Sarah Farmer

In the Spring of 2020, closures and safe distancing orders swept much of the United States due to the COVID-19 pandemic. This paper presents a case study of pivoting an in-person empowerment program focused on lifestyle interventions for people newly diagnosed with Mild Cognitive Impairment (MCI) to an online program. Working as rapidly as possible to sustain participant engagement, our design decisions and subsequent iterations point to initial constraints in telehealth capabilities, as well as learning on the fly as new capabilities and requirements emerged. We present the discovery of emergent practices by family members and healthcare providers to meet the new requirements for successful online engagement. For some participants, the online program led to greater opportunities for empowerment while others were hampered by the lack of in-person program support. Providers experienced a sharp learning curve and likewise missed the benefits of in-person interaction, but also discovered new benefits of online collaboration. This work lends insights and potential new avenues for understanding how lifestyle interventions can empower people with MCI and the role of technology in that process.

In the era of COVID-19 planners, and more broadly, city administrators and policy makers, have learned to cope with the accelerated pace of change, the broad band of uncertainty, and the need for rapid decision-making strategies. This, in the context of ever more diverse communities and greater reliance on technology as an effective response to the social and public health challenges of the pandemic. “Smart” cities harness distributed communication and service delivery technologies to enhance the quality of urban life. The voices of citizens from marginalized and under-served populations, such as older adults and people with disabilities, are vital to the development of inclusive smart cities. In this paper expanding an inclusive policy design approach is proposed that uses ‘personas’ to actively engage those citizens.

While there has been significant progress in the development of rapid COVID-19 diagnostics, as the pandemic unfolds, new challenges have emerged, including whether these technologies can reliably detect the more infectious variants of concern and be viably deployed in non-clinical settings as “self-tests”. Multidisciplinary evaluation of the Abbott BinaxNOW COVID-19 Ag Card (BinaxNOW, a widely used rapid antigen test, included limit of detection, variant detection, test performance across different age-groups, and usability with self/caregiver-administration. While BinaxNOW detected the highly infectious variants, B.1.1.7 (Alpha) first identified in the UK, B.1.351 (Beta) first identified in South Africa, P.1 (Gamma) first identified in Brazil, B.1.617.2 (Delta) first identified in India and B.1.2, a non-VOC, test sensitivity decreased with decreasing viral loads. Moreover, BinaxNOW sensitivity trended lower when devices were performed by patients/caregivers themselves compared to trained clinical staff, despite universally high usability assessments following self/caregiver-administration among different age groups. Overall, these data indicate that while BinaxNOW accurately detects the new viral variants, as rapid COVID-19 tests enter the home, their already lower sensitivities compared to RT-PCR may decrease even more due to user error.

In the Spring of 2020, closures and safe distancing orders swept much of the United States due to the COVID-19 pandemic. This paper presents a case study of pivoting an in-person empowerment program focused on lifestyle interventions for people newly diagnosed with Mild Cognitive Impairment (MCI) to an online program. Working as rapidly as possible to sustain participant engagement, our design decisions and subsequent iterations point to initial constraints in telehealth capabilities, as well as learning on the fly as new capabilities and requirements emerged. We present the discovery of emergent practices by family members and healthcare providers to meet the new requirements for successful online engagement. For some participants, the online program led to greater opportunities for empowerment while others were hampered by the lack of in-person program support. Providers experienced a sharp learning curve and likewise missed the benefits of in-person interaction, but also discovered new benefits of online collaboration. This work lends insights and potential new avenues for understanding how lifestyle interventions can empower people with MCI and the role of technology in that process.

In the era of COVID-19 planners, and more broadly, city administrators and policy makers, have learned to cope with the accelerated pace of change, the broad band of uncertainty, and the need for rapid decision-making strategies. This, in the context of ever more diverse communities and greater reliance on technology as an effective response to the social and public health challenges of the pandemic. “Smart” cities harness distributed communication and service delivery technologies to enhance the quality of urban life. The voices of citizens from marginalized and under-served populations, such as older adults and people with disabilities, are vital to the development of inclusive smart cities. In this paper expanding an inclusive policy design approach is proposed that uses ‘personas’ to actively engage those citizens.

In the Spring of 2020, COVID-19 closures and safe distancing orders required healthcare programs across the US to cease in-person treatment. This paper presents a case study of rapidly pivoting a novel, 12-month comprehensive clinical lifestyle program combining education, occupational therapy, cognitive training, and social interaction to an online application-based education program. The focus of the program is empowerment research for people newly diagnosed with mild cognitive impairment (MCI) and their care partners, and is conducted by the Emory Brain Health Center. Georgia Tech developed an education application (named MyCEP) for use with our MCI and care partner population combining off-the-shelf services and customized user interfaces. We used an iterative design and development process, testing our application with our end users and our treatment providers, and made updates based on our discovery of the need for new capabilities and requirements. We present the discovery of emergent practices by family members and healthcare providers to meet the new requirements for successful virtual engagement.

While there has been significant progress in the development of rapid COVID-19 diagnostics, as the pandemic unfolds, new challenges have emerged, including whether these technologies can reliably detect the more infectious variants of concern and be viably deployed in non-clinical settings as “self-tests”. Multidisciplinary evaluation of the Abbott BinaxNOW COVID-19 Ag Card (BinaxNOW, a widely used rapid antigen test, included limit of detection, variant detection, test performance across different age-groups, and usability with self/caregiver-administration. While BinaxNOW detected the highly infectious variants, B.1.1.7 (Alpha) first identified in the UK, B.1.351 (Beta) first identified in South Africa, P.1 (Gamma) first identified in Brazil, B.1.617.2 (Delta) first identified in India and B.1.2, a non-VOC, test sensitivity decreased with decreasing viral loads. Moreover, BinaxNOW sensitivity trended lower when devices were performed by patients/caregivers themselves compared to trained clinical staff, despite universally high usability assessments following self/caregiver-administration among different age groups. Overall, these data indicate that while BinaxNOW accurately detects the new viral variants, as rapid COVID-19 tests enter the home, their already lower sensitivities compared to RT-PCR may decrease even more due to user error.

The paper describes the development of the RADx Test Tech Verification Core as part of the NIH-funded Rapid Acceleration of Diagnostics (RADx) Initiative. RADx was launched to speed up the development, commercialization, and implementation of COVID-19 diagnostic technologies. The Test Verification Core is a multi-institutional and transdisciplinary team charged with laboratory and clinical evaluation of technologies; providing regulatory expertise to speed approval and distribution of technologies; usability evaluations from the perspective of the end user; and engineering assessments to determine robustness of design.