1. The problem your project solves
The current COVID-19 coronavirus pandemic is an emergency on a global scale with healthcare systems and clinicians struggling with huge numbers of patients visiting medical facilities. To lessen this burden on medical staff, governments are trying desperately to convey certain public health messages to stop the burden increasing, however following shifting guidelines can be challenging, particularly in an age of social-media disinformation. In addition to this, for the first time in recent history, swathes of the population are required to remain inside for prolonged periods of time to tackle the virus. In this new context, individuals’ typical routines for promoting healthy behaviors are often disrupted with simple health promoting activities (a short walk around a park, for example) currently much more difficult to achieve. Prolonged periods inside may likewise lead to feelings of isolation, poorer mental health, increased risk of interpersonal conflict and difficulties sleeping. These factors in turn could lead to increased COVID-19 transmission or increased visits to medical facilities for preventable reasons.

2. The solution you bring to the table
To address these challenges to public health and “pandemic lifestyle care”, we are developing Elena+, named in honor of the Italian Nurse that was photographed exhausted from treating COVID-19 patients. The Elena+ app, publicly available free to use on both iOS and Android, utilizes a chatbot to interact with simple pre-defined answer options selectable by individuals and offer personalized coaching in topic areas related to their health, which may be under strain during this COVID-19 period of self-isolation. Importantly, our solution is very simple to use, designed for users with varying degrees health literacy and technological affinity, and is location independent, i.e. requires no travel by individuals (i.e. as resources are delivered digitally by a chatbot). Topics included with the Elena+ app are: (i) COVID-19 health information, (ii) physical activity, (iii) mental health (loneliness, anxiety, sleep and finding resources), and (iv) diet/nutrition (to be included in a future version).

3. What you have done during the weekend?
Building up on the ground work performed over the last two-weeks, this weekend we have: (i) started to implement the mental health module into the application, (ii) finished physical activity chatbot scripts, (iii) found individuals to help translate into Spanish and German, (iv) created and integrated new app artwork, (v) created social media handles and website for Elena+, (vi) created two promotion videos for the app (in conjunction with two media agencies which kindly volunteered their time and expertise to help).

4. The solution’s impact to the crisis
Our digital health intervention has three main influences on the crisis. Firstly, by keeping individuals informed with trustworthy COVID-19 health information, we lessen the risk of transmission, and thusly lessen the number of new infected patients arriving at hospitals. Secondly, through our lifestyle intervention, we aim to help individuals cope with current social-distancing guidelines and empower them with resources related to their health (mental or physical). This can help boost immune systems, mental resilience and other positive wellness factors, lessening potential risk of ill health and further strains on the healthcare system during the crisis. Thirdly, through the data gathered in the app, we can better understand the topic of “pandemic lifestyle care” and understand what topics and materials are most used and/or rated as most popular by participants. This could allow us prepare resources in case of a future second wave.

5. The necessities in order to continue the project
We are a group of interdisciplinary university researchers and students with specialism in behavioral and digital health, developing and promoting the project with the kind support of two media agencies whom volunteered to help us for the Hackathon (we pitched our product to them on 23.04.2020). However, we still would need further support to extend our reach and potential impact greatly. Translation and marketing for each of the nation states of Europe (and beyond) would be important, to help reach as wide an audience as possible. In addition, for a fully polished and dynamic product, it would be necessary to have a dedicated technical team. Finally, additional funding will used to integrate more digital coaching content into the app, some examples include; (i) making the intervention more gamified to boost engagement, (ii) tailoring coaching content for specific at-risk populations, or (iii) adding contact tracing into the app, which would be most effective as part of a pan-European solution with the backing of the European Union.

6. The value of your solution(s) after the crisis
In recent years, a variety of innovative digital health interventions using chatbots have had success targeting individuals suffering from chronic diseases. However, relatively few attempts have been made to leverage this technology for improving population level health and certain vulnerable sub-populations. This application will indicate what can be done in the future with pandemic care (i.e. data will show which topic choices are popular and how individuals use such apps) however it may in addition show how such technologies can be used to empower individuals to make heathier lifestyle choices, and the Elena+ app can lay the ground work for other holistic lifestyle interventions targeting population health. Per design of this intervention, it could also be fully possible to deliver the intervention in a decentralized and an open-source manner whereby the data, software and intervention content are publicly available and sub-teams led by motivated parties in individual countries make and implement relevant cultural adaptions to improve success. It would, of course, be highly possible for this to continue through start-up companies and/or in the academic sphere.

7. The URLs to the prototype and additional information

Prototype screencast

Project website

Bitbucket repository

Extended abstract

Elena+ Video

The Team's Story

8. Additional remarks
To see the Elena+ app in action, please view our prototype screencast in the section "Try it out" or contact mail@elena.plus to receive test account credentials. Elena+ it is completely open-source and easily scalable. Reach out to us if you wish to convert the app into your language!

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