Focusing on what people need, not what the organization needs – A case study of the Norwegian Cancer Society

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Summary of results

As a result of focusing on people’s top tasks (what people really need) and helping them to do what they needed to do as quickly and easily as possible, the Norwegian Cancer Society has seen a:

  • 70% increase in one-time donations
  • 88% increase in monthly donors registered
  • 164% increase in members registered
  • 348% increase in incoming links
  • 80% increase in visitors

The need for change

The Norwegian Cancer Society (NCS), a non-profit organization, used to have lots of content on its website that was very long and detailed. However, “a lot of the content failed to answer peoples’ most important questions,” according to Ida Aalen, senior interaction designer at Netlife Research. “For example, an article about colon cancer began with a long-winded explanation of why you have a colon, rather than answering the reader’s immediate questions relating to cancer.”

“The website was not prioritized and was difficult to navigate,” Ida continues, “partly due to the fact that as many as 45 people had access to publishing on the website. Nor was there an overall strategy for their website.” These 45 people had produced over 5,000 pages.

“We had known for a long time that our old website was outdated,” Beate Sørum, Digital Fundraiser for the Cancer Society states. “We knew that it was not prioritized, overgrown and unruly. It had become this maze where you navigated deeper and deeper into the site, losing track and never really finding what you were looking for. This had been recognized for years, but it took some time for the organization as a whole to mature to the idea that we didn’t just need “a new design” – we needed a whole new structure, strategy and way of managing a website. We knew it would be hard work and a few battles, and so we chose to work with Netlife, who we knew would give us what we needed – not what we wanted.”

Peter Drucker once said that all organizations are basically the same, whether they be armies, churches, non-profits or commercial organizations. It’s certainly true that in working in web consulting for almost twenty years, I keep seeing the same problems coming up again and again in non-profits, intranets, commercial websites, government websites, etc. These time-honored, constantly recurring issues can be summarized as follows:

  1. Content that doesn’t address customer tasks but rather focuses on unnecessary context and/or on organizational needs.
  2. Distributed publishing that results in poor or no editorial oversight and a constant flow of silo-based, organization-focused content.
  3. Websites that get worse over time because, while they have processes to publish new content, they rarely have processes to remove old and out-of-date content.

Defining a clear vision and strategy

Together with the top management at the Cancer Society, objectives, key performance indicators and target groups were identified. After much collaborative discussion involving all areas of the organization, the following concept was adopted.

Often when people ask Google their cancer-related questions, the answers they get are not trustworthy. “What does the diagnosis entail?” “What are my chances?” “How do I avoid getting the same disease as my mother?” The answers exist, and behind the statistics, white coats and bureaucracy are human beings who are willing and able to help.

Knowledge kills fear. The Cancer Society website is a natural authority in the field. People get verified and understandable answers. It is not a faceless institution, but rather a community of competent professionals with names, faces and answers.

The basic strategy was to organize and design around people’s top tasks using the Core Model approach(see Appendix 1). The Core Model is a method for prioritizing content and navigation based on customer top tasks and the organization’s business goals.

The next step was to carry out a top tasks analysis using the Customer Carewords method. This involved a significant period of research where every key task of the target groups was collected. These groups were then asked to vote on what was most important to them. The top tasks of the target groups were:

  1. Treatment
  2. Symptoms
  3. Prevention
  4. Research

The tasks that were at the bottom of the list included:

  1. Donations
  2. Gifts
  3. Annual report
  4. Press releases

The top task of “treatment” got as much of the vote as the bottom 22 tasks. A clear league table of task importance had emerged. What was very obvious was that making a donation was not a top task for people who visited the website. “As a digital fundraiser, I was quite frustrated at fundraising not even being an outspoken goal for the website,” Beate states. “But I am amazed at how well everything has worked out, working contextually to get donations. We have to be very aware of what situation people are in when we present them with a request for a donation.” In trying to get more donations, the traditional marketing approach would be to give much of the space on the homepage over to asking for donations. And in fact that is how the old homepage looked, as we can see from the following image.

clear- vision-and-strategy1

The approach the new Cancer Society website takes is very different. It now focuses on helping people get the type of information they need (treatment, symptoms, research) as quickly as possible, as we can see.

clear- vision-and-strategy2

This is true customer-centric design—putting the needs of the customer front and center. Then, in appropriate places, such as on research pages, there were carefully phrased calls to action. As we can see from the following image, there are appropriate calls for support and donations in the right column.

clear- vision-and-strategy3

“It is interesting to see just how little impact the front page has on donations,” Beate says. “The previous page had two large banners, more visible donation menus/options and frequent “news” asking for donations – and yet donations are now doubled after we removed all this from the front page. This proves how well the Core Model, and giving people what they came for first, works. It is much more effective to have asks in relevant content, than to interrupt people with banners and donate now-buttons, when they are really trying to accomplish something completely different.” The whole area of making a donation was also completely redesigned. “Where our old website had all the ways of supporting us presented with more or less equal importance given to each,” Beate explains, “for the new site we chose ONE method of supporting to be on top. The task that you most likely came to these pages to do.” The old site had lots of competing calls for donations.

clear- vision-and-strategy4

The new site prioritizes one donation message.

clear- vision-and-strategy4

As Ida sums it up, “For the Cancer Society, asking a person who is afraid they might have lung cancer, to “please donate” might be inappropriate or even rude. But asking someone who is reading about research on lung cancer about donations, makes a lot more sense. If somebody thinks research is important, they might be susceptible to donate to cancer research.” It’s all about understanding the context of the task that the person is trying to complete.”

It works for banks too

The ideas we’re talking about here are not simply for non-profits. They work for all sorts of organizations. For example, Norwegian bank, Sparebanken Sogn & Fjordande used to have a classical bank homepage. It was full of images of smiling faces and marketing offers. But it knew that its customers had problems logging in. So, it decided to do something radical. It stripped its homepage of all marketing. (It also deleted 50% of its content.) Then, in the center of the homepage, it placed the login. After a customer logged-out it did, however, present a single marketing offer. What happened? Visits to its product pages rose by 520%.

Collaboration: building bridges across silos

Another key to success was that the solution was developed based on Netlife Research’s highly collaborative and interdisciplinary approach (see Appendix 2).

Historically, the Cancer Society worked in silos. It wasn’t that people didn’t want to collaborate. It was more that they were often unaware of what other colleagues were doing. “A specific example of where there was a lack of collaboration in the old website was skin cancer,” Ida explains. “In the “about cancer” section you could read about skin cancer, but the section about “prevention” also had pages about what skin cancer was. And neither of these linked to each other.” This, of course, led to duplication, confusion and content bloat.”

In the new website, if you read about lung cancer, for example, you find links to “heredity” and “gene variants” from other parts of the website “This way,” Ida states, “there’s no longer a need to explain about heredity or gene tests for every single cancer form that might have some hereditary factor.”

This allows the page in question to really focus on the specific task. So, if you want to know about symptoms for breast cancer, the content gets straight to the point.

This approach reduces not only the number of pages (pages have been reduced from more than 5,000 to approximately 1,000.) but also the amount of content on each page. It allows for much greater focus. The content gets straight to the point. Often, web content gets cluttered with general and related information, which means that the specific concrete information the page promises to be about can get lost.

Governance is key

For collaboration to be successful it needs a management model. “The new management model, where it is clearly stated that the whole editorial board is responsible for the entire website really helps collaboration” says Marte Gråberg, web editor for the new

The old distributed publishing model allowed 45 people to independently contribute to the website. Now, six people oversee and control the site. “Making this shift has not been easy,” Marte states, “even though everyone is on board in principle. Making a big cultural change takes time. Losing old habits takes time. This is why it is of crucial importance that we have a document, signed by management, stating what the goals for the site are, and the management structure for the website. This is our go-to-argument whenever someone wants something on the page that isn’t necessarily a good idea from a content point of view. It is what gives the web managers the authority to even have the discussion.”

“It is a huge cultural change to start working like we are now doing. We’re not there yet, but we are so far down the road that we know we won’t turn back. We can see the Key Performance Indicators, so we are now proving worthy of the trust we were initially given on faith. Everyone wants the new site to succeed, and not grow into the mess the old one was.”

Here’s the organization chart for the new model.


The professionals on this team:

  • have overview of all content
  • know people’s tasks and goals
  • work in a collaborative and interdisciplinary manner
  • know their field and know how to write for it

“The departments no longer own the content,” Ida states. “They’re sources.” For many years, distributed publishing has been the preferred model for website management. Give control to the department / author, the thinking went. They know their own content better than anyone. Distributed publishing was also cheaper because you didn’t need a central team. In other words, you didn’t need to hire professionals.

However, distributed publishing can have major weaknesses, for example:

  1. It can result in silo-based publishing and thinking. There is no overview of everything that is being published and this leads to organization-centric writing and duplications as different silos create the same content.
  2. Many content authors like to publish their own content. This can result in a content explosion that results in confusing navigation and search. Also, as the site grows bigger it becomes harder to manage and review.

The new model is very much focused on quality, not quantity and on cross-disciplinary collaboration. “If people want to add something to the website,” Ida states, “they need to write down their answers to the following five questions, and the web editor and her 5 colleagues need to agree with these answers for it to be published.”

  1. Who’s the target audience?
  2. Does this content cover some need or task for this target audience? Which?
  3. Does this content cover a strategic goal for The Cancer Society? Which?
  4. Describe how you imagine this content will be found and used by the user.
  5. Why is the website the right channel for this content?

Collaboration across functions / disciplines is key to maintaining content quality and ensuring that a focus on people’s needs are kept front and center in everyone’s thinking. Duplicate content is greatly reduced because the team is constantly discussing what they are doing and sharing ideas and insights. There is now a holistic view of the website, rather than the old silo-based view.

If there is one lesson to be learned from the Cancer Society’s success story it is the benefits of prioritization, and this is never truer than when it comes to the mobile experience. As Ida says, “the small screen forces us to prioritize.” And this is a very good thing. After you have created your mobile environment you then ask the hard question: Well, if this is what we need for the mobile experience, why do we need this extra stuff for the non-mobile experience?

Continuous improvement, not launch and leave

A good website is never finished. There is always something to do so as to optimize it in order to achieve maximum performance. “After first launch we’ve already revised two of the donation forms quite heavily, “Beate states. “We are constantly monitoring numbers and Key Performance Indicators, and improving everything even more, bit by bit.”

“As for the content work, improvements are a very high priority to our web editor” Beate continues. “We have revised almost every page on the site in the last year through her guidance and focus. And I don’t mean check that the page is updated – I mean really worked on them, as a team, where one week we’d all be working on the cancer form pages. This means that people who have no clue about medical language and jargon would revise those pages. That way we can weed out jargon, complicated medical terms; things that are hard to understand for the average person. The overall content improves too, as we identify and remove each other’s bad habits, and pick up each other’s good ones.”

They can spend this quality time on improving the content because:

  • They now have 1,000 pages to manage rather than the previous 5,000. The website is actually ‘manageable.’ The management is done by one fulltime editor and 6 others who dedicate a minimum of 25% of their time.
  • They are working collaboratively and—more importantly—in an interdisciplinary manner. Staff are getting out of their silos. They are getting regular feedback from others who are not part of their particular team. And they themselves are giving regular feedback to other teams.

The metrics of success

The Norwegian Cancer Society’s overall objectives are to:

  • Decrease the number of people who get cancer
  • Increase cancer survival
  • Ensure quality of life for cancer patients and their friends and family

The website is now truly helping them achieve these goals:

  • Funds by donation have increased, allowing for more cancer research.
  • More researchers apply for funding.
  • More people find trustworthy, authoritative and easy-to-understand answers to their questions about cancer, regardless of the device they use.

Here’s a sample of some key metrics:

  • 70% increase in one-time donations each month
  • 73% increase in total donation sum each month
  • 88% increase in monthly donors registered each month
  • 164% increase in members registered each month
  • 348% increase in incoming links
  • The number of people visiting the website in August 2013 was 90,000; up from 50,000 in August 2012.

The Core Model

Are Gjertin Urkegjerde Halland, Senior Information Architect, Netlife

The Core Model is a process for prioritizing content and navigation based on user tasks and business goals. A core is a page, component, or navigation flow that is the optimal way for someone to complete prioritized (top) tasks, and one or more defined business goals. It’s important to note that a core does not have to be a page. It could be a navigation path or flow, or a YouTube video.

A core can connect with offline channels like phone or an invoice. The important thing is that we focus on the customer task and the business goal, rather than the format or channel. We measure success based on whether the customer task has been completed and business goals have been achieved, not on whether the page, video, etc., has been launched. In other words, we measure outcomes, not inputs.

Before you start with the Core Model you have to define and prioritize user tasks and business goals (usually using Customer Carewords or similar methods). Based on this analysis we connect tasks to goals and prioritize which core areas to work with. We work in interdisciplinary groups (usually with the customer) seeking to find the best solution for one core area at a time The main focus of our work is to solve the user task.

Once the task can be completed simply and quickly, we then look at what forward/outward paths naturally connect to the core. Are there related tasks? Are there ways we could help fulfill other business goals? Obviously, we work carefully not to add anything that would interrupt the user’s ability to complete the core task.

Next, we work on inward paths – how will/should people access / find our core task pages? Once that core task is working, we move on to the next core task, and so on. Finally, we examine how the core tasks relate to each other, and how we can create a unified design.

The benefits of the core model are:

  1. It allows for creative approaches to content-driven design: What solves the task/goals best? A text page? A video? An infographic? A web form? Etc.
  2. It allows for novel approaches to navigation, findability and getting links from external websites. Where are the users when an information need / user task arises? What are their mental models? How can users access our core pages? Through the homepage? Through our menus? Through Google? Through social networks? Through a URL on a physical invoice? Etc.
  3. It promotes a holistic and cross-channel approach to website development.
  4. It helps organisations stay focused on prioritized user tasks.

The Netlife Interdisciplinary Approach

Ove Dalen, Knowledge Manager, Netlife Research

We are organized into four different teams here in Netlife. Each team is self-sufficient in delivering digital solutions to our clients. Each team has roughly 10 persons each of whom manages several projects. These are the disciplines and roles covered in each team:

  • designer
  • user research
  • content
  • project manager
  • interaction design
  • front end development

One person can cover several of these roles. For instance some of our designers are also good at interaction design. And some of our best people at content are also good at user research.

We have different types of expertise: writing, typography, user knowledge, interaction, illustrations, form designs, pictures. We combine each of these to create digital solutions. At the heart of our method is an iterative approach to problem solving. Our teams solve problems together, in increments—not in stages where different disciplines ‘solve’ the problem and hand it over to the next discipline. We have found that this approach creates the best solutions.

Our projects are streamlined in a three step process:

  • Analysis
  • Concept
  • Design

Every step is inter-disciplinary. Designers do brand analysis; interaction designers do user research, and so on. In the design stage (and remember, design here is not only visual, it´s also content and everything that entails) everything is put together in a HTML-prototype were everyone, both graphical designers, content professionals and interaction designers contribute and work together to create the end product.

Gerry McGovern

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Norwegian Cancer Society
Netlife Research

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