Working in partnership with Cincinnati Children’s Hospital Medical Center (CCHMC), the Business Innovation Factory (BIF) explored preterm births in Cincinnati. With a laser tight focus on Avondale, CCHMC’s home and community, we wanted to understand the human factors that contribute to the inexplicably high rates of preterm births — babies born before 37 weeks of pregnancy and design solutions to reduce the trends.

Design Challenge

How might we lower the rate of preterm births in Cincinnati by better understanding women’s experience with pregnancy and designing new human-centered models for intervention?

In 2013, Ohio had more preterm births than any other state in the Union. Hamilton County — which is home to some of the best medical resources in the country, including CCHMC — ranks higher than any other county. By understanding why this is happening, we can use this understanding to change the outcomes through valuable human-centered solutions.


We conducted 16 two-hour, in-home interviews, including a self-documentation activity, with women in order to understand their attitudes about pregnancy and to uncover the values, beliefs, and motivations that guide and shape their behaviors. We interviewed a dyad of dads to understand how men experience and influence parenthood and their partner’s pregnancy. We also interviewed 19 community stakeholders — representatives from the healthcare industry, from community organizations, and faith based organizations. We hosted six community writeboards at popular neighborhood spots where community members contributed their thoughts on two questions regarding pregnancy. Throughout our research process, we vetted findings through community critiques — our sounding-board included mothers from Avondale as well as professionals from the medical, design, and research industries. Finally, we hosted a Participatory Design Studio with moms and stakeholders, to use our collective talent and capabilities to shape our insights and opportunity spaces into concrete concepts for transforming pregnancy outcomes.

Impact Statement

BIF identified four insights that have shifted the lenses of leaders of the StartStrong team, (the Cincinnati initiative to lower preterm births) and developed 10 solution concepts that have high potential for improving pregnancy outcomes. We’ve provided the models and methods for StartStrong to test these concepts; they are currently prototyping and testing three in the real world. BIF is always looking for further opportunities to use our insights and concepts in other real-world contexts to transform the health and wellness experience of families.