Fotonovelas for health literacy

Fotonovelas for health literacy

Generative research reveals crucial insights about rural, Hispanic users

  • "Fotonovelas for Health Literacy" is an interactive prototype for a bilingual, mobile-first website.
  • I oversaw the entire project lifecycle over six months, including discovery, concepting, prototyping, and testing.
  • The generative research was particularly challenging and is the focus of this case study.


  • How can we better understand the behaviors, attitudes, needs and frustrations of rural, Hispanic immigrants in the US related to devices and internet access?
  • How can we create an engaging and informative digital experience that is accessible to these users?


Develop a high fidelity prototype by completing all stages of the product design cycle, including:

  1. Discovery Research
  2. Concepting
  3. Prototyping
  4. Testing


The Rural Women’s Health Organization (RWHP) has provided health literacy education to Hispanic immigrants and families in rural north-central Florida for over twenty years.

The RWHP's educational products have always been print-based, limiting their distribution.

Some residents experience low technological literacy, limited internet access and mobile-dependent use patterns.

1. Discovery Research

At this stage, my focus was to understand users' experience and their problems related to accessing the internet.

I knew the target users to be the same community served by the RWHP: newly arrived Hispanic immigrants in rural, north-central Florida (Levy County). An underserved population spread across a wide geographic area, I knew this stage of work would prove challenging.

Key actions

  • Set research goals
    • Characterize users’ internet usage, device preference, and technological literacy
    • Determine the appropriate device-size, format (native app or web-based), and styling for a digital solution
  • Conduct user research from interviews and secondary sources
  • Analyze data using affinity mapping
  • Synthesize data by creating user personas

Key findings

  • Hispanic residents in rural Levy County have limited access to internet due to multiple factors: cellular network, data limits, sharing device with other family members, work hours.
  • Hispanic residents in rural Levy County (and nationwide) prefer Spanish language and/or bilingual content.
  • Hispanic residents in rural Levy County generally find the English language as a significant barrier to information accessibility online.

Key insights

  • A mobile-first website was preferable over a native mobile app.
  • A fully bilingual site and interface would increase user engagement for English language learners.
  • A minimalist interface with limited animations and visual elements was preferable to maximize accessibility to users with low technological literacy and limited bandwidth.


  • How to problem-solve recruitment-related issues in primary research

In recruiting participants for interviews, I faced barriers unique to this context and population, e.g., rural isolation, long work hours that limit individuals’ availability, and uncertain legal status that leaves some hesitant to be interviewed.

I overcame this challenge by finding individuals who had worked directly with this community. In one case, I enlisted a colleague, who contacted and interviewed the community member herself. In this way, I got a far more precise understanding of the problem than if I'd relied on secondary research alone.


2. Concepting

At this stage, my approach was to narrow the scope of the project.

Key actions

  • Create a journey map for each persona, ideating features and interactions to solve the persona's problems
  • Develop user flows around two user stories
  • Conduct card sorting session to inform site map
  • Create site map for initial wireframes and prototyping


  • Not all desired features that emerged in Concepting could be included in the prototype.

Ultimately, not all of these were necessary for the minimum viable product. That said, they will make great updates in a future iteration.


[Include user stories, user journey, site map]

3. Prototyping

At this stage, my approach was to build prototypes of increasing complexity that could be validated in usability testing.

I’ll admit I was initially quite intimidated, having no prior experience with user interface design or design software. That said, I was tremendously proud of the growth I made: from sketching paper wireframes on butcher paper to a fully interactive prototype in Adobe XD.

Key actions

Create low-fidelity paper wireframes

Create mid-fidelity wireframes and prototype

Create high-fidelity prototype in Adobe XD


It's easier for me personally (as a left-hander) to use markers and draw oversized wireframes on butcher paper, as opposed to scribbling in pen/pencil on notebook-size templates

It's valuable to be knowledgeable in multiple design tools, as Adobe XD afforded interactions unavailable in Figma (my preferred platform).

4. Testing

At this stage, it was time to validate my designs and I was eager for the feedback.

Key actions

Design usability test and script

Recruit and schedule participants

Conduct remote usability testing

Conduct preference testing

Analyze results in usability testing report

Modify final prototype based on recommendations


  • Plan ahead to allow for complications related to recruitment, scheduling

Initial recruitment challenges were now complicated by the onset of COVID-19. I opted for remote testing, and I reached out again to secondary contacts to widen the pool beyond hard-to-contact primary users.


[Insert spreadsheet, severity analysis]


My prototype includes:

  • mobile-first design pattern;
  • fully bilingual site design and UI elements;
  • integrated audio narration built into UI, for accessibility to low-literacy users

See the final prototype in Adobe XD here.

Next steps

The best upgrade for this project would be additional features and functionality that serve to build community, for example:

  • buttons for sharing to social media;
  • an ability to add comments;
  • a calendar of community events,
  • a searchable database of local organizations and resources


  • Understanding the problem is the most important stage in design.

Primary research was difficult and labor-intensive. If I had settled for desk research alone, the problem would have never been accurately defined. And a solution cannot exist in isolation of the problem.

  • I have a lot of relevant non-UX experience (surveys, interviews, qualitative analysis - as a research coordinator) that is directly applicable to user research and analysis.

That made the work intuitive and immediately enjoyable.

  • In visual and user interface design, ‘perfection is the enemy of progress.’ Becoming overly focused on UI elements is time-inefficient and makes it harder to be flexible when changes are needed.