What is DOORS?Because individuals with serious mental illness (SMI) are at high risk of digital exclusion due to low digital literacy, our team created a digital literacy training program, Digital Outreach for Obtaining Resources and Skills (DOORS). DOORS is a community-oriented, research-backed digital literacy training program that teaches essential laptop and smartphone skills.
Consisting of nine core learning modules with associated slides, handouts, and manuals, this program was designed to be hands-on, interactive, and adaptable. We are grateful for the support of the Sidney R. Baer, Jr. Foundation for supporting this work. |
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We're developing and piloting a new series of modules to help patients navigate the rapidly changing world of generative AI, safely and on their own terms.
Read more →When we first built the DOORS curriculum in 2018, generative AI wasn't part of the conversation. The focus was on fundamentals: how to navigate a smartphone, send a message, join a video call. Those skills remain essential. But the technology landscape has shifted dramatically, and our curriculum needs to keep up.
Generative AI is no longer something people have to seek out. It's embedded in search engines, social media, customer service lines, and the smartphones our participants use every day. Even people who have never opened an AI chatbot are encountering this technology, often without realizing it. At the same time, concerns about AI's impact on mental health are growing. Highly publicized cases of so-called "AI psychosis," alongside the rise of AI-powered scams and misinformation, have made it clear that patients need practical tools to navigate this new environment.
We don't think the answer is telling people to avoid AI entirely. For many of our participants, that's not really possible given how deeply integrated the technology has become. And a prohibitory approach risks stigmatizing patients who are already using AI, making them less likely to discuss it with their providers, which limits opportunities for clinical intervention when it matters most. Instead, our approach is harm reduction through education: equip people with the knowledge to use these tools safely and critically, while being transparent about the risks.
To that end, we've been developing and piloting DOORS AI, a new series of three modules that extend the DOORS curriculum into the world of generative AI:
Like the rest of the DOORS program, these modules are designed to be hands-on and interactive. Participants don't just hear about AI; they practice prompting, evaluate real outputs, and discuss what this technology means for their lives. The sessions are informed by feedback from previous DOORS participants and are being piloted across a range of healthcare and community settings in the Boston area, including psychiatric outpatient programs, clubhouses, and inpatient units.
We're using anonymous pre- and post-session surveys to understand how these modules affect participants' confidence, trust, and sense of safety around generative AI. Early feedback has been encouraging. As one participant put it: "Learning the basics of AI is very helpful. I'm learning about terms and words that I didn't know about before."
A publication detailing this program and our pilot findings is forthcoming. We'll share it here when it's available. This work is supported by the Sidney R. Baer, Jr. Foundation and the BIDMC Department of Community Benefits, and we're grateful for their continued investment in digital equity.
If your organization is interested in bringing DOORS AI to your site or learning more, reach out to us at [email protected].
— The DOORS Team
A new training protocol developed with the Society of Digital Psychiatry is on the way. Here's what it includes and why it matters.
Read more →We're excited to share that a pre-print of our latest work, an updated Digital Health Navigator training protocol, is now available in JMIR Mental Health.
The expansion of technology into healthcare has created real opportunities for innovation in how care is delivered. But those advances can't be equitably leveraged unless patients have adequate access to both the technology itself and the foundational skills to use it. This gap is where Digital Health Navigators come in: members of a healthcare team whose role is to support patients' uptake of digital health tools through digital literacy training and connection to technological resources.
Over the past several years, our team has seen firsthand how impactful this role can be, and also how much the landscape has changed since we first started training navigators. The tools are different, the patient needs are different, and the healthcare systems adopting these roles are more diverse than ever. We needed training materials that reflected that reality.
Working with the Society of Digital Psychiatry, we've developed an updated training protocol designed to equip Digital Health Navigators with the pedagogical, technical, and interpersonal competencies they need. The training is built around four modules, each grounded in activity-based learning so that trainees develop those competencies through practice rather than just lecture slides.
A few things we're particularly proud of in this version:
There are still challenges to scaling the Digital Health Navigator role, including questions around funding, integration into existing workflows, and sustainability. We don't shy away from those in the paper. But we believe this protocol gives organizations a strong, evidence-informed starting point.
We'll share a link to the full publication once it's available. In the meantime, if your organization is interested in Digital Health Navigator training, reach out to us at [email protected]. We'd love to talk.
— The DOORS Team
We're launching this space to share updates about the DOORS program: stories from the field, research highlights, and more.
Read more →Since 2018, the DOORS program has grown from a hands-on digital literacy workshop into a broader initiative that now includes volunteer networks, community partnerships, Digital Navigator training, and ongoing research. A lot happens behind the scenes, and we think it's time to start sharing more of it.
The DOORS Program blog is a space for dispatches from the people doing this work every day. Here you'll find updates on what we're building, reflections from the DOORS team, stories from our partner sites across the Boston area, and a closer look at the questions driving our research.
Some of what you can expect from us:
We started DOORS because we believe that access to technology shouldn't be a barrier to accessing care. That belief hasn't changed, but the landscape around us has. AI tools are entering everyday life, telehealth is here to stay, and the need for digital literacy is only growing. We want this blog to be a space where we think through those challenges openly, share what's working, and stay accountable to the communities we serve.
Thanks for reading. We're glad you're here.
— The DOORS Team
Client testimoniesI am overwhelmed by your kindness and generosity. I am an absolute novice who learned from you the initial steps so that I am less intimidated by the technology. They’re tricky, but I am moving forward slowly. Thank you for presenting such an informative and enjoyable course. I was really interested in how you merged health issues with smartphones. I found out that smartphones can really enhance one’s health and mental health. This is good education for people who do AND don’t have a smartphone. Good for all people, disabled or well/healthy. |
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Module 1 introduces clients to digital technology and its functions in everyday life. This module overviews the anatomy of devices and the basic gestures we use to interact with them. Clients learn how to make their devices more comfortable by adjusting the brightness, changing font size, and adjusting volume. Participants will also learn how to connect to Wi-Fi. Common symbols are introduced and interwoven throughout the session. Any participant who does not currently own a smartphone or laptop is guided through governmental resources to determine their eligibility for receiving a free digital device. This session is integral for teaching clients with low baseline digital literacy, as it develops essential skills for learning more advanced skills in future sessions. The smartphone version of this module teaches participants to make a phone call.
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The second module teaches participants how to customize their devices to accommodate their preferences. This module is inherently more personalized as participants may only be interested in a few specific features. Through group discussion, participants are encouraged to think of a few things they may want to change about their device or that they have previously changed on other devices. Participants are then shown how to find the accessibility settings on their devices. The session guides participants through three categories of accessibility settings: vision, hearing, and interaction. For smartphones, participants are directed to exit the accessibility settings section to access voice typing settings. For computers, participants are directed to additional mouse settings outside of the accessibility section to change the speed of their mouse. The session concludes by asking participants if there is anything else they would like to change about their device. Facilitators may use any leftover time to address those questions and anything that was not covered in the session. This module promotes engagement with devices by removing any barriers clients may face when using their devices.
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The third module teaches participants how to use the internet safely. The session starts with an open discussion about participants’ current internet use. The session then introduces tools for finding information and how to search for topics on Google. To ensure participants can navigate the internet safely, we emphasize the importance of identifying scams. The latter half of the session focuses on common signs of scams and what to do when a message may be a scam. This includes an activity where participants are shown various messages and asked to identify clues signifying whether it is a scam. With these practical tools, they will be better equipped to evaluate online information and messages critically. While the instant access to information provided by the internet encourages engagement and awareness, it also presents risks, such as exposure to scams. Navigating this landscape is key to using devices safely, and this session focuses on building those skills.
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The fourth module focuses on using our devices to communicate through e-mail and text messages. For smartphones, this session begins with discussing what text messages are and how to send one. For laptops and smartphones, participants are first shown the functions and anatomy of e-mail. Participants are then taught how to write and send emails, including common e-mail etiquette and attachments. For smartphones, this also includes learning how to use the camera function on their device to take and send a photo. Those with limited digital literacy skills might not be aware of or feel comfortable using all the social features available on their devices. With few ways to connect with others, participants have a limited ability to initiate social interactions and engage in their communities, which in turn heightens their risk of feeling isolated and lonely. Furthermore, they may be unable to view or respond to important email correspondence, for example, with their medical provider, leading to disadvantages in accessing treatment. This session works to mitigate this disparity and shows participants how they can use their devices to socialize with loved ones and friends in casual settings, as well as more professional written communication.
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The fifth module builds on the written communication skills learned in the last session and teaches participants to make video calls via Zoom and, for smartphones, Facetime. Hands-on activities and ample one-on-one instruction ensure that all participants benefit from these two skills. The session begins with discussing what video calls are and what we can use them for, such as seeing a healthcare provider or contacting loved ones. Then, participants are guided through creating a Zoom account and joining a Zoom call. Participants are also taught the function of the various Zoom buttons and video call etiquette. For smartphones, the session proceeds to teach participants how to make video calls via Facetime for iPhone or Google Duo for Android. This session can be divided into two if the baseline digital literacy of the group is low as both skills are complex and require multiple steps to be completed. This module helps to promote participants’ ability to communicate with professionals and extend their communication means with family and friends, thus expanding their ability to attain employment, receive important notifications, and advocate for themselves.
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In the sixth module, participants are shown how they can use their devices to manage their responsibilities. The session begins with a discussion centered around daily routines and responsibilities, allowing staff and fellow participants to understand how using digital organization tools might be useful for their day-to-day lives. To sustain engagement throughout the session, it is important that participants feel they are learning about resources that are directly applicable to their expressed needs. Then, participants are shown how to plan an event on Google Calendar or the Calendar app, setting its title, date, time, and whether it is a repeated appointment. For smartphones, the Maps app is then introduced, and participants learn how to reach a desired destination and favorite commonly frequented locations. Lastly, Notes or Google Documents are introduced as a way for participants to write down anything of interest or importance, including to-do lists and journaling. After each resource is discussed, hands-on activities allow participants to gain familiarity with each resource and determine if the resource meets their needs. Access to a device can promote ease of access to a wide variety of organizational tools in an instant. These tools can reduce the burden of needing to remember commitments or daily tasks and allow patients to navigate their surroundings easily and accurately.
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The seventh module focuses on helping patients use the internet to discover and consolidate new skills, as well as for entertainment. This session begins with downloading the YouTube app for smartphones or navigating to the YouTube website for laptops. Participants are then shown how to navigate the YouTube homepage, view their watch history and use the search bar. After opening a video, participants are taught how to use the video player, as well as the meaning of the various symbols. This module provides participants with skills and knowledge to apply to other media players. For laptops, participants are also shown how to make and view bookmarks by having them bookmark a video they are interested in. Platforms like YouTube can help participants seek new skills or review old skills, such as those learned in this course. This session aims to give participants the tools to expand their knowledge and seek entertainment on their own for free.
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The eighth module encourages participants to use their devices for well-being and fun in two ways: through patient portals and music-listening platforms. The session begins with a discussion of patient portals, where the benefits of portals and their real-world applicability are emphasized. A hands-on activity facilitates participants’ enrollment in their patient portal. Once participants are signed into their portal, they can navigate to a few common functions. By teaching participants how to use their patient portals, this module aims to increase their access to healthcare services. The second part of the session begins with a group discussion of the benefits of listening to music and how participants have listened to music before. Participants are introduced to Spotify and guided step-by-step on how to sign up for it. Participants are also shown how to play a song and add songs to a playlist. This section wraps up with a discussion of other streaming services participants may be interested in. By showing participants how to use their smartphones to have fun, this session will also promote their engagement and consistent use of their devices after DOORS instruction ends. The session concludes with a discussion of what skills participants have learned, and they are encouraged to come up with goals for the future.
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The ninth and final module introduces Artificial Intelligence (AI). The session begins by describing AI, explaining that it is essentially when a computer is trained to learn and think like a person through information or data. Throughout the rest of the sessions, participants learn about the history of AI, the difference between chatbots and search engines, and most importantly how to use AI chatbots safely. An overview of how to identify AI content is given with a special focus on identifying scam inquiries.
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We have created a Digital Navigator training manual that compiles all the materials associated with the Digital Navigator role developed by our lab. The manual includes: how to assess digital literacy and run digital literacy sessions (DOORS), how to run a virtual Digital Clinic, and an in-depth explanation of the MINDapps app rating framework and how to navigate the database with clients/patients.
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