Seattle Children’s doctors, Abby Rosenberg and Joyce Yi-Frazier created an intervention called Promoting Resilience in Stress Management (PRISM). This intervention model is designed to teach teen patients resilience – the ability to maintain psychological and physical well-being in the fact of stress – to buffer the impact of serious illness.
The Digital Health team received a request to digitize the PRISM modules in Tonic, a digital intake tool currently leveraged at the organization. Tonic was not a suitable tool for this effort so we partnered with two companies, Artefact and General UI, two premier, local designers and developers respectively. Their services were provided pro-bono as a donation to the hospital, valued at over $170,000. Through this collaborative partnership, a proof -of- concept app was created, digitizing four tools in the PRISM toolkit, to supplement the in-person intervention.
- Increase the impact of the intervention: The digital tool can be delivered to virtually unlimited number of patients, who can use the tool when they need it the most, regardless of the availability of researchers at the bedside. In addition, the partnership aims to reach teens and their families on personal devices when not at the hospital, to coach and nudge them to continue in their practice. We will explore engagement with the curriculum in hopes that the digital interface enhances participation.
- Accelerate our understanding of the effectiveness of resilience techniques in digital environments: Through focus group discussions and user evaluations, as well as analysis of the longitudinal usage data, we will gain clear understanding of the patient experience and the effectiveness of the different training modules.
- Demonstrate that through thoughtful design and outcome focused thinking, technology can augment the impact of the work of researchers, scientists and healthcare providers. In addition we hope to show that digital interfaces like this expand the impact research-driven interventions in hospitals can have on patients across the US and beyond.
Findings & Reach
Duration of Pilot
January 2018-May 2018
Original pilot was targeted for 12 weeks but extended to increase enrollment.
# of downloads
Limited by a cumbersome and lengthy enrollment process requiring manual request and multi-step downloads
Average number of sessions per user
Total number of 114 sessions, many accessed only once, some accessed >10 times.
New vs Returning Visitor
33% / 67%
26 users returned more than once
Median duration of session
From google analytics
- Working with external firms provides areas for growth and opportunity as well as presenting challenges in workflow, adjusting to outside timing, heavy legal involvement and additional layers of communication.
- It is hard to get apps into the hands of teens. Downloads and test flight protocols were a barrier to engagement.
- Paper instructions and multistep processes are a barrier for uptake, we rely heavily on our provider and clinical staff partnerships.
- Collecting feedback to understand engagement via surveys was challenging due to low response rates.
- We had to strike a balance between wanting the curriculum to be widely available while protecting the IP of researchers’ protocols.