The activities of our daily lives—walking around town, using our phones, playing video games—serve many purposes. They allow us to be productive, stay informed, and relax. Now, thanks to a wave of new digital technologies, those same activities can double as health interventions and research opportunities that are not only more convenient but, potentially, more effective and accurate.
Leveraging digital tools to improve access and broaden Sargent’s reach isn’t new. One of the college’s marquee digital programs—the online postprofessional doctorate in occupational therapy—has been training leaders in the field for almost two decades and has alumni on six continents. And the Center for Psychiatric Rehabilitation was an early adopter of telehealth services to expand their life coaching program for college students. But recent years have brought on newfound digital innovation, catalyzed by lessons learned when teaching and research were forced online during the COVID-19 pandemic.
Karen Jacobs, a clinical professor of occupational therapy, is Sargent’s associate dean for digital learning and innovation, a position that was created in 2019. She’s a liaison with the wider BU community, including Digital Learning & Innovation, which includes the Center for Teaching & Learning and the Shipley Center, programs that support faculty looking to innovate.
She’s also an in-house resource for faculty. She helped train faculty members in remote learning technology in the early days of the pandemic. Four years later, she’s able to focus on more proactive ideas—like the use of artificial intelligence in OT interventions.
“We have a mindset of innovation at Sargent College,” Jacobs says. “It’s exciting. I feel very grateful to be working at this period in time when things are just exploding with possibilities to be innovative.”
Artificial Intelligence, Real Benefits
Karen Jacobs is excited about artificial intelligence. “I don’t see any limitation to the potential, quite frankly,” she says. It’s a message she delivered in an address to the OT conference in South Africa and will bring to the New York State Occupational Therapy Association as their keynote speaker in November 2024. “I want to be in on the ground level, helping companies understand what we do as occupational therapy practitioners so that we can advance the use of AI in an ethical and responsible manner,” she says.
For more than a year, Jacobs has been working with KorroAI—a start-up that is designing a gaming platform for occupational therapy practitioners to use with kids living with a wide range of diagnoses—to conduct feasibility tests for its first product. In the game, participants play an astronaut exploring new worlds and navigate challenges like climbing a virtual rock wall. The game uses computer vision, an AI-powered technology that interprets images, to assess the skill level of the participant and adapt the game’s level of difficulty.
KorroAI represents a breakthrough on multiple fronts, Jacobs says. Occupational therapy practitioners might see a child only once a week and can struggle to motivate them to practice at home the skills they’ve learned in the clinic. The gaming experiences provide a more appealing way for kids to practice the skills they’re working on with their occupational therapy practitioners—who in turn can receive data about each child’s progress. The AI adaptations also mean a child can get more out of the experience—a child learning to write, for example, might typically practice holding a pencil whereas the gaming experience can provide different finger isolation exercises and gradually adjust the level of difficulty.
Smartphones, Smart Interventions
As a clinical psychology PhD student, Dan Fulford wanted to understand what happened to patients with serious mental illnesses, like schizophrenia, outside the clinic and lab. Using a technique called ecological momentary assessment (EMA), he began collecting data from study participants repeatedly during their day. To do that, he used the latest in mobile technology at the time: the Palm Pilot.
Now an associate professor of occupational therapy, Fulford still uses EMA—but in a far more sophisticated manner. His study participants use their smartphones to track their precise locations, phone conversations, text messages, and other app usage—millions of lines of data that Fulford hopes hold the answers to not only when people feel lonely but also how interventions can be sent by phone in real time to help them.
“Technology is something that will provide opportunities to supplement and extend the support that you get in a one-on-one psychotherapy session,” Fulford says. But to realize that goal, he first needs to get a better understanding of which data are reliable and significant, and how to translate that into interventions, a labor-intensive process that may eventually use machine learning or artificial intelligence.
“If we can use that data in a predictive model, that would allow us to provide the opportunity for an individualized intervention for that person.”
Remote Trials, Relevant Data
Deepak Kumar, an associate professor of physical therapy, was preparing a study of exercise-based physical therapy treatments for knee osteoarthritis when the pandemic forced him to change plans. Kumar and his team typically collected movement data from participants in their lab, but they had to supplement that data using remote sensors that recorded additional measurements at home. The results surprised them.
Kumar noticed that some participants showed improvements in their movement in the lab but not at home, suggesting that they weren’t walking in a natural manner during the lab visits. “The outcome we’re collecting at home is potentially giving us more relevant information about [a participant’s] condition,” he says.
Buoyed by his findings, Kumar launched via telehealth a fully decentralized study—a trial that takes place outside of a typical clinical setting—of the safety and feasibility of mindfulness and exercise interventions. Participants from more than 20 states were recruited online and provided with motion-tracking sensors. A follow-up project recently received funding from the National Institutes of Health.
Decentralizing studies is a potential win-win, Kumar says. Done well, they can increase access to participants and provide more relevant data to researchers.
Online Services, Worldwide Reach
At the Center for Psychiatric Rehabilitation (CPR), online mental health services have a long history. The center’s coaching program for college students, which began in 2010, has always offered remote sessions to supplement in-person meetings. Flourishing Families, a program launched in 2021 to support the families of young adults with mental health conditions, is fully online.
“Everybody could use some help but not everybody knows how to access it. It’s important to make this as accessible as possible,” says Chelsea Cobb who, along with Paul Cherchia, codirects both programs. CPR coaches have worked with students from more than 230 institutions, helping them navigate life and providing a bridge to more focused mental health services when needed. And for families, meeting online gives them access to a community well beyond their geographic area. One 2023 cohort continues to meet monthly, long after their six-week workshop with a BU coach ended.
Cobb (CAMED’17) still believes that in-person meetings are invaluable for many people, but remote offerings allow a greater diversity of students and families to benefit from CPR programs. “We’ve been able to broaden who we serve,” says Cobb. “Oftentimes, students who are underserved don’t have access to mental health resources. We can be a real gateway to seeking help.”