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This project aims to develop problem-solving training (PST) for civilians, veterans, and service members with Traumatic Brain Injuries (TBI). In collaboration with a study at TIRR Memorial Hermann, it focuses on creating an e-health app to improve accessibility. I designed a chatbot app that integrates the original phone- and paper-based training, enhancing emotional support, organization, and conversation flow for easier access to PST, which helps improve psychological health after TBI.
Traumatic brain injuries (TBIs) are often caused by blows to the head from accidents or sports injuries. They can lead to lasting cognitive impairments, such as memory deficits, communication barriers, and difficulty solving problems.
Problem-Solving Training (PST) is an evidence-based intervention that helps improve psychological health after TBI. Currently, it relies on professional coaching and workbooks. Clinical professionals are exploring whether a digital app could expand access and improve progress tracking for both patients and providers.
I was responsible for designing solutions to transform the traditional training process into a digital format. This included creating wireframes, presenting design rationale to stakeholders, developing high-fidelity prototypes for development, and designing conversation flows to enhance the natural user experience during problem-solving training.
When considering how to assist the PST process with documentation, I recalled a past community health assessment, where elders struggled to complete questionnaires independently, requiring staff to read questions aloud and provide explanations. Additionally, the stakeholder suggested making the process more gamified to make the process more engaging and less monotonous for users.
Proposed Solutions:
1. Chatbot app – Uses a game-like conversational tone to enhance user interaction and engagement.
2. Survey-style app – Features different game-like interfaces at each training step, ideal for experienced individuals who need to record their thoughts efficiently.
People with TBI have varying levels of independence and face different challenges after injury. To better understand the PST process and target users, I researched academic papers, workbooks, anonymous PST worksheets, and an audio recording of a coach teaching the process to individuals with TBI.
To gain deeper insights, I also interviewed clinical experts to understand the common challenges individuals face during training.
Users Tend to Jump to Solutions
Individuals often dive into solutions without fully exploring all options, which can lead to ineffective or incomplete solutions.
Difficulty in Setting Goals
Individuals frequently struggle with setting clear, actionable goals. They may not know how to define a goal that is specific, measurable, achievable.
Challenges with Goal Feasibility
Individuals sometimes set goals that are unrealistic or beyond their control. This can hinder their progress and lead to frustration.
Emphasis on Developing Independence
The training aims to improve individuals' independence, so they need to develop their problem-solving skills and not rely solely on the coach's answers.
Avoiding Overwhelm
To prevent individuals from feeling overwhelmed, choosing to "do nothing" is always presented as an option when addressing problem-solving.
Focus on One Task at a Time
It is more effective for individuals to concentrate on one task at a time rather than juggling multiple tasks, which can lead to better outcomes and reduced overwhelm.
Planning Development Through Calls
Individuals typically consult with a coach by phone to make plans. This indicates a need for more advice during the planning process.
Weekly Evaluations
Individuals evaluate their progress on a weekly basis. This regular check-in helps them assess their effectiveness and adjust their strategies as needed.
In this project, the stakeholders selected a chatbot app as the design direction. To create a vivid and engaging interaction, it was important to define the chatbot’s role and personality. Beyond designing the user workflow and interface, I also developed the chatbot persona and conversation flow. Since the stakeholders emphasized gamification, I proposed using a fictional, cartoon-like character to make the conversation more engaging during training.
When creating a fictional character, referencing existing characters can help develop a more well-rounded personality. My inspiration came from Dory in Finding Nemo, who has a short-term memory deficit, similar to challenges faced by individuals with cognitive impairments. This led me to develop Mr. Ray as a persona, using Dory's traits to make the character engaging and relatable.
To align with the PST workbook and meet documentation needs, I designed key features: chat page, menu, milestone page, history page, PST info page, and help page. Understanding that users may be apprehensive about transitioning from paper to digital, I incorporated guidance elements based on the original worksheets, aiming to provide a sense of familiarity and reduce the learning curve.
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We hold monthly meetings for this project, collaborating with stakeholders, clinical professionals, developers, and individuals with training experience to co-create and refine the design. Here are some key insights of the ideation:
Interface Confusion
Many participants didn't express their opinions, which might indicate that the interface and features are too complex for them.
Preference for Real Coaches
A participant noted a dislike for the cartoon icon as a coach, preferring real people over fictional characters, suggesting they view the training process as needing a professional assistant.
Inappropriate Dialogues
A clinical professional pointed out that some dialogues might not be suitable. The developer recommended creating a conversation script to aid in development.
Initially, we considered using a rule-based system to keep the design simple. However, after research, we recognized the importance of the coach not only assisting individuals with TBI in goal setting and plan development but also ensuring they feel understood—a key finding from previous project research. As a result, we iterated to a hybrid approach, combining both rule-based and AI-powered elements. The rule-based system maintains the structured steps familiar to users, while the AI component enhances emotional responsiveness, creating a more natural and empathetic interaction. This approach helps users feel understood while also providing personalized guidance for goal setting and planning.
During our monthly meeting, many participants expressed concerns about AI leading the coaching process. They felt that AI should not provide direct answers or plan development, as PST training aims to foster self-independence. Additionally, some participants suggested that a conversation summary would help them review their training more effectively.
To address these concerns, we refined the design by limiting AI’s role to emotional support and conversation organization, rather than direct coaching. However, since some PST steps can be challenging for users to generate ideas, we replaced AI-generated suggestions with a library of common solutions contributed by other users. This allows the app to suggest frequently chosen solutions, creating an indirect yet supportive interaction for users.
In the problem-assessment (A) step of the PST process, the goal is to consider the who, what, where, when, and how of the issue. However, I felt that addressing all these questions at once could be overwhelming for users, especially at the beginning. To make it easier, I divided the process into three parts:
1. Defining the problem
2. Expressing feelings and context
3. Evaluating its importance
The first part may help clinical staff identify common issues for the future. The second allows individuals to express their feelings without judgment, while the third reinforces the purpose and significance of the training.
At this step, I focused more on button-based responses, treating it as a warm-up. By offering predefined options for users to select from, the task becomes less daunting and allows them to ease into the process without feeling overwhelmed. This approach encourages users to focus on one small part at a time, making the entire process more manageable.
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During iteration, I applied the 80/20 rule, focusing only on the most essential functions. The focus group seemed confused when reviewing previous prototypes, as their discussions primarily centered on the PST process and documentation. Therefore, a minimalist approach was crucial to reduce cognitive load and prevent potential frustration.
To improve accessibility, the app includes a voice assistant, enabling individuals with visual impairments to interact with it more easily. Additionally, the developer implemented multiple accent options for users to choose from, enhancing personalization and user comfort.
The theme of the app design reflects growth, stability, and warmth, aligning with its purpose. I chose light brown and dark green to symbolize natural elements like soil and trees, while ensuring high contrast for accessibility. For typography, I selected Radio Canada and Inter to balance readability with a warm, inviting feel. Additionally, I designed icons representing problem areas in documentation using warm-toned colors to maintain a cohesive and approachable aesthetic.
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During onboarding, users can select their coach, and a brief audio greeting is provided. This allows users to choose a voice they feel comfortable with.
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On the homepage, users can review their weekly tasks and see reminders or advice from their coach. The large user and coach icons allow for easy access to settings.
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To provide users with direct guidance, a prompt in the message area always informs them of the next steps to continue the process. Additionally, I designed many questions with button-based answer selections to help reduce mental workload and make the process easier to navigate.
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The archive allows users to review their previous training and track the percentage of the process they’ve completed.
The previous designs are similar to the latest version but without the visual identity and fine adjustments. The designs include a desktop version, but the team has decided to develop the mobile version first and conduct user testing.
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The clinical experts will conduct formal user testing with participants to assess the app's effectiveness compared to the traditional coaching process. The app will also offer multiple languages to reach a broader target population.
