Little Journey is a psychological preparation and support tool that engages and supports children and their family undergoing a healthcare procedure as part of standard care or a clinical trial.

The issue

Peri-procedure anxiety is common and affects 75% of children and 33% of adults. Psychological preparation and support of children and their families is an integral component of high- quality care. Pre-procedure anxiety (PPA) has been linked with worse psychological and physiological outcomes - affecting both children and adults alike. PPA also applies to clinical research, acting as a barrier to participation, adherence to medication and trial retention. Psychological preparation has been shown to be effective at reducing PPA but requires significant staff time commitment and therefore cost.

Telemedicine and PPA interventions delivered in the patient’s own home can provide a cost-effective method of delivering peri-procedure support. The coronavirus disease 2019 (COVID-19) pandemic has further highlighted the need for such interventions.

About Little Journey

The Little Journey platform was founded by Dr Chris Evans, an NHS doctor and academic, based on his clinical and research experience. Little Journey is a co-designed multi-faceted behaviour change intervention developed to support children and their parents or guardians end-to-end through a clinical trial.

It consists of a mobile app delivering multi-faceted preparation and support for children and their parents, a web-based hospital portal enabling healthcare and research organisations to configure the mobile app to their own local patient pathways and trial protocols, and a research management tool to monitor individual trial participants progress and engagement.

Core modules and functionality

The platform consists of configurable modules designed to engage, prepare and support families from first awareness of a clinical trial to trial completion.

PROCEDURE PREPARATION: age tailored virtual reality tours help to familiarise and desensitise participants and their families to different trial procedures remotely. Each tour is configurable to the local hospitals' patient pathways.

TRIAL INFROMATION: Interactive timelines outline the trial protocol with information about what happens at each stage to keep families informed of upcoming trial appointments.

MEDICATION MONITOR: A gamified tool to promote adherence to the trial medication with interactive rewards, buddies and achievements.

DISTRACTION TOOLS: Age-tailored relaxation exercises and distraction games to support children through stressful procedures (including games played using a virtual reality headset).

TRIAL OVERSIGHT: A research management oversight tool enabling research staff to monitor and support families

LOCALISATION:The current app content is available in 16 languages with new content localisable to any language

Current Progress

• adopted by over 50 NHS and international organisations to support children through routine healthcare procedures

• supporting a large global CRO in trial with complex design, multiple procedures and extended medication adherence

• 30% reduction in anxiety in children with Autism/ADHD

• 97% satisfaction rate

• 42% reduction in on-the-day cancellations

The future

We are using data to better understand participants behaviours to identify the ideal research participant and modify the behaviours of others to support them to become the ideal participant