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Designing Electronic Problem-Solving Training for Individuals With Traumatic Brain Injury: Mixed Methods,

Matthew Schmidt1,2, Yueqi Weng2, Shannon Juengst3

  • 1College of Pharmacy, Department of Clinical and Administrative Pharmacy, University of Georgia, River's Crossing, 215, Athens, GA, 30602, United States, 1 (706) 542-3000.

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Summary

Community-based participatory research (CBPR) enhanced the usability of a mobile health intervention for individuals with traumatic brain injury (TBI). This approach ensured the Electronic Problem-Solving Training (ePST) tool was accessible, effective, and user-centered for TBI survivors.

Keywords:
community-based participatory researchmHealthproblem-solving trainingrehabilitationtraumatic brain injuryusabilityuser-centered design

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Area of Science:

  • Rehabilitation research
  • Human-computer interaction
  • Digital health

Background:

  • Traditional TBI rehabilitation research often overlooks the experiences of individuals with TBI, leading to interventions lacking relevance and effectiveness.
  • Community-based participatory research (CBPR) offers a collaborative framework empowering patients, caregivers, and clinicians in research.
  • CBPR emphasizes power sharing and sustained engagement to create more impactful health solutions.

Purpose of the Study:

  • To apply CBPR principles to the design and usability evaluation of the Electronic Problem-Solving Training (ePST) mobile health (mHealth) intervention for individuals with TBI.
  • To integrate community feedback throughout the design process, from initial concept to final prototype.
  • To assess the sociotechnical-pedagogical usability of the ePST intervention with TBI partners.

Main Methods:

  • A mixed-methods case study design guided by CBPR principles and learning experience design.
  • Utilized a 33-member Community Advisory Board and 10 Community Engagement Studios involving TBI survivors, caregivers, clinicians, and researchers.
  • Employed empathy interviews, persona development, rapid prototyping, and usability testing with think-aloud protocols and the Comprehensive Assessment of Usability for Learning Technologies (CAUSLT) instrument.

Main Results:

  • Co-design process translated community feedback into an empathy-informed, user-centered prototype, identifying TBI-specific design needs like linear progression and clarity.
  • Usability testing revealed participants struggled with complex navigation but excelled with sequential content; practical refinements included shorter lessons and simplified navigation.
  • The ePST intervention demonstrated high overall usability (CAUSLT score 4.25/5), 80% knowledge accuracy, 100% module completion, and efficient task completion times, indicating effective learning and comprehension.

Conclusions:

  • Sustained CBPR throughout the design and development of the ePST mHealth tool resulted in high usability for individuals with TBI.
  • This study established a full-cycle pipeline linking community partnership to measurable usability outcomes for mHealth development.
  • The research produced community-informed design principles and a reproducible mixed-methods approach for formative mHealth development in TBI rehabilitation.