R03 – Using Human Centered Design for Technology-Enabled Behavioral Treatment of Depression in Urban and Rural Cancer Centers
Principal Investigators
Gary Hsieh, PhD, Associate Professor, Human Centered Design and Engineering
Amy Bauer, MD, MS, Associate Professor, Psychiatry and Behavioral Sciences
Project Description
Depression is highly prevalent but undertreated in patients with cancer, particularly in rural populations. The overall objective of this research is to use technology to enhance depression care for patients in cancer centers by improving access to behavioral activation (BA), an evidence-based treatment. This research supports the UW ALACRITY Center mission by applying expertise in mental health and in human-centered design to address usability and sustained quality of delivery of BA in a Collaborative Care (CoCM) setting.
| Setting | Urban and rural cancer centers |
| Population | Patients with cancer and depression, providers, and administrators from rural and urban cancer centers |
Intervention and/or Implementation Strategy Designed or Redesigned
| Intervention | Development of a digital platform to support the delivery of Collaborative Care (CoCM) for depression using behavioral activation (BA), an evidence-based treatment. The intervention uses human-centered design to address contextual constraints and implementation challenges. |
| Implementation Strategy | Two-phase approach: Aim 1 engages diverse stakeholders in a human-centered design process to discover contextual constraints and gather requirements for the digital platform. Aim 2 develops an early prototype through an iterative process, eliciting feedback from providers and patients to ensure appropriate, acceptable and usable design. |
Impact
This project accelerates translational behavioral health research by generating knowledge to inform technology-enabled service delivery models and their integration into general medical settings. The intervention addresses the critical gap in depression treatment for cancer patients, particularly in rural areas where access to mental health services is limited. By enhancing access to behavioral activation through technology and collaborative care, the project has the potential to improve depression outcomes for cancer patients who often experience high rates of untreated depression.
Project Publications
SCOPE: Examining Technology-Enhanced Collaborative Care Management of Depression in the Cancer Setting
Proceedings of the ACM on Human-Computer Interaction 9(2); 2025 · PubMed · Publisher
Authors
Anant Mittal, Tae Jones, Ravi Karkar, Jina Suh, Spencer Williams, Yihao Zheng, Lydia M. Andris, Nicole Bates, Amy M. Bauer, Ty W. Lostuter, Jesse R. Fann, James Fogarty, Gary Hsieh
Abstract
Collaborative care management is an evidence-based approach to integrated psychosocial care for patients with comorbid cancer and depression. Prior work highlights challenges in patient-provider collaboration in navigating parallel cancer care and psychosocial care journeys of these patients. We design and deploy SCOPE, a platform for technology-enhanced collaborative care combining a patient-facing mobile app with a provider-facing registry. We examine SCOPE through a total of 45 interviews with patients and providers conducted in SCOPE‘s 15 months of design and development and 24 Months of SCOPE‘s deployment for actual care in 6 cancer clinics. We find that: (1) SCOPE supported patient engagement in its underlying collaborative care and behavioral activation interventions, (2) patient-generated data in SCOPE improved patient-provider collaboration between and within in-person sessions, (3) SCOPE supported providers in delivering care and improved care team collaboration, (4) experience with SCOPE created evolving expectations for collaboration around data, and (5) SCOPE‘s deployment in actual care surfaced important implementation barriers. We discuss the implications of our findings in terms of designing for engagement with behavioral health interventions, negotiating patient data sharing and provider responsiveness, supporting personalized self-tracking goals in evidence-based interventions, exploring the role of digital health navigators in technology-enhanced care, and the need for flexibility in aligning technology-supported interventions to patient needs.
Parallel Journeys of Patients with Cancer and Depression: Challenges and Opportunities for Technology-Enabled Collaborative Care
Proceedings of the ACM on Human-Computer Interaction, 4(CSCW1) · PubMed · Publisher
Authors
Jina Suh, Spencer Williams, Jesse R. Fann, James Fogarty, Amy M. Bauer, Gary Hsieh
Abstract
Depression is common but under-treated in patients with cancer, despite being a major modifiable contributor to morbidity and early mortality. Integrating psychosocial care into cancer services through the team-based Collaborative Care Management (CoCM) model has been proven to be effective in improving patient outcomes in cancer centers. However, there is currently a gap in understanding the challenges that patients and their care team encounter in managing co-morbid cancer and depression in integrated psycho-oncology care settings. Our formative study examines the challenges and needs of CoCM in cancer settings with perspectives from patients, care managers, oncologists, psychiatrists, and administrators, with a focus on technology opportunities to support CoCM. We find that: (1) patients with co-morbid cancer and depression struggle to navigate between their cancer and psychosocial care journeys, and (2) conceptualizing co-morbidities as separate and independent care journeys is insufficient for characterizing this complex care context. We then propose the parallel journeys framework as a conceptual design framework for characterizing challenges that patients and their care team encounter when cancer and psychosocial care journeys interact. We use the challenges discovered through the lens of this framework to highlight and prioritize technology design opportunities for supporting whole-person care for patients with co-morbid cancer and depression.