designing for pediatric adherence and asthma - medicinex 2012 @stanford university - rouja pakiman...
DESCRIPTION
Background Having a child with a chronic condition like asthma is a struggle for any family. Initially, parents feel unsure, overwhelmed and scared. Over time, they express to feel worn out and frustrated. On a daily basis, adhering to the nebulizer treatments is the biggest challenge. Children don’t like the nebulizer treatment and fight it. Parents know how important it is for their child’s health and insist. Children perceive having to sit still and do the nebulizer treatment as punishment, especially while their siblings are free to play. Also, children perceive the 12-minute treatment as much longer. To the surprise of his mother, a five year old boy in Arizona, announces that it takes “an hour and a half”. We believe that design has the power to turn these daily fights into nurturing moments for parents and children to achieve maximum benefits of the nebulizer treatment without putting the relationship at risk. Approach Eight technology-savvy families with at least one child with asthma participated in the qualitative research explorations. All children were between the ages of 5 to 11 and had been diagnosed with asthma at least 3 months prior. Ethnographic research allowed us to gain deep understanding of adherence challenges around nebulizer treatments carried out at home. Remote participants submitted images of in-home treatment and shared their stories about adherence challenges over the phone. Synthesizing the findings into a design framework and design principles inspired the development of prototypes. Children and parents explored the prototypes in multiple iterations and provided feedback for improvements. The interactive storybook reframes the children’s relationships with their breathing mask. Using augmented reality technology, children enter a magical world by putting on the breathing mask. Interacting with the screen wearing the magical mask, the child feels empowered and engaged. Storytelling prompts invite parents to participate. Markers on screen that activate ‘quests’, create a meaningful role for parents to contribute to the storybook. Being part of a treatment session, takes the pressure off parents and puts them on the same team as their child, rather than working against each other. Conclusion Young children rely on their parents to drive adherence. Yet, children have little say and experience current treatments as something that’s being done to them, rather than done together. So their only choice is to throw a fuss and make it difficult for their parents. In response, parents take on authoritative roles which makes them uncomfortable and puts their relationship with their children at risk. The interactive storybook prototype is not the silver bullet for adherence in children with asthma; however, it addresses adherence challenges to the nebulizer treatment turning daily struggles into nurturing moments for parent and child.TRANSCRIPT
MedicineX, Stanford September, 28-30, 2012
Rouja PakimanMFA User Experience & Interaction DesignCalifornia College of the Arts
Lucie RichterDesign Research, Senior LecturerCalifornia College of the Arts
Designing forPediatric Adherence & Asthma
The Reality for Millions of Children, Every Day
Families Struggle Adhering to the Prescribed Treatments
Asthma Prevalence*
20% ER visits
13 Million missed school or work days
Annual healthcare costs: $50 billion**
Annual costs per person: $3,259
* CDC, Vital Signs: Asthma Prevalence, US, 2001- 2009** Cost of asthma management in children & adults combined
The Adherence Loop, IDEO 2007
believe
knowact
reinforce frame
prompt
Facilitated Adherence in Pediatrics 2012
believe
knowact
reinforce frame
prompt
The Nebulizer Experience
How might we as designers... get parents and children to adhere to the daily nebulizer treatment?
The CurrentDaily Nebulizer Experience
The childfights back
... but then gives in & gets board
Design Principle->Engage the child
Parents struggleto love theirfighting child
... but they empathize withtheir child
Design Principle->Create Positive Family Dynamics
Parents feelguilty of torturing their child
... but do it to provide good care
Design Principle->Assign a meaningful role to the
parents
Design Principles 1.0
Engage the child
Create positive family dynamics
Assign a meaningful role to the parents
Ideate, Prototype, test, Iterate
Probe A Role-play to engage the child
In which scenariosdo people use masks outside of medical
treatment?
Immersive Role-play Experience
In which scenariosdo people use masks outside of medical
treatment?
Immersive Role-play Experience
-She wanted more accessories, scenes and set-ups
-He wanted more action and challenges
Augmented Snorkeler and Astronaut
Role-play works... but
how might we make it sustainable?
how might we involve the parents closer?
Storybooks
Families already have storytelling sessions
Interactive Role-play Storybook
Tom Swift: A good match
Tom is an astronaut while his nebulizer becomes his space
Tom Swift Testing
Feedback
Iteration Discovery!
Series of small studies to enhance role-play experience
The plastic mask: the most intimate part of the experience
Even a princess can have asthma!
Storybook credit: Sue Redding
Text appears in the presence of the mask
Text appears in the presence of the mask
The mask becomes the child’s magic wand
Probe B
Family Storytelling
Parents Participate
Parent’s Participation Triggers Quests
Discoveries During Prototyping
From role-play concept to storytime
From focus on the setting to creating a relationship
between the child and the mask
From parents watching the child to parents taking
the seat next to their child
Magic Mask: not a silver bullet in managing asthma
Design Principles 2.0
Engage the child
Create positive family dynamics
Assign a meaningful role to the parents
Design a sustainable program
Fit into family lifestyle
Build a relationship between the child & the device
Next ...
Q A&