User experience (re)design and evaluation of a self-guided, mobile health app for adolescents with mild Traumatic Brain Injury

Abstract

Mild Traumatic Brain Injury (mTBI) is a significant cause of morbidity for adolescents. Currently, there is a lack of evidence-based interventions to address common sequelae of mTBI. To address this gap, we designed a program to promote recovery for adolescents following mTBI. Preliminary testing of the Self-Monitoring Activity Regulation and Relaxation Treatment (SMART) program demonstrated good usability but indicated a need for modifications to the program. The SMART application was redesigned with the addition of more interactive and gamified components. Content was also reframed to specifically target and engage adolescents with mTBI. We describe the usability evaluation of the updated SMART application. Children aged 11-18 years diagnosed with mTBI who were 1 to 6 months post mTBI were recruited to participate in a 1-2-hour usability session in which they thought aloud and responded to targeted usability-related questions during their interaction with the SMART program. After completing the session, participants rated their usability experience using the System Usability Scale (SUS) and rated the overall user-friendliness of the program. Participants' responses during the session were qualitatively coded and analyzed. Six adolescents participated in a usability session (average age = 13.7 years). On the SUS, participants rated the program as highly usable (M = 85.6, SD = 3.24). They also had overwhelmingly positive feedback regarding the content, design and structure of the program. Overall, findings suggest that the redesigned SMART program was usable, acceptable, and relevant to adolescents with mTBI. Based on adolescents' feedback, additional modifications were made before the program undergoes efficacy testing.

Keywords: adolescent; concussion; m-health; mTBI; recovery; rehabilitation.

Figure 1.

SMART v.1.0 learning modules (left) and symptom/activity monitoring input (right).

Figure 2.

Redesigned elements of symptom monitoring patient data input screens in SMART v.2.0 based on mobile design patterns, including (1) replacement of numeric Likert scales with emojis, (2) sliders and iconography, and (3) buttons.

Figure 3.

Elements of gamification in SMART v.2.0 include the ability to earn stars for completing various tasks and activities (top) and to earn achievements for completing entire learning modules (bottom).

Figure 4.

Screenshots of SMART v.2.0 modules showcasing pedagogical agents (represented as avatars) that serve as more knowledgeable peers, coaching and guiding patients through learning modules.