Agenda

1. CALM:Collaboratively Augmenting Longitudinal MonitoringCo-design & Co-production, our journey so far…Kelly McGurk, Olivia & Phil Hewitt, Adi Sharmaon behalf of the CALM Team

2. Agenda • Background: Why and what is CALM? • INVOLVE: Co-design and Co-Production • Benefits to young people and their families • Evaluation and qualitative feedback • Next Steps

3. Why CALM? Monitoring mood is very helpful: • Allows a sense of autonomy and self-regulation • Informs the identification of a personalised ‘relapse signature’ and ‘early warning signs’ • Conventionally done in ABS using pen and paper:

4. Why CALM? • Young people wanted an App! • Using email, completion of mood charts increased from 30% to 60% • Sought pump priming funding from NTW

5. What is CALM? • CALM is an innovative mobile Application • Co-designed and co-produced with young people, 16-25 years, with Bipolar Disorder, their family members, clinicians, researchers and members of Boxmodel • Offers an easy way of logging daily moods and emotions. • A way of longitudinal monitoring as per NICE guidelines.

6. INVOLVE: Co-design May 2015 – June 2016 6 weekly workshops: 6 young people and 6 parents Discussion focus: self management of Bipolar Disorder Socialisation Learning Excitement Relaxation Distraction Regulation

7. INVOLVE: Co-production • June 2016 – September 2016 • 6 weekly workshops with 6 participants and 6 parents • Discussion focus: production of the App • Developed the App in December 2016

8. Mood charting • No numbers • Sliding scales that change colour

9. Gives live feedback to young people on ‘how’ they are doing • Can identify patterns over time

10. Lifeline • Useful in crisis situation

11. Benefits to Young People

12. Benefits to Families

13. Qualitative Feedback • Interviewed 10 young people • Questions exploring usability of the App • Inform next steps of App development

14. QUALITATIVE RESULTS: KEY THEMES • Describe the App • “…Helpful…discrete…simple…quick” • Favourite Features • Slide scale • Lifeline • Graphs • Least liked • Not having reminders • Writing section • Not enough emotions in dictionary

15. QUALITATIVE RESULTS: KEY THEMES What would you add / change about the App? • Add blank slide scale • Add more words to the emotion dictionary “”I would probably change some of the words on itand add things like tired, excited, cheerful”” • Personalise the App i.e. colour schemes, profiles and what helps me section • Interactive i.e. add games • Closed group forum i.e. learn from others experiences • Dashboard for services • Add reminders i.e. have secret code/word

16. Our Vision Further develop the CALM App to respond to the requirements outlined by the current users: • GPS tracking for the Lifeline feature • Customisable alerts and reminders • App personalisation i.e. profile • Medicinal information • Therapeutic activities i.e. interactive mindfulness, games, doodle page • Integrate wearables (activity, sleep patterns, heart rate) • Development of a buddy App (USP) • Clinician dashboard development • Expand the user-base to include patients with other forms of mental health disorders Bipolar UK have provided support for this project.

17. Benefits to Clinicians • Better use of clinician time: • See the right person at right time i.e. person centered care • Reducing metabolic syndrome • Linked to RIO documents • Dashboard for professionals • Cost-effective • Leaner way of practicing

18. Benefits for NTW • An ‘Outstanding’ Trust needs outstanding innovation • Will keep us at cutting edge • Inform NIHR grantapplications • Potential for commercialization as IP held with NTW

19. Acknowledgements THE RESEARCH TEAM Aditya Sharma1,2, Bethany Anderson3, Madeline Balaam2, Alan Easton3, Darren Flynn2, Sophie Hodgetts2, Magdalena Glod2, Tim Horwood3, Paul Hutton3, Andrew Marshall2, Kelly McGurk1, Clare Smiles3, & Steven Wallace3 1.Northumberland Tyne and Wear NHS Foundation Trust and Newcastle University, UK, 2. Newcastle University, Newcastle upon Tyne, UK 3. Boxmodel Digital Media, Newcastle, UK ALL OF THE YOUNG PEOPLE AND THEIR FAMILIES WHO CONTINUE TO TAKE PART IN THIS RESEARCH PROJECT

20. References • [1] Hidalgo-Mazzei, D., Mateu, A., Reinares, M., Matic, A., Vieta, E., & Colom, F. (2015). Internet based psychological interventions for bipolar disorder: Review of the present and insights into the future. Journal of Affective Disorders, 188, 1-13. • [2] Hidalgo-Mazzei, D., Mateu, A., Reinares, M., Murru, A., Mar Bonnin, C., Varo, C., Valenti, M., Undurraga, J., Strejilevich, S., Sanchez-Moreno, J., Vieta, E., & Colom, F. (2013). Psycho-education in bipolar disorder with a SIMPLe smartphone application: feasibility, acceptability and satisfaction. Journal of Affective Disorders, 200, 58-66. • [3] National Institute Health Research, (2003). INVOLVE: Exploring the impact of public involvement on the quality of research: examples, UK. • [4] Wright P, McCarthy J. Experience-centred Design: Designers, Users and Communities in Dialogue. Morgan & Claypool Publishers, 2010. • [5] Field, A., & Hole, G (2003). How to Design and Report Experiments. Sage, UK. • [6] Tennant, R., L. Hiller, R. Fishwick, S. Platt, S. Joseph, S. Weich, J. Parkinson, J. Secker & S. Stewart-Brown (2007) The Warwick-Edinburgh Mental Well-being Scale (WEMWBS): development and UK validation. Health Qual Life Outcomes, 5, 63. • [7] Rizvi, S.L., Dimeff, L.A., Skutch, J., Carroll, D., Linehan, M.M. (2011). A pilot study of the DBT coach: an interactive mobile phone application for individuals with borderline personality disorder and substance use disorder. BehavTher, 42(4), 589–600.