Toward Data-Driven Digital Therapeutics Analytics: Literature Review and Research Directions

With the advent of Digital Therapeutics (DTx), the development of software as a medical device (SaMD) for mobile and wearable devices has gained significant attention in recent years. Existing DTx evaluations, such as randomized clinical trials, mostly focus on verifying the effectiveness of DTx products. To acquire a deeper understanding of DTx engagement and behavioral adherence, beyond efficacy, a large amount of contextual and interaction data from mobile and wearable devices during field deployment would be required for analysis. In this work, the overall flow of the data-driven DTx analytics is reviewed to help researchers and practitioners to explore DTx datasets, to investigate contextual patterns associated with DTx usage, and to establish the (causal) relationship of DTx engagement and behavioral adherence. This review of the key components of data-driven analytics provides novel research directions in the analysis of mobile sensor and interaction datasets, which helps to iteratively improve the receptivity of existing DTx.Comment: This paper has been accepted by the IEEE/CAA Journal of Automatica Sinic

The ethics of digital well-being: a thematic review

This article presents the first thematic review of the literature on the ethical issues concerning digital well-being. The term ‘digital well-being’ is used to refer to the impact of digital technologies on what it means to live a life that is good for a human being, and review the existing literature on the ethics of digital well-being, with the goal of mapping the current debate and identifying open questions for future research. The review identifies key issues related to four key social domains: healthcare, education, governance and social development, and media and entertainment. It also highlights three broader themes: positive computing, personalised human- computer interaction, and autonomy and self-determination. The review argues that three themes will be central to ongoing discussions and research by showing how they can be used to identify open questions related to the ethics of digital well-being

A framework for guiding the interdisciplinary design of mHealth intervention apps for physical activity behaviour change

The global pandemic of noncommunicable diseases and its associated premature mortality rates and socioeconomic burden have led to increasingly intensified efforts towards designing and delivering health promotion interventions aimed at addressing the leading modifiable health risk behaviours, such as physical inactivity. Developing physical activity behaviour change interventions that target individuals at the dual intra-interpersonal socioecological levels of health promotion has become a key objective worldwide. Digital and mobile technology is revolutionising the ways in which health behaviour change interventions are delivered to individuals across the world, with mobile health applications (mHealth apps) increasingly recognised as a powerful means of promoting physical activity behaviour change. However, with the growth and opportunities of mHealth apps, come several design challenges. Key design challenges concern the integration of theory, the incorporation of evidence-based behaviour change techniques, the application of persuasive systems design principles, and the importance of multi- and interdisciplinary collaborative design, development and evaluation approaches. These key challenges influence the output product design and effectiveness of mHealth physical activity behaviour change intervention apps. There exists a paucity of approaches for guiding and supporting the multi- and interdisciplinary collaborative design, development and evaluation of mHealth physical activity behaviour change intervention apps. To address this gap, this research study proposes an Interdisciplinary mHealth App Design Framework, framed by a novel boundary object view. This view considers the diverse communities of practice, boundary objects and supporting artefacts, process activities, and knowledge sharing practices necessary and relevant to the design of effective mHealth physical activity behaviour change intervention apps. The framework’s development is guided by a Design Science Research (DSR) approach. Its core components are based on the findings of a critical theoretical analysis of twenty existing multi- and interdisciplinary digital health development approaches. Once developed, the framework is evaluated using a qualitative DSR linguistic interpretivist approach, with semi-structured interviews as the research instrument. The thematic analysis findings from interviews with thirty-one international academic researchers and industry practitioners informs the iterative modification and revision of an enhanced Interdisciplinary mHealth App Design Framework, constituting the main DSR artefact contribution of the research study. In addition, four theoretical contributions are made to the mHealth intervention app design body of knowledge, and a practical contribution is made through the provision of guideline recommendations for academics and industry practitioners. Methodological contributions are also made in terms of applying DSR, adopting a hybrid cognitive reasoning strategy, and employing a qualitative linguistic interpretivist approach to evaluation within a DSR project.Thesis (PhD) -- Faculty of Commerce, Information Systems, 202

The public health potential of mobile applications to increase physical activity

Background: Physical activity (PA) is an important behavioural determinant of morbidity and mortality and is a public health priority. The accessibility, convenience and wide reach of mobile applications (apps) makes these digital interventions a potential mode for delivering PA interventions at scale. At the end of 2017 there were 325,000 health apps available publicly, with “fitness” apps being the largest category of all health apps. However, most apps on the market have not been evaluated and little is known about their quality. Aim: This PhD investigated the public health potential of publicly available PA apps. Methods: The following studies were conducted: 1) a review and content analysis of the most popular PA apps on the market to assess their quality, defined as safety, likely efficacy and positive user experience; 2) a study using regression models to determine the association between popularity and quality of those apps; 3) a feasibility crossover trial assessing two apps for increasing PA; and 4) a qualitative study assessing the acceptability of the trial procedures and exploring the experiences of the two PA apps. Results: Popular apps had high usability but there were issues around their safety and likely efficacy. Popularity was not associated with likely efficacy. The feasibility trial and the qualitative study showed that such a trial would be feasible and acceptable to participants. The enablers and barriers to increasing exercise using the apps were identified. Conclusion: The discrepancy between quality and popularity represents a missed opportunity for behaviour change interventions. Hence, the public health impact of PA apps is unlikely to be achieved when market forces “prescribe” what is used by the public. The motivation to use the apps varied substantially and it is important to identify when, for whom, and in what context PA apps are most likely to facilitate behaviour change

Design revolutions: IASDR 2019 Conference Proceedings. Volume 4: Learning, Technology, Thinking

In September 2019 Manchester School of Art at Manchester Metropolitan University was honoured to host the bi-annual conference of the International Association of Societies of Design Research (IASDR) under the unifying theme of DESIGN REVOLUTIONS. This was the first time the conference had been held in the UK. Through key research themes across nine conference tracks – Change, Learning, Living, Making, People, Technology, Thinking, Value and Voices – the conference opened up compelling, meaningful and radical dialogue of the role of design in addressing societal and organisational challenges. This Volume 4 includes papers from Learning, Technology and Thinking tracks of the conference

Social Norms in Fourth Amendment Law

Courts often look to existing social norms to resolve difficult questions in Fourth Amendment law. In theory, these norms can provide an objective basis for courts’ constitutional decisions, grounding Fourth Amendment law in familiar societal attitudes and beliefs. In reality, however, social norms can shift rapidly, are constantly being contested, and frequently reflect outmoded and discriminatory concepts. This Article draws on contemporary sociological literatures on norms and technology to reveal how courts’ reliance on norms leads to several identifiable errors in Fourth Amendment jurisprudence.Courts assessing social norms generally adopt what we call the closure principle, or the idea that social norms can be permanently settled. Meanwhile, courts confronting new technologies often adopt the nonintervention principle, or the idea that courts should refrain from addressing the Fourth Amendment implications of new surveillance practices until the relevant social norms become clear. Both of these approaches are flawed, and they have substantial negative effects for equality and privacy. By adopting norms perceived as closed, courts may embed antiquated norms in Fourth Amendment law—norms that often involve discrimination on the basis of race, gender, or class. By declining to intervene when norms are undeveloped, courts cede power over norm creation to companies that design new technologies based on data-extractive business models. Further, judicial norm-reliance and nonintervention facilitate surveillance creep, where familiar data-gathering infrastructures are used for new types of surveillance and monitoring. This Article provides, for the first time, a full, critical account of the role of social norms in Fourth Amendment law. It details and challenges courts’ reliance on social norms in virtually every aspect of Fourth Amendment jurisprudence. And it explores potential new directions for Fourth Amendment law, including novel doctrinal paradigms, different conceptions of stare decisis in the Fourth Amendment context, and alternative institutional regimes for regulating government surveillance

Engaging older adults with age-related macular degeneration in the design and evaluation of mobile assistive technologies

Ongoing advances in technology are undoubtedly increasing the scope for enhancing and supporting older adults’ daily living. The digital divide between older and younger adults, however, raises concerns about the suitability of technological solutions for older adults, especially for those with impairments. Taking older adults with Age-Related Macular Degeneration (AMD) – a progressive and degenerative disease of the eye – as a case study, the research reported in this dissertation considers how best to engage older adults in the design and evaluation of mobile assistive technologies to achieve sympathetic design of such technologies. Recognising the importance of good nutrition and the challenges involved in designing for people with AMD, this research followed a participatory and user-centred design (UCD) approach to develop a proof–of–concept diet diary application for people with AMD. Findings from initial knowledge elicitation activities contribute to the growing debate surrounding the issues on how older adults’ participation is initiated, planned and managed. Reflections on the application of the participatory design method highlighted a number of key strategies that can be applied to maintain empathic participatory design rapport with older adults and, subsequently, lead to the formulation of participatory design guidelines for effectively engaging older adults in design activities. Taking a novel approach, the final evaluation study contributed to the gap in the knowledge on how to bring closure to the participatory process in as positive a way as possible, cognisant of the potential negative effect that withdrawal of the participatory process may have on individuals. Based on the results of this study, we ascertain that (a) sympathetic design of technology with older adults will maximise technology acceptance and shows strong indicators for affecting behaviour change; and (b) being involved in the design and development of such technologies has the capacity to significantly improve the quality of life of older adults (with AMD)

Development of a smoking cessation smartphone application for pregnant smokers focusing on the role of identity

This thesis reports two strands of work leading to the creation of a smartphone application harnessing identity change to promote smoking cessation during pregnancy. The first strand studied the role of smoker identity in smoking cessation. Using data from a national prospective study of smokers in England, Study 1 found that most young women do not have a positive smoker identity but that those who do are less likely to try to quit smoking, independent of other smoking-related attitudes. Study 2 used prospective national survey data and showed that adopting a non-smoker identity after a quit attempt predicts medium-term abstinence. Study 3 was a meta-ethnography of smoker identity in young adults and found that multiple smoker identities evolve depending on the context and that these do appear to play a role in cessation. The second strand related to the development of the application itself. Using interviews with pregnant smokers, Study 4 found that, from their perspective, stopping smoking would require strong enough motivation, improved ability and a supportive social and physical environment. Study 5 involved focus groups of health professionals working with pregnant smokers and solicited recommendations regarding the design and delivery of digital cessation aids in pregnancy. Study 6 used data from a pilot randomised controlled trial of the smoking cessation website, MumsQuit, to assess associations between exposure to particular components and four-week continuous abstinence. Six behaviour change techniques were associated with abstinence: promoting problem solving, providing feedback on behaviour, promoting self-monitoring of outcomes of the behaviour, providing feedback on outcomes of the behaviour, providing social reward, and promoting self-reward. The thesis concludes with a description of the development of a smartphone application, SmokeFree Baby, based on preceding work