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The approach in developing design goals and guidelines derives in part from evidence-based practices (EBP) in autism interventions and in design. Instead of strict adherence to an EBP process, modifications were made due to deficit of empirical research on residential environments for adults on the spectrum. The chapter describes the process undertaken in identifying and assembling the range of research that underlies the design goals and guidelines of subsequent chapters. With an eye toward research integrity as well as relevancy, the approach encompassed both empirical research and reflective practice, including the lived experiences of those on the spectrum. The mechanics of the search and selection process is described in this chapter, and further detailed in the Appendix.

The convergence around best practice also opens up opportunities for divergence and conflict within and among the enactment of those best practices. Using a production of culture approach, this chapter traces how AIDS organizations in Accra put best practices into practice, and identifies moments of entropy that emerge when designers produce campaigns. In a field that has converged around the value of incorporating formative research into the design process, organizations make themselves distinct by doing formative research differently. These divergences, namely whether organizations collect categorical or narrative data from audiences, lead them to produce campaigns with what I call “categorical” and “narrative” styles. Different styles produce more or less effective campaigns, undermining the intended goals of AIDS organizations. Organizations incorporate “cultural ombudsmen” into the design process who draw moral and cultural symbolic boundaries around the appropriateness of campaign ideas. Obmudsmen, with their veto power, can squash campaign ideas that designers like best and that have the support of communities, putting the practices of formative research and securing buy-in in conflict. This opens campaigns up to entropy, as organizations put out “lowest common denominator” campaigns that may have less resonance and lack organizational support.

AIDS organizations do not have good measures of the outcomes they want to engender. Without compelling evidence that campaigns are working, organizations invested procedures that purport to make effective campaigns. These procedures, circulated by “best practice reports,” give designers tools to impose order on this complex cultural environment. Through a process of institutional isomorphism, AIDS organizations globally have converged around these best practices, which give organizations a measure of accountability and legitimacy to international donors. Designers on the ground appreciate this move to best practices like making evidence-based campaigns and securing the support of cultural stakeholders. Following best practices gives them confidence that they can to make the best possible campaign and faith that they can predictably shape how citizens understand and act in response to HIV. The global convergence around these best practices has negative consequences as they increase cultural entropy. Investing so heavily in the design process, with a commitment to making one perfect campaign, has left AIDS organizations open to blind spots. For instance, they mostly forego evaluation and miss the ways their campaigns are misinterpreted. By putting their eggs all in one basket, one widespread and unforeseen disruption undermines years of work.