LXD — Group Documentation
Group Members: Michelle Cedeno, Rebekah Geiselman, Greg Bunyea
2/21 — Group Planning + Presentation
Masters Students Presentation Reflection (credit to Suzanne + Laura)
- perception of aging process vs. personal behaviors — connection to idea of control/lack of control
- doctor reliance on patient’s memory and honesty
- context of patient living space
- importance of focusing on certain demographic/illness
Homework
- Come up with more specific demographics (heart disease, lung conditions, specific problem). Verify the groups we come up with are important/headed in the right direction with the UPMC speakers.
- Verify UPMC visit details when Michelle hears back
3/1 — Post Shadowing Meeting Ideas
Potential Problem Spaces:
- how to help patients understand what each medication does to understand the value of each part of their wellness plan
- how to show patients who think their diagnosis only effects them that it actually effects on others (family, community) to make them more open to change
- streamlined/transparent community health resources for hospitals with a different demographic (Mercy, Shadyside)
- focusing on symptoms rather than the actual disease (teach patients how to deal with symptoms on their own before going back to the hospital)
- COPD patients as demographic
3/1 — Plan
Tues. 3/5: come up with individual problem space and audience interests
Thurs. 3/7: narrow down group problem spaces/audience (3–5)
Spring Break: come up with individual early-stage intervention ideas
(Spring Break) Tues 3/12: potential meeting day
(Spring Break) Thurs. 3/14: potential meeting day
Tues. 3/19: narrow down group early-stage intervention ideas
Thurs. 3/21: share out 3–5 group ideas with class
3/7 — Narrowing Problem Focus, HW Plan
Class Activity
Charted main problem interests, narrowed each down into components and matched with relevant theories/frameworks.
Homework
Solutions that fill in the “HOW” section of the chart (possible interventions). Use theories and frameworks as guidance. Begin storyboarding if have idea(s) you’re excited about.
3/12 — Group Meeting: Greg Catch Up, Planning
Today we met to catch Greg up on the progress we’d made during the week and begin to plan potential solutions to share with the class next week. We wanted to make sure Greg was comfortable with the more specific direction we’d taken during last week’s class and see if he had any questions on comments on our current ideas.
Luckily, we agreed that our ideas had followed the natural progression of our more systems-level research and brainstorming phases, and we felt that our personal interests overlapped and supported the main problem areas we’d narrowed down. Most importantly, we believe that each problem area presents a real opportunity for positive change and meaningful impact for UPMC and readmissions.
As we discussed the potential solutions we’d come up with during class, such as workshops, card games, or matching tools, we determined that our interventions are currently at too general a level, so we each plan to choose 2–3 categories of solutions and work to turn them into more defined ideas.
When we meet during next class, we’ll be able to share our more specific solutions as a group and determine which of our group solutions we’d like to move forward with and get feedback on from the class.
3/19 — Solutions and Storyboards
During today’s class time we started by brining our individual ideas together. We had a diverse spread of ideas that covered our main three problem areas: Patient Motivation, Symptom Management, and Community Health Resources. Sharing out our ideas we were able to merge certain solutions together and create more tangible concepts.
Group Ideas
Community Health Resources:
- Community Health Resource Database — a database for doctors and nurses including the organization names, contact info, services, ect. for community health resources by neighborhood.
- Personalized Patient Form for Matching with Resources — a tool for doctors and nurses to use to match and refer patients to community health resources. The form would information such as the patients neighborhood, financial/physical constraints, native language, ect.
- Mobile Medical Unit Community Tour with Open Houses — a collaborative event between the hospital and community resources where the mobile medical van would stop outside different resources and hold activities while the organization holds an open house to increase visibility.
Symptom Management:
- Breathing Coach ing— A scaffolded experience where COPD patients learn how to regulate their breathing.
- Mood Monitor — a wearable item, such as a ring or bracelet, that uses different sensor and measurements to report the wearer’s emotional state so patients can be self aware about their mood and adjust their behavior accordingly.
Motivation:
- Conversation Cards — a conversational/scenario-based card game played between caregivers and patients to set goals, plot milestones, and realize connections.
- Personalized Reminder System — an auditory support system that reminds, encourages, and guides patients using the voices of the patient’s support system.
Once we had a full list of ideas and had defined and discussed each possible solution, we moved on to storyboarding each one as a group on the whiteboards. Though we weren’t able to storyboard each idea as a group, our goal for this round of storyboarding 1`was to determine the steps and facets of each concept, and then refine the “final” storyboards for next class.
Early Storyboards
For Next Class
We chose to split up our main concepts and each refine a storyboard for Thursday’s class. We’re hoping that the speed-dating session will help us further narrow down a direction so that we can begin to get towards the level of detail needed for our final concept. However, as a group we’re happy with the broad range of concepts we’re bringing to the table and believe they’ll spark a rich discussion.
Refined Storyboards
3/21 — Speed Dating Takeaways
Juliana
Overall Concept Rankings: The classmates I presented to consistently ranked the “Conversation Cards” and the “Personalized Reminder System” as their top choices, and the database as their lowest choice.
Concept Notes:
Breathing Coach — Classmates enjoyed the specificity and scaffolding of this concept, but felt it might have been too limited and that it didn’t account for refreshers or support post-discharge/practice
Conversation Cards —Classmates enjoyed the take-home aspect of this concept and the connection to motivation, but had concerns about how to get less expert adults engaged in a meaningful conversation and the specifics of the form/the prompts
Reminder System —Classmates enjoyed how all-encompassing this concept was, as well as the use of a resonant voice, but they worried about the scaffolding being too consistent rather than progressive and the potential finite variation of the recordings
Database —Classmates enjoyed how useful this kind of tool could be, but felt it didn’t connect as clearly with a particular learning outcome or experience, and that it could be redundant for TC’s/nurses who already have many other resources they need to refer
Michelle
Community Health Resource Database
- think of other modes to hand patient community information
- how practical is it to assume doctors and nurses will familiarize themselves with database
- should it be geared to social workers
- How can hospital have access to database
- What form does it take
- Ecosystem
- App
- Computer
- Website
Personalized Reminder System
- What if a patient resistant to technology
- Is there a physical component that can be involved
- Can there be an aspect that helps patient log progress to then show doctors
- Is there a way to visualize the goal or reminder
- What if the patient has no living family
- How can we connect to the community
Conversation Cards
- How can we visualize the goal more
- How can we motivate them instead of just reading
- How to document goals in other ways throughout the process
- New goals need to motivate the patient not just at the time of the hospital
- How can the caregiver be involved not just during the game
- How to market the game
Breathing Coach
- Does UPMC not already have this
- What are the different variations of breathing
- Take into consideration the gravity of the breathing problem
- Different levels of need
- Depth of problem
Greg
Community Health Database
- What would these look like, form may be flexible for the plan.
- Where’s the learning? A bit didactic information delivery.
- Seems helpful but highly complex, fairly vague
- Consider other users — doctors and nurses have time constraints already
Personalized Reminder System
- Could still feel like a new technology that needs integrating into the life of eldery
- Some pieces are broad — what can we actually pull off given our time constraints?
- How could we keep the support relevant?
Conversation Cards
- The goal is a bit vague — get more specific about the audience
- Needs a feedback loop
- May be too simple/easy to ignore — consider the exact form it takes
Breathing Coach
- Where’s our challenge? There isn’t a lot of complexity as currently presented
- What else is happening here? There could be more under the hood
Rebekah
Community Health
- how do you push it so it’s not just a database; how can patients use it too?
- more of a hospital tool
- how do you make sure they learn?
Conversation Cards
- how do you facilitate
- idea: UPMC reaches out to family →not just the patient, but family contributes as well
- are they really learning long-term behaviors?
- what is the mode of delivery and how can it not come off as juvenile for older patients?
- can it be self-initiated, is the caregiver necessary?
Reminder System
- older patients may be more resistant →is it appropriate given the technology?
- can it be interactive but in a different form that doesn’t scream new tech
- what is the specific target audience →do they have the resources/comfort/knowledge to use?
Breathing Coach
- how do they currently do this?
- can it be integrated into meditation apps?
- needs more building and scaffolding
- who would actually coach?
3/22 — Getting Specific! Finally!
The Meeting
Today’s meeting was one of our most productive so far; we were able to go through our feedback from the speed dating session and use some of the biggest points to direct our work in further narrowing our problem area and audience.
One of the largest take-aways for our group from the session was the lack of focus of our problems and solutions in comparison to other groups due to the relatively large range of our audience. We realized that “elderly” or “COPD patients” were still too vague as user groups, so we worked to narrow a specific audience in terms of age, disease, stage of disease, emotional state, and level of support system.
This exercise led us to delineate two potential user groups. The first would be COPD patients aged 60–80 years old, who have been dealing with their diagnosis for a while and are now experience further complications due to their age. The second group would be COPD patients aged 40–60 who have just been diagnosed or are in the early stages and looking to be proactive.
We chose to move forward with the older age group as we know it’s a high demographic at UPMC, and we feel this audience offers more of a design challenge in terms of the solution’s form as well as the potential for more impact.
In order to re-define our goal and begin to consider potential solutions and forms, we decided to redo the clarifying questions with our new, more specific audience in mind.
Our revised Who, What, Where/When, Why are as follows:
WHO: 60–80 year old COPD patients. Grandparents, retired, potentially alone. Has non-permanent caregiver or support system.
WHAT PROBLEM: Patients lack motivation to follow their wellness plan because they attribute health problems/COPD complications to age rather than personal behavior and think their condition is out of their control.
WHERE/WHEN: Begins at home, ASAP post-discharge when caregiver is still present. Continues at home further after discharge when caregiver is no longer physically present.
WHY: More motivated/confident/independent patients. Less complications and readmissions due to patients not following wellness plan or not knowing how to handle symptoms.
Once we had a refined goal, we then began to consider solution and form by brainstorming the HOW. Rather than coming up with a completely new set of solutions or jumping into storyboarding right away, we wanted to list potential facets, complications, and theories we should keep in mind.
Another take-away from the session was the idea that elements of both our conversation cards and remind system ideas could potentially be combined in a more creative and meaningful way to create a learning experience aimed at motivating patients. This feedback really informed our brainstorming, and led us to blockbust our initial thoughts to make sure we were being as broad and rich in our thinking as possible.
For the blockbusting, we tried to define the concepts we’d initially listed beneath “HOW” to make sure we weren’t assuming an understanding or trying to utilize concepts that we didn’t fully grasp ourselves. This exercise led us to really dive into what a designed ecosystem means and looks like, specifically when related to an older audience.
Once we’d determined that an ecosystem was not just a digital system, but could be a system of related physical artifacts or experiences, we started to think about potential forms.
The forms we came up with included…
- cards
- stickers
- buttons
- vision board
- voicemail
- letters/diary entries
- “voodoo” dolls/representative dolls
- blocks
- game pieces
We then connected potential forms with some of the components we’d been thinking about, possibly linking voicemails and diary entries to a digital storage space, and the vision board to a patient’s timeline or goals.
Moving Forward
Now that we finally have a clear and narrow sense of our problem, our goal, and our audience, we each plan to continue building out solutions that encompass what we discussed. Our hope is to bring our independent ideas together again and be able to storyboard and specify a solution next week.
3/25 — New Ideas
Juliana:
When brainstorming new ideas, I wanted to draw on concepts from our Conversation Cards and Reminder System ideas but combine them in a way that incorporated both digital and physical forms and more directly tied into a learning experience, rather an a consistently scaffolded experience.
PATIENT MOTIVATION DIARY
My first ideas was a “Patient Motivation Diary” where patients could either record daily audio or written entries of their achievements and obstacles of the day/week. At the beginning of the diary, the patient would be guided with prompts such as, “Where there moments where you were proud of yourself today? When and why?” to help them summarize and reflect on their experience, but as the diary progressed, that scaffolding would decrease to categories such as “achievements”, “obstacles”, “reflections”, “looking forward” until eventually the diary would potentially be a completely open-ended tool.
COMMUNITY TIPS/STORIES LOG
My next idea was a “Community Tips & Stories Log”, which was based off feedback that our reminder system could use a more personalized touch and the idea that being able to actually hear a conversation or story might be more powerful for patients than simply reading back a summary of a conversation. In this idea, the patient would have a store of messages, either written in a book, or maybe a compilation of audio/video clips from different community members such as family, friends, neighbors, church members, other patients with the same disease, ect. The messages could be split into different categories, such as “Diet”, “Medication”, “Obstacles”, where each message would give either a tip or a personal story of how the speaker handled the category. While I think this idea could carry a lot of meaning and tie into motivation due to the highly personalized nature, I think it isn’t yet connected to a learning opportunity or scaffolding.
“WHAT’S NEXT? TIMELINE”
My final idea was a “What’s Next? Timeline” that could potentially include a tactile visual, an audio, and a digital component. The tactile visual component would be a physical “vision board” with a timeline that patients would keep in their house. The vision board would be made with the CG or support system to give it a personal touch, and would shift/increase once goals where met to allow patients to plot new milestones (Potentially made of flip sheets, so you could go from month to month, like a more free-form calendar).
The audio component would relate back to the “Motivation Diary” idea, where patients could reflect on their goals and share their emotions or setbacks in a longer form, rather than trying to fit everything onto their vision board.
The audio component would also connect with the digital component, a website or app, where the recordings could be stored and shared with the patient’s CG or support system, so the patient can receive feedback and support as well as access a full timeline of their progress. The digital portion would also allow the patient to take a photo of each vision board flip sheet when it was completed, and would upload that progress to the full timeline as well as alert the CG or support system that a new goal has been fulfilled. (There could also be a response method once a new goal is completed where CG’s or support system members are prompted to send back a letter or a video message/voicemail)
Again, this idea would have a more scaffolded approach, and allow a richer learning experience for the patient, as the vision board and audio prompts would be scaffolded in a way to encourage independence overtime.
3/26 — Concepts to Theories, Planning for UPMC presentation
Roles for Presentation:
Notetaker — Rebekah
Pitch — Greg + Michelle
Questions — Juliana
Weekend Progress:
To get the group on the same page and refresh ourselves on our discussion from the previous meeting, Juliana presented the ideas she’d come up with over the weekend that she felt touched on most of the major points.
In order to present, she quickly storyboarded the concept on the whiteboards and then as a group we responded on what aspects we felt were or were not realized in the concept.
The biggest takeaway from this discussion was the realization that we’d become too focused on the concept of a designed “ecosystem” and that the incorporation of multiple components meant that no single component was fully fleshed out. We decided the best way to move forward was to come up with a single artifact or solution in greater detail, and then perhaps storyboard the way that item could be part of a greater ecosystem further down the line.
Individual Ideas:
Having decided to focus on particular parts of an ecosystem rather than an entire group of designed experiences/artifacts, we took about half an hour to come up with new individual ideas. When we shared out our refined brainstorming, it became clear that Greg, Juliana and Rebekah had come up with similar ideas that could all be combined into a “Motivational Patient Journal”, and that Michelle had been considering questions that could lead to a richer implementation of this journal form.
Juliana’s concept was especially concerned with variety of the pages, scaffolding of potential prompts, and the personalization through collaboration with the caregiver or support system.
Rebekah’s notes were more centered on incorporating specific symptoms (both mental and physical) and challenges that COPD patients face, and also featured a digital component where the patient’s entire timeline could be stored.
Greg’s notes were very goal related, and focused on the integration of goals at different scales and various check-in points.
While Michelle had begun to consider some different forms than a journal on her own, the questions she’d come up with the apply to her own brainstorming ended up being applicable to the journal form we’d come up with.
Those questions were…
- How might we explore data physicalization/visualization as a path to community or caregiver engagement/action
- How might we explore the association between visual and auditory perception within health narratives
- How do materials communicate meaning?
- How do we encourage a more interactive design process that allows for the production of experiences tailored to individual health plans?
Discussion with Stacie
Once we had a clearer idea of our concept and the theories that could root it, we informally presented to Stacie to get her feedback. From this discussion, some major points and challenges to consider while moving forward emerged. They included…
- How do you make a journal that feels caring rather than pandering?
- How do you motivate patients to even use the journal? (This especially has to do with age and gender dynamics)
- How do you achieve relevance for the patient, not just the caregiver?
- How do you reward journal users?
- How do you show an immediate benefit of using the journal when a lot of the health benefits would be longer term?
- How do you help the patient feel ownership/investment in the journal?
- How do you incorporate variability so patients don’t get bored and can use methods/prompts that work for them?
Moving Forward
Our goal for our next meeting is to have some possible answers to some of the questions above, as well as examples of potential pages/activities in the journal. We know we won’t have fully developed answers for every question by the time we present to the hospital, but we’d like to have secure answers for some of the bigger questions, such as how the learning experience will look, how it will be valued by patients, how it could be a varied experience, and how it will motivate patients.
3/31— Concepts to Theories, Planning for UPMC presentation continued
In this meeting, we had to get business done. Nervous about the presentation on Tuesday, we wanted to make sure that we were all on the same page. We had to do some extreme synthesis and narrowing of our concept. Before this meeting, we had all agreed to focus on Advanced COPD patient, aged 60–80, with a temporary caregiver. However, we ourselves had many gaps in our learning and knowledge of COPD. We took the time today to familiarize ourselves with the disease and resonated with patients who are involved in pulmonary rehab.
By honing in on pulmonary rehab COPD patients, we realized our goal notebook journal tracker can be a companion piece for their visit. We thought that this would be a great idea to utilize resources already available to the patient. By defining our user group further, we found it easier to define what attainment goals and motivation could help our user want to use our notebook. The two learning principles that we probed at were the Principles of Motivation and Structured Flow of Goals. Below is an example of how these two learning theories merged together for our journal.
Next Step
we met on Monday night to go over our pitch and strategy. We want to do further research on
- COPD
- symptoms
- tracking
- breathing practices
- exercises
- diet
- goals
- form
- pages
4/2 — Presenting to UPMC
Overall, the share-out with the UPMC representatives went really well. We presented our InDesign files to UPMC and showed how our concepts developed and our learning methods that informed our concept.
There was no specific criticism or major revisions that were mentioned, but a lot of important clarifying points were brought up along with some important questions to consider moving forward. Both Pam and Kristin were glad with our level of specificity and detail in our target population and problem and mentioned it was a “hot topic” that many current UPMC projects are trying to tackle.
Questions to Consider:
- Is there going to be anyone monitoring this? Or helping them keep track?
- How do you motivate someone to write these goals?
- How do you make sure that they are achievable?
- How do you encourage them to interact while they are at this space?
- How can we make the idea of a journal appealing to COPD patients?
- What is that behavior that will help?
- How will you integrate it into the work flow?
- How will the TCs use the booklet to support that interaction with the patient that they can then pass it off to them?
Things to research:
- Research on disease specific populations’ use of journaling — has this shown success with other populations in the past
- Incorporate SMART goals into the journal
- Helpful in the final presentation to understand the cost — how much? What is the maintenance that all of the information is up to date with medical best practices? — business perspective
There was a lot of emphasis placed on meeting the patient where they are, and encouraging a bit of agency. By allowing the patient to have control on how they want to move forward and use the journal, or at least have them think they made the decisions on their own, this can encourage them to take it more seriously. This particular population is difficult and often fragile making it critical to personalize their experiences and make sure they are willing to and comfortable with this new companion journal to their pulmonary rehab process.
Next Steps:
After we review the notes as a group, we will dive deeper into form and content of the journal. In addition, an email will be sent to Pam requesting more information on UPMC-specific pulmonary rehab practices and ask the following questions that we didn’t get to during our brief 15-minute meetings:
- How can we find specifics for pulmonary rehab patients at UPMC?
- Does this make sense as a compliment to pulmonary rehab?
- What do current COPD patients receive upon discharge?
- Is there any sort of tracking mechanism encouraged during pulmonary rehab?
4/4 — Catching Up + Moving Forward to Prototyping
Catching Up
We took the first few minutes of class to go back over our feedback from UPMC. This gave us a chance to compare our initial ideas and how different elements of those concepts could be utilized in our final solution as well as identify current gaps in our knowledge. We were then able to lay out our next steps and considerations moving forward.
Next Steps/Considerations
- specifics of pulmonary rehab in order to inform journal pages/sections
- how to motivate patients to use and continue using the journal
- what already exists?
- specifics of form
Specifics of Rehab
We reached out to our contacts from the UPMC speed dating session to get more specific information on the UPMC pulmonary rehab process. Our contact directed us to the following info…
Specifics of Form
Once we had a clearer understanding of the rehab process and goals we started to list out aspects of our final form.
- re-fillable journal so can be continued and customizable
- different modules/inserts depending on patient preference
- green,yellow,red light system
- attachable pen
- include lung visualization
- include page on goals related to performance, social, affect
- maybe include potential for collaboration?
Specifics of Use
While considering the form we also began to visualize how the journal would be used by coming up with the following questions. We hope to answer these once we have some actual pages and iterations to work with.
- what does facilitation from rehab provider look like?
- how often does the use or sharing out of the journal happen?
- how often does journaling on their own happen?
FOR TOMORROW’S MEETING
- schedule and deadlines
- send email to Pam
- budget/potential costs/providers
- market research
- page brainstorm
3/5/19 —
Schedule:
First things first we came up with a schedule for the next few weeks of what we want to accomplish. Our ultimate goal is to have potential cover and journal materials as well as printed pages for our classmates to interact with.
Tues. 4/09:
- Market Research
- Potential Pages — aligned to goals
- Schedule Call with Pam (COMPLETED VIA EMAIL)
Thurs: 4/11:
- any new ideas uploads
- pages to InDesign files/print
Tues. 4/16:
- narrow down pages we want to keep
- art store to look at materials
Thurs. 4/18:
- Various cover materials
- Pages/Inserts
- Refillable journal mechanisms?/bring refillable journal
Budget:
We tried to come up with an exact budget, however we realized we’ll need to actually come up with our specific pages/insert ideas in order to see what exact costs our project entails. As of now the main cost areas we came up with include…
Printing Costs
Cover Materials
Writing Utensils
Tech Stuff? (arduino, ect.)
Potential Ideas:
Then we got into the fun part! Using some of the goals and parts of pulmonary rehab as well as our earlier form considerations we listed potential pages. In order to blockbust while simultaneously generating ideas, we decided to start with ideas as far from the expected as possible in order to generate a wide range of both feasible and perhaps less feasible options.
The “Crazy” Ideas
- a spread that plays a wave/ebbing and flowing sound when you open it that you can match your breathing to
- buttons on each page that let you chose which emotional/health state you’re in. Red, Yellow, or Green.
- a spread you can take our and crumple up if you’re feeling frustratated
- a “finger labyrinth” a.k.a page with a raised maze/design you could trace with your finger
- a scratch and sniff page of calming essential oils
- a page you can draw on with your fingerprint (ph paper?)
- a page with lungs made of bubble wrap that patients can pop
- a page or cover that lights up when you use it
- a spread with a pop up or inflatable lung visualization
The “Normal” Ideas
- a scrapbooking spread where you can paste and pin your own items and use stickers
- a page with a pocket/envelope where you can store momentos
- pages with different list headings
- coloring pages
- pages that you can take out when finished, unfold and reveal art/a design you can hang
- a collaborative spread with prompts you could do with others. “Draw a future event you’re excited about”, ect.
- SMART goal pages
- page listing the red, yellow, green light system
- page with reflective prompts
- page with open space to draw on/fill with color
For Next Class
We’ll each come up with actual layouts/more specific ideas for different pages or journal sections to share out with each other. We’ll also continue to look into what similar products or experiences are already on the market and how effective they’ve been.
4/9 — Working in Class
Page Ideas/Physical Prototyping
Since we’d come up with page ideas over the weekend and outlined the different key components of Pulmonary Rehab, we decided to move right into physical making to get a sense of what different pages could potentially look or feel like. For inspiration we looked at a variety of materials and existing journals, from pocket planners to re-fillable journals and cards that play a recording when opened. By looking at a few different examples we came up with the dimensions for our own journal, 5.5 X 8.5 inches, which we thought was large enough to fit content in a readable and interactive way, without being too imposing.
We initially started with the “fun” pages, the more tactile and interactive pages we’d brainstormed. These included labyrinth pages with different thickness levels of the maze, a page of perforated letters and envelopes, as well as pages with pop-up visual representations of the lungs.
However, after a quick prototyping session, we realized that we needed more concrete examples of the pages more directly tied into the patient’s learning experience, such as mood/wellbeing tracker spreads or goal-setting pages. This led to a discussion on the flow of different pages, whether we want each kind of page to be in its own section or we want to stagger different pages within the same section. We determined that user testing of pages in various orders will be a key step in our process, and decided to finalize concepts like the specifics of the spreads themselves and the visual language and voice of the journal overall before deciding on a particular page order.
Making Spreads
The two learning oriented spreads we chose to work on as a group where the Tracker and Goal Setting spreads.
Tracking — The goal of the tracker was to combine the Green/Yellow/Red Zone system with a space to track changes and take notes on what caused the change to show progress over time.
We opened the spread with an overview of the Green/Yellow/Red system that describes the state of the patient and corresponding actions they should take. On the facing page we included a monthly tracker where patients can place a sticker in the corresponding color for how they feel that day.
Following the first spread, the tracker section begins a weekly tracker system, where patients have a more detailed day-by-day view. For each day of the week, patients can record the color of the day as well as give the reasons for their state. Originally, we’d planned on having multiple spreads with both pages of week trackers, however, we also came up with a option where the left page of the spread is a weekly tracker and the right page is an open space to leave more detailed notes. Moving forward we need to decide which version to use, as we want the spread to be as inclusive of different patient needs as possible.
Goals — The goal setting spread was meant to define and give examples of strong goals as well as lead patients in creating and evaluating their own goals.
We initially wanted to use SMART goal guidelines as the framework for creating goals, however, we went through each component of the acronym to make sure the terminology was appropriate for our audience. We came up with an abbreviated version of the acronym, MART, that we felt was more simplified, accessible, and easier to implement in a spread.
Rather than jumping right into a guided goal setting exercise or worksheet as the first page of the spread, we decided to begin with a more open-ended visualizing exercise to introduce patients to the topic. On the left side of the first spread, patients are given space to write/draw what they imagine when they picture what they want to do, where they want to go, and how they want to feel by the end of rehab. On the righthand side, we establish a timeline that stretches from NOW (when they receive the journal) until the End of Rehab so they can begin to plot their journey, as well as the MART system and guiding questions for each letter of the acronym. We decided to go further into this spread as homework due to time constraints.
Next Steps
Moving forward, we decided to continue working in the space of pages/spreads directly aligned with the facets of pulmonary rehab. We split the main components (Medication/Inhalers, Breathing Techniques, Energy Conservation, Nutrition, Smoking Cessation, Weight Management, and Stress Management) amongst ourselves to create rough spread layouts by next class.
- Tracking — Juliana InDesign spreads
- Goals — Michelle and Greg
- Medication and Inhalers — Greg
- Breathing Techniques — Rebekah
- Energy Conservation and Pacing — Michelle
- Nutrition — Juliana
- Smoking Cessation
- Weight Management — Rebekah
- Stress Management — Juliana spreads
4/16 — Spreads Size, Visuals, and Voice
Today was a really productive and important session. Through discussion and iteration of spreads we were able to come up with the overall structure of the journal as well as the specific pages and number of pages we’d like to prototype.
Sharing Spreads
We started out by sharing the spreads we’d come up with over the weekend, and thought of how they could be ordered in relation to each other as well as adapted to fit the 5.5x8.5 dimensions we want for the final.
The spreads we came up with covered Nutrition/Diet, Breathing Techniques, Stress Management, Green/Yellow/Red Zones, and Goal Setting. While we were really happy with the content of the spreads we’d come up with, we weren’t sure about how to order them, so we laid them all out on the whiteboard and tried different ordering options. We considered having each topic be it’s own section that included a separate tracker and was followed by correlating activities, but we realized having multiple trackers would be burdensome to users and that the segmented approach didn’t necessarily facilitate a holistic learning experience.
So we moved on to a day by day idea, where the content heavy pages of our spreads would become resources that we will group together either at the front or back of the journal, and each daily page will have an activity linked in some way to one of the 5 main themes as well as a segmented tracker at the bottom of the page where the patient can mark green/yellow/red for each aspect (their diet, breathing, stress, and overall zone).
NEW SPREAD LAYOUT
Approaching the journal as a daily reflective and interactive tool rather than a segmented, academic tool helped us move forward into coming up with the specific pages, ordering, and length of the journal we hope to prototype for the final presentation.
Activities Brainstorming
Once we determined the structure of each spread we worked as a group to come up with an even amount of activity page ideas for each component of the journal (Goal Setting, Zone Tracking, Diet, Breathing, Stress Management).
The ideas we came up with included…
Goals — goal setting pages, goal check in pages, goal reward pages
Zones — zone matching to color, zone matching to color and action
Diet — match food to feeling, write/send a recipe, draw a balanced meal
Breathing — finger tracing to guide breathing, draw the lungs
Stress Management — guided meditation, muscle relaxation prompt, community web
Once we had a list of potential pages, we decided to separate them into weeks, allocating at least one activity for each component per week. We decided to open the journal with the goal setting page followed by the zone tracking page, as we feel these two areas are the ones most connected to learning.
Each week kept the same ordering of the sections so that the first day of the week would be a goal check in followed by a Zone matching page of increasing complexity. We want to be sure to scaffold the Goal Setting and Zone Matching activities as the other activities, such as stress management techniques and Diet remain at the same level of scaffolding throughout the journal.
We came up with three weeks worth of ordered pages. For the testing class, we plan to bring spreads for at least two of the weeks to get feedback from our peers. After coming up with the content and order for three weeks we also looked at the journal as a whole, determining where other aspects of the journal such as the informative resource sheets, blank note-taking pages, and folder/pocket for notes would be placed in the journal.
Visual Language
During this class we also began to experiment with possible color schemes and visual language for the journal. We began a preliminary style sheet including both typefaces and color palettes.
Moving forward, we feel the third color palette is the best option because it hits the middle ground between subdued/clinical and bright/energetic. However, if time allows we’d like to create the journal in all three color schemes so that patients could take their pick and feel the journal was more personalized.
Voice
We didn’t have time to get into the specifics of the voice of the journal today, but we hope to get the exact phrasing and vocabulary of the different pages sorted out during next class. Overall, we know we want to avoid childish/condescending language and we want to use a conversational tone. While we don’t want to overwhelm users with clinical or advanced vocabulary, we also don’t want them to feel like we’re babying them.
Discussion With Chen
At the end of class we were able to share our progress with Chen, who brought up some valuable points. The main takeaways from our discussion were…
How do we convey value — As of now, we plan to connect the content of the resource pages to the value of each section. We’ve also structured our activity pages in a way that incorporates the value of the patient’s wellness through the language and exercise itself.
How do users track their progress— While we’ve moved away from the idea of having a monthly tracker or multiple weekly trackers, there will still be staggered check-in and reflection points for patients in the form of the goal pages.
Overall, we were happy to see that we are already taking these points into consideration, but they’ll be important to keep in mind as we move forward.
4/18 — Talking with Stacie, Working on Voice and Layout
Learning Theories —
Presentation —
- Slides — scenario based, one topic at a time
- Prototype — full # of pages even if blank to show size
Testing —
- semantic differentials
- scaffolding
- motivated to continue (favorite components/least favorite components)
- interactions (using stickers)
What to do for Tuesday —
- InDesign spreads to get feedback on visual language, form
- Written spreads for learning content
- Materials for feedback (color/texture of paper, cover)
Revised Spreads
Steps for Tomorrow’s Meeting
Finalize Spread Details — where do stickers go, what are “instructions” and “notes for today” titles
Translate to InDesign —
Make Polls/Tools for Testing —
Visit Art Stores — smile stickers, colored stickers, food stickers, page papers, cover materials
4/19 — Making Pages and Testing Tools
Pages we want to make for Tuesday:
- Template
- Zones x3
- Goals x3
- Content Pages x4 (Zones, Breathing, Diet, Stress)
Page Changes:
Instructions — “Today’s Activity”
Spread Layout —
Master Page:
Dividing Tasks:
Reb — testing questions and semantic differentials
Greg — goal and goal check in content
Michelle — spread assets
Juliana — text content and page formatting
4/23 — Spreads for Testing, Feedback
Spreads:
INSERT PICS
Questions & Response for Stacie:
- Describe Testing Session —
- The main goals of our testing session where to see how users reacted to the scaffolding and level of engagement of various pages as well as test how users reacted to the current visual language in terms of type, color, and iconography.
2. Describe the Outcomes —
- We received very thoughtful and personal feedback from all 4 pairs of users, some of which aligned with problem areas we’d already identified and some of which highlighted areas we hadn’t given as much thought to yet. The main two areas of concern highlighted through feedback were the open-ended-ness of the goal spreads as well the juvenile tone of the visual language. We also received interesting suggestions in terms of how to differentiate different weeks by color and by zoomed-in timelines, as well as notes on preferences for larger changes in spread layout, such as spreading a single activity over both pages.
- It was also nice to receive some purely positive feedback in terms of aspects of the journal that users enjoyed and were excited about. The finger tracing and scaffolded Zone activities were some of the favorite pages, and the fact that the journal consists of short, daily activities that align with rehab was also appreciated.
3. Describe How Outcomes Inform Next Steps
- The two main next steps are refining our visual language, mainly testing different color schemes and stroke weights, and editing the goal spreads to include more concrete guidelines and potential examples. Overall, we also need to go over the instructions and layout of each spread and make sure they are as logical and concise as possible.
- Once we’re confident in the language and layouts for the first week of spreads, we want to narrow down any additional pages we’ll be producing for the UPMC presentation and begin putting everything together for our final prototype and presentation materials.
4. Describe Outstanding Questions
- What spreads/weeks are we creating for the presentation?
- How can we make instructions shorter without losing clarity?
- How do we refine a visual language that balances the playfulness of an activity book without seeming condescending/patronizing to our older audience?
- How can we tell a story about the journal when we present it, so that even without a full journal, our audience understands and appreciates the structure and value?
4/30 — Finalizing Week 1 Spreads and Content Pages
Spread Options:
We started today’s class by laying out the various options we’d come up with for the journal’s first week of spreads and determining which aspects/spreads were most effective.
There were about 3–5 variations for each type of spread, with differences in color usage, font weight, and instructional language. Below are some of the variations we considered.
LUNG VISUALIZATION SPREADS
Decision: For the lung visualization spreads, we chose to use instructional language that was more welcoming and less demanding, such as “Try imagining…” rather than “As you draw imagine…”
LETTER TO FUTURE SELF SPREADS
Decisions: For the letter writing spreads, we actually came up with a new version of the instructional language to avoid repeating the word “about” twice. We also chose to keep the “Dear Future Me” text left aligned to provide more room for writing and keep the flow of elements consistent.
SWIRL TRACING SPREADS
Decisions: For the swirl tracing spread, we noted that the more concise instructions at the top was most effective. Therefore we decided on keeping the top instructions concise while including the two full lines of encouraging instructions at the bottom of the activity. (We’ll also be repeating this text style on the goal check in spreads, so it will feel cohesive with the rest of the journal)
ZONE MATCHING SPREADS
Decisions: For the zone matching spreads, we realized there was conflicting implications behind having the box outlines in dotted lines, as we previously used dotted lines to indicate where to place stickers. We decided to change the dotted lines to thin, lower opacity full strokes. We also chose not to outline the right hand column zones/symptoms as the size discrepancy between the boxes makes the task unclear. And finally, in order to differentiate the change in activity on the third week of zone matching, we decided to place a box around both the patient and the empty lines to indicate it is no longer a matching activity.
DIET MATCHING SPREAD
Decisions: As of now the placement of food names is pretty haphazard, so we decided to clean up their placement as well as incorporate a low opacity icon for each to make the page more engaging. We also discovered a typo in the instructions that we will fix!
GOAL SETTING SPREADS
Decisions: In terms of language for the goal-setting spreads, we found the versions with bolded guiding questions more effective than the six subquestions on their own. In terms of visuals, we agreed that incorporating the timeline helps contextualize the goals, and that the version of the timeline with the specific week highlighted is most helpful. We will carry that same timeline into the goal check-in spreads for consistency.
GOAL CHECK IN SPREADS
Decisions: In order to contextualize this activity, we plan on incorporating the timeline with the highlighted week into the goal check-in spreads. We also found the spread with “How do you want to feel by next check in” on the right hand page more effective in giving users a more open ended opportunity to reflect. However, in order to make the instructions for that question clearer and explain the greater space, we plan on adding smaller more encouraging instructions, similar to those on the swirl tracing spread, at the bottom of the right page.
Overall Spread Decisions:
- Make “Today’s Activity” highest in the hierarchy by keeping the large type size
- use bold/semi-bold for the main guiding questions/headers
- Only bold keywords in the goal setting and goal check in spreads
- make tracker icons on right hand page grey rather than blue
- move page #s further to the sides of the pages (potentially make smaller)
Next Tasks:
Juliana — spread edits
Michelle — content page edits, assets
Rebekah — presentation materials
Greg — presentation materials
5/1 — Updated Week 1 & Scaffolded Spreads
For our final prototype we decided to create the first week of the journal as well as a full set of the scaffolded Zone Matching spreads in order to show the progression.
The only spread from week 1 that we haven’t discussed as a group before is the Community Mapping spread, so we’ll go over language and visuals in class tomorrow to determine which of the two current spread versions is more effective
Updated Spreads (In Order)
