7. Health & Behavior Change

Traditional goal setting simply assumes a binary outcome for goal evaluation. This binary judgment does not consider a user's effort, which may demotivate the user. This work explores the possibility of mitigating this negative impact with a slight modification on the goal evaluation criterion, by introducing a `margin' that is widely used for quality control in the manufacturing fields. A margin represents a range near the goal where the user's outcome will be regarded as `good enough' even if the user fails to reach it. We explore users' perceptions and behaviors through a large-scale survey study and a small-scale field experiment using a coaching system to promote physical activity. Our results provide positive evidence on the margin, such as lowering the burden of goal achievement and increasing motivation to make attempts. We discuss practical design implications on margin-enabled goal setting and evaluation for behavioral change support systems.

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リンク: https://doi.org/10.1145/3411764.3445313

We present a qualitative study of a six-month pilot of WhatsApp-based facilitated peer support groups, serving youth living with human immunodeficiency virus (HIV) in an informal settlement in Nairobi, Kenya. Popular chat apps are increasingly being leveraged to enable a combination of patient-provider communication and peer support in informal contexts. However, how these interventions are experienced in Global South settings with phone sharing and intermittent data access is understudied. The context of stigmatized illnesses like HIV further complicates privacy concerns. We draw on chat records and interviews with youth and the facilitator to describe their experience of the intervention. We find that despite tensions in group dynamics, intermittent participation, and contingencies around privacy, youth were motivated by newfound aspirations and community to manage their health. We use our findings to discuss implications for the design of chat-based peer interventions, negotiation of privacy in mobile health applications, and the role of aspirations in health interventions.

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リンク: https://doi.org/10.1145/3411764.3445276

Health and well-being are integral parts of the human experience, and yet due to numerous factors are inaccessible for many communities. The transgender community is no exception and faces increased risk for both physical and mental illness. This population faces many unique challenges before, during, and after transition. To gain a deeper understanding of the trans community's health and well-being needs, we conducted twenty-one interviews with transgender individuals to determine how they navigated their identities and transitions. From our interviews, we examine and highlight the unique needs of the trans population with respect to health, well-being, identity, and transition. We discuss how designers can better understand and accommodate the diversity of this community, give suggestions for the design of technologies for trans health and well-being, and contribute open areas of research.

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リンク: https://doi.org/10.1145/3411764.3445545

Interfaces designed to elicit empathy provide an opportunity for HCI with important pro-social outcomes. Recent research has demonstrated that perceiving expressive biosignals can facilitate emotional understanding and connection with others, but this work has been largely limited to visual approaches. We propose that hearing these signals will also elicit empathy, and test this hypothesis with sounding heartbeats. In a lab-based within-subjects study, participants (N=27) completed an emotion recognition task in different heartbeat conditions. We found that hearing heartbeats changed participants’ emotional perspective and increased their reported ability to “feel what the other was feeling.” From these results, we argue that auditory heartbeats are well-suited as an empathic intervention, and might be particularly useful for certain groups and use-contexts because of its musical and non-visual nature. This work establishes a baseline for empathic auditory interfaces, and offers a method to evaluate the effects of future designs.

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リンク: https://doi.org/10.1145/3411764.3445362

Homesickness, which refers to feelings of distress caused by separation from home, is prevalent among university-aged students. Chronic homesickness can exacerbate mood problems, erode academic performance and lead to dropout from school. The present research examines how students use digital technologies to resolve the experience of missing home. Qualitative interviews and diaries with 50 students at major Australian universities revealed that technologies play a significant role in alleviating homesickness. Specifically, students use technologies to acquire social contact, find help and support, build co-presence to recreate their home, connect with culture, experience distant places, and regulate emotions. However, the use of technology sometimes led to increased emotional labour, frequent exposure to homesickness triggers, and heightened perceptions of distance. We conclude by discussing possible design implications for new technologies that allow students to alleviate homesickness by experiencing their home from afar.

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リンク: https://doi.org/10.1145/3411764.3445100

The ubiquity of self-tracking devices and smartphone apps has empowered people to collect data about themselves and try to self-improve. However, people with little to no personal analytics experience may not be able to analyze data or run experiments on their own (self-experiments). To lower the barrier to intervention-based self-experimentation, we developed an app called Self-E, which guides users through the experiment. We conducted a 2-week diary study with 16 participants from the local population and a second study with a more advanced group of users to investigate how they perceive and carry out self-experiments with the help of Self-E, and what challenges they face. We find that users are influenced by their preconceived notions of how healthy a given behavior is, making it difficult to follow Self-E's directions and trusting its results. We present suggestions to overcome this challenge, such as by incorporating empathy and scaffolding in the system.

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リンク: https://doi.org/10.1145/3411764.3445151

We propose TiltChair, an actuated office chair that physically manipulates the user's posture by actively inclining the chair's seat to address problems associated with prolonged sitting. The system controls the inclination angle and motion speed with the aim of achieving manipulative but unobtrusive posture guidance. To demonstrate its potential, we first built a prototype of TiltChair with a seat that could be tilted by pneumatic control. We then investigated the effects of the seat's inclination angle and motions on task performance and overall sitting experience through two experiments. The results show that the inclination angle mainly affects the difficulty of maintaining one's posture, while the motion speed affected the conspicuousness and subjective acceptability of the motion. However, these seating conditions did not affect objective task performance. Based on these results, we propose a design space for facilitating effective seat-inclination behavior using the three dimensions of angle, speed, and continuity. Furthermore, we discuss promising applications.

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リンク: https://doi.org/10.1145/3411764.3445695

How effectively do we adhere to nudges and interventions that help us control our online browsing habits? If we have a temporary lapse and disable the behavior change system, do we later resume our adherence, or has the dam broken? In this paper, we investigate these questions through log analyses of 8,000+ users on HabitLab, a behavior change platform that helps users reduce their time online. We find that, while users typically begin with high-challenge interventions, over time they allow themselves to slip into easier and easier interventions. Despite this, many still expect to return to the harder interventions imminently: they repeatedly choose to be asked to change difficulty again on the next visit, declining to have the system save their preference for easy interventions.

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リンク: https://doi.org/10.1145/3411764.3445295

A commitment device, an attempt to bind oneself for a successful goal achievement, has been used as an effective strategy to promote behavior change. However, little is known about how commitment devices are used in the wild, and what aspects of commitment devices are related to goal achievements. In this paper, we explore a large-scale dataset from stickK, an online behavior change support system that provides both financial and social commitments. We characterize the patterns of behavior change goals (e.g., topics and commitment setting) and then perform a series of multilevel regression analyses on goal achievements. Our results reveal that successful goal achievements are largely dependent on the configuration of financial and social commitment devices, and a mixed commitment setting is considered beneficial. We discuss how our findings could inform the design of effective commitment devices, and how large-scale data can be leveraged to support data-driven goal elicitation and customization.

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リンク: https://doi.org/10.1145/3411764.3445111

In India, and other developing countries, Community Health Workers (CHWs) provide the first line of care in delivering necessary maternal and child health services. In this work, we assess the training and skill-building needs of CHWs, through a mobile-based training intervention deployed for six months to 500 CHWs for conducting 144 training sessions in rural India. We qualitatively probed 1178 questions asked by CHWs during training sessions and conducted a content analysis of the learning material provided to CHWs. Further, we interviewed 48 CHWs to understand the rationale of information seeking and perceptions of training needs. We present our understanding of the knowledge gaps of CHWs and how the current learning material and training methods are ineffective in addressing it. Our study presents design implications for HCI4D researchers for mobile learning platforms targeted towards CHWs. We also provide policy-level suggestions to improve the training of CHWs in India or a similar context.

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リンク: https://doi.org/10.1145/3411764.3445605

We present findings from a three country study exploring the intersection between female intimate health and religious beliefs. Through a qualitative study with Muslim female populations in Pakistan, Bangladesh and Malaysia, three different Muslim majority contexts, we examine the deep impact Islamic beliefs have on female intimate health and well-being. Our study investigates the perceptions, attitudes and behaviours of Muslim women to their own intimate and sexual bodies through their experiences of menarche, marriage and reproduction and menopause. The intersection of religion and female sexual bodies and health is a neglected area within HCI and we highlight how inextricably specific Islamic values are linked with women's reproductive health in Muslim communities. We further discuss the opportunities and challenges of designing technologies for religious, non-secular beliefs and values with the aim to improve intimate health practices amongst Muslim women and to broaden the scope of health design within HCI.

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リンク: https://doi.org/10.1145/3411764.3445496

Nurses frequently transfer patients as part of their daily work. However, manual patient transfers pose a major risk to nurses’ health. Although the Kinaesthetics care conception can help address this issue, existing support to learn the concept is low. We present KiTT, a tablet-based system, to promote the learning of ergonomic patient transfers based on the Kinaesthetics care conception. KiTT supports the training of Kinaesthetics-based patient transfers by two nurses. The nurses are guided by the phases (i) interactive instructions, (ii) training of transfer conduct, and (iii) feedback and reflection. We evaluated KiTT with 26 nursing-care students in a nursing-care school. Our results indicate that KiTT provides a good subjective support for the learning of Kinaesthetics. Our results also suggest that KiTT can promote the ergonomically correct conduct of patient transfers while providing a good user experience adequate to the nursing-school context, and reveal how KiTT can extend existing practices.

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