Applied team is working with Professors Melanie Gold and David Bell at the Mailman School of Public Health, Columbia University to build a young men teenage pregnancy prevention (YMTPP) study app for a 4-year trial on Young Men’s Health (YMH).

As a part of this trial, the YMTPP app is supposed to be able to aid motivational interviewing of young men about their sexual behavior which might lead to pregnancy. The app will gather behavioral data on young men’s diet, exercise, smoking & alcohol use, as well as sexual activities and based on data gathered via app, young men will receive counseling from lifestyle coaches.

To accomplish motivational interviewing and counseling via an app, we implemented “card sort” technique in building this ResearchKit app.

What is Card Sort?

Card sort is a technique, strategy or a game that helps in structuring meaningful conversation around any topic or issue. It can be used in classrooms to teach students or in behavioral and cognitive research to convey a particular concept, or, to provide focused motivational interviewing and counseling thereafter. 

In this game the subjects are asked to pick and choose or “sort” from a pile of cards with different values. Depending on what the research is trying to accomplish, the value of the cards used may vary. For example, in the Young Men’s Health study which we are working on, the cards may have personal attributes such as: adventure, attractiveness, achievement, belonging, confidence, fame, fidelity, health, monogamy, pleasure, romance, tolerance, dependability, and other similar values.

Each card will have a word that represents the value and a set of words which describes that value. 

Now, first, the participants are asked to sort these value cards into – “Important to me” and “Not important to me” categories.

Once this is done, the participants are asked to pick 2-3 cards that are most important to them and put it under a new category called “Very important to me”.

Overall objective of selecting 2 or 3 personal value cards that are most important to the subject, is to allow the research counselors to have a conversation about – first – why those values are particularly important to that person at that time in his life, and – second – more importantly, to relate it to the behavior change that the research is trying to encourage. The specific order in which the cards are chosen are not of concern.

How did we implement Card Sort in ResearchKit App for Young Men’s Health Study?

The Young Men’s Health trial for which our team is making the app, aims to educate young men on preventing becoming a father at young age. The study is designed in such a way that – one group of subjects will receive motivational interviewing to improve fitness, and the other group of subjects will receive motivational interviewing for teenage pregnancy prevention, via app. The study will then compare the effectiveness of motivational interviewing in both groups.

This study app allows users to play a card sort game on their android or iPhones. Various personal value cards will be presented to the subjects on their phones. They can sort the cards just by swiping cards up or down to place them into  “important to me” or “not important to me” or “most important to me” categories.

Now, if someone chooses “Adventure” as one of their “very important” cards, then, as per the card sort method, the research team will first ask – why is this card important in your life? Through the app,  motivational interview coach or counselor can ask open ended questions to fully understand the value of each of the three chosen cards, and then prepare a summary of the reasons why the cards were important to the subject.

Second, the counsellor will ask the subject, one-by-one, how these three values relates to the intervention – to fitness or to prevent being a father at teenage (depending on the group the subject is assigned to). Depending on the response, the participant may then be counseled or provided educational materials via the app, to change or improve his behavior.  

Subjects may take time to decide their preference of the 3 “most important value cards”  since they have to choose from a pile of value cards which is already “important” to them. Subjects may also go back and change their preference of the 3 most important card they chose.

Card sort game is a great method to study cognition, behavior, and, lifestyle, as well as to encourage a particular behavior or lifestyle.

Stay tuned for the launch of the YMTPP app in coming months!