Helping couples with spinal cord injury get their groove back: interdisciplinary online intervention development

Alexandra L. Terrill, PhD , Justin J. MacKenzie, PhD , Majia Reblin, PhD , Jackie Einerson, MOT, OTR/L , Jesse Ferraro, MPS, MFA , Roger Altizer, PhD
1 2 3 1 4 4
1
Department of Occupational & Recreational Therapies, University of Utah, Salt Lake City, USA; 2Department of Physical Medicine & Rehabilitation, University of Utah; 3Department of Health Outcomes &
Behavior, Moffitt Cancer Center & Research Institute, Tampa, USA; 4 Entertainment Arts and Engineering, University of Utah

Research Objective Methods Results

• Navigating spinal cord injury (SCI)-related changes can impact Design: Development and prototype testing (See Figure 1 for Feedback from stakeholders resulted in development of app
health for both partners: Individuals with SCI and their partners key steps in the app development timeline) features for individuals with (potentially) limited functional ability.
are both at higher risk for depression and lower quality of life. Intervention: SupportGroove is based on a previously- Initial designs lacked accessibility design principles made visible by
• Little attention has been paid to developing behavioral developed pen-and-paper PPI for couples post-stroke. The 8- end-users. (See Figure 3a for design iterations)
interventions targeted towards supporting these dyads. week self-administered intervention consists of brief activities
Solutions included large text, single-click, and minimal scrolling to
• Existing interventions are limited by physical, social, structural, completed individually and as a couple.
facilitate menu navigation for individuals using eye-gaze
and economic accessibility. Participants/Setting: Initial development meetings between technology. (See Figure 3b)
• To respond to this need, we developed a web-based app the investigative team and the app design team included a
“design box” (Figure 2) to outline user needs and key elements
(SupportGroove) to deliver a positive psychology intervention
of the app.
(PPI) for dyads post-SCI.
Main outcome measure: Feedback survey and interview.

Web-delivered (vs. app)

Assistive
Figure 1. tech
Mobile vs. computer
Designbox
Immediate vs. delay tracking

Tech Figure 3a. Iterations I, II, and III

Endusers: Couples

Stakeholders
coping with SCI Key components: Uplifting

Aesthetic
• All injury levels 1) Adjustment to SCI Calming
• Use internet 2) Research capacity Polished, clean
Clinicians 3) Accessibility and engagement Not whimsical
Neilson Foundation

• Initial meeting with Gapp Lab
• Discuss potential stakeholders
May-June
Problem Statement
Figure 1. Timeline of app creation
“Current self-reporting solutions that address the well-being of SCI patients
and partners are not effective in encouraging personal or dyadic driven
activity engagement and measuring and recording useful data of a patient’s
• Decide on app name: SupportGroove and partner’s well-being.”
• Continue app testing and fixing “bugs”
January
Solution

Figure 3b. Login page, activity pages, and activity post.

• Investigator brainstorming session
• Design box #1 with GApp Lab
• Begin discussing accessibility features
July
2017
• Video shoots: app/intervention training videos
• Continue app testing and fixing “bugs”
February
Figure 2. Designbox
SupportGroove provides a simple and clear web-based platform where patients and caregivers can log their
experiences doing well-being activities, track how they feel, and interact on a daily basis, and identify positive
and negative trends during recovery with tools for clinicians to collect and interpret data and progress
Prototype testing allowed further refinement and demonstrated high
usability and engagement with activities in the app.
Qualitative feedback indicated high levels of satisfaction,
accessibility, and confidence in potential utility of the app.
Process: As we developed a prototype, stakeholders and end-

2018

• Add all training videos to app

users, including clinicians and individuals with SCI, were
• Continue app testing and fixing “bugs”, include new videos
• Invite stakeholders March
involved in the iterative process to inform the design and
Conclusion
• Design box #2 with GApp Lab

August
• GApp Lab students start creating app
usability of the app. The SupportGroove app was developed with stakeholder input to
Videos explaining the program and offer a more accessible behavioral intervention for dyads coping
Wrap up spring semester with GApp Lab
•
• activities were filmed and inserted into
Continue app testing and fixing “bugs”, include videos and with SCI.
April
intervention protocol
the app.
Online tools that are accessible and engaging provide better
• First iteration of app
• Stakeholder meeting #1: neuro rehabilitation occupational therapists The SupportGroove prototype was then dissemination of behavioral interventions.
September
tested by 10 dyads for 2 weeks to identify
• Begin discussing intervention protocol and recruitmenttechnical errors and gather feedback on
Acknowledgement of financial support:
•
usability and accessibility.
Continue app testing, include videos and intervention protocol Craig H. Neilsen Foundation PSR#440457;
May
University of Utah Consortium for Families & Health Research
• Second iteration of app
• Stakeholder meeting #2/3: neuro rehab physician, adaptive recreation
coordinator, individual with SCI
Contact: alex.terrill@hsc.utah.edu