NEAT-O

Creating an Experience Strategy That Comes to Life

What is NEAT-O?

NEAT-O is a digital Cognitive Behavioral Therapy (CBT) program tailored for individuals with opioid use disorder (OUD) and concurrent anxiety or mood disorders.

What’s the problem?

Professors at the University of Minnesota (Anker/Rinehart Labs) are creating an mHealth application using an empirically supported CBT framework, and they needed support proposing a patient-centered strategy for the experiential design of the app. They have the framework and modules of content that will be incorporated into the app, but they need to better understand the value and use the app will bring to individuals with OUD. Furthermore, they want to visualize how the app will be incorporated into the lives of the individuals using it and the impact it may have on their care experiences and outcomes.

The Challenge

Creating an experience strategy for a digital therapeutic and visualizing how it comes to life

My Role

Served as UX Researcher and UX Designer - supported by a team of UX researchers and designers at various steps throughout the project.

Team

Liz C. and Abdi I.

Research Deep Dive (team)

Strategy Statement (team)

Guiding Principles (team)

Experience Strategy Map (team provided input into content; Liz created the map)

System of Prototypes (Cassie and Abdi created individual prototypes and are identified in the design section)

The Methods

What we did…

Our time to complete this project was short, so we needed to first start with a stakeholder interview to align on the realistic goals of what we could accomplish in the time we had, and to also outline what’s out of scope (i.e., it’s not a silver bullet). We learned that the module content for this digital mHealth app was completed, and a primary goal of theirs was to map out the experience that someone may have when using the app (when it’s up and running). They also wanted to be able to visualize what this experience may look like.

Not really knowing much about digital therapeutics, we needed to deep dive into relevant research. We split up research articles and created a shared Googledoc to generate our research findings.

Key findings from my research on existing mHealth apps:

  • include communication option between individuals using the app and healthcare professionals

  • take into account health literacy and accessibility

  • gain trust

  • 10 new heuristics were outlined specifically for mHealth apps

Shared google doc with my findings from article reviews

From there, we were able to outline and agree on a strategy statement and guiding principles to stay within the scope of the project goals. We referred back to these frequently to ensure we continued to stay aligned on the goals throughout the project.

Strategy Statement

All user experience touchpoints for NEAT-O will help individuals with opioid use disorder and co-occurring anxiety or mood disorders to feel supported and empowered so they are able to effectively manage their recovery journey and improve their quality of life. We will do this by focusing on personalized therapeutic experiences and comprehensive progress tracking.

Guiding Principles

Adhere to the old and new heuristics for design based on research that identified 10 new mHealth app heuristics.

Use intentional and compassionate language in our copy, reflecting correct & current terminology for those experiencing OUD.

Remember who the individuals with OUD are and keep their experiences in mind when walking through steps in the app.

Design Experience

Once we established the guiding principles and strategy statement, we were ready to start thinking about the steps individuals would go through while using the app, and mapped it out to make sense of it. We wanted the experience to start from when the person first heard about the app (e.g., while attending outpatient treatment) until they were completed with the modules as this would help us to think about the overall experience versus someone just going through the steps of the app. I came up with stages (ranging from pre-contemplation to action) when thinking about the mindset someone would be in if they were contemplating using the app all the way to taking action and deciding to use the app.

Because the app hadn’t been created yet, my team honed in on visualizing the screens and experiences users would encounter, including receiving notifications, visualizing the home screen and module screen, and visualizing how the screen may look when users are monitoring progress of module completion. This would give stakeholders a visual of how the screens could look.

Mapping out the experience

Honing in on key features users would experience using the app

My team decided it would be best to split up tasks due to limited time we had on this project. So, Liz took lead on the experience map (below) to visualize various touchpoint an individual would use, and Abdi and I split up screens we would design. I chose to complete the design for notifications someone would receive on the home screen, and also the design for how progress would be monitored. See the next section for the design.

Figure 1: Map generated by Liz with input from Cassie and Abdi.

The Design

System of Prototypes…

When designing the home screen notifications, I first wanted to ensure that privacy was taken into account. To address this, I decided the general app name that would be displayed on the home screen when someone receives a notification would be ‘mHealth.’ There wouldn’t be any words or phrases that would indicate mental health or substance use. Second, I wanted to focus on motivational notifications as positive reinforcements to indicate a benchmark that was completed. Different badges sent via notification would indicate the completion of a module, and a motivational phrase or statement would be sent as individuals progress through the program (e.g., “Nice job completing module 1 yesterday!”). Along the same line of providing positive reinforcement statements/symbols, I decided it would be helpful to have a notification reminder of when someone wants to start a module for the day. Essentially the thought is that we all are all busy with daily activities, and reminders serve as a way to keep us on track with the goals we set for ourselves.

I also wanted to think about other ways someone could receive notifications, especially if they weren’t logging into the app to complete their work within a specified time frame. To address this, I decided the person would receive an app notification that they received an email from their care provider. Stakeholders can consider the time frame someone would receive an email if they haven’t logged into the app (e.g., email is sent after 24 hours of someone not logging into the app) after a certain time frame.

Figure 1: Annotated prototype of home screen notifications

Moving onto the design for the module progress screen, I wanted this to have visual and written cues for progress that was completed by the person. If a module is completed, the status bar will be filled and the module marked completed. Likewise, if a module has yet to be started the status bar won’t be filled in. If a module is in progress, the status bar will indicate the progress completed combined with the percentage.

Figure 2: Annotated prototype of module progress

Figures 3 & 4: Abdi’s home screen and module screen

Conclusion & Next Steps

Conclusion…

NEAT-O is a digital Cognitive Behavioral Therapy (CBT) program tailored for individuals with opioid use disorder (OUD) and concurrent anxiety or mood disorders. To help visualize this app coming to life, we ideated a series of experiences (from the time a person first heard about the app to completion of the modules), and touch points were mapped out based on how we viewed an individual going through the content in the app. To go a step further, specific touch points were honed in on and made into annotated prototypes to provide a visual to the stakeholders including: a person receiving notifications from the app and what the notifications might be, how progress is monitored and seen, what the module screen might look like (option to listen to content or read content to improve accessibility), and what the home screen could look like. All of the prototypes were guided by the principles we outlined at the start of this project.

Next Steps…

  • Further research is recommended to determine the types of notifications that are helpful to individuals. Specifically, what notifications are most motivating and what is the frequency of the notifications (e.g., at what point are too many notifications counterproductive and then decrease motivation).

  • Usability testing is recommended to determine the app’s ease of use, especially through the steps of each module.

  • Trust may play a role in whether or not someone is willing to even download the app. Further research should be conducted to target how trust is gained from individuals who are skeptical about using a digital therapeutic and how this will be addressed.

  • Further research should target an individual’s health literacy prior to them using the app. Specifically, who or what system is providing information about the app at the start? I think about someone who may be seeking help for the first time and they are introduced to this app by their primary care physician who may not be an expert in OUD. What is the script or information that is given to individuals on the app’s purpose, how it works, what they can expect, and how it incorporates into their overall journey to sobriety (or reduced use - harm reduction).