Developing the CHILD (Children’s Health Information Links of Denton) System to Help Children, Families, School Personnel and Professional Healthcare Providers

Context

A comprehensive study by a leading north Texas children’s hospital revealed that mental health issues are the leading threat to children’s health in Denton County, Texas, topping childhood obesity, asthma, domestic violence and oral health. Over 7% of Denton County residents under 18 suffer from some form of a mental health disorder. If left untreated, these issues often develop into adult mental and behavioral disorders.

Challenge

There were two of these. The first involved creating a web-based communications network that facilitated mental health awareness, information delivery, community building and data collection on behalf of healthcare providers, caregivers, educators and young people. The second involved ensuring that our development team consistently received meaningful contributions from two of the County’s major public service organizations, its public-school system and one of its premier children’s healthcare providers.

Methods

Persona-based Modeling
Scenario Building
Heuristic Analysis of User Scenarios
Ethnographic Interviews
Stakeholder Interviews and Focus-Group Sessions
Future-casting

Key stakeholders from each of the four groups of users for whom the CHILD website was designed actively participated in each of its stages of development. Our faculty-led teams of three to six graduate-students facilitated interviews and focus groups throughout our decision-making processes. These allowed a diverse array of people to tell stories about their experiences dealing with mental health issues, or about helping young people who were experiencing them. We used this “soft data” to positively affect the organization and the functionality of the entire CHILD website. These kinds of design processes helped both our teams and the project stakeholders to significantly alter many of their preconceptions about children’s mental health, and, in some cases, to treat or deal with it more effectively than they had before.
Primary Objectives

1. To create a user-responsive website that worked across a variety of platforms to improve the standard of children’s mental health in Denton County, Texas.
2. To meet the needs and aspirations of four main user groups: the children themselves, their parents and other caregivers, school personnel, and children’s mental healthcare providers
3. To provide professional children’s mental healthcare providers in Denton County, Texas with data sets they could use to better marshal their resources to meet key challenges as they arose.

Allowing Human-Centered, Ethnographic Research to Frame Key Issues

Our faculty-led, graduate student teams began the design research process that guided much of the decision-making that guided this project by formulating and operating a series of seven etic observation sessions. These involved observing approximately 15 members from each of the four primary user groups as they attempted to use extant web resources to identify or use resources to deal with one or more issues involving children’s mental health. No interaction between those being observed and the student teams occurred during these sessions. The etic observations were followed by individual and focus group interviews to gather more information that could inform how the C.H.I.L.D. website prototype needed to be planned, designed and developed.

Extant Children’s Mental Healthcare Resources in Denton, County, Texas
Identifying the Most Significant Barriers

Prior to the design and implementation of the C.H.I.L.D. website prototype, the UNT interaction design team worked with our community partners to identify four primary groups of people/users in Denton County as being most in need of the types of services and resources that this website could facilitate. These are depicted in the grey type that appears at the outermost edges of each of the four quadrants in the diagram at right. A series of seven coordinated observation sessions augmented by individual and focus group interviews revealed the array of “problematic issues” per each group of users that are rendered in the colored type. The closer an issue appears to the center of the diagram, the more problematic it was deemed to be.

An Improved Array of Children’s Mental Healthcare Resources in Denton County, Texas
Using the C.H.I.L.D. Website to Overcome the Most Significant Barriers to Access and Usability

Many of the issues that members of each of the four primary user groups had identified as being “acutely problematic” prior to the design and implementation of the C.H.I.L.D. website prototype proved to be much less so afterward. Usablity testing data gathered and analyzed from approximately 15 members of each of the four groups after their interactions with the prototype are depicted in the image at right. Note that issues which were deemed “acutely problematic,” prior to their usage of C.H.I.L.D., particularly for parents and children, have “migrated” away from the center of the diagram to its periphery.

Designing a Prototype That Facilitated Input and Output from Our Key Stakeholders

The C.H.I.L.D. (Childen’s Health Information Links of Denton) website was designed and developed using a “call-and-response” approach to asking users from the four primary groups of stakeholders to provide small “chunks” of privacy-protected information in exchange for receiving useful, subject-specific information in return. One of the over-arching goals of the C.H.I.L.D. website was to have it be used to help catalyze the formation of interlinked community groups that could also use the site to provide mutually beneficial support to each other.

Takeaways: what we learned that will guide our future efforts

The user-experience-based research processes formulated and operated by the faculty-led, graduate student teams guided the design and development of a prototype for the CHILD website that effectively met the needs and aspirations of each of its four user groups. These included young people experiencing mental health issues, their parents and teachers, and members of the children’s mental healthcare community of Denton County.

Allowing the eventual users of the CHILD website to actively participate in the decision-making that guided its development helped ensure that the most viable and practical concepts and approaches were discussed, which often led to them being prototyped. This involved gathering, analyzing and assessing information from each of the user groups during several successive cycles of usability testing so that key concerns about the organization and general functionality of the site could be effectively addressed and resolved.

Operating these types of design processes also helped our diverse stakeholders set aside most of their preconceptions—most notably about interaction design and ways to deal with children’s mental health—in favor of ensuring that a more open-minded approach could evolve.

One of the most crucial things that the team learned was how important it was to afford individuals opportunities to share their personal stories about dealing with their own mental health issues, or helping others deal with theirs. In turn, this led to the evolution of one of the websites most important, community-based features: that of making it relatively easy for individuals to learn that “they were not alone” in dealing with mental-health-related issues, and that pools of resources existed in Denton County to help them.