Daisy Wheel App — Get In Touch Foundation

The Get In Touch Foundation, a program with the mission to educate women and men about breast cancer, asked us to help expand its current capabilities and increase user engagement with their Daisy Wheel App for iPhone. Using a rapid Contextual Design approach, we quickly moved beyond assumptions to gain an actual understanding of Daisy Wheel’s target audience: girls in grades 5-12. We conducted a series of semi-structured interviews as a way to reveal their current activities and actual practices for maintaining good women’s health.

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Description

The Daisy Wheel App is the digital version of a physical artifact used to guide young girls through a Breast Self Exam. The user spins a wheel shaped like a daisy to reveal eight tips of how to do a Breast Self Exam. Both the Daisy Wheel and the Daisy Wheel App are part of the Girl’s Program run by the Get In Touch Foundation, a non-profit organization to provide breast health initiatives that educate women and men in the crusade against breast cancer.

The Daisy Wheel App was featured as a case study on the UX Clinic, an effort to share design expertise with the software development community.
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Participant’s Insights

After ending the interview phase, the design team went through an interpretation session where we discussed the main points of the interviews and transcribed them onto separate notes. Following the discussion we clustered the notes to form an affinity diagram based on common themes that we noticed. By taking the key points we gathered from the interviews, we found emerging patterns in the girls’ behaviors, which helped us identify opportunities for expanding the existing Daisy Wheel App. Out of the research came three main insights that guided our idea and concept generation:

  • Girls’ lack of awareness about preventive care
  • The influence of people’s experiences
  • How girls find and share information about health

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Concept generation

After analyzing the data, we began to ideate on how our findings could be translated into new functionalities for the next version of the Daisy Wheel App. We chose to focus on the app as a platform for promoting self-expression and social connection in a way that encourages girls to modify their behavior regarding preventive care.

Prototype 1. TESTIMONIALS AND HOW TO VIDEO

[one_half]Daisy Wheel has two types of tips:

  • Tips with the steps for doing a Breast Self Exam (BSE) (how-to tips)
  • Tips about the importance of doing BSE (recommendation tips)

For the how to tips we added instructional short videos with tutorials showing exactly how to do each step of the BSE. For the recommendation tips, we showcased testimonials of people telling their experiences fighting breast cancer. In addition to those testimonials, we added an option we are calling “my own experience”, where girls using the app can record a video with their own testimonial that can be shared with their friends.[/one_half][one_half_last]Taskflow:

  1. A girl accesses the Daisy Wheel App and explores the ‘how-to’ tips where she watches a video tutorial with directions on how to perform a BSE
  2. She spins the wheel and switches to a recommendation tip. In this case the video is a testimonial
  3. She decides to contribute to the testimonial collection and records her own experience
  4. Her own experience is then featured as a testimonial video in a recommendation tip

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Prototype 2. QUOTES AND PHOTOS

[one_half]The concept of quotes and photos was inspired by the need for increased awareness about the importance of BSE as a way to detect cancer at an early stage, as well as an alternative way to spread information about health.

Girls are encouraged to share photos within the Daisy Wheel community. Then girls can pick from a set of quotes: some quotes have an inspirational nature related to hope and strength, other quotes are about breast cancer facts and how small steps towards prevention can make a big difference. Girls also have the option to add a quote of their own. This imagery is then used as the building blocks for the “reminders”, explained in the third prototype.[/one_half][one_half_last]Taskflow:

  1. A girl takes a picture to add to Daisy Wheel’s quote collection;
  2. There is an option to select from the image gallery
  3. She selects a quote to add to her image
  4. She shares the image with the Daisy Wheel community, and has the option to share through social media

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Prototype 3. REMINDERS

[one_half]The purpose of the reminders is to encourage and empower girls to become aware of their own health at an early age. Based on the interviews and statements such as ‘when someone I trust gives me advice, I take action’, our aim was to create an experience that was friendly, personal, and approachable. When a girl receives a reminder to perform a BSE, the reminder is accompanied with an image from the Daisy Wheel quote collection, which serves as both a prompt for preventative action and support from the community.[/one_half][one_half_last]Taskflow:

  1. A girl gets a reminder to do this month’s BSE in the form of a photo with a quote from another user
  2. The system asks if she practiced the BSE, and if she responds yes she gets a feedback message congratulating her
  3. The girl receives a badge for completing this month’s BSE, she gets a flower in a pot (a visual representation of her health)
  4. She is then encouraged to share her badge with her friends

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UX Clinic — Sharing Design Expertise With The Community

At the beginning of 2014 I initiated and led the development of the UX Clinic, an effort to share our design expertise with the software development community and train members of the design team at Nearsoft.

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Description

The aim is to facilitate the planning, exploration, concept generation, early prototype iteration, evaluation, and refinement of websites and applications submitted to our program through the use of User Experience design tools and methods.

Each edition of the UX Clinic culminates in a 25 minute-long episode via Hangout On Air (HOA). We broadcast our process and recommendations for a new case study every three weeks. In addition, we generate a report as the final outcome of the analysis we make for each episode’s case study.
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UX Clinic Process

  1. Open Call For Cases. We receive submissions for participation from potential case studies (can be an App/Website/System)
  2. Case Study Selection. We examine each case study before making a decision, that includes visiting their website, using the app, and having brief interviews with the person that submitted the case.
  3. UX Design Process. We dive deep into the case: research > interpretation > ideation > prototype.
  4. On Air Share Out. The case study joins us for a live broadcast where we share the outcomes and answer questions using Hangouts On Air.
    Report with a Proposal of Design Iteration. We craft a report containing all our insights and recommendations on how to improve the case study’s users’ experience.

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This is a video of one of our episodes:

 

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Purpose and Value

Through the UX Clinic process we develop clear recommendations that our case studies can implement on their next design iteration. Our ultimate goal is that the investment of our expertise and time can bring a positive impact to the business objectives of each case study, while improving the overall experience of their users.

In addition to the recommendations we give to our featured case studies, we would like the UX Clinic to be a resource for designers and non-designers getting started using design methods and incorporating users’ input into their design processes. Through the UX Clinic we share our process, the type of design methods we use, and most importantly, how we use those methods and adapt them to each project’s unique characteristics—finally drawing on people’s insights to design for positive experiences with digital platforms and services.

Visit the UX Clinic Website
and our Twitter account
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Outcomes

Download a sample of a full report we generate for each episode:

UXClinicReport-E05BusinessOrigami-MarysolOrtega
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Social Play and Bimanual Activities for Children with Cerebral Palsy

This investigation explores the design of a digital interactive system as a means for promoting social play and the mastery of everyday activities that involve both hands simultaneously in children between six and eight years old with Cerebral Palsy (CP).

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Description

Children with unilateral spastic Cerebral Palsy (CP)—a permanent disorder that affects one side of the body, and frequently involves the hand more than the leg—have activity limitations, hindering social and motor skills.

Increasing bimanual activity levels for children with CP can prevent subsequent functional limitations resulting from muscle weakness. Also, achievements of both of these goals may improve their performance in daily activities and have roles that are more active in social settings.

Prototypes shown feature the design of multiplayer interactive experiences in combination with Tangible User Interfaces (TUI)—a type of interface that combines physical objects and digital interfaces—adding the therapeutic benefit gained from manipulating physical objects.

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Researchable Question

How can the design of Touch and Tangible User Interfaces (TUI) multiplayer interactive system encourage social play and the practice of bimanual activities in children from six to eight years old with Cerebral Palsy?

Subsidiary Questions

1. How can the design of avatars by children with CP in an interactive environment contribute to their sense of mastery in bimanual activities?
2. How can cooperative play stimulate the acquisition of social skills in children with CP?
3. How can the combination of a touch and a TUI in cooperative quests stimulate the practice of bimanual activities in children with CP?

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The final prototypes of the proposed activities are shown in this video:

 

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The video below shows the early stage of paper prototypes for the selected fine motor skills and was the starting point for testing interaction between potential participants, touch, and TUIs.

Paper Prototyping TUI and Touch-based Interface
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The prototypes show possible applications when designing for the development of social and fine motor skills for children with unilateral spastic CP through multiplayer experiences. The design of discrete moments demonstrate how interactive systems would live in the existing environment, and exhibit ways in which different stakeholders would approach this new activity.

The two videos posted here show a proposed layout, in which the TUIs interact with multiple tablets that communicate with each other based on proximity. The designed activities are for a school environment, where children play socially in their spare time. Having multiple devices instead of a single tabletop provides two major affordances. On one hand, a group of children can arrange the devices in a variety of ways, providing flexibility and a wide array of gameplay options. On the other hand, a child can use a single tablet for individual play, in settings other than school.
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Research Methods

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Semi-structured interviews (n=3) with teachers and a program manager from two non-profit organizations focused on children with CP were conducted individually.

The aim of the interviews was to gather qualitative data regarding the lives of children with CP before and after they turn six years old in social and educational contexts. One of the purposes was to identify how schools integrate play in physical rehabilitation and social environments through tools, technologies, and activities available for the children. Each interview had an approximate duration of 40 to 60 minutes; a list of questions guided the interviewer through the process, providing flexibility to focus on specific areas and allowing fluid communication.

To get a better understanding of shared mental models regarding collaborative games this investigation included a semi-structured focus group with gamers (n=5) of collaborative role-playing games. The prompts used were open-ended, asking participants to share their experiences, perceptions, opinions, feelings and attitudes about these types of games.

At the end, they generated a list of key topics that emerged from the conversation:

  • A good role distribution is vital for succeeding on a quest.
  • Avatar selection and how collecting items makes an avatar more powerful.
  • Playing a game is primarily about having fun, players are not serious about completing a quest all the time; at the end “it is just a game”.
  • Group members have to trust each other.
  • Groups perform decision-making with a democratic approach.
  • Leadership emerges in an organic fashion.
  • Players communicate a lot during the game.
  • Social connections arise within the magic circle and they permeate outside the circle even if players abandon the game environment.

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20130130ResearchThesis
Charlie Gaddy Children‘s Center (Raleigh, USA) and APAC –Association Pro People with CP (Hermosillo, Mexico) were the two Non-Profit Organization Focused on Children with CP that participated on the interviews for this study

Additionally, observational studies (n=13) were done with the purpose of witnessing the ways in which six- to eight-year-olds interact with each other, parents, staff members, and with physical objects in a setting where they are encouraged to learn through play.

Using a customized data collection sheet (See Sample) based on the AEIOU (Robinson et al. 1997) organizational framework—Activities, Environments, Interactions, Objects and Users (Stakeholders)—the study not only takes into consideration interactions but also the context within which they unfold. The interactions were coded into two main categories, divided by types of communications (verbal vs. non-verbal) and types of interactions (exchange, competition, conflict, collaboration, and accommodation).
20130130ObservationThesis Data collection sheet used for the observational studies. (Click image to enlarge)[/one_half_last]

Design Methods

The aim of using design methods was to figure out the activities and functions that a new system should incorporate in order to satisfy the different stakeholders’ needs and desires. This approach helped in the generation of a series of principles that guide the new activities in the current space where the participants currently interact with each other. Consequently, it aided in the identification of leverage points that could be expanded by the design of artifacts using the capabilities of digital technologies, as well as a place and time where these activities could fit in the lives of the participants. The principles, patterns, and leverage points guided the process for designing prototypical artifacts that mediate activities of participants’ new practices.

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Affinity Diagramming

To begin the analysis of the interviews and observations, the data went through rounds of interpretation, capturing key moments into notes. The process consisted of recounting the interview and observations guided by transcriptions and notes without summarizing or leaving anything behind. The approach used for capturing and classifying the different moments was to think in terms of observations, gaps, questions, issues, insights, and design ideas during descriptions of specific events, use of artifacts, important characteristics, and cultural differences.

The captured key moments from the interview and observation experiences were assembled into an affinity diagram. Looking beyond key words and focusing on how the moment revealed relevant issues for the new practice, clusters of notes emerged in an organic way based on the type of reasoning the notes were addressing.[/one_half]

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20130130AfinnityDiagram-MarysolOrtegaThesis

Identifying patterns and relevant issues through Affinity Diagramming with the collaboration of  Kezra Cornell

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Personas

Drawing on insights from the affinity diagram and activating the participants’ voice through first-person statements it was possible to define the children’s core behaviors and needs through the creation of personas, a method first described by Alan Cooper (2004).

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Personas for designing to develop social and fine motor skills in children with CP. (Click image to enlarge)

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Visioning

Extracted from the analysis done through the affinity diagram and the creation of personas were a set of design ideas that guided the early prototype iteration:

  • Avatar creation and digital exhibit
  • Collaborative quests and role distribution
  • Activities for verbal and non-verbal communication

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  • Customization of level design
  • Tracking and documentation system with progress visualization
  • Multisensory experience including physical objects for haptic, visual, and audio feedback

These fundamental design ideas made it possible to create a high-level concept storyboard as a starting point for sketching user interface ideas.  The storyboard reflected big pieces of the system’s workflow, and a vision of how activities unfold in future participants’ use of the system. See figure below.

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System map of the envisioned design environment. (Click image to enlarge)

Prototypes

TUI and Touch-Based Interface for Practicing Bimanual Activities. 

The combination of Tangible User Interfaces (TUI) and Touch-based User Interfaces –such as the iPad or Android tablets–can work together to create enjoyable and fun experiences for children with CP.

One of the purposes of the prototypes was to display potential interactions that involve bimanual activities with a specific range of motor skills such as gripping, reaching, releasing, coordination, and stabilization. The selected motor skills are a deconstruction from a list of daily activities found on CHEQ (Sköld et al. 2009), a questionnaire designed to assess children and adolescents’—6 to 18 years old—hand-use experiences. The questionnaire assesses 29 daily activities; this project analyzes six specific activities: inserting a straw in a juice box, buttering a slice of soft bread, putting toothpaste on a toothbrush, cutting on a chopping board, pulling the zipper of a jacket, and screwing off the cap of a small, unopened soft drink bottle (see table below). As a result, the prototypes include interactions to practice the fine motor skills most frequently found on this set of six every day activities.

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Deconstruction of fine motor skills from selected set of daily activities from CHEQ Questionnaire. (Click image to enlarge)
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Prototype 1. Design of Avatars Contributes to the Sense of Mastery in Bimanual Activities

According to James Paul Gee “Video games recruit identities and encourage identity work and reflection on identities in clear and powerful ways” (2007). As a child develops a virtual identity (see slideshow below), he or she projects his/her real identity on the virtual character. Once a child gets involved with the character, he/she will look for the success of the virtual identity. The child achieves success through activities that involve the practice of fine motor skills (see slideshow below). The aspirations a child has for the virtual identity becomes the motivator to keep practicing  these activities.

The interface consistently requires the use of fine motor skills used in everyday activities when a child interacts with the system or with his/her peers. For instance, the images below show how responding to prompts related to personal preferences requires the use of gestures such as dragging, and twisting, skills used in daily activities such as putting toothpaste on a toothbrush or unscrewing the cap of a bottle of soda.

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The child develops a virtual identity while choosing an avatar using bimanual gestures.

Prototype 2. Collaborative Play for the Development of Social Skills

In this case, the children engage with a collaborative drawing activity that encourages the practice of social skills. During the activity, each child begins by drawing in the game (see slideshow below). After a while, each child receives an alert announcing that the system will assign his/her current drawing to a peer. Continuing the activity on their peer’s drawing, the children exercise social skills such as, social awareness, by showing understanding and empathy for others; responsible decision making, by making constructive choices both as an individual and as a group; and relationship skills, by working in teams (see slideshow below).

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Prototype 3. Collaborative Play for the Development of Social Skills

The combination of Tangible User Interfaces (TUI) and Touch-based User Interfaces –such as the iPad or Android tablets– can work together to create enjoyable and fun experiences for children with CP. This prototype displays potential interactions that involve bimanual activities with a specific range of motor skills such as gripping, reaching, releasing, coordination, and stabilization. The selected motor skills are a deconstruction from a list of daily activities found on CHEQ (Sköld et al. 2009), a questionnaire designed to assess children and adolescents’—6 to 18 years old—hand-use experiences. See slideshow below.

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Conclusion

Providing new challenging and engaging activities for children with CP to practice social and fine motor skills can lead to the development of continuous and enduring habits that could increase their well-being. One of the main goals of the design environment is to increase motor capabilities, motor performance, and a sense of mastery. This is achieved by providing status and encouragement, and applying an important principle from video games through elements of gamification: it is okay to fail, you can—and should—always try again.

During the design of the prototypes, it was important to find ways of interaction that were similar to current activities that children do in physical therapy and/or at school. Furthermore, the implemented gestures are movements that form parts of sequences for performing daily activities. This investigation strongly relies on the concept of transferability, in which children practice a set of motor skills that may be successfully applied in activities not directly related to, but require an analogous set of skills.

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References
Cooper, Alan. 2004. The Inmates Are Running The Asylum. Indianapolis: Sams-Pearson Education.
Gee, James Paul. 2007. What Video Games Have to Teach Us About Learning and Literacy. New York, New York, USA: Palgrave Macmillan.
Robinson, Rick, Ilya Prokopoff, John Cain, and Julie Pokorny. 1997. AEIOU Framework. E-Lab. http://help.ethnohub.com/guide/ aeiou-framework.
Sköld, Annika, Liselotte Hermansson, Lena Krumlinde-Sundholm, Ann-Christin Eliasson, and Karolinska Institutet. 2009. Children’s
Hand-use Experience Questionnaire – CHEQ. http://www.cheq.se/home/about

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Creative Commons License

Social Play and Bimanual Activities through Multiplayer Interactive Experiences for Children with Cerebral Palsy by Marysol Ortega Pallanez is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
Based on a work at http://marysolortega.com/project/masters-thesis-social-play-and-bimanual-activities-for-children-with-cerebral-palsy.