Why is this product needed?
- Of the more than 18 million cancer patients and survivors, over 80% have no access to cancer-specific mental health care.
- Fear of recurrence is the #1 unmet need among cancer survivors.
- This leads to more outpatient and ER visits, more doctor visits, higher cost of care, and lower quality of life.
The Design Process
Background
The leadership at the company recognized the importance of developing a product tailored towards cancer patients in remission, knowing that this application had the potential to make a significant impact on the largest and often overlooked segment of the cancer population. What further fueled this ambition was the company's established relationships with two renowned cancer institutes, Memorial Sloan Kettering, and the University of Sydney, which granted permission to utilize clinically backed psychological interventions. This collaboration allowed our team to incorporate evidence-based, psychological support directly into the app, ensuring that the product could offer not only practical, but also scientifically validated assistance to patients.
User Research
The product owner and I had the privilege of engaging with 20 cancer patients and survivors, delving into their fears and concerns about the possibility of their cancer returning. They shared their deeply personal experiences, revealing a common thread of anxiety, uncertainty, and stress that weighed on both them and their caretakers. Their stories shed light on the emotional and psychological toll that cancer can have long after treatment ends.
Several key insights emerged from these discussions that directly influenced the app's development. Firstly, their concerns highlighted the longing for help with living more peacefully with these fears. Secondly, their desire for connection and reassurance led to the inclusion of a community forum within the app where users can share experiences and seek advice from fellow survivors. Finally, their appreciation for mindfulness and mental well-being practices inspired the incorporation of guided meditation and stress reduction exercises. Ultimately, these conversations played a pivotal role in ensuring that the app not only met the practical needs but also addressed the emotional and psychological well-being of cancer survivors.
In addition, we consulted with FCR (Fear of Cancer Recurrence) experts from top cancer institutes, Memorial Sloan Kettering Cancer Center and The University of Sydney, to further understand FCR impact on patients, the implications of combining the interventions, and potential product strategy.
Ideation and Conceptualization
After interviewing patient advisors, conversing with key stakeholders, and holding cross-functional brainstorming sessions, I developed three high-level concepts to present to patient advisors for feedback. The first was coined as "The Journey". This concept was structured similarly to a more typical online course in which content was linearly broken down into sections and exercises were assigned to users. The second concept was called "Mood of the Day". This concept used metrics on how the user was feeling in the moment to deliver content based on their current mental state. The idea was that we could immediately soothe users in a state of high fear by delivering them proper exercises and saving the course education for moments of low fear, when they could absorb the content better. Lastly was the "Sandbox" concept - this concept gave the user full autonomy of the structure of the course; they'd unlock content and exercises as they go, but they'll choose the order in which they go through it. The reason for this concept was that during our user interviews, advisors voiced how powerless they felt during treatment. Everything was out of their control. The Sandbox concept empowers the user by allowing them to chose their own path. The goal in presenting these concepts to patient advisors was to start narrowing down what format would make the content most digestible to them and what features would keep them coming back to the app to ensure that they got the most out of the therapy.
Patient advisors unanimously preferred the linear session-based approach of the Journey. With that in mind, I created 3 low-fidelity prototypes each with a different theme: a mountain journey theme, a garden theme, and a user-interest themed. Once again, we presented these to advisors. Patient advisors voiced that they weren't as interested in the mountain-based concept since they felt that they had already "conquered a mountain" by going through cancer treatment and they didn't like the idea of having another one put in front of them. However, they were split 50/50 on the remaining two themes.
Iterations
Using patient feedback, I created more in-depth prototypes of the interest-based and garden themes, incorporating feedback from our advisors to better illustrate our ideas. I gathered feedback from 23 users.
Garden Theme
As users progress through each session, they are rewarded with virtual plants for their digital garden. The therapy sessions are inherently harmonious with plant metaphors, like the idea that "growth takes time but is always worth the wait." The digital garden becomes a reflection of the users progress, where each plant symbolizes their personal growth. Additionally, in the spirit of community and support, users can gift other users plants for their gardens, fostering a community of mutual encouragement.
Feedback on the Garden Theme
- Users liked the imagery of the garden as a metaphor for growth
- Also a good metaphor that it’s going to take time and effort until they see the fruits of their labor
- They liked how it’s a virtual escape, it feels immersive
- Users enjoyed the sense of ownership it gave them since they get to build on something every day
- A lot of positive feedback on some of the copy used in the prototypes - “you’re flourishing” was called out multiple times
- Users liked the feeling that they were playing a game vs. requiring intrinsic motivation to come back day to day.
“Feels generic enough that everyone could enjoy it, even me who is terrible with plants”
“I’ve arrived at a place that makes me feel a little better”
“Cancer is a scary subject so it is helpful to include metaphors that help make it more lighthearted that are still respectful”
“I like that the more you get into this the more you’re filling out your garden, it’s fun. I can see some people really enjoying that”
Interests Theme
Since the use of metaphors is so important in the therapy, the Interests theme allows users to customize the themes of the metaphors by entering their own personal interests. We then take the users input to personalize the metaphors given to them throughout the course. Additionally, we rewarded the users with achievement badges at they progressed.
Feedback on the Interests Theme
- Users liked the ability to customize a part of the application right away
- Resonated more with people who didn’t think they were good gardeners
- Users liked the badges in this theme, they felt like a good motivator for some users to continue progressing
- Having more than one interest to select added variation to the metaphors that users liked
“You feel like you have more choice at the very beginning”
“I like being able to choose different interest-based things”
“I loved the variety of customizing your metaphors”
Observations
- Overall, the majority of people prefered the garden theme.
- People had more to say about the garden theme, even when they said they liked the interests theme better
- For users who preferred Interests, the main motivations for that preference were the ability to customize and the presence of badges
- Users who preferred Interests still said they would use the Garden theme. The garden was not so niche as to dissuade use
Hypothesis
We can combine the two themes in a way that feels organic (no pun intended). The overall app will leverage the garden theme and gamification, with the addition of badges and customizable interest-based metaphors for education and explanation.
Next Steps
Create a hybrid of the two themes that also:
- Asks users for their interests in registration or early on
- Maximizes gamification - include badges with the garden theme, make a bigger deal about daily streaks, gift plants to other users in the community feed
- Includes a social/community component
- Includes survivor stories/testimonials
Final Designs
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