Savoring for better sleep in a war zone: Co-design of a brief digital tool for Ukrainian youth

Ukrainian youth have been enduring war for 3 years. War-related stresses include grief, deprivation, worry about loved ones, and fear of bombardment. Air raid sirens sound at all hours of the day. Stresses such as these can contribute to poor sleep, and poor sleep reduces resilience.  Savoring, the practice of consciously attending to and amplifying positive experiences, enhances positive emotions which can serve to buffer effects of stress (“undoing effect”) and build long-term resources (“broaden and build”). There is growing evidence that savoring at bedtime can improve sleep.

We partnered with two NGOs, War Child and the All Ukrainian Foundation for Children’s Rights (AUFCR), to co-design a brief digital tool to teach Ukrainian youth how to improve their sleep by savoring positive experiences at bedtime. We developed a chatbot through an iterative co-design and testing process with 65 Ukrainian youth. Then we conducted 3 rounds of focus groups with 18 Ukrainian youth to refine the chatbot and develop onboarding and dissemination strategies.

The digital tool runs for 4 days, requiring only 5 minutes of engagement daily. Each day, users learn a component of the tool: savoring (when you recall and enjoy an uplifting experience), switching (when you redirect your attention and feelings away from a distressing experience and toward an uplifting experience), capturing (when you make a point of noticing and remembering uplifting experiences), and generating (when you seek out uplifting experiences). Content is delivered via the youth’s preferred messaging platform (e.g., Telegram or WhatsApp), and includes interactive exercises, memes, stickers, check-ins, reminders, and offline activities. Participants have the option to continue receiving reminders and prompts beyond the initial period, as well as track their sleep quality. Participants are invited to share tips with other Ukrainian youth and motivate them to practice savoring.

All 18 focus group participants (age range = 16-23) engage fully with the digital tool. Days of sleep tracking ranged from three days to two weeks. Participants described how they thought savoring affected their sleep, and they provided suggestions for improving the tool and its content. Participants expressed enthusiasm for the digital tool and for the benefit of participating in the focus groups.

Ukrainian youth found a chatbot-based digital tool teaching savoring for sleep to be appealing and useful. Focus group members suggested: more empathy, irreverence, and surprise in the chatbot’s responses; more opportunities to support peers through use of the chatbot; and clarification of the savoring and switching skills to increase salience and prevent any negative effects. The co-design process showcased the motivation of Ukrainian youth to connect with each other and contribute to the resilience of their peers. Based on these promising findings, we are undertaking an engagement pilot to optimize the digital tool as an intervention and enhance the near-peer components designed to facilitate sharing of the intervention.

Open-source protocol:
Prototype Telegram chatbot (in Ukrainian): https://t.me/Better_Feeling_Bot