Stress Management Intervention

Project for Design Studio 1 (September 2019 - December 2019)
Team: Lauren Totino, Anne Riitho, Carly Hoyer

Summary

Over the course of our 3-month design project, my team designed three prototypes of products aimed to help undergraduate students at Boston College who experience stress. Students at Boston College face a unique set of stressors as they transition from high school into university life, which can come to dominate their lives and become overwhelming for many. We saw this as an opportunity to design an intervention that would help students learn and internalize positive stress management techniques that they can rely on during college as well as during future life transitions after graduation.

Goals

• Help BC students learn and internalize positive stress management techniques

• Help students learn transferable habits - ones that are practiced, tried, and true for the individual

• Encourage learners to name their primary stressors, identify and anticipate situations that may cause stress, and proactively respond with an action plan

• The long-term outcome is a graduating populace that can transfer stress management skills to their daily lives during and beyond their time as students at BC

Our intention was not to develop something to replace a program or service that BC already offers to students experiencing stress, rather the aim was provide to a personal, individual-only activity for students to reflect on stress. For the first iteration of our design, we made two different prototypes to represent two different product options: a journal and an app. These represent two different approaches to helping students manage their stress and begin to form positive stress management habits:

• Journal - Focus on reflection through writing about stress, a process scaffolded by organizing the journal into Daily, Weekly, and Monthly sections, each containing prompts for thinking and writing. We included enough pages for about 3 months of use in one book.

• App - Focus on identifying stressful experiences and taking action, a process scaffolded by identifying stressors by category and on creating an "Action Plan" to manage the identified stressor(s).

For the second iteration of our design, we made a third prototype, a planner-app hybrid, where the planner represents the writing and reflection side, while the app represents the data collection side (i.e., scanning a QR code in the physical planner to upload information to the app component). The design infuses the best attributes of the first iteration prototypes to integrate reflection and action-taking:

• From the journal: Prompts to get students to think about and reflect on their stressors

• From the app: Pre-defined categories of stressors and response activities

• New element: Symbols that represent categories of stressors and behaviors that students can circle in the planner, and then scan and upload into the app, which would summarize the data

Offering Invitations to Engage

• Positives - Since the expectation is that students would voluntarily use the journal/hybrid (i.e., not mandatory upon starting freshman year), the concept would be inviting to students who are looking for a way to manage stress but don't want to see a counselor. Before even using the journal/hybrid, some students may see the value up front in how it is aimed at fostering private reflection, rather than carrying the expectation that they will have to share it or turn it in, like other school work.

• Shortfalls - We did not explore how students might use the journal/hybrid in tandem with in-person coaching or group sessions at BC. Rather than over-promoting that the journal/hybrid is for personal use only, it may be more inviting to give another entryway, such as the option to share what one has written. Students who opt to be a part of coaching or a group session are probably more likely to be willing to share, as that is why they are participating: to talk about stress. The journal/hybrid could be something such a student writes in and then decides which parts to share with their Health Coach or with their group during a session.

Support for Mental Model Building

• Positives - The journal/hybrid encourages students to write and reflect about their lives as a way to manage stress, which fosters the accommodation process that involves updating their existing daily/weekly/monthly schema to include time for personal reflection. Since the context of the design is BC students who are experiencing stress, “hot” conceptual change could also be at play here, because it is driven by the motivations and emotions of the learner. If engagement with the journal is a response (motivation) to dealing with stress (emotions), then conceptual change regarding reflection as a habit is more likely to occur.

• Shortfalls - There is not enough evidence in the journal/hybrid design that providing reflection prompts will actually cause the student to engage in habit-forming or habit-changing behavior with regards to stress management. Cognitive Behavior Therapy (CBT) is about challenging and changing behaviors toward situations that are based on unhelpful, negative, or distorted perceptions; drawing from our initial research on CBT would have been more relevant to the design context, which ultimately has to do with the psychological and emotional impact of stress on a student’s life.

Testing our prototypes played a significant role in propelling us forward from one iteration to the next. Feedback from testers greatly influenced our decision-making and direction with the project.

• Testing our first iteration prototypes - We gave our first iteration journal and app prototypes to the Learning Engineering cohort and faculty to interact with and provide feedback on. We used the most salient pieces of feedback to guide us through a systematic review of the design decisions we made in the first iteration, and why we made those decisions. For example, we received feedback that the app focuses too much on taking action and does not have enough features to emphasize reflection (which the journal has), so we revisited our justifications for designing the app this way. This helped us identify what concepts from the first iteration were worth including in the second iteration, like ensuring we had enough features to emphasize reflection.

• Changing our approach to testing with students - Before presenting the second iteration prototype (the planner-app hybrid), to our BC student testers, we ran it by the Learning Engineering cohort and faculty first. Overall, the consensus was that they missed the availability of the free-writing space for open-ended prompts in the journal because they value the opportunity to answer more reflection-oriented questions. The more "efficient" features of the planner that were designed to eventually integrate with the app (i.e., the symbols for circling) were not as favorably regarded, and the app component started to seem more and more like the least desired aspect of our proposed stress management intervention. This led us to bring the original journal prototype from the first iteration back into the picture, since it contains all the features our cohort testers actually missed most when testing with the hybrid. Given this, we decided to conduct A/B testing with our student testers, giving 2 students the journal prototype and 1 student the hybrid prototype.

• Collecting feedback from students - After all 3 students used their respective prototypes for a week, we conducted debrief interviews with them to gather feedback about their experiences. After interviewing the 3 students, we drew key conclusions from their feedback that could help inform design in a next iteration:

• Students enjoy and value free-writing, reflection, and engaging in practices like writing affirmations and goal-setting ("finding power in the pen").

  • Key Takeaway - We had assumed that students would not want to free-write in a journal because they might consider it extra work that they do not have time for, but they found that engaging in written reflection is more insightful than quickly circling symbols.

    • Next Iteration - We would remove the app component, which focused on data collection and quick summaries, and stick to just the physical journal concept.

• Students were learning adaptive behaviors all along - the habits of making goals, setting priorities, writing what is on their mind, doing affirmations, etc.

  • Key Takeaway - The act of reflecting is the "fight it" action when dealing with stress. Our design does not need to ask them to find specific ways, methods, and action plans to fight stress, because the practice of reflection is doing that in and of itself.

    • Next Iteration - We would focus on further scaffolding the reflection process, and de-emphasize making specific action plans to fight stress.