At Baycrest, I manage the department of Culture, Arts & Innovation, a subdivision within the innovation portfolio that supports a holistic vision of health and wellbeing that embraces innovation, technology and the arts. My colleague Dr. Kelly Murphy (clinical Neuropsychologist at Baycrest) and I began exploring the intersection of neuropsychology, arts, and cognitive impairment five years ago after I attended several symposia led by the Museum of Modern Art in New York (MoMA) and participated in a workshop given by MoMA at the Art Institute of Chicago (2010). The symposia and workshop were based on MoMA’s program for individuals with mild cognitive impairment (MCI) and early dementia called Meet me at MoMA, an educational curriculum for facilitators in museums to engage individuals with MCI or early dementia and their companions in conversations about art in order to stimulate thinking, the sharing of ideas, and the building of relationships. Together, Dr. Murphy and I created a version specific to clients with MCI and early dementia living in Baycrest’s Long Term Care and acute hospital settings using Baycrest’s own art collection, titled the Baycrest Art Walk (the first iteration of our app ArtonTheBrain). The success of the program and the limitations of its paper-based format led us to question how we could reproduce the benefits of engaging in meaningful conversations using the arts as the vehicle for engagement in a virtual setting. In the summer of 2014, we led a series of participatory design sessions with two user groups (Baycrest’s Learning the Ropes for Living with MCI™, and Baycrest’s Freeman Day Program for Seniors) who had MCI and early dementia to explore their technology readiness, interest in participating in a virtual-based leisure activity, and to identify a common need amongst all users. The outcome of the sessions culminated in our proof of principle, ArtonTheBrain.
The social and economic burden associated with dementia is tremendous. This is why it is imperative that scientists research effective methods for delaying or slowing progression of disease processes causing dementia, such as Alzheimer’s disease and cerebrovascular disease. At present there is no pharmacological cure; however there is now substantive evidence that lifestyle choices, such as those related to productive and mentally complex leisure activities, can make a positive impact on disease course (Fratiglioni et al., 2004; Middleton & Yaffe, 2010). There are a number of barriers that make participation in leisure activities difficult, particularly for those with complex care needs. Examples of such barriers include time, distance, transportation limitations, cost, mild vision or hearing loss, low mood, mobility problems, and cognitive decline.
At present, there are a limited number of evidence-based mobile health solutions that target older adults with complex care needs. With respect to the journey of aging, the Center for Aging and Technology describes successful Connected Aging as “being more than just about health – it is about empowering and supporting the whole person through telecommunications and internet-based technologies.”
Our application, ArtonTheBrain, addresses the whole person – it is a solution intended to promote the health and well-being of seniors with chronic health problems who are aging in place. ArtonTheBrain uses visual art as a platform to deliver an enjoyable, user-driven experience that is both mentally and socially engaging. We developed this mobile health solution to address the problem of reduced access to meaningful recreation in these seniors.
ArtonTheBrain is in partnership with the Art Gallery of Ontario, who are providing curatorial content, art expertise, and a digital repository of images for this application.
Our Hacking Health Journey
From the get-go, our Hacking Health team hit the ground running. Our talented team includes: JC Pilaprat (UX, graphics), Keith McManamen (UI), Mini Riar (Dev), Kemal Ahmed (Dev), Andy Tran (Dev), Sahil Kharidia (Dev), Paola Poletto (AGO, art content), Alex Lee (PM/Dev), Nadia Berger (UI), Candice Richardson (Social Media), and Baycrest (Aviva Babins, Kelly Murphy). We began with a preliminary journey mapping session at the hackathon, using the Usability Matters’ framework, developing persona hypotheses of likely or possible end users.
Following suit, we established a working schedule that best suited the designers, developers, and Baycrest teams’ schedules. Our weapon of choice for project management, Trello.
Next, Kelly and I began sharing findings from our proof of principle study, a very large scope of research for Keith to sink his teeth into, and set a series of milestones for the team to achieve through our two-month hack-a-thon journey.
The month of April was dedicated to better understanding the user. We invited every member of the team to participate in and facilitate a series of focus group sessions, one-on-one interviews, and accompany seniors from Baycrests’ Residential Living Property (Terraces) and the Freeman Family Day Centre to outings at the Art Gallery of Ontario (sponsored by the Elia Family). In doing so, we were able to dispel preconceived notions about MCI, early dementia, and other chronic health problems in older adults.
About the Design Research / UX Process/ Development
In order to test and refine the initial persona hypotheses, the design team employed various research methodologies including ethnography, focus groups, guerrilla surveys, the Cooper method of persona generation (About Face 4), and user interviews. Some of the variables the design team considered important to explore further encompassed a seniors’ access to, comfort with, and attitude towards technology; attitude towards mental health and participation in ones own health journey; and strength and type of social networks. Our resulting personas map consisted of 5 potential end users. These models allowed the design team to pinpoint which user profile was ‘marginal’ so that we could focus our efforts in designing for this user. This allowed us to bring access to a broader user base. Our next steps included creating journey maps and storyboards of potential use cases and scenarios.
JC and Keith designed the focus groups, surveys, and in-person interviews with our use group. Understanding the routines, behaviours, attitudes, and abilities of the end user allowed the team to design a product that was not only useful, but had the potential to easily integrate into the users’ day-to-day lives.
We integrated outcomes and observations from all participatory design sessions into a clean, smooth, and universally usable UI. The eventual prototype of the product was tested from our targeted “marginal” user segment. We evaluated usability, task completion and user satisfaction. This was a successful UX test for this iteration, and we implemented our insights from this into resolving identified navigability and accessibility challenges.
The visual design process for ArtonTheBrain involved creating a moodboard that illustrated the colours and temperaments that a user should experience via the application. The applications’ structure was created using a sitemap and wireframes, and the UI graphics referenced design guidelines, accessibility analysis and usability conventions.
The development teams’ goal was to create a working prototype that could be used on a variety of platforms and easily modified to support a large database of art content. Together, Alex, Mini, Kemal, Sahil, and Andy worked in a sprint/agile setting with the design team to rapidly iterate ArtonTheBrain.
In May, we head into the recording studio! A special thanks to Audio Process (www.audioprocess.ca) who donated studio and staff time to record and produce post-production edited content for the application. In this photo, JC records curatorial content from The Passenger Pigeon Hunt:
The next steps for our app
The next steps for the application include applying to various funding sources to enable the launch of a four-year research study (focus groups and a larger RCT) with Dr. Murphy (Clinical Lead), Dr. Hasher (Lead Scientist), Dr. Rowe (Psychologist), and myself (Project Lead). The funding would be used to evaluate whether use of the product is associated with positive health outcomes for seniors such as improvements in well-being, active living, and reduced need for health resources. The proposed research will provide consumers with an evidence-based addition to seniors’ health toolkits.