NEVERTOODEEP: SELF HARM APP
Never Too Deep: “I am listening”
Self Harm Reduction App for Individuals
Mary Cueva
HCOM 515Mobile Health Design
Lisa Gualtieri & Bradley Moore
July 9, 2015
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Executive Summary
The following paper will propose the creation of an app- Never Too Deep- with
the purpose to reduce the severity of self harm and increase the engagement of
individuals in their social life. As Karen Conterio says in her book, Bodily Harm, “Self
harm typically starts at about age 14. But in recent years we’ve been seeing kids as young
as 11 or 12. As more and more kids become aware of it, more kids are trying it.1” For the
purposes of this app, we will be targeting an audience of students ages 14-18 which start
developing increased risk of triggers that can offset self harming behavior. The app
design process will be delineated through the: background, needs assessment of the target
population, personas and their scenarios, competitive analysis, description of design,
wireframes, evaluation plan, development plan, marketing plan, limitations, and
references.
The Self Harm app will be based on evidence-based guidelines and innovation to
differentiate it from other sexual health apps. The app will use a gamification approach to
engage the target audience not only in a physical realm but in a virtual realm as well. It
will be compatible with both iOS and android smartphones. There will be a website to
refer to for those that do not own smartphones or own iOS/Android platforms. They will
be able to see what the game app is about and try a demo but they will not be able to play
and get the full experience. The website will just be there as a point of reference for
individuals. It will have all the videos shown in the game and will have information about
self harm as well as provide resources for people to use if they need it. It will also
provide a hotline number that will also be used in the app for individuals that need
someone to talk to about their self harm immediately. The app will be continually
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updated based on needs, expectations, and time frames for the user to continue
engagement and participation in the app.
Background
Self harm comes in all shapes and sizes. For now, it can be implied that the
general consensus believes self harm to be an intentional injury to one’s own body,
usually leaving marks that cause tissue damage. The severity of it depends greatly on the
individual performing acts of self harm. Self harm is an unexplored and often
misunderstood mental health disorder and it can affect anyone at any time.
There are very few apps that are specific to self harm. Self harm has a hard time
standing alone as a mental health disorder, it is often times attached to broad categories of
mental health illness such as eating disorders or depression. There are many apps out
there that provide coping mechanisms for depression and health tips for nutrition. The
thing about self harm is that although yes, it can be easily blurred in the different realms
of mental health illness, it is very deadly and toxic on it’s own that it deserves more credit
as a debilitating mental illness.
The idea is to create a mobile application that can provide support and healthy
coping mechanisms in a way that can decrease the severity or risk of self harm. The
mobile app will be used to provide a safety net among users. The process of gamification
will also be used because of the high appeal in our target audience.
Whether it is consoles or phone apps, millennials in the target audience age gap
are the highest users of phone apps and online gaming. Averaging 12.4 hours per week2,
millennials beat every other generation in connectivity through online or console gaming.
Apps are also a huge outlet to create a connection with the target audience because most
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people in that age range have a smart phone. They love mobility and would rather use a
laptop or smart phone than a desktop computer. Creating something that is easily
accessible or stimulating will be very important in order to help reduce risk and increase
participation in the target audience’s social life.
In 2011, TIME talked about teens who cut and getting help for them online and
showed that 28% of self-injury videos on YouTube included in action footage of
committing self-harm3. Imagine the target audience of this campaign who has easy access
to the Internet and blogs at the swipe of their fingers coming upon videos showing them
other people also committing the same acts as themselves. They will relate and
understand the videos but it can also make them believe that the act of self-harm is okay
because so many other people do it and post videos on YouTube about it. If the keywords
“self-harm” are searched on YouTube there are over 135,000 videos uploaded. They can
easily find a network of people where self-harm is accepted but also toxic because they
are not getting help they are just understanding their situation and making themselves feel
like it is okay to perform those acts.
The plan is to create a way to be able to have self harmers accept their situation
but also seek help as a cue to action. One way to do this is to create a stimulating app by
using the gamification approach, which will be used to not only make the audience more
aware of their actions in order to reduce the severity of their actions but also address the
social norms associated with self harm. The app will be used to redefine self harming
behavior. The theories that will be used are the theory of planned behavior and the health
belief model.
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The theory of planned behavior offers the guideline to guess an individual’s
behavior based on their actions. As of now, it is easy to assume that a teenager that
engages in self harm will not stop unless we introduce the health belief model
components of severity, susceptibility, etc. According to Aizen, the theory of planned
behavior is based around three components: attitudes, subjective norms, and control4. The
app will be used to redefine current attitudes and beliefs about self harm in order to help
the target audience understand the importance of their actions. By addressing the barriers
(further explanation in limitations) that social norms provide, there can be more room for
self efficacy among the target audience to engage and continue with the behavior towards
self harm reduction.
The health belief model addresses perceived susceptibility and perceived severity.
In our audience of self harmers, perceived susceptibility is low simply because it has a
high and rapid escalation. The behavior patterns of self harm are so unpredictable
especially with the target audience. They have the perfect cocktail of hormones and stress
to put them on the edge when many things can act as triggers. Self harm is a free agent
and plays by no rules, that being said, many people do not believe that they are
susceptible to committing the behavior and are often in denial. In order to decrease that
edge and slow down the rapid escalation, the target audience has to be aware of the
consequences in their actions. There has to be a line drawn where the costs outweigh the
rewards. The app must make it personal to the individual so there can be an increase in
susceptibility towards the health behavior if they continue on the same track. We will use
cues to action in our NFC chip nudge, calendar, and notifications to provide users with
other coping mechanisms.
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Needs Assessment of Target Population
In high school, which is where our target audience will be at, there are the social
pressures of fitting in somewhere. Most self-harmers feel like the don’t belong anywhere
and even if they do have a group of people they hang out with, they feel like they have
very little in common with them and may even feel forced to be with their group simply
because that’s what everyone else does. They try too hard to fit in and because of that
they feel like they can never be comfortable because they have to work so hard to feel
included. When they are home they are mute and would rather spend their time alone.
Individuals vary on the degree of self-harm they inflict but they will always inflict more
physical pain on days that do not go well.
The audience tends to5:

Spend a lot of time on social media and smart phones

Stress about their inexperience and is easily anxious

Close themselves up to receive help because they usually feel emotions of
loneliness and misunderstanding.

Have a “get through the day” type of attitude because of the low value they have
for themselves

Feel like their only outlet is through pain inflicted by self-harm (coping
mechanism).
When it comes to committing acts of self-harm it is hard for people to realize that
they have gone too far because they do not care for the consequences. Most people that
feel the impulse to inflict self-harm do so in secret. Usually self-harmers inflict pain in
areas of the body that are easily covered by clothing. They are shy about their scars and
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do not let people in because they are too afraid that no one would understand their
reasoning and judge them. They tend to develop distant relationships with the people
around them such as friends and family members. This can create a domino effect that
makes them believe that they are alone and start losing their self worth.
It’s not that they don’t value life, it’s that they don’t value themselves. This is the
key issue that self-harmers face. They stop caring about themselves and what is
happening to them because it is the easiest way to bear the pain. Self-harm is a coping
mechanism. They feel like they should be left alone and the worst part is that in that
loneliness where all they have is self-harm to cope it becomes a dangerous situation. Selfharming is almost like a drug and can get addicting. Many people in the target audience
are prone to be severely affected by this coping mechanism because they feel like the
temporary moment of relief, while they perform the act of self-harm, will make things
easier. The language that many of the YouTube videos use talk about self-harm as if it
was like an addiction and they just don’t know how to stop. The biggest question is how
far they will go to feel relieved by inflicting harm on themselves.
The app will be designed in a way that it will give the user many chances or cues
to action to engage in that are not the act of self harm. Whether it is a “nudge” from a
listener or a notification of a nearby event, the app is designed to provide distractions and
offer other coping mechanisms for the user. It will provide a community among other
users on the interface to interact with one another whether it is fellow self harmers or
people that want to help them. A self harmer using the app should feel more secure in
talking about their problems. They will be navigate around their “world” freely and
embark on a journey to get back on track.
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Personas and Scenarios
Skylar (15) – Skylar has always had problems with school. The kids don’t get her humor
and she usually finds herself eating lunch alone at her high school’s bleachers. Her
parents are still married but they keep having very heated discussions. When that happens
she puts her headphones on and starts playing League of Legends (LoL, an online RPG
game), it seems to be the only thing she’s good at these days. That’s the only place where
she finds some peace but lately even that’s been hard. She can’t seem to focus or
concentrate as her parent’s arguments get bigger and start involving her and it’s become
very frustrating to deal with that at home so she stays late and plays at school.
There are little ribbons all over the floor today, such as weird combination, they’re purple
and turquoise6. Skylar knows that usually ribbons are associated with some type of
awareness thing but there are so many throughout the year that it doesn’t even faze her.
She picks one up attached to some flyer. The flyer has a coupon to some type of app but
it’s a gaming app so it catches her attention. She looks it up on her laptop and although
it’s not what she expected, she plans to try it out anyways. She’s really good at games
and apparently you can choose your role. In LoL, she usually plays a support character
for the attack damage carry so she doesn’t think it should be too different.
Jayke (17) – Jayke is a nice guy, for the most part. Unfortunately, when he gets angry or
sad he tends to throw out punches on himself. He’s a wrestler on the varsity team in his
high school so his parents never ask why his hands and body are all bruised up. They’ve
never been to one of his games anyways to know the extent of physical effort required.
He doesn’t hate them, how can you hate someone who’s never around. He just wishes he
had someone to talk to. His buddies from the team are there but he can’t talk to them
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about what he’s feeling, that’s lame. They think he trains extra hard on his own which is
why he’s always so banged up so he has to play off that tough guy vibe they’ve always
given him. The reality is that he’s frustrated inside and can’t let it out or tell anyone. His
last episode of throwing punches almost cost him a tournament after he hit himself so
hard he blacked out.
Today at school there was an announcement for a place to call for people that need
someone to talk to, some sort of organization. They mentioned that it’s completely
anonymous and his buddies were yelling in his ear so he couldn’t hear the rest but caught
the end about going to the office. After school he walks up to the office and finds it
closed but there is a flyer posted on the door with a phone number. He assumes it’s
related to the announcement because of the content. Apparently there’s also a gaming
app. He thinks that’s pretty cool, it’s been a while since he’s played games for fun, he’s
very competitive but he takes a picture of the flyer and calls the number. After he’s done
he feels a little relieved, it felt pretty good to talk to someone again. The person on the
phone really encouraged him to try out the app and gave him a discount code. Jayke’s not
sure he’ll use it but the person advised him to be careful when he has his punching
episodes and that the app could help him stop and understand what and why he’s doing it.
Jayke doesn’t think he has a problem, he feels better after talking to the person. He writes
down the code anyways, just in case.
Lulu (14)- Lulu is a cutter. She’s been that way since freshman year. She always wears
long sleeves and pants to hide her scars even on the hottest of days. Her parents are
divorced and she lives with her mom, who moves around a lot. Lulu doesn’t think it’s
worth making friends when she knows she’s going to switch schools in a few months
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time. She is very shy and has a hard time expressing herself vocally. She spends most of
her time alone and is usually okay with it but sometimes she gets so lonely and so
frustrated in her loneliness that she resorts to cut herself violently. One time she cut a
little too deep and had a hard time making the bleeding stopped but she managed, just
barely. It ended up getting infected but she played it off as if she fell and cut her knee. It
was a pretty clever lie and she got patched up and sent back to her trailer home with some
antibiotics. She took it a few days but didn’t finish them; she figured she could use the
rest of the pills for later if it happened again.
This new school seemed pretty lame, there were so few kids that it was hard for her to
blend into the background. They were all talking about some new gaming app called
Never Too Deep and she scoffed because she knows for a fact that it can get pretty deep
when you’re a person like her. When she realized it was about self harm her eyes grew
wide as if a deer was put in the spotlight of a car’s high beams. She wondered how
informative the app was and if the other kids could tell that she was a self harmer. Not
that it mattered much, she’d be moving in a few weeks and she’d never have to see those
kids again. But no one judged her or asked why she was wearing a hoodie and pants in
the 90 degree weather so she was in the clear. One of the kids did mention a video on
how to clean wounds for self harmers so she figured she had some use for the app. She
did not want to go back to the emergency room; there are only so many clever lies she
could tell her mom before she knew something was up.
Max (18)- Max has always been the type of guy that goes out of his way to help people
out. He comes from a great and loving home and volunteers on weekends. He firmly
believes that giving back to the community brings good karma and luck. He likes it too,
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last year her went on a trip to Cost Rica to build a town a water faucet and it was so great
to see the kids dancing in the water. That’s the type of stuff he lives for. Max just has a
way of understanding people and really wants to know how to be able to comprehend
people’s actions and decisions which is why he’s taking AP psychology this year.
Today in class Mr. Donigan was offering extra credit to students that download the app
Never Too Deep. Max has heard of the app before, it’s basically all over Facebook. He
figures he’d give it a try because after all he gets extra credit and there’s good karma
behind helping kids that hurt themselves. He finds people who hurt themselves
interesting not because he thinks they are weird but because he wants to understand why
they do it so he downloads the app and signs up as a listener. The app is anonymous but
that doesn’t bother him, he just hopes he can keep making a difference somewhere.
Competitive Analysis
The apps in this competitive analysis were chosen because they had specific
features that were interesting to further develop in the gamification app for self harmers.
There were also not many apps to choose from that were self harm specific and the apps
below had the most information and description provided.
1. App or device name, logo,
url
1
2
3
Skarz Diary
SAFE Alternatives
uMatterUCanGetHelp
https://itunes.apple.com
/us/app/skarz-
https://itunes.apple.com/
us/app/safealternatives/id57639664
https://itunes.apple.com/
us/app/umatterucangeth
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2. Objective at a glance
What is the objective,
problem, or challenge the
app or device seems to be
addressing?
3. Purpose and Goals
How clear are the purpose
and goals of the app or
device at a glance from
name, tagline, and imagery?
Does it match the objective
at a glance?
4. Users
Is there any information
about users through
descriptions, images,
stories, testimonials, or
usage data?
5. Ratings and reviews
What are the ratings,
reviews, and feedback?
diary/id727448684?mt
=8
2?mt=8
elp/id673760408?mt=8
At a glance, the
objective is to maintain
a record of self harm
activity
At a glance, the
objective is to self
assess and keep a log of
self harm activity. Then
it offers different
alternatives to use
instead of self harm.
Intended for self
evaluation but not to
diagnose self harm. The
goal is to stop self
harming behavior and it
does match the objective
at a glance with the
tagline “Self Abuse
Finally Ends.”
At a glance it just seems
to be a resource app or
point of reference for
users to seek help.
Lack of control,
struggling, and
vulnerable are common
descriptions on the blog
of the website. There
didn’t seem to be many
visuals just text.
There are not many
reviews just one for the
current version that
mentions that they are
The website for the app
has testimonials about
personal stories but the
app doesn’t.
The purpose is to
manage difficult
emotions and decrease
self harm behavior. It
aims to help challenge
negative thoughts and
provides positive
coping statements. At a
glance it is not clear
what the purpose is
other than keeping a
record of activity for
the self harmer as in
logs to check in and see
how they are doing and
progressing almost like
self management. It
does match the
objective but it doesn’t
really go beyond that,
the only further
information is given in
the description.
The app is targeted
toward self harmers but
is not to be used as a
sole substitute for
therapy according to
the disclaimer at the
bottom of the app.
There are not many
reviews but it seems
like it strikes an
average stand, some
The app:
• shows some articles
from the
uMatterUCanGetH
elp.com website
that will help you
keeping on positive
attitude
• shows list of
suicide prevention
support centers
• shows support
centers location
nearby you
• shows your
location and
support centers
nearby you
Feedback that the
videos won’t play on
app and that they don’t
understand how to use
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people had issues with
the diary deleting or
clearing information
after 100 days.
very happy with the
results. They suggested
to include a positive
accomplishments
checklist
This is the only data
(found on website)
1. Overall Rating: 4.69
2. Knowledge of
speaker in subject
matter: 4.94
3. Overall
preparedness: 4.94
4. Organization of
presentation: 4.75
5. Speaker's ability to
communicate: 4.88
6. Encouragement of
participants to take
an active part: 4.75
7. Value of handout
materials: 4.29
8. Value of subject
matter to me: 4.76
the app.
An experienced clinical
psychologist according
to the description.
Not based on research
but clinical experience.
Unknown.
There are many
different fonts used.
Has a uniform display
which is good for the
user.
The display is very
simple but the design
thought about the user
and tried to make
navigation easier. There
is very limited
functionality of the app
with the best feature
being the video but they
don’t play (design
error).
There are only two
reviews to go by,
therefore it is hard to
tell. There is no data
about retention. There
are 68 likes on their
Facebook page.
6. Downloads and use
How many users/downloads
are there? Is there data
about retention?
7. Research
Was there any research,
evidence-based guidelines,
or experts involved?
8. Design
How professional or
attractive is the design?
Unknown.
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There is a lot of word
cluster and less
imagery. It’s simple but
looks very clustered.
The color scheme is
interesting though.
9. Layout and navigation
(for an app)
What sections does the app
have and are they delineated
by content type, roles, or
user needs? How usable
and organized are the layout
and navigation (including
labels and menus)? Do they
make options apparent?
10. Branding and external
affiliations
Who created the app or
device and why? Is there
organizational branding,
accreditation, sponsorship,
Four primary
navigation tools: My
Diary, My Distractions,
My Statistics, Skarz
Story. They seem to be
delineated by content
and user needs in the
“Diary Report Form.”
There is a back button
to return to the
previous scene but no
other facility in
navigation.
Alicia Saunders created
the app.
Log section is also
broken down with great
detail.
The video they reference
to for the logs is more
animated but is carried
by words and
explanation. The videos
are a decent time, max 5
minutes long. They have
uplifting music in the
background.
The navigation seems
pretty simple with the
different layouts broken
down into sections.
“Nationally recognized
treatment approach”
The S.A.F.E.
Psyched Psychology
ALTERNATIVES®
Services: A Perth based philosophy begins with
psychology practice in the assumption that,
The hotline/phone
number is the first thing
seen when opening app
(on the home page). The
bottom of the app has a
navigation tool that
makes it easier for
users to look through
the app and it’s features.
The navigation icons are
not misleading and are
literally what they say
they are.
Sponsor is Center for
Health and Learning
and Outright Vermont.
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or advertising?
11. Expert content
What are the expertgenerated components, if
any, available (including
text, graphics, audio, video,
blogs, directions, ask the
expert, glossary, quiz, chat
with an expert)? Does
expert content identify the
author and date written and
reviewed?
12. Oversight
Is there an advisory board or
clinician involvement?
13. Literacy and readability
Is the content in the app
clear and easy to
understand? What about any
descriptions or instructions
for an app or device?
Western Australia
providing psychology
support for adults,
adolescents and
children.
The Skarz Diary
mission is to help
people to build up their
ability to manage
difficult emotions and
decrease their selfharm behavior. While
other support people
and therapists may not
always be available at
the time of an upsetting
incident, the Skarz
Diary is a tool that can
be accessed via mobile
24/7.
although temporarily
helpful, self-injurious
behavior is ultimately a
dangerous and futile
coping strategy which
interferes with intimacy,
productivity and
happiness. There is no
"safe" or "healthy"
amount of self-injury.
We also believe that
self-injury is not an
addiction over which
one is powerless for a
life.
A treatment team of
Unknown.
experts uses therapy,
In the “Diary Report
education, and support
Form” there is feedback toto empower clients to
help the user understand identify healthier ways
what is happening and
to cope with emotional
why as well as what they distress.
can do to feel better. It Reliance on words, the
gives them advice and
context of relationships
provide a distraction
as the primary means for
option
managing feelings, and
gaining self-awareness
and self-control
There is an experienced Based on clinical
Unknown
Clinical Psychologist
experience
The content is easy to
understand and there is
a lot of description. The
instructions are very
simple as well.
The content is a simple
set up with several
resources. The self
assessment
questionnaire is very
easy but limited to true
or false questions
Description: Everybody
needs help sometimes.
Help comes from
friends, family, people
nearby and even from
yourself. If you are
having suicidal thoughts
or are worried about
someone else, don't
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keep it to yourself.
Don't wait for a crisis to
ask for help. You
Matter. You can get
help.
14. User-generated content
and sharing
What are the user-generated
components (including
discussion forums, blogs,
videos, “likes”, comments,
ratings, and reviews)?
Which, if any, social media
is used?
15. Policies
Are there explicit privacy
policies or ones for how
information is used at
registration?
16. Registration
Do users register and, if so,
what can they do before and
after registering? What
information is tracked or
displayed? How is personal
information used?
User generated content
could not be found
besides one review
expressing their
concern that the
calendar swipes
information after 100
days. Facebook is used
as a reference to the
app but they do not
update app often or
update Facebook page
often.
The website has reviews
and feedback about the
treatment program but it
is unclear if it is app
specific. Facebook and
Twitter are used in
addition to the website.
1. Instructor's
knowledge of
material: 5.0
2. Instructor's
presentation of
material (clear,
organized, etc.): 4.9
3. Handouts, readings
used in class: 4.7
4. Instructors' response
to questions &
concerns: 4.9
5. Overall rating of
training: 4.9
The app also has great
customer service
according to one of the
reviews and have timely
feedback.
There are only reviews
on the iTunes or Google
Play app store which
express concerns that
the videos don’t load.
Unknown.
Password protected logs
for privacy of user.
Unknown.
There doesn’t seem to
Users have to make an
be a registration, it
account in order to use
seems to be a personal
the app.
diary log. The app
tracks behavior patterns
based on self harm
activity over the course
of time. (Time and
There is no registration.
There is no information
tracked. It is more of a
resource app. The only
personal information
would be anything
answered in the quiz.
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Date Selector. Reports
incidents of self harm).
17. Cost
Is there a cost for the app or
device? Are there premier
features?
$1.99
18. Devices and websites
Does the app or device tie
into any others apps,
devices, social media, or
websites?
19. Support and feedback
Is there a website or support
forum for users? Is there a
way to provide feedback? Is
there a feedback survey?
https://www.facebook.c http://www.selfinjury.co
om/skarzdiaryapp/info? m/
tab=page_info
http://www.umatterucan
gethelp.com/index.php/t
hink-you-need-help/usemobile-app
The support form
redirects to their
Facebook page. It is
unknown if there is a
feedback survey.
(+)The best feature is
that they keep a log to
track incidents of self
harm. The distraction
section is also a great
cue to action to steer
away from behavior but
it is hard to tell whether
it works for the user or
not. Another thing is
that they try to explain
the reasoning behind
why the user self
harms.
(-) It’s not that it has
bad features but for the
target audience it
would not be feasible
or appealing to have to
input data. The app also
does not go beyond
explaining what self
harm is and uses loss
framed messages. A lot
of people don’t seem to
use it based on the low
ratings and reviews and
They only have a
information provided
there does not seem to
be a feedback survey.
20. Overall assessment
What are the overall best
and worst features of the
app or device?
$0.99
They have a website,
Twitter and a Facebook
and have a review
column so they probably
have a survey.
(+) Compatible with
iOS and android. There
is log security password
to protect personal
information. They have
many sources through
their website, Twitter,
and Facebook for users
to be exposed to the app.
Timely feedback and
simple design.
(-) Must go to Youtube
to get explanation of
logs
http://www.youtube.co
m/playlist?list=PL2Xom
4oeN6iP_gVabYia4ISZ1wr3
m66B
Free
(+) iOS and android
compatible. Has
different resources to
seek help based on
location. Has videos to
show how to reduce
severity and take care of
wounds as well as
helpings start a
conversation. They have
a hotline or phone
number to call for help.
(-) The videos don’t
automatically play from
the app, they don’t load.
Long name for
searchability. Videos
are not separated by
category. Mentioned
bug fixes about videos
but they still don’t play.
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they don’t update the
app often. Only
compatible on iOS.
Wipes out memory
after 100 days.
Things Borrowed: From the Skarz Diary the management/tracking system functionality
of self harm incidents will be borrowed. The distractions feature will also be borrowed to
provide user with cues to action to replace self harm impulse. From Safe Alternatives the
different outlets used to promote the application (treatment plan) will be borrowed
because it has showed high success in their cases. From the UMatterUCanGetHelp app
the support center based on location, educational videos, and hotline idea will be
borrowed.
Things to Avoid: We want to avoid long names for the app. Avoid loss frame messages.
For the purposes of the young audience the design is too boring and unappealing so we
will avoid that. Avoid having user have to use another site such as YouTube to play
videos. Avoid too much input and self assessment quizzes, they take too much time away
and don’t help the user as much unless they understand their results or the app pieces
everything together for them.
Our Unique App: Our app will provide all the educational information and awareness
about self harm to users with a different approach, gamification. We will use some of the
functionalities from the competing apps on the market to make it more interactive for the
user and more fun. As with all games there will be objectives that the user will have to
achieve but it won’t be extremely difficult. The app will be designed to create a virtual
world of the area in which they live in everyday by using GPS functionality and
highlighting resources in the area such as the UMatterUCanGetHelp having support
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centers based on location. Educational videos will also be used for users to look at and
implement in the game as it will ask them trivia questions about videos not just about
their personal self harm. The videos will be about self harm but we want to shift the focus
away from users thinking it’s just them and help them understand that they are not alone.
The app will have the hotline number as a resource which will automatically be uploaded
into the contact’s list. The app will have two supporting sites to gain traction and go viral
through Facebook and Twitter. The updates and responses will be quick and there will be
updated perks every month to keep users interested in playing. The app will also use
seasons or times of the year as an advantage to tweak the worlds of the users to closely
resemble their reality. The app will also steer away from making users feel dependent but
rather independent and in control. When they reach the end of the highest level they will
be given a choice to prestige and continue their journey to reduce self harm behavior or to
use the tools they learned during the experience playing and become a listener or guide
for other self harmers.
Description of Design
The set up of the “world” of the user will be very similar to the set up in a
Pokémon game with the only difference that it will use the GPS and phone data to morph
itself into the real world setting of the user. The user will be able to openly navigate
across their world. The more they explore their real world the bigger the virtual world
will get because of the GPS map design. The app will also use weather features to mimic
the user’s current weather conditions.
When the user first opens the app, the home page will have the Never Too Deep
logo of a person helping up another person up a cliff. The interface will then switch to
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another image with the cliff but the person that was hanging at the edge is at the very
bottom and the person helping the person on the edge is pulling themselves over the edge.
The user will then get to choose which role they want to play the can play as the
“Listener” which will be those users trying to help or they will play as the “Self Harmer”
which will be those users that can use the help. They will then be introduced to an
interface to create their personal character that will interact with others in the world
whether they are human users or computer users (robots). The reason for including
computer users is for the audiences such as Lulu that do not live in facilities where there
are many people using the app or move around alot. In order for them to also actively
participate they will have computer users help them gain experience points to level up.
There will be 30 levels total. When a user completes all 30 levels they will have a
chance to prestige and start all over as the same role or in the case of the self harmer role
they will be able to switch to the listener role. This step is very important for self harmers
because it gives them independence and empowerment to be able to help others after
being stigmatized as always needing help for being “weak” or “vulnerable.” The prestige
perk will allow users to be able to customize their characters more as they some up more
points and experience. Our Jayke persona would appreciate that level of competitiveness
as the level go higher and will keep users like him engaged if they pass quickly because
the higher level and more prestige, the better the perks achieved.
Experience is gained through answering trivia questions about self harm,
watching videos about self harm and answering questions afterwards to see if the user
paid attention, and exploring interactions among their world. The GPS locator will use
the Internet to search for local events close by to help the user engage in activities. The
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app will send the user a nudge as a cue to action to check it out or make them aware of an
event close in proximity. If a user passes by another user with the app they gain
experience as well but not as much as they would if they answered a question, joined an
event, or chatted with the other user. The user will gain achievements throughout the
game as they level up.
Just as great as it is to gain experience, there is a way to lose experience as well.
In the home page the setting of the two people and the cliff was described earlier. As a
self harmer reaches higher levels, each time they open the app the self harm character
will be higher on the cliff. If they become inactive they lose experience points and start to
appear lower on the cliff. They do not lose experience points if they get a question wrong
but if they miss many questions, such as 5 in a row, they will. Listeners have an easier
time but it takes them longer to level up. If they express misconduct or bad behavior
towards self harm individuals they lose their perks. The point is to help out the self harm
users and encourage them, something our persona Max would appreciate. Even our
Skylar persona could appreciate this app because it a game app and she can play a
supportive role in the listener role.
The app design frame will be updated every month to fix any bug issues among
users. It will have a way to customize characters and provide different resources for users
based on their GPS location. Even if they live somewhere where there are no resources,
they will be able to navigate virtually and find places that can help whether it is chatting
with the computer user or listener user or visiting websites and learning from the
educational videos provided in the app.
Wire Frames
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Evaluation Plan
It will be necessary to gain user feedback on the usability, appeal, and
effectiveness of the app before it is launched to the public. Therefore there will be 7 main
points along the development and design process that there will have to be a check in to
make sure we are on the right track. The first will come after the conceptualization of the
design to make sure it matches the goals and objectives of the app. The second point will
come after consulting with experts from health communicators to self harm researchers to
game developers about how the language and messaging has to be distributed not only in
the app but in the campaign process as well. Assessments about fluidity in content with
facts have to be checked in order to provide the best version of an edutainment game app
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about self harm. The third point will come after the first two months of the actual game
planning and developing stage. This assessment will be to make sure things are coming
together early on and if there are issues coming up, we still have time to solve them
before the day of the launch. The fourth point will come on month 6 of the game planning
and development phase to check up on the progress of the design and also make sure that
it is being designed for the target audience. The fifth point will come at month 9 to make
sure the design is feasible and the storyline makes sense in the development of levels for
the game app. The sixth point will come during the focus groups, this assessment will be
to make sure that the app is in fact being designed for the target audience and it provides
feedback on any issues needed to fix the app before launch date. The last point will be at
month 17, a month before launch date just to make sure that things were updated and
issues from the focus groups were addressed by the game and visual design team.
Development Plan
To reach a larger audience the app will be compatible with both Android and iOS
devices. There will be a Facebook and a Twitter to actively endorse the app and
complement the different perks of the app. There will also be a website where users can
find out more information about the app and try a demo before they invest in the app. The
app message framing will be discussed with health communicators to provide gain frame
messages in tweets, Facebook posts, and the app. Gain frame messaging should be used
uniformly throughout the app in order to send the right message to users. Emergency
medical doctors and researchers of self harm will be used as guides to make sure the
content provided in the app is as accurate as possible while still keeping a gamifcation
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approach. They will be periodically consulted throughout the development and planning
phase as well as the execution phase to tailor towards the audience needs.
In order to develop the app there will have to be sponsors to endorse it. They will
be either for profit or non profit organizations that are interested in creating a game app
for smartphones. The organization goal should be to reduce self harm severity and
increase engagement in self harmers lives. The organization must be willing to try
different approaches but have an established philosophy of helping individuals. The
marketing team will work very closely with schools to be able to endorse the ads on their
property when the app is launched nationwide. Based on the proposed app design, the
estimated cost to create the app would be ~$70,000. Around $8,000 will go towards
design platforms for iOS and android. $54,000 will go towards game design, visual
design, GPS locator services, weather services, and the complementing website. $2,000
will go towards marketing and endorsing the app on social media. The remaining $6,000
will be used for schools to provide discount codes or free codes for students to download
the app. The app will cost $0.99.
It is estimated that the app will take 18 months to develop and get to the main
market. The first 2 months will be about conceptualizing the design and another 2 months
will be needed to consult with experts about the content provided in the app. It will take
10 months for development and completing the first prototypes, during this time here will
be constant communication between experts in the self harm field, health communicators,
and game developers to visualize the concept of the world platform. 3 months will be
used to test out the beta versions of the app among focus groups to make sure the
language among the design is right and catch any bug issues for the GPS and weather
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feature within the app to resemble the users current real world scenario. Last month will
be set up for campaign launch for the app as endorsements start drawing to a close.
Marketing Plan
The app will be announced during the first week of school (mid/ late August). It
will then launch during the first week of September. National Suicide Awareness Day is
September 10, although we do want to steer away from the stigma of close association to
suicide, we cannot ignore that it plays a huge part in the campaign. It will be launched
before the day, September 10, and stand alone while also hinting that suicide is the worst
possible scenario or risk that a self harmer can face if they go too far. The app will be
reintroduced during midterm and finals week for students. Only participating schools in
urban areas will be able to get the marketing materials such as flyers and posters but there
will be printable flyers on the website. Students will be able to take advantage of the
discount counts if they enter their name, date of birth, school name, and student ID. That
is the only information they will have to provide and it will be kept confidential, schools
will only be able to see the number of students signed up but not who, if many students of
schools are signing up, those schools will be able to order packages of marketing
materials.
During the announcement week, the website will go live and students will be able
to try the demo offered on the website. The Facebook and Twitter pages for the app will
have heavy volumes of posts and tweets to endorse the app and have teaser screenshots of
the app. The main tagline will be #iamlistening[insertcity]. After the week is over, the
app will launch and the first 500 students will be able to download the app for free. Then
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the regular price will go back up to $0.99. The tagline after the launch will be
#neveralone[insertcity].
When the commotion dies down the Facebook and Twitter pages will still
continue posting any updates, bug fixes, or holiday related events. The pages will also
post gain frame messages to encourage users to continue their journey not only in their
game world but also in their personal battles with self harm.
Limitations
There are many limitations among self harm users with this game app idea. The
message framing has to be particular to them and often times may only be understood by
them and not the listener users. It becomes difficult to be able to create the game app to
equally satisfy both the users in the listener role and the self harm role but the point is to
help out the self harmers. The biggest barrier is the social stigma behind being a self
harmer. That is a difficult barrier to overcome without being able to change perspective
on what people already know or think they know about self harm. There is also the idea
that self harmers will still not stop their behavior and although it would be ideal to have
them stop that is not the intention for this app. This app is meant to reduce severity of self
harm and increase engagement in the users’ life among their peers. That goal might be
lost in translation to outsiders but hopefully the target audience will understand the
purposes behind the app.
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References
http://www.webmd.com/mental-health/features/cutting-self-harm-signstreatment
2 http://www.verizondigitalmedia.com/content/verizonstudy_digital_millennial.pdf
1
http://healthland.time.com/2011/02/23/self-mutilation-videos-on-youtube-may-causekids-to-hurt-themselves/
3
4
Ajzen, I. (2006). Theory of Planned Behavior Diagram. Retrieved from
http://people.umass.edu/aizen/tpb.diag.html
5
http://www.helpguide.org/articles/anxiety/cutting-and-self-harm.htm
6
http://www.suicidepreventionlifeline.org/getinvolved/awarenessribbons.aspx
About the author
Mary Cueva is currently a graduate student pursuing her MA in Health
Communication at Emerson College.