In partnership with leading researchers, Ker-twang is developing a low-stigma, self-reinforcing digital intervention that interrupts anxious and depressive symptoms and promotes healthy sleep.
The team includes Ronald Dahl, Distinguished Professor, School of Public Health, UC Berkeley; Dana McMakin, Professor of Clinical Science, Department of Psychology, FIU; Monika Lind, Postdoctoral Scholar and Digital Mental Health Innovator, UC Irvine; and Megan Cherewick, Assistant Professor, Department of Community & Behavioral Health, CU Anschutz. We have also collaborated closely with War Child and the All Ukrainian Foundation for Children’s Rights, and have received support from CERES and the Templeton World Charity Foundation.
In addition to the Ukrainian adolescents who became part of our digital design team, we worked with two young Ukrainian researchers – Karina Mokhammed and Lilia Martinkovska – who helped recruit participants, interpret cultural nuance, facilitate co-design sessions, and keep youth voices central throughout.
Conflict-related stress severely impacts sleep quality for Ukrainian adolescents, which in turn undermines emotional health and resilience during this critical developmental period. Traditional mental health interventions are difficult to scale and access in conflict zones.
Savoring
Savoring is the practice of consciously attending to and amplifying positive experiences. It enhances positive emotions that can serve to buffer effects of stress and build long-term resources. There is growing evidence that savoring at bedtime can improve sleep by displacing rumination/worry, reducing vigilance, and promoting feelings of safety to support sleep onset and quality.
Goal
We sought to develop a savoring intervention that was:
Informed by evidence and effective in improving sleep and wellbeing.
Culturally appropriate and engaging for Ukrainian youth.
Accessible via technology already in use and scalable to reach youth across Ukraine.
Brief enough to capture attention quickly.
"I am now going through a rather stressful moment in my life. My brother was mobilized. And, in fact, this project turned up very successfully, because my sleep deteriorated greatly. Therefore, this work has even been therapeutic and I could learn from my own experience how this chatbot helps people in stressful situations." - Youth co-design participant
We created a tool called Uplift that teaches adolescents via their messaging platform of choice (e.g., Telegram or WhatsApp) how to savor uplifting experiences at bedtime to displace rumination and improve sleep. The tool consists of a conversational interface with interactive exercises, entertaining memes, personalized check-ins, and peer support. Uplift engages users during the day, and bedtime skill practice occurs without the digital device, thus avoiding the digital sleep intervention pitfall of encouraging device use at night.
Uplift can be delivered at a fraction of the cost of traditional mental health services, at an optimal time for maximum effect (bedtime), at an optimal age for altering mental health trajectories (adolescence), and in a format that is both engaging and accessible.
1. Human-Centered Research With Ukrainian Youth
We conducted in-depth interviews with Ukrainian adolescents and assembled a Youth Digital Design Team to understand questions such as how war and displacement were affecting their sleep; when and why worry and rumination intensify; how youth were using their phones; what types of digital experiences felt trustworthy, relevant, and engaging. Our research revealed the the challenges Ukrainian youth currently face:
Normalized trauma: For many, the war had become a constant backdrop disrupting sleep and daily life
Interrupted sleep: Air raid sirens sound at all hours; youth described lying awake worrying about loved ones or unable to sleep after bombardments
Family displacement: Many had friends or family members who fled abroad, creating new social dynamics and feelings of isolation
Universal adolescent stress: In addition to living near active conflict zones, youth experienced stress about exams, their social lives, and the things adolescents everywhere often navigate.
Digital dependence: Frequent electricity and internet outages made reliable digital access critical but challenging. Phones were also a key way of staying connected with peers.
Ukrainian youth were eager for connection, stability, and purpose:
Connection and belonging: Strong desire for peer relationships and ways to stay connected
Desire for stability: Craving routine and predictability amid chaos
Agency and purpose: Wanting to contribute meaningfully and help others
Youth connected with the concept of savoring:
They experienced bedtime as a key moment for worry and rumination
Many were already using virtual tools to communicate and de-stress and expressed interest in trying new approaches
A brief, self-directed format aligned with their busy, unpredictable schedules
The focus on finding moments of uplift – rather than eliminating stress – felt realistic and empowering
2. Rapid Prototyping & Co-Design
Working with the Youth Digital Design Team we assembled, we experimented with early concepts and prototypes such as: digital manuals, short-form video explanations, simple practice exercises, virtual spaces, and eventually a lightweight messaging-based solution.
Youth contributed with frank, specific feedback: what felt cringe, what felt motivating, what metaphors landed, and what felt supportive in wartime. They contributed language, humor, and ideas for the designs. This process led to a messaging-based chatbot that struck a balance between expert guidance, informal support, and engaging exercises and examples.
Design Preferences
Humor and levity: Youth wanted content that incorporated humor without minimizing their experiences
Near-peer voice: They valued and engaged with content that felt like it came from peers
Interactive and bite-sized: Short videos, memes, stickers, and interactive exercises were most engaging
Flexible and responsive: They wanted control over timing and the ability to customize the experience
3. Chatbot Development & Iteration
We built a prototype on Telegram (the messaging platform of choice for Ukrainian youth) and undertook multiple rounds of testing. Completion was initially low, so we analyzed drop-off points, gathered qualitative feedback, and revised. We added more humor, memes, and personalization; made savoring instructions clearer and more actionable; strengthened early “hook” moments to sustain interest; and improved the flow and activities. Subsequent rounds showed far stronger engagement and uptake of savoring.
4. Co-design With AUFCR Youth Leaders
We partnered with AUFCR to run structured co-design workshops, during which youth leaders tested the module; identified confusing moments and emotional barriers; suggested content, metaphors, memes, and improvements; shared candid reflections on using savoring under war conditions.
Among other key improvements, our youth partners found ways to help youth feel less guilty about experiencing and savoring uplifting emotions during wartime. For example, they recorded brief audio messages that we included to address this barrier directly, an important reframing that strengthened emotional resonance. Key insights from this formative work include the importance of:
Creating opportunities for youth to support each other and contribute to Uplift (e.g., with user-generated content and savoring prompts), which proved a remarkably powerful motivator to participants.
Creating an adaptive content schedule and reminder framework to respond to varied usage patterns (e.g., power vs. intermittent users) and account for distinct user preferences.
Using humor, empathy, and discovery to drive engagement and savoring practice.
Near-peer relationships drive engagement. The peer distribution model was powerful—youth leaders reported feeling motivated to help others, and participants trusted recommendations from peers.
"These workshops helped me get out of such a mental case a little. I had big problems with work throughout July. I was standing idle and somehow I didn't feel very good because I didn't do anything, I didn't feel useful in this world. And while working on this project, that feeling returned. And I felt better because of the thought that I was doing something useful now, it would help someone." - Youth co-design participant
5. Engagement Pilot
We piloted the refined module with 78 youth from AUFCR’s Child Friendly Spaces.
We developed a chatbot-based intervention delivered via Telegram that teaches four interconnected savoring skills over four days (~5 minutes per day) and prompts device-free exercises during the day and at bedtime.
Savoring: Recalling and enjoying uplifting thoughts – the mental version of savoring delicious chocolate
Switching: Changing your mental channel from one you don’t like (e.g., feeling stressed or worried) to one you do (savoring uplifting thoughts and feelings)
Capturing: Making a point of noticing and remembering uplifting moments
Generating: Seeking out uplifting experiences that are enjoyable in their own right and
can be savored later
Core Features:
TikTok-style videos: Brief, pedagogical videos explaining concepts with visual demonstrations
Interactive exercises: Guided practice sessions with real-time feedback
Culturally relevant memes and stickers: Ukrainian humor and references that youth found relatable
Youth testimonials: Audio clips from peer co-designers sharing their experiences
The "Memory Machine": Suggestions for brief uplifting activities youth could try during the day
Check-ins and reminders: Gentle prompts to practice and troubleshoot challenges
Near-peer onboarding: Youth were invited to onboard other youth to share their experience using the tool, building trust and motivation while creating a sense of collective experience
Offline activities: Bedtime savoring occurs without digital devices to avoid screen time before sleep
Engagement
63% of participants completed the 4-day intervention.
50% continued to use the optional reminders and sleep logging features beyond the core module of four days, many for over thirty days.
Participants were very positive about savoring and the practical techniques for managing bedtime thoughts, with a Net Promoter Score of 60 for whether they would recommend savoring to a friend (Creators of NPS, Bain & Company, suggest a score: Above 0 is good; Above 20 is favorable; Above 50 is excellent)
Sleep Findings
The majority of users who completed the module reported improved sleep from baseline:
Sleep Ease: 76%
Sleep Quality: 68%
Ease Waking Up: 79%
Users who continued using the application for longer periods reported more substantial and consistent improvements across all metrics.
"For me, it was most useful in the sense that even when the day was the most unsuccessful, or, perhaps, filled with such negative emotions, you still sit and try to make a pleasant memory of what it was after all. And in this way, we begin to appreciate such things. The smallest pleasures: that today I ate such a delicious dish, or today I met a person whom I have not seen for a very long time, today I heard such useful information. And so you think about it before going to bed, and you get inspired, and you know how this motivation is on you at night."
We are eager to scale Uplift to youth across Ukraine. In addition to improving the module, the team is pursuing opportunities to: adapt Uplift for youth in other countries and contexts; conduct a feasibility and preliminary outcomes trial; and scale access to Uplift through partnerships and commercialization.