SBIR-STTR Award

OC Go Facilitating fidelity and dissemination of evidence based treatment for childhood OCD via an interactive crowd sourced patient provider tool The long term objective of this project is to leverage mobile technologies and crowdsourcing to create a new paradigm of evidence based treatment delivery and dissemination as current methods are often insufficient The project seeks to refine and assess OC Go a HIPAA compliant web based clinician portal and patient side mobile application designed to increase patient adherence to evidence based treatment EBT for Obsessive Compulsive Disorder OCD a common and impairing condition and provider ability to effectively implement EBTs OC Go allows clinicians to create and push tailored assignments to patients on their mobile devices with an optimized user interface that includes patient accountability and support features Accordingly patients can be guided to do assignments by themselves between sessions with increased fidelity over the course of treatment OC Go also directly empowers clinicians to learn from and teach one another via a searchable crowd sourced i e clinician sourced library of exposures multimedia assignments and assessments related to specific symptoms or search terms Interactive assignments are created by clinicians or supervisors using a drop and drag toolkit and can include step by step written or audio instructions patient video capture of exposures writing assignments speaking assignments anxiety cuing stimuli exposure oriented puzzles cartoons gaming templates joint child parent assignments and many other types of creative technology enabled activities Once created and shared to the public library any clinician can assign any task to any patient for homework or in session use with one touch The crowd sourced library is rated by clinicians and curated for quality control Use of OC Go is expected to increase patient engagement compliance treatment efficiency dissemination of EBTs and therapist confidence and expertise Phase I Specific Aims Complete development of OC Go Refine user interface via collaborative consultation and user acceptance testing UAT with community clinicians drawn from several treatment contexts and expert clinicians at a UCLA OCD specialty clinic Refine crowd sourced library usability expand search tools and enable curating Assess strengths and weaknesses and refine key functions based on clinically relevant outcomes and UAT in clinical piloting with OCD diagnosed children N sessions therapists Phase II Specific Aims Continued Development Patient and clinician product testing Conduct randomized trial N to test compliance with therapeutic assignments primary outcome and treatment efficiency as defined by slope of clinical improvement over course of sessions secondary outcome in EBT with and without OC Go Simultaneously continue iterative improvements with UAT and seed the crowd sourced library via partnership sourcing with three prominent Child OCD clinics Then sequentially partner with community users in the field N to examine adoptability measures product educational value and to continue iterative product improvement given a large volume of users in ecologically valid settings Project Narrative Title OC Go Facilitating fidelity and dissemination of evidence based treatment for childhood OCD via an interactive crowd sourced patient provider tool In the United States there are approximately million children and million adults with Obsessive Compulsive Disorder OCD Effective evidence based treatments EBTs for the disorder exist but patient engagement in effective treatment and the lack of clinicians with the necessary expertise seriously limit public health efforts to address this debilitating disorder The current application is directly related to public health because the proposed mobile and crowd sourced technology has the potential to increase patient engagement and adherence to effective treatment while also directly empowering clinicians to learn from and teach one another about effective methods to address specific patient symptoms

The long-term objective of this project is to leverage mobile technologies and crowdsourcing to create a new paradigm of evidence-based treatment delivery and dissemination, as current methods are often insufficient. The project seeks to refine and assess OC-Go, a HIPAA-compliant web-based clinician portal and patient-side mobile application designed to increase patient adherence to evidence-based treatment (EBT) for Obsessive Compulsive Disorder (OCD), a common and impairing condition, and provider ability to effectively implement EBTs. OC-Go allows clinicians to create and push tailored assignments to patients on their mobile devices with an optimized user interface that includes patient accountability and support features. Accordingly, patients can be guided to do assignments by themselves between sessions with increased fidelity over the course of treatment. OC-Go also directly empowers clinicians to learn from and teach one another via a searchable crowd-sourced (i.e., clinician-sourced) library of exposures, multimedia assignments, and assessments related to specific symptoms or search terms. Interactive assignments are created by clinicians or supervisors using a drop and drag toolkit and can include step-by-step written or audio instructions, patient video capture of exposures, writing assignments, speaking assignments, anxiety-cuing stimuli, exposure- oriented puzzles, cartoons, gaming templates, joint child-parent assignments, and many other types of creative technology-enabled activities. Once created and shared to the public library, any clinician can assign any task to any patient for homework or in-session use with one touch. The crowd-sourced library is rated by clinicians and curated for quality control. Use of OC-Go is expected to increase patient engagement, compliance, treatment efficiency, dissemination of EBTs, and therapist confidence and expertise. Phase I Specific Aims: Complete development of OC-Go: 1) Refine user interface via collaborative consultation and user acceptance testing (UAT) with community clinicians drawn from several treatment contexts and expert clinicians at a UCLA OCD specialty clinic; 2) Refine crowd-sourced library usability, expand search tools, and enable curating; 3) Assess strengths and weaknesses and refine key functions based on clinically- relevant outcomes and UAT in clinical piloting with OCD-diagnosed children (N=50 sessions/6 therapists). Phase II Specific Aims: Continued Development/Patient and clinician product testing: 1) Conduct randomized trial (N=32) to test compliance with therapeutic assignments (primary outcome), and treatment efficiency as defined by slope of clinical improvement over course of 6 sessions (secondary outcome) in EBT with and without OC-Go; 2) Simultaneously continue iterative improvements with UAT and seed the crowd- sourced library via partnership-sourcing with three prominent Child OCD clinics; 3) Then sequentially partner with community users in the field (N=100) to examine adoptability measures, product educational value, and to continue iterative product improvement given a large volume of users in ecologically valid settings.

Public Health Relevance Statement:
In the United States there are approximately 1.2 million children and 3 million adults with Obsessive  Compulsive  Disorder  (OCD).  Effective  evidence-­?based  treatments  (EBTs)  for  the  disorder  exist,  but  patient  engagement  in  effective  treatment  and  the  lack  of  clinicians  with  the  necessary  expertise  seriously  limit  public  health  efforts  to  address  this  debilitating  disorder.  The current application is directly related to public health because the proposed mobile and crowd sourced technology has the potential to increase patient engagement and adherence to effective treatment, while also directly empowering clinicians to learn from and teach one another about effective methods to address specific patient symptoms.

Project Terms:
Accountability; Address; Adopted; Adult; Anxiety; base; Cartoons; Child; Childhood; Clinic; Clinical; clinical efficacy; Clinical Trials; clinically relevant; Collaborations; Communication; Communities; Compliance behavior; Computer software; Consultations; crowdsourcing; Custom; Databases; design; Development; Diagnosis; Disease; Drops; effective therapy; empowered; Evidence based treatment; Feedback; Funding; handheld mobile device; Health Insurance Portability and Accountability Act; Impairment; individual patient; Instruction; Joints; Learning; Letters; Libraries; Measures; Mediation; medical specialties; Methods; mobile application; mobile computing; Multimedia; Obsessive-Compulsive Disorder; Online Systems; Outcome; Parents; patient engagement; Patients; Phase; Play; Prevention; primary outcome; Privatization; Protocols documentation; prototype; Provider; Public Health; Quality Control; randomized trial; response; Sampling; secondary outcome; Seeds; Side; Source; Specific qualifier value; Stimulus; Symptoms; Technology; Testing; Therapeutic; tool; Touch sensation; Treatment outcome; United States; Update; usability; Videoconferences; Writing