R3/D3 Project Update: Health, Wellness, and Safety after TBI February 2017

Goals of this Discussion Understand the health, wellness, and safety topics that are important to you Get your opinion on how technology may or may not be helpful in managing your health, wellness, and safety goals Show you examples of different types of technology that may be used to support health, wellness, and safety goals & get your feedback.

Consent Purpose and what we plan to do Benefits/risks Confidentiality Voluntary participation We appreciate your input and help Purpose – previous slide Benefit – not to you directly but could help others; you will receive a gift card at the end Confidentiality- we are recording your comments but will not connect your name with any comment as we summarize our findings Can stop at any time – without affecting your care here at Shepherd (still get gift card?) We appreciate your input and help

Impacts of TBI * We know that TBI can affect you in many different ways Cognitively (ability to think) Physically Mood/Behavior Cognitive Effects Memory Organization Planning Physical Effects Mobility Strength Endurance Sleep Mood/Behavior Effects Stress

Background Questions Lets learn more about you… Hand out survey? Complete & review the pre-interview survey Age, gender, income, tbi date….rest of stuff in your plan

Learning About You When you first discharged from Pathways and transitioned home, what were some of your health, wellness, and safety concerns? What are your biggest health, wellness, and safety concerns now? rest of stuff in your plan

Learning About You How has your injury affected your ability to… Be physically active? Get quality sleep and overcome fatigue? Manage stress? Organize your thoughts, think, remember, and get things done? How have you managed these issues (coping strategies)? Have you ever used technology to manage these issues? rest of stuff in your plan

Do you have trouble with? Memory Planning Attention Medication management Getting physical exercise Falls Sleep problems Stress management Anxiety Socialization Ask them to rank order (allow for equal / don’t know) *Maybe ask them the TOP 3 they have trouble with? ADD: Organization Time Management

Comfort with Technology Do you own or use a… cell phone computer wearable device How do you use technology? web browsing calendar texting

Can technology help? *Coaching and feedback We will be showing you some examples of how we might help you (with coaching and feedback) obtain your health goals What’s on this slide: -Wearables (health coaching messages) -Interactive video exercise -Cognitive games -Medication management/reminders -Summary display of different information you might want to track (calendar events, medication prescriptions, sleep quality, etc.)

Exercise Technology Would they be interested in guided chair exercise? Prefer standing exercises? Exercise games? Automated just-in-time feedback? Counting of repetitions? What do they think about having the Kinect camera recording their movements with a “skeleton” image? What about avatars instead? Would it be helpful to have a social exercise system? Would they prefer simple step counts or calorie expenditure from the wrist device? Both? Would it be helpful to see if their balance, strength, endurance, flexibility were improving? Stress/Mood related technologies: Breathing exercises Relaxation techniques

Wearable Technology *Take picture of all wearable technology and insert on this slide There are lots of wearables on the market. You might have one of these. They measure things like activity level (step count or calories), heart rate, temperature, skin conductance (stress) May not need so many examples….just a picture I already had

Wearable Technology - ACTIVITY Example: Garmin Vivoactive HR May help you with your activity Motivation Help keep track of information Steps Heart rate Fitness program (strength training goals, cardiovascular goals, etc.)

Feedback Display Information Feedback Display-What do you think about how this looks?

Wearable Technology - STRESS Example: MS Band 2 May help track indicators of stress levels Body temperature Electro Dermal Activity (EDA) Hear Rate Variability (HRV)

Feedback Display Information Feedback Display – What do think about how this looks?

Sleep Technology Example: Beddit May help track your sleep quality How long it takes you to fall asleep Hours you slept # of times you got up Periods of restlessness

Sleep Technology Explain how the sleep technology/monitor might work The sleep sensor goes 2. During the night, it keeps 3. The next day you see under the mattress pad of your sleep. How well you slept. or sheet.

What can sleep technology tell you? Information Feedback Display on Sleep- What do you think?

Memory and Cognitive Technology Technology supporting medication management Organization Reminders Top picture shows a bluetooth enabled medication dispenser (knows when compartment opened and closed) Need help remembering to take your medications? Lower picture is from a Web cam below the dispenser that appears in real time on the Web. A coach or family member could help and make sure the right medications are put into the dispenser and taken out in a timely way. We could remind people more intelligently to take their meds (and how, e.g., with food) Don’t remind when on phone, asleep, etc. Remind when near the dispenser

Brain Games Brain games to help with memory, attention, impulsivity, and planning With these adaptive cognitive computer games you can work on developing memory, planning, attention and other cognitive functions. We would also be able to give you feedback on improvement over time. Would this be important to you?

Communication Technology Staying socially connected Phone Email Text Skype How do you like to communicate with others? How would you like to get the support you need for you health, wellness, and safety goals? Can give task challenges for the week and view progress toward goals Would you like to view progress via a Web site (tablet, laptop, phone)? Would you like to have a phone app to get all of your info? Like in slide10. Coaching messages via text messages? Voice over phone? Text on watch? Reminders? Feedback?

Communicating with a Health Coach LAST QUESTIONS: Revisit Types of feedback and what interventions would be important to you? - RANK ORDER Of this kind of data that is important to you Who do you think about the information being shared with family and clinicians? Do you have any concerns about sharing/privacy? What information would be helpful for the caregiver? What would be ok for a coach to see vs. clinician vs. caregiver Consider the benefits vs. trade-offs What would be some good incentives? How could the technology give you more independence?

Thank you for your time!?