ve been reflecting recently on how my charity, Diabetes UK, has benefited from an Agile approach. I contributed to a blog post earlier this year and then was invited to speak on the subject this month at the School for Social Entrepreneurs, as part of the Third Sector Digital Leaders programme they run jointly with the fantastic Zoe Amar. I also led a session at the Barcamp NFP half-dayer (more on that in a future post too) on the same subject.

We’re well underway with a digital maturity programme to help everyone at Diabetes UK make better use of digital and to expand and amplify what we’re able to do through digital channels; and we have recently moved office and adopted a more ‘agile’, flexible working approach – and designed our new building around it.

Adopting Agile

We’ve been using Agile as our main digital development methodology at Diabetes UK since 2012 – officially. But we were also able to adopt some of the principles a bit earlier than that, to help us solve particular problems. And we’ve been able to use an Agile approach to help the wider organisation develop their digital skills while contributing to digital projects.

Agile by stealth

I think I became aware of Agile around 2010 when we launched our online risk score. Three of the key elements seemed to be:

  • Product ownership
  • User stories
  • An incremental approach/development of minimum viable product (MVP) at each stage.

Although we didn’t have full adoption by the charity at that point, and certainly for the risk score it took a while to agree a product owner (meaning the Digital team was the de facto owner till we did), we were able to develop user stories and make incremental improvements/MVPs. I thought of this as ‘Agile by stealth’ – which worked as a way to benefit from some of the principles while we worked on getting agreement for a more official Agile approach. Because we had user stories ready and waiting, we were able to move quickly whenever small amounts of funding became available, usually through sponsorship, to make the priority improvements and put them live.

Agile in action

I took us fully Agile for digital development in 2012 (although we’ve never been truly ‘textbook’ about it – eg our developers are not in-house and the project team works on multiple projects, not just one sprint for one project at a time – but this still works really well for us and shows you can implement it in a way that suits you). An initial catalyst was having senior management who wanted to see results quickly but wanted to keep tight control over the release of budget. Agile had the big advantage of the incremental approach – which meant gradual spending for gradual, visible improvements.

It also meant we could capitalise on a bigger funding opportunity to improve the risk score – for the short term, to support an outdoor ad campaign, and, for the long term, to make it genuinely more user-friendly and effective as a tool to identify people at the highest risk of developing Type 2 diabetes and to encourage them to seek a medical diagnosis.

Agile as a transformer

A bit later, as part of our new digital strategy, we also finally identified and agreed owners throughout the organisation for our various digital products.

This made the user stories much richer and allowed us to focus on internal users as well as external ones. It also promoted a real feeling of ownership and engagement from the owners – they felt more invested in the success of the product, more conscious of the need to be user-led, more able to get hands-on with analytics and testing, and – crucially – more likely to see the value of finding additional budget to support digital marketing for their product. To encourage engagement it’s important to demystify Agile and show that it’s not just a set of buzzwords but actually a pretty common-sense approach that puts the users first and allows you to identify, prioritise and make improvements that satisfy user needs.

Our small improvements to the risk score from 2010 to 2012 and bigger improvements in 2013 and 2014 were followed last year by the development of an electronic version of the risk score – an app – that could be used offline at our Roadshow events, where we often have no wifi access – but that could push the data to the master risk score database once we were somewhere with a connection.

The benefits of Agile were clear again: although I wasn’t involved in the app project, we had actually had the app (or rather the requirements that led to it) as one of our user stories on our backlog right from the beginning in 2010 – and this, combined with product ownership and a hands-on approach from our Prevention team, meant we could make the case for budget and get moving quickly to launch the app as an MVP, but continue to make improvements as we tested it in the field. It has greatly improved our efficiency and accuracy at capturing data and permissions, providing results (and GP referrals where needed), and providing follow-up information for all opted-in users.

Agile as an enabler

I liked the analogy my brilliant co-presenter at the Digital Leaders event, Amanda Derrick, used to describe the Agile approach – that it is an enabler, like the app her choir uses to monitor their performance and make sure everyone sings in tune. The enabler is key to success but the focus is on the outcome – what we care about – the harmonious singing.

Most recently, we as a charity have also adopted a more agile or flexible approach to how we work, allowing us to create a system and a workplace that helps us work together in a better way. This allows us to sit and work together in project teams and for sprints, as well as providing a dedicated testing room where we can run everything from user research to user acceptance testing, involved internal and external users. And it means Agile is one more aspect helping us to achieve the digital maturity I mentioned at the start of this post.

Are you using Agile?

It was great to be involved in a discussion about Agile with such an engaged group for the Digital Leaders event and I’d love to know how you use Agile, or aspire to that approach, in your own work.

Fitbit, the Quantified Self and behaviour change

My step-by-step guide…

I was introduced to the concept of the Quantified Self in 2013 – a combination of a presentation by a colleague and a BBC Horizon programme called ‘Monitor Me’.

My connection with mHealth goes back a bit further, to when we at Diabetes UK developed a smartphone app called Diabetes UK Tracker, based on extensive user and market research, from 2010 to 2011.

But I didn’t really start tracking my fitness myself until two years ago this month, when I attended an event on behaviour change run by Alcohol Concern but covering a wide spectrum of behaviour change research, programmes and digital tools.

There was a prize for the most engaged participant and I was delighted when my live tweeting and sharing of photos led to me being chosen as the winner.

My prize was a Fitbit Zip. A simple pedometer that clips to your clothing. I had tried phone-based pedometer apps before but the main issue was always how quickly they drained the battery, as well as doubting how well they could really measure our steps, especially when not always on your person.

The Fitbit Zip links via Bluetooth to an app on your smartphone and you simply have to tap it (usually a few times, quite hard) to activate the sync.

To be continued …

The value of user research

Redeveloping the Diabetes UK online risk score – a test for Type 2 risk

In my post about becoming vegan I mentioned how it had helped me finally reach a fitness goal – of reducing my waist size. If you’ve met me you might not think I have a particularly large waist and you might wonder why it was was a goal for me to reduce it – but working for Diabetes UK I’m conscious of really how relatively small your waist size needs to be before your risk of developing Type 2 diabetes is increased. Especially when, as in my case, this is combined with age, family history of the condition, and my particular ethnicity.

There has also been coverage in the press today (31 July) about Public Health England’s report on the relationship between Type 2 and obesity – for example, on the Diabetes UK websitethe Guardian and BBC News online – with a clear emphasis on waist size and belly fat as a measure for Type 2 risk.

Online risk score test, version 1 – mid 2010 to mid 2013

Diabetes UK launched its online risk score www.diabetes.org.uk/riskscore – to test your level of risk of developing Type 2 – on 1 July 2010. Developed with the University of Leicester and the University Hospital of Leicester NHS Trust, a paper version of the questionnaire is used in face-to-face tests at Diabetes UK events. Answering seven questions gives a score from 1 to 47, which puts you into one of four risk levels: Low, Increased, Moderate and High. If you score 16 or above – Moderate or High – we recommend you see your GP for a blood test, with the option for users to be sent an email with a GP referral letter attached.

We in the Digital team at Diabetes UK developed an interactive online version of the tool, with the agency Nonsense, on a small budget, in a quick turnaround time, working closely with the charity’s Clinical team of diabetes healthcare professionals. The first iteration centred around photos and testimonies of real people, each with one of the four risk levels. After answering each question, the user saw a pop-up with a comment from the relevant case study, and their final result was also accompanied by a case study.

As a charity with a limited budget we were unable to make significant improvements to the risk score until 2013, when we received funding as part of charity corporate partnership. In the meantime, I did develop a handful of user stories to inform possible development should funding become available.

Last month the online risk score passed the milestone of 500,000 uses since launch, and on 1 July it reached its fourth birthday, so, with a lot of recent media coverage about the issue of type 2 risk, I thought now would be a good time to blog about it, and what has happened in the year since I embarked on the redevelopment.

Aims of the revamp, mid 2013 onwards

The charity planned a major outdoor and online advertising campaign to help identify some of the seven million adults at most risk of developing Type 2 diabetes. The advertising in autumn 2013 encouraged people to see their GP or take the test online so, we wanted to ensure the test would be effective.

I knew from our initial user stories that we had to update the technology (with the advent of touchscreens, and responsive mobile design) but also wanted to fully optimise the test by understanding how people used the tool and any problems they faced. So we commissioned ethnographic 1-1 user research with current users of the risk score, focusing on the most at-risk C2DE socio-economic groups – taking place in users’ homes, with their own devices.

The testing told us we had to improve the risk score before making it a key part of the campaign. Some changes were because technology had moved on, but most were because of insights into how users in the target groups approached and used the tool. Personally I found the testing results very eye-opening. There were low levels of digital literacy, even if people were using more up-to-date devices such as smartphones.

Our redesign addressed the following issues.

Wrong measurements:

  • Users did not actually measure their weight or waist size – eg giving their jeans waist size, which can be smaller – so the importance of accurate measurements needed to be stressed up front and with each relevant question
  • We saw that this would be exacerbated if using on a mobile device, having just seen an ad when out and about, without a tape measure or scales to hand – so we realised that a reminder for mobile users to re-take the test at home would be useful.
  • Usability issues, especially on touchscreens – eg unable to operate ‘slider’ controls, or preferring to type in values.
  • Some users didn’t realise that the sliders required actual measurements to be input – instead they just chose a position based on a more general ‘low to high’ or ‘underweight to obese’ scale.

The critical issue here is that this under-reporting means that many users would be scoring too low and not being placed in the right result for the risk band (Low/Increased/Moderate/High).

We found it would help if we show users their actual, numerical risk score too – to show how close they are to the next level up or down.

‘Test mode’ vs ‘learning mode’:

  • Users were in ‘test mode’ while taking the test, expecting to be able to work their way through the questions quite quickly without distraction.
  • As such, they weren’t in ‘learning mode’ and tended to miss or ignore the pop-ups, or felt they got in the way.
  • Preferred a simpler, cleaner design for the questions.

Conversely, users expected more information at the end:

  • Disappointed by the promised ‘full report’ just briefly reiterating the score/probability they’d seen on screen.
  • Expected fuller, personalised information at this point (after the test) about the questions and their answers, and what impact this had had on their final result.
  • Also hoping for more information about what to do next – more compelling/urgent, and more practical guidance (what to do, who to speak to).

Sharing or recommending by social media or email:

  • All users thought that this function meant their personal, individual test results would be shared – rather than just a link to take the test.
  • Needs to be clear to the user and the people they share with why it’s important to take the test, how common Type 2 is, how many people are undiagnosed without knowing it, etc – to reinforce the need to test, but to find a balance between highlighting key reasons to take the test (eg ‘you might have one of the risk factors, it’s a common condition, with many people undiagnosed’) but depersonalising it (eg ‘I’m not saying you are overweight’).
  • No-one wanted to share the test before they got their results.They couldn’t see why they would recommend the test – would their friends/family find it offensive – would they be suggesting they were unhealthy/overweight?
  • No-one wanted to share the test before they got their results.

Design:

  • Some users also found the numbering of the screens at the bottom confusing – positioning and design not distinct enough from the main input screens.

The revamp

The main elements of the 2013 revamp were:

  • Responsive redesign, so that the test scales and reformats to suit multiple screen sizes.
  • Introduction of an alert to save to home screen if it senses a user is using a mobile, and offer of a reminder email – so users can more easily take the test when they’re at home, with scales and a tape measure.
  • Cleaner/clearer design for each question screen, stripping away pop-ups of case studies.
  • Improved language on all questions – eg making it clear what counts as a close relative, and giving a wider range of options for ethnicity.
  • Clear emphasis on the importance of taking actual, current measurements of weight and waist size, and not relying on memory, estimation or jeans waist size.
  • Much improved results screen – including:
    • giving a full breakdown of points per question, what the scoring means, and which risk factors can be addressed (eg weight, waist size), which are simply genetic (ethnicity, family history of diabetes) and which will change over time (age)
    • showing your full score in points, as well as which of the four risk bands you are in, making it clearer how close you are to the next risk level up or down
    • reserving the case study content until after seeing your results, instead of throughout the test
    • giving clear links to information on the Diabetes UK website about what to do next to reduce your risk.
    • allowing simple social media sharing but making it clear that only the test, not your results, would be shared.

Results since the revamp

We provide risk assessments in person at our programme of roadshows across the UK, as well as in pharmacies of our corporate partners. This helps us to assess more than 25,000 people each year. And in a typical year, before the redesign, we had between 75,000 and 100,000 uses of our online risk score.

Using digital media for an online version of the risk score, promoted through our email marketing, social media, grant-funded Google Adwords account and through users sharing the tool, helps us to reach at least three times as many people as the face-to-face risk assessments that require more staff and financial resource, and rely on footfall.

In fact, with the success of the redesign we have now reached 300,000 users online in the past year (July 2013 to June 2014) – 12 times as many as we can reach through face-to-face assessments.

We saw immediate improvement in usage, referrals and results following the redesign.

  • Year 1: 100,000 uses
  • Year 2: 75,000
  • Year 3: 75,000
  • Year 4: 300,000 (25,000 pre-relaunch, 275,000 post-relaunch)

The relaunched test saw more uses (30,000) in the fortnight of the ad campaign, than it saw in the previous three months (25,000). We have seen more uses (245,000) in the nine months after the end of the campaign than we saw in the whole first two years (175,000).

Since relaunch, from 275,000 tests, the test has referred 75,000 people to their GPs.

This compares with 28,833 people referred after 175,000 tests in the previous 27 months, and shows the benefits of user-centred redesign, supported by focused audience research, and a boost from advertising.

Significantly, the proportion of people being referred increased from 16.5% to 27.3%, suggesting that the redesign and improved usability reduced the under-reporting of weight and waist size.

Passing the 500,000 mark:

On 10 June the online risk score passed the landmark of 500,000 uses since its launch nearly four years before. This was partly helped by a journal article predicting a large increase in Type 2, covered by the national press, and including a link to the risk score from a BBC online news piece. In fact, on the day, I watched the counter jumping up and up with every browser refresh – so much so, I thought it would be ideal for a quick Vine.

But even without this boost, we were already seeing the residual effect of the campaign and the effect of the redesign, and increased public awareness supported by regular media coverage of the issues.

And by its fourth birthday, with less than a year since the redesign, the online risk score had passed 550,000 uses – doubling the number in less than a year since the redesign, compared with the number of uses in the previous three years+.

User survey results:

We send follow-up emails to users – an average of 2,500 a month begin an email journey to support them in making lifestyle changes.

We surveyed 8,900 people who used the online test in the month following the relaunch:

  • 97% found the test easy to complete
  • 90% found the online experience helpful; just 2% disagreed and 8% were neutral
  • 83% said they would visit their GP; 38% already had – leading to 49% of these being diagnosed with Type 2 diabetes
  • 85% said they would now eat more healthily
  • 81% said they would exercise more.

Next steps

We’re not stopping there – we are now looking at the existing user stories that we haven’t had development funding for before, such as an offline electronic version for use at roadshows and other events, to help address the current issue of timelag between the data passing from point of capture and going into our CRM system for email follow-ups.

And we plan to do further assessment of the follow-up emails after this year’s programme of roadshows is complete.