To provide assistance following the bombing at the Boston Marathon and the explosion in Texas, the National Center for PTSD, US Department of Veterans Affairs, has posted the following material. These pages link to an abundance of targeted information:

Resources for Survivors and the Public
Includes: Acts of Violence, Terrorism, or War: Triggers for Veterans
Resources for Providers Responding to Sudden Trauma

Prominent links are posted to these resources on the National Center for PTSD Website www.ptsd.va.gov. These resources will be publicized using social media (on PTSD Facebook and Twitter accounts) so please monitor those sites and repost/retweet.

Mary M. LaMarca, Librarian
National Center for Post Traumatic Stress Disorder
Department of Veterans Affairs
White River Junction, Vermont
Mary.LaMarca@VA.gov

The NN/LM NER’s thoughts and prayers are with all those affected by yesterday’s tragedy at the Boston Marathon. Our deepest sympathies to those who lost loved ones in this tragedy. We exhibited at the Boston Marathon Expo at the Hynes Convention Center this weekend and were inspired by the hundreds of runners we talked with at the booth. This tragedy is unfathomable, and we are in shock. We appreciate the outpouring of support from our friends throughout the country and the world.

The National Library of Medicine hosts many disaster information resources. If you are looking for a missing loved one, the NLM has activated the Lost Person Finder. Both People Locator and the ReUnite app are being updated, and LPF exchanges data with Google’s Person Finder.

The Disaster Information Management Research Center (DIMRC) includes resources to help cope with disasters, violence and traumatic events. This site includes resources for mental health and emotional response to traumatic events, intervention and treatment, and resources to help emergency responders, healthcare workers and volunteers manage traumatic incident stress. There are resources for professionals, teachers, parents and others working with children. This page includes multi-language resources in Arabic, Chinese, French, Japanese, Russian and Spanish. DIMRC includes a resource with information on mass casualties. The DIMRC listserv and Twitter feed is a way to stay up-to-date with disaster related information resources.

The MedlinePlus, Coping with Disasters page, includes information to help survivors of mass violence recover from disasters.

The American Red Cross recommends the following to recover emotionally from a disaster:

• Take care of your safety. Find a safe place to stay and make sure your physical health needs and those of your family are addressed. Seek medical attention if necessary.
• Limit your exposure to the sights and sounds of disaster, especially on television, the radio and in the newspapers.
• Eat healthy. During times of stress, it is important that you maintain a balanced diet and drink plenty of water.
• Get some rest. With so much to do, it may be difficult to have enough time to rest or get adequate sleep. Giving your body and mind a break can boost your ability to cope with the stress you may be experiencing.
• Stay connected with family and friends. Giving and getting support is one of the most important things you can do.
• Try to do something as a family that you have all enjoyed in the past.
• Be patient with yourself and with those around you. Recognize that everyone is stressed and may need some time to put their feelings and thoughts in order. That includes you!
• Set priorities. Tackle tasks in small steps.
• Gather information about assistance and resources that will help you and your family members meet your disaster-related needs.
• Stay positive. Remind yourself of how you’ve successfully gotten through difficult times in the past. Reach out when you need support, and help others when they need it.

More at: http://www.redcross.org/find-help/disaster-recovery/recovering-emotionally

On Monday, March 25, 2013, I attended the Healthcare Experience Design Conference (hxd) in Boston, MA. The conference was attended by designers, technologists, product managers, researchers, entrepreneurs and patients who are passionate about improving the health care experience. This post is part two of a summary of the sessions I attended.

The Happiness Project

Gretchen Rubin, author of Happiness at Home and the Happiness Project, offered her advice for happiness. Her resolutions are to get enough sleep, get exercise, jump, and enjoy your sense of smell. She said possessions are a source of joy and frustration. She asks herself: Do we use it? Do we love it? Do we need it? Her key to happiness are strong, long term relationships. She declared “Happy families have fun traditions.” You can discover more about Gretchen Rubin’s Happiness Project, and her experiments in the practice of everyday life at: http://bit.ly/10a4QZU

Considering the Whole Individual

Alexandra Drane of the Eliza Corporation discussed the challenges of life and how hard it can be to make important healthy behavior changes. Certain concerns that are the root of health conditions, but rarely get discussed at the doctor’s office. These “unmentionables” include sex, drugs, and a crappy boss. She said the top health problems in the US are in fact stress, sleep, care giving, money concerns, lack of support, relationship problems. People who report 4 or 5 unmentionables have the most health issues. Buffers, such as a strong network of peers, spirituality, and exercise, help. Patients who felt more vulnerable were less healthy, and felt less powerful. Her message encouraged attendees to apply this information as an industry and to build programs that increase buffers like social supports, spirituality, and exercise. Learn more about the unmentionables at: http://bit.ly/WWF6kQ

Calming Technology

Neema Moraveji, from Stanford University, informed us that calm isn’t just about being relaxed. Calm is a restful alertness. He teaches a Designing Calm class at the Stanford Institute of Design. He led a guided meditation for the audience. He talked about Grok design, which means to understand or comprehend something. More on this at: http://en.wikipedia.org/wiki/Grok He recommended identifying stressors, mitigating stressors, and designing with avoiding stress. He showed a variety of student projects, including a meditation, relationship, and mindful eating apps. He showed us Breathwear, a new technology to stream breathing data to your phone.

Health Navigation

Dan Brousseau of Emperia, asked, “are we ready to innovate the healthcare experience?” He said innovative organizations embrace risk and failure, show a natural bias towards customer needs and expectations, demonstrate extraordinary levels of collaboration across function and discipline, and experiment. Service experience values make people feel comforted, involved, safe, trusted, and important. Using a customer transformation model, Emperia sought to improve the experience for customers and employees, raise efficiency of experience delivery and align service design with hospital strategy. They shadowed service employees, and discovered that it is the health navigators who determine the experience. Cultivating the health navigator experience created one central contact to help coordinate the clinical experience.

Patient Innovators and Instigators

A panel of three patients shared their health journeys and the tools they created to advocate for their health. Ken Spriggs, a patient with Crohns Disease was inspired by ePatient Dave’s Ted Talk (Give Me My Damn Data, http://bit.ly/YTLDtb). It inspired him to get all of his medical records and scan and make them searchable. Then, he compiled key data and charted it. The next patient, Lana asked what is needed – empathy, education, community and creativity. She cleverly mashed up social media sites to track her moods and maintain her health. She combined Social Me with Facebook to see what affected her moods, explored Four Square to see what places she loved the most, and used Instagram to card sort experiences. She left us with a powerful message – everyone can repurpose. Katie McCurdy shared her story of living with Myasthenia Gravis. She created a paper timeline of symptoms, medications and memories. She insightfully said, “memories are data, too”. Her closing remark encouraged us to assemble and visualize our patient stories.

Designing Work for Health and Profit

Martin Adler of Healthrageous, asked us, “Do we have a disease management problem or do we have a time management problem?” Since work is where most people spend the majority of our time, why not start at the workplace with healthy design solutions. He said the greatest health return is to reduce sitting time. He showed the workplace of the future, with treadmill and cycling desks. His vision for a healthy workplace includes increased access to windows and plants, access to free and convenient snacks, and a casual dress atmosphere to encourage more physical activity throughout the day. There was literally a picture of an elephant in his picture of the workplace of the future, which represented the possibility of sensors and tracking the health and physical activity of employees at the workplace. In my opinion, it would be great if more workplaces encouraged flexible work plans, gave daily wellness breaks, and provided healthy atmospheres with windows and plants. I’m not a fan of the tracking.

Patients Like Me

Jamie Heywood, chairman of PatientsLikeMe, delivered the final Keynote of the day. PatientsLikeMe helps patient share information on their health conditions to compare treatments, symptoms, and outcomes. It is a wealth of personalized research. He discussed different ways to measure medicine and interacting domains. He talked about the evolution of the site how measuring patients at the point of care for characteristics of intervention, environment, severity, and impact should be used to inform and help the next patient. http://bit.ly/16Y7WVT

Inspiration

I left this conference feeling inspired. I left with dreams for the innovation of the healthcare experience. I left with a deeper understanding of the complex issues at the intersection of design and the healthcare experience. Design is not just for designers. Design is for everyone. Design helps us understand what motivates people, how to call people to action, and how to create an outstanding experience. I highly recommend this conference for anyone interested in a cross-disciplinary exploration into improving the healthcare experience. Thanks hxd 2013 for an amazing experience!

By Michelle Eberle, Consumer Health Information Coordinator

On Monday, March 25, 2013, I attended the Healthcare Experience Design Conference (hxd) in Boston, MA. The conference was attended by designers, technologists, product managers, researchers, entrepreneurs and patients who are passionate about improving the health care experience. The conference’s tagline was “where healthcare and design intersect.” It was an amazing day full of insights on how to improve the health care experience. It made me reflect in new ways about the intersection of design and provision of health information. It made me think about how to take better care of my own health and the health of my family. I would like to share what I learned at the conference.

Reality is Broken, SuperBetter

In the Opening Keynote, Jane McGonigal, creator of SuperBetter, and the author of the book, “Reality is Broken: Why Games Make Us Better and How They Can Change the World,” shared how games can help solve the world’s most urgent problems, including hunger, poverty, climate change, and obesity. She wants us all to learn how can we take feelings from games and apply them to real life. She hopes we can take the superpowers we learn in games and integrate them in our lives and world. Superpowers from games – secret identify, power up, allies, bad guys, quests – teach us important life skills like how to take power of a situation, deal with trauma, bring support to our experience, become psychologically flexible, commit to action, and feel good every day. She said lessons learned in games strengthen positive emotions, make us happier, more confident, and more determined. View her inspiring TEDTalk, “Gaming can make a better world.”

Reader-Centered Design for Health Communication

Sandy Hilfiker and Molly McLeod of CommunicateHealth shared six strategies to create easy to use health websites and applications from the Office of Disease Prevention and Health Promotion’s Health Literacy Online Guide. Tips include: 1) Learn about your users and their goals; 2) Write actionable content; 3) Display content clearly on the page; 4) Organize content and simplify navigation; 5) Engage users with interactive content; and 6) Evaluate and revise your site. CommunicateHealth recommended involving users with limited literacy in formative research by partnering with community organizations to recruit special populations.

How to Design User Habits

Nir Eyal of Stanford University discussed how to use a hook to take people from states of low engagement to high engagement. He discussed the four parts of the hook – a trigger, action, reward and investment. He said, “habits aren’t created, they are built upon.” Some triggers are external, like alarms, calls to action, emails, stores, and authority. Internal triggers are in users heads. He discussed the Fogg Behavior Model and the six motivators of behavior. Nir referred to Skinner and how creating intermittent rewards increases response rate. Creating an endless search leads to rewards: for the tribe (social), for the self (mastery, consistency, completion and competency), and for hunt (food, money and information). Technology products that store value get better the more you use them. Eyal charged the audience to create preference and cultivate meaning.

Inclusion by Design

Dr. Ivor Horn of the Children’s National Medical Center and George Washington University School of Medicine shared that what matters is how we communicate with patients, families and parents. She said “trust and listening matter in the health and design process.” She taught two don’ts and one do. Don’t make assumptions. Don’t just take, give. Do collaborate. She told a moving story about how frustrations with helping her father navigate the healthcare environment inspired her to become a doctor to facilitate change. In her experience, parents who had a greater self-efficacy are the parents who talk a lot and ask questions. She said to always think, how can what I am designing help those that need help the most.

Health Behavior Change and Beyond: The Health Benefits of Success Experiences

David Sobel, MD, MPH, co-author of the book, “Living a Healthy Life with Chronic Conditions: Self-Management of Heart Disease, Arthritis, Diabetes, Asthma, Bronchitis, Emphysema and Others” asked us to think of a change we had made. What helped us make that change? Why did we make that change? He talked about roads to behavioral change including pleasurable change, breakthrough change, environmental change and incremental planned change. The key indicator to making a healthy behavior change is a sense of confidence, self control, and self efficacy. One approach to behavior change is to encourage patients to make small steps, which leads to a gradual increases in confidence, mood, and efficacy. He asked important questions: Do we really know what motivates people? Where should we focus? Which curve can we shift? How can we strengthen self-efficacy? His message urged participants to move beyond boring health education programs. He talked about Eliza’s research on the “unmentionables”—that what makes it hard to manage health conditions, and often results in them, are life issues like stress, sex, sleep and a crappy boss – the very things that don’t get discussed at the doctor’s office. There are many ways to increase self-efficacy including persuasion, modeling, cognitive reframing, and mastery experiences. However, many prescribe failure by their general, long term, unpleasant, and difficult delivery and nature. His recipe for prescribing success is to choose behaviors that are specific, personal, easy, rapid, and pleasurable. He urged the participants to celebrate successes. His three powerful final thoughts encourage us to: 1) Help people find their passions. Screen for pleasure. Discover what drives and motivates people. 2) Help people discover their own solutions. Ask – what do you think will work for you? 3) Celebrate successes! His final message — everything that feels good is not bad for you.

By Michelle Eberle, Consumer Health Information Coordinator