Using a Tablet Screening Tool (TickiT) in Adolescent Health Care


Authors: Pei Yoong Lam 1, Mariana Deevska 1, Janet Bartnik 1, Dana Warn 1, Anna Gravelle 1, Robert Issenman 2 

1 British Columbia Children’s Hospital, Vancouver, Canada, 2 McMaster University, Hamilton, Ontario, Canada

Acknowledgements to: Terry Viczko 1 and Natalie Bunimov 2


 Psychosocial evaluation is the recommended standard of care in youth health care. At BC Children’s Hospital, inpatients psychosocial reviews are documented 45% of the time. To improve documentation, inpatient evaluation of The Adolescent Screening Questionnaire (ASQ), a paper based psychosocial screening tool, was conducted. Youth found the questionnaire to be understandable and acceptable but suggested questions could be more positive. However, 25% of youth refused to participate (J Adolesc Health 50(2):0 (2012)). 


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Presented at: IAAH Istanbul May 16th-18th 2012



TickiT is a tablet based communication platform that collects patient inputted data using a simple, interactive graphic interface. A University of British Columbia study (in press) found TickiT to be comprehensible for youth (14-20 years) irrespective of age, gender or ethnicity. Youth are willing and more likely to agree for their information to be shared with health care providers when using computer based health screeners (Australian and New Zealand Journal of Public Health Volume 25, Issue 6, pages 520–524, December 2001)

 Fig 1: Tickit Survey Module

Fig 1: Tickit Survey Module



To evaluate the feasibility of using an electronic psychosocial screening tool (TickiT) with adolescents in different hospital settings. 

To trial a tablet platform (TickiT) adapted from the paper based ASQ to improve uptake of psychosocial screening. 



 The ASQ was adapted and modified for a mobile tablet platform, target population 14-18 year old females and males (n=80).

BC Children’s Hospital Inpatients: 

 Fig 2: Youth Results Acceptability

Fig 2: Youth Results Acceptability

• Surgical ward (n=15), Medical Ward (n=15), 

BC Children’s Hospital clinics: 

• Cystic fibrosis (n=16), Youth Health (n=15)

McMaster Children’s Hospital

• Clinic (n=19 Gastroenterology)

A follow up paper based survey was used to determine ease of interpretation and satisfaction with the tool by both patient and health care provider. Data was entered and analyzed using Excel.


Youth Feedback

 Fig 3: Youth Results Completion Time

Fig 3: Youth Results Completion Time

 80 patients were approached, 1 refused and 1 did not complete the survey (N=78, uptake and completion 98%). The average age was 15.6 years with 56% being males.

Youth Time to Complete Survey

 In both hospitals, the majority of youth finished the survey in under 10 minutes.

Health Provider Results

 25 Residents, 3 pediatric attendings, 2 surgical attendings and 8 outpatient physicians participated in the evaluation of TickiT.

 Fig 4: Health Provider Results

Fig 4: Health Provider Results



  • Most outpatient visits were follow-up appointments so providers were already familiar with patient issues
  • Nursing and Allied Health staff were not included although they often manage psychosocial issues in multi-disciplinary teams
  • TickiT report mechanism was not evaluated


  1. TickiT was universally accepted by youth and enabled sensitive information to be collected in a short period of time
  2. TickiT was most useful in settings where the patient was unknown to the provider 
  3. Some teams found the information collected challenging and will require support and education to manage it

Future Directions

  1. To include Nursing and Allied Health teams in an evaluation of using the mobile platform TickiT in a health care setting
  2. To support providers who are challenged by the information collected in a psychosocial assessment
  3. To assess the role of TickiT in the other settings e.g. emergency departments
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