WeSmile

WeSmile is a web-based application that helps the patients with intellectual or developmental disabilities and their caregivers (Direct Support Professionals and families) to prevent dental diseases through knowledge/skill acquisition, risk assessment, action plan, and follow up materials.

Scope

Product Strategy
User Experience Design
Instructional Design

Client

Columbia University College of Dental Medicine
The Arc

Timeline

Jun. 2022 - Apr. 2023

My Role

Design Strategy
Lead Product Designer
Project Manager

CONTEXT

More than 7 million Americans with intellectual or developmental disabilities (ID or DD) need spacial health care. Oral health matters as it is related to general health directly. However, maintaining good oral health or receiving dental care can be particularly difficult for the ID or DD population. To better serve the individuals, a research team from Columbia University College of Dental Medicine started educational and service initiatives, with funding from the U.S. Health Resources and Services Administration (HRSA). The key project is to develop a new dental special health application.

The new application will

- Support Direct Support Professionals (DSPs) in day habilitation programs to work with people with ID or DD

- Enable people with ID or DD and their caregivers to use it in different scenarios

- Help people with ID or DD to develop good oral health habits

THE CHALLENGE

Designing a new dental care application that helps people with ID or DD and their caregivers to receive dental health education and make behavior changes.

AIMS

Understand ID and DD population's main barriers and challenges in oral health
Identify primary users and secondary users, their pain points and a day in life
Enable users to make dental health behavior changes

RESEARCH

Intellectual and developmental disabilities (ID and DD)

Intellectual disabilities are disorders that involve difficulties in mental tasks such as learning, reasoning, problem-solving, and so on. Developmental disabilities affect intellectual functioning, physical functioning, or both. Examples include Down syndrome, Autism Spectrum Disorder, cerebral palsy, Fragile X Syndrome, and more.

Different Types of Disabilities

ID in reading

Have difficulty in understanding relationships between letters, sounds, and words; have problems with reading comprehension

ID with motor skills

Have problems with both gross and fine motor skills

ID with language

Lack ability to speak and to understand spoken words

ID with auditory and visual processing

Have difficulty in processing the things they hear and see

*Sources: HealthyPlace

ID Severity level, capabilities, and needed support

*Sources: Understanding and supporting learners with disabilities, HealthyPlace

Living Context and Setting of Support

Individual with DSP

-Outside home in the community

-DSPs assist individuals to improve their self-help, socialization and adaptive skills

Small Group Series

-Small group experiences take place during the courses to develop skills and community involvement

Day Habilitation Programs

Individual Residential Alternatives (IRA)

Supervised IRAs

-Traditional family-style group homes

-24-hour staff support and supervision for up to 14 residents

Supportive IRAs

-IRAs are limited to 3 or fewer residents

-Need-based support for those who are living in their own homes or apartments

Home

Individual with families

-Live at their own home with parents or siblings

IDD Populations' barriers in dental healthcare

Interviewed dentists and day habilitation program's managers who work with IDD population

Caregivers, especially in the context of care homes lack recognition for dental healthcare's importance
Staff in providing oral hygiene were not aware of how to help/provide toothbrushing (or basic oral healthcare) for the patients with different needs
Lack of information and understanding about mouth-body connection
Food is often used as rewards for this patient group which can be adding challenges in oral healthcare

KEY FINDING

01/

Various disability levels and situations

02/

Need caregivers' support in different living contexts

03/

Caregivers lack awareness in dental healthcare

04/

Dental providers do not provide toothbrushing knowledge/skills

05/

Behavior change is hard

USER INSIGHT

User Needs

DSPs (or others caregivers) are able to manage a few people with IDD during the same time period
DSPs (or others caregivers) and people with IDD are able to recognize the importance of dental healthcare
DSPs (or others caregivers) can assist people with IDD learn dental healthcare knowledge and skills and receive support to make behavior change
Enable people with mild IDD are able to learn knowledge and skills with limited support

User Goals

Create supportive environment: access support and resources easily in different living contexts
Enhance motivation: understand the importance of dental health
Facilitate ability: acquire effective knowledge and skills to manage dental health
Make behavior change: apply knowledge and skills learned in their daily life to manage dental health

CONCEPT AND STRATEGY

Who will be primairy users and secondary users?

At the first stage, the application will directly used in day habilitation programs (for IDDs) in New York State. As people with IDDs have limited cognitive abilities to use a new application, DSPs (Direct Support Professionals) will be the primary users. At the time that people with mild IDDs have learned how to use this application, they will become the secondary users.

Primary User

DSP

slide 19 times a day brushing teeth 1.png

Secondary User

People With Mild IDDs

Which knowledge and skills do users need?

To understand which knowledge and skills users need, we collaborated with Subject Matter Experts (Columbia University dental professors, dentists, and dietitians) to identify IDD population's risk areas in dental healthcare. After analyzing these risk areas, we identified five learning goals that are import to IDD population :

Week 1: Access dental care
Week 1: Oral hygiene
Week 2: Make healthy food choices
Week 3: Make water your go-to drink
Week 4: Thoughtful eating

How to support users make behavior changes?

After conducting research on behavior change theories, we applied social cognitive theory and health belief model to the learning process design. The process includes four steps to support behavior change:

1. Risk Assessment

Perceived severity
Perceived susceptibility

2. Goal Setting

Self-efficacy
Cues to action

3. Action Plan

Health Motivation
Perceived benefits
Break barriers

4. Follow-up

Self-efficacy
Cues to action

Multiple choice questions to identify users' dental health risk areas

Fill a form to identify responsible person

Educational guide and regular flyers to help users learn knowledge and skills

Reflect on action plan and work better on next goals

From determinants of behavior change to behavior change strategies, learning experiences, and educational content.

INFORMATION ARCHITECTURE

USER FLOW

KEY FEATURES' DESIGN DECISIONS

How to support DSPs who work with people with severe IDDs (can not use digital devices)?

Using digital devices looks common for many people. However, it is not a easy thing for some people with IDDs. In this case, I designed to enable DSPs and caregivers to use their own devices to help people with IDDs from the first step: registration.

How to enable many to many interactions between DSPs and people with IDD?

One challenge in design is that one DSP will work with a few IDDs while one IDD have support from a few DSPs. How to enable the many to many interactions in the application and make sure each DSP can take his responsibilities?

Option 1: All digital

Option 2: All physical

Option 3: Interplay between physical and digital

How to make the application accessible to the people with IDDs?

Make the application simple