CHILDSPLA project talk: Children’s health state preferences learnt from animation

Last week, Joan Ashworth Head of RCA Animation Programme presented a collaborative research project aiming to design an animated app to measure the health states of children in hospital. The project is very relevant and echoes some of the themes and methodology explored in our AHRC Game project.


The project is a collaboration between the London School of Hygiene and Tropical Medicine, Great Ormond Street Hospital, and the Royal College of Art. It brings together health psychologists, health economists and animation filmaker. CHILDSPLA (more details here) explores a new method to gather children’s view about their health in which the team uses animation and co-design process to build an interactive iPad ap. The project is half way through but they already carried a series of co-design workshop in different schools to design and animate the character.

Researching with children instead of researching about them.

Working with two different age groups,┬áNeus Abrines-Jaume explained how difficult the process was in terms of getting the children on board: How do you tell children about the project? How do you explain what is a research project to a five years old? It was very interesting to see what kind of “tool” they designed to communicate the project to the children. They adopted two different approaches for the two age groups. For example they design two information booklets: one for the 4/5 years old category and one for 11/12, showing visually to the children: “what is a research project”, ” the team members”, “how can the children help”. The team explained how challenging it was with the very young children, how to not overwhelm them with information, try to find the balance between text and visual.

Throughout the process, children were generally more interested in animating than designing the character. They also noticed that the older children were able to make a distinction between things they like and things that were appropriate for the project. During the sessions, children were given template to design their own character. According to the team, the participants understood that their input will influence the design and this motivated them. So it was very important to make the children understand that the team “will listen to them”.

Childspla final animation character.

One learning point was the colour of the character: orange, both the team and the children concluded it was a good colour for the skin as not extremely different from any real skin colour but also far enough from reality to be identified with a specific ethnicity.

After spending some time looking at designing the character, the team got the children to think about how the figure should move. They worked in small groups and proposed different representations of different health states. The animator from the team would draw the suggested poses and ideas from the children and get feedback from them.

Starting with schools, the team went later to hospital context in order to get feedback from children that were ill. They took iPads around and found that the app would give more control to the children to express their state/feeling. They mentioned how usually parents tend to speak for their children and don’t let them to express themselves.

In the second part of the talk, Health Psychologist Jo Wray introduced some of the challenges of the project and told about Great Hormon Street Hospital which is one of the world’s leading children’s hospitals.

Slide from Jo Wray showing the children from different hospital’s department involded in the project.

From her slide, main issues to consider:

  • As professional one question, how are we going to use the app?
  • How does animation compare with other forms of presenting the information?
  • How well do children understand the animation?
  • How easy do children find the animation?
  • Do they like the animation?
  • How does the animation compare with other gold standards (most appropriate one)?
  • Does the animation distinguish between ill and healthy children?
  • How many children do we need to test the app in a scientifically robust way?

The main challenges:

  • Ethics committee requirements
  • Numbers needed (244 ill children)
  • Need for champions
  • Time
  • Engaging clinicians and keeping them engaged (short/long term engagement)
  • Other studies (many other research project)
  • Parents/excluded parents

Potential benefits from a clinical perspective:

  • Parent and child feel more satisfied that their experience of illness has been understood
  • Child has more of a direct voice by being able to communicate how they are
  • Health professional may have a better idea about the child’s condition and therefore make/recomment more optimal modifications to treatment at a given time point
  • A health outcome for the patient (an actual clinical outcome) may improve as a result of Chilspla.

Things to consider:

  • Are some constructs of Childspla more relevant for particular conditions?
  • Do some constructs work better than others?
  • Are we covering all of the key areas of importance?
  • Will Childspla be sensitive to changes over time or might we need some disease specific modifications?
  • Could the app be used as a monitoring device for children at home?

This is where they were when presenting the project last week at the RCA. We found their way of working and “journey” very inspiring so we are looking forward to seeing the end result/process!

Relevant Links:






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