The Art of Waiting: Evaluation of an Interactive Media Experience in a Children's Hospital Clinic Waiting Space

The purpose of this study is to test the hypothesis that providing low-intensity opportunities for interactive play can improve the waiting and overall clinic experiences of children. This study evaluates an innovative, interactive system called ScreenPlay designed to realize the intentions of the "Healing Environment" in the waiting space of a paediatric hospital.

Study Overview

• Status: Completed
• Conditions: Anxiety
• Intervention / Treatment: Other: ScreenPlay

Detailed Description

Existing entertainment and distraction options (e.g. toys, video games) meet neither organizational standards nor families' needs with respect to accessibility and infection control. Additionally, they do not provide the types of positive experiences (e.g. calm, low intensity) that are most desirable for children awaiting treatment.

The goal of this research is to empirically evaluate the effectiveness of ScreenPlay, a technology that enables users to create or manipulate animations on a screen/projection, and to provide an evidence-informed model for the design of optimal paediatric waiting spaces. A blinded, clustered, parallel randomized controlled trial applying objective outcome measures and qualitative methods will be used to compare children allocated to one of three waiting conditions at a large urban rehabilitation hospital: (a) no media (standard care), (b) passive media (a silent nature video), or (c) interactive media (ScreenPlay). This study will answer the questions:

Can Interactive Media (i.e. ScreenPlay):

1. reduce state anxiety in children/youth attending an outpatient clinic? and,
2. improve child, parent, and staff satisfaction with the clinic experience?

We hypothesize that:

1. Decreases in state anxiety will be greater for children exposed to ScreenPlay for 10 minutes than for those exposed to passive (i.e. a nature video) or no media (i.e. standard care/control). The decrease in state anxiety associated with ScreenPlay will be >5 points on the normalized 100 point State Anxiety Scale.
2. ScreenPlay will generate more movement/activity on the floor (i.e. an indicator of active engagement with the system) than the passive media or control conditions as measured via contact floor sensors.
3. The waiting and overall clinic experience of children with diverse mobility, parents, and staff will be perceived more positively when exposed to ScreenPlay as compared to passive media or control conditions.

• Study Type: Observational
• Enrollment (Actual): 310

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Toronto, Ontario, Canada, M4G 1R8
      • Holland Bloorview Kids Rehabilitation Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 5 years to 19 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Participants include clients, their parents/guardians, and staff associated with the outpatient clinic at Holland Bloorview Kids Rehabilitation Hospital.

Description

Participants include clients, their parents/guardians, and staff associated with the outpatient clinic at Holland Bloorview Kids Rehabilitation Hospital.

1. Children and youth aged 5 to 19 years and their guardian/parent.
2. Anticipated wait time ≥30 minutes to allow time to complete the study.
3. Ability to communicate in English through speech, writing/typing, or other communication device. Note: For children who cannot communicate their thoughts/feelings, parent-proxy may be used.
4. All outpatient clinic staff

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Cross-Sectional

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Interactive media; ScreenPlay	Other: ScreenPlay; Interactive technology
Passive media; Silent nature video
No media; Standard care

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
State Trait Anxiety Inventory, STAI	The STAI is used to capture apprehension, tension, nervousness, and worry.	Baseline, after 10 minutes of exposure to intervention, and immediately following appointment.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Modified Yale Preoperative Anxiety Scale, mYPAS	The mYPAS observes activity, vocalizations, emotion expressivity, state of arousal, and use of parents, to ascertain children's anxiety state.	Baseline, after 10 minutes of exposure to intervention, and immediately following appointment.
Faces Pain Scale Revised, Faces-R	Faces-R is used to capture self-reported pain. The scale is composed of 6 gender neutral faces showing increasing levels pain/hurt from "no pain" to "most pain possible"	Immediately following medical/therapeutic intervention.

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Behaviour Mapping	An unobtrusive, observational technique used to systematically define/record distinct behaviours including: mobility, activities, social interactions, emotion expressivity, attention/engagement, and description of challenges encountered.	Administered during the participant's 10 minute exposure to the intervention.
Contact sensors	ScreenPlay incorporates a 'pressure' floor composed of 100 contact sensors arranged in a 10 foot by 10 foot grid. Activity metrics (e.g. number, duration, and frequency of activations) are extracted for each contact sensor and for the amalgamated grid.	Data from sensors is continuously collected from 7am to 5pm from beginning of data collection (June 2012) to end of data collection (April 2013)
Feedback questionnaires	The surveys inquire into child, parent, and staff perceptions of the waiting space and their overall clinic experience through a mixture of open- and close-ended (e.g. Likert scale) questions.	Child and parent surveys are administered post-exposure. Staff surveys will be administered nearing the end of the recruitment deadline.

Collaborators and Investigators

• Sponsor: Holland Bloorview Kids Rehabilitation Hospital
• Collaborators: Canadian Institutes of Health Research (CIHR)
• Investigators: Principal Investigator: Elaine Biddiss, PhD, M.A.Sc., Holland Bloorview Kids Rehabilitation Hospital; University of Toronto

Study record dates

Study Major Dates

• Study Start: June 1, 2012
• Primary Completion (Actual): June 1, 2013
• Study Completion (Actual): June 1, 2013

Study Registration Dates

• First Submitted: January 30, 2013
• First Submitted That Met QC Criteria: July 23, 2013
• First Posted (Estimate): July 26, 2013

Study Record Updates

• Last Update Posted (Estimate): August 1, 2014
• Last Update Submitted That Met QC Criteria: July 30, 2014
• Last Verified: July 1, 2014

More Information

Terms related to this study

• Keywords: Anxiety; Technology; Hospital Design
• Other Study ID Numbers: BloorviewKR