R.I.S.E. currently has all of the necessary interfaces for the user to perform all of the functions currently available and the functions that shall be implemented in the future. The input functions for all of the screens are functional, and there is a basis for the user information files that will store each individual user's journal, medication, and other records. However, at this point the user information system has not been fully implemented into an efficient database. The video and sound playback still has to be fully implemented and are currently disabled. The address book of the e-mail function, as well, has all of its interfaces completed, but the functionality, particularly in storage and retrieval of the addresses, has not yet been completed. The e-mail and appointment scheduling also have the entirety of their interfaces and input areas, but actual sending of e-mail and appointment requests is not yet functional.
Overall, R.I.S.E. needs to be fleshed out and
full functionality given to the more complex of the functions.
Overall, R.I.S.E. needs to be fleshed out and full functionality given to the more complex of the functions.
RISE currently includes the following functions:
1.)Login/ Logout/ Add New User
RISE enables the user to login by selecting a user name from the list. It also allows the new user to add his/her name to the system conveniently. After the user inputs and confirms the name that he/she wants to add, the user will be automatically brought back to the login screen where the newly added name has been stored. This addition be shown in the login name list. In other words, the login name list is not static and can be updated.
RISE enables the user to easily logout the system from the "Exit" menu (providing the options of "Logout" and "Exit the program") on the bottom of every screen. We did not provide password protection for login for three reasons: first, we assumed the PDA is personally used; second, there is already password protection to login to the operating system on the PDA and no need to duplicate the efforts; third, to minimize the user’s login steps, especially if emergency self-help being needed.
As shown in the Main Menu, RISE has five main functions:
2.) Self-help Resources
· Psychotherapeutic Exercises
It includes "Thought Evaluation" and "Good Feeling Exercises". Under "Thought Evaluation", it asks the user to follow 3 steps of reviewing and recording his/her current thoughts. Under "Good Feeling Exercises", it asks the user to follow the 8-step instruction to sooth his/her current feeling.
· Relaxation/Anxiety Relief Exercises
It includes "Meditation Relaxation", "Muscle Relaxation", and "Diaphragmatic Breathing". Under "Meditation Relaxation", it guides the user to do meditation relaxation exercises by following 1-4 steps; under "Muscle Relaxation," it guides the user to do exercises by following a-h steps; under "Diaphragmatic Breathing," it guides the user to do exercises by following 1-6 steps.
· Media Selections
It includes "Video/Images" and "Audio". Under "Video/Images," there are buttons of three basic functions: Add new video/images, View the stored video/images, and Remove some stored video/images, so that the user can not only enjoy the media but also edit his/her media library. Right now the "View" control button is working and the user can view pictures/photos available in the list. Similarly, under "Audio," there are "Add," "Listen," and "Remove" dummy function buttons as well. We met difficulties with implementing multi-media functions for PDA application in VB.Net.
To note, the user can easily get back to the "Self-help Menu" or to the "Main Menu" from the "Menu" on the bottom bar of every self-help screen.
3.) Daily Journal
RISE allows the user to record daily journal entries and browse through past journal entries by selecting dates. Also the user can easily get back to the "Daily Journal Menu" or the "Main Menu" from the "Menu" on the bottom bar of every daily journal screen. We did not develop the database to hold the records, so that the interface’s data display is static.
RISE allows the user to keep track of his/her medication by recording the following medication information: Medication type, Time/Date of dosage, Amount of dosage, and Side effect / Memo. To avoid input error, most of the entries are selection from lists. Also the user can easily get back to "Main Menu" from the "Menu" on the bottom bar of medication record screen.
To send an email, the user can select email addresses which are stored in the application and get a response of "successfully sent". But the "Attachment" button is not implemented and there is no Internet connection built in RISE. The user is supposed to be able to add / remove/edit the therapist and group addresses in the application. Right now only the "Add" function is working and the email address list can be updated. Also the user can easily get back to "Main Menu" from the "Menu" on the bottom bar of the emailing screen.
6.) Appointment Scheduling
To schedule an appointment, the user can directly send a request to therapist’s office by specifying the time and other comments. But since there is no Internet connection built in RISE right now, the appointment cannot be sent out. Also the user can easily get back to "Main Menu" from the "Menu" on the bottom bar of the scheduling screen.
There is still room to improve the design and the navigation system. For example, subjects requested "Next" and "Back" buttons in order to traverse most recently viewed screens or to return to a screen where erroneous input has been made or which was left prematurely.
The self-help resources require more content and exercises. In order to keep therapy effective and make it easier for patients to continue with therapy, a very broad range of self-help materials needs to be available. A feature that allows download of new exercises from a website or a feature that allows creation of new exercises by a therapist would help keep the content fresh and diverse.
The disabled functions, media playback, and user information database need implementing and in order to give the interface full functionality.
Also, connectivity to a PC would enable users and their therapists to print out information if desired and might act as way to download or create new self-help material.
Recommendations to future developers
It is highly recommended to have more background knowledge of the depression/anxiety problems and cognitive therapy, both self-help and group therapy, before the developer starts building the system. To develop such a device, developers need to involve themselves in the therapy process and get a good understanding through direct communication with the patients, or even better, have the real patients (groups) as design partners during the design processes. RISE involves a lot of journal typing and networking, but a PDA application seems to be cumbersome in these cases. An initial survey with potential users prior to design can be helpful to find out the most desired and applicable features. If the typing can not be avoided, the developers should think of intelligent ways to simplify the typing process such as using templates to minimize the user effort.
Future developers should particularly take care to perform extensive design and re-design before actually implementing any new functions in order to take into account the small size of the screens and the limited tools available in the .NET Compact Framework. Our designers had to re-design many screens several times in order to keep as much information and functionality consolidated as possible while keeping the screens legible. Also many of the features we had designed could not be implemented given the limitations of the .NET Compact framework.
Finally, running long term pilot tests in conjunction with willing therapy groups will give a much better idea as to whether the interface actually augments and facilitates therapy as hoped. One of the goals of R.I.S.E. is to encourage continued therapy and face-to-face contact with the therapist and therapy group. Long term tests and studies will be needed to help meet these goals.