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

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.