The national headlines flooded in last month after researchers at the UNC School of Medicine became the newest users of Apple’s ResearchKit and CareKit for their cutting edge research on postpartum depression. 

 
But what those outlets failed to mention was a small Durham development and strategy firm helping make that research happen for the first time via an app. Little Green Software, named after the inspirational little green aliens from “Close Encounters of the Third Kind”, is becoming a go-to for researchers hoping to recruit for and conduct their studies via mobile devices. 
 
The team of 11, eight in a renovated downtown building and three in Brazil, has helped Duke University’s Center for Advanced Hindsight build its (Sample) Size Matters survey app and other researchers at Duke study adolescent cancer survivors using a mobile game. But the PPD study may be its highest profile work since starting in 2008, giving it the potential to expand its capabilities to research of all kinds worldwide. 
 
“Part of our culture is working with people that are doing things that have impact,” says principal Don Mullen. UNC’s study, called PPD ACT (Action toward Causes and Treatment), certainly counts as that. Research shows that one in seven women suffer from postpartum depression but many more aren’t being treated for it. UNC hopes to reach 100,000 women, a figure well above traditional research studies, and in just six months. 
 
The press will certainly help, but the use of ResearchKit as well as the design of the app is a critical way that figure may be achieved. Key is a “no friction” consent process that’s part of ResearchKit but designed by Little Green Software to be way simpler and easy to understand than the traditional multiple pages of fine print required for research. 
There’s also a small section with coping resources and tips, but one that could be expanded over time so that women come back to the app when they are having symptoms or if they want to see how the study is going. That ongoing engagement was typically lacking in traditional studies.
 
To make the app more accessible, the team at Little Green Software is also working to translate the app in a variety of languages so women can sign up around the world. Already, teams in the UK and Australia are using it to collect data. 
 
More broadly, the work could be expanded to all kinds of research studies, and it could include the many sensors and wearable devices people now use to monitor their health. Little Green Software has experience in this realm. It helped one Canadian client called Orpyx, create a shoe insole with a foot pressure sensor to let diabetes sufferers know if they are cutting off circulation to the foot. Mobile and watch apps tell the person to get up and move around or remove the shoe. 
 
Holzwarth expects more research studies will connect with wireless devices like Bluetooth scales, fitness trackers and blood pressure monitors to track mood or activity levels as part of the survey. 
 
A few key challenges still persist. There’s no similar kit and open source marketplace for Android devices, and there’s still no easy way of collecting, storing and making sense of all the data. Little Green Software built its own database and back end for the UNC study, but it’s in talks with IBM Watson Health, which offers back-end services free for ResearchKit-based apps, with the ability to up-sell on big data analytics. 
 
“The more that services like Watson and devices are used and we have specialties that we can do efficiently, it’s going to become easier for researchers to translate their ideas into apps,” Holzwarth says.
Little Green Software published a full case study of the UNC project on its blog here