Are HIV smartphone apps and online interventions fit for purpose?

Sexual health is an under-explored area of Human-Computer Interaction (HCI), particularly sexually transmitted infections such as HIV. Due to the stigma associated with these infections, people are often motivated to seek information online. With the rise of smartphone and web apps, there is enormous potential for technology to provide easily accessible information and resources. However, using online information raises important concerns about the trustworthiness of these resources and whether they are fit for purpose. We conducted a review of smartphone and web apps to investigate the landscape of currently available online apps and whether they meet the diverse needs of people seeking information on HIV online. Our functionality review revealed that existing technology interventions have a one-size-fits-all approach and do not support the breadth and complexity of HIV-related support needs. We argue that technology-based interventions need to signpost their offering and provide tailored support for different stages of HIV, including prevention, testing, diagnosis and management

A content analysis of popular diet, fitness, and weight self-tracking mobile apps on Google Play

Mobile health applications, especially diet, weight, and fitness apps, have become increasingly popular over the years. However, the content and quality of these apps is not well understood. In order to address this, we performed a preliminary content analysis of the diet, weight, and fitness mobile apps on the Google Play Store to better understand the features of such apps. We conducted a descriptive analysis of 159 relevant apps and analyzed the top free 15 for tracked indicators, goal setting, types of input, reminders and notifications, social and community features, and connecting to experts. Based on these preliminary findings, we identify gaps and discuss their importance to future research in this space

So you're planning a baby?: a review of preconception care apps

Previous research shows couples favour online information sources when seeking support for preconception health and pregnancy planning, with mobile applications (apps) becoming increasingly popular. This study aimed to establish what smartphone apps currently exist to support couples when preparing for pregnancy. A functionality review was conducted to explore app content and an analysis of user reviews was undertaken to investigate user views towards existing apps. 25 apps were analysed, which provided information on diet, weight, alcohol, smoking and caffeine amongst others. Positive reviews mainly referred to the helpfulness of the app. Negative comments focused on the over simplification of information. Overall, user comments showed a positive response towards existing preconception care apps, but users reported concerns towards information accuracy and reliability. Further work will be undertaken to evaluate whether existing apps engage users to improve their preconception health care and whether these apps fulfils user requirements

“Support for the supporters”: a qualitative study of the use of WhatsApp by and for mentor mothers with HIV in the UK

Third-sector organizations, an important support for people living with HIV, increasingly use digital technology to improve service efficiency and reach. However, there is limited empirical evidence on this use by women living with HIV. The 4M Network (4MNet) is a peer-run UK-wide network of trained Mentor Mothers (MMs) living with HIV; it uses the WhatsApp platform as its primary digital communication tool. We report on a qualitative study about 4MNet MMs’ experiences of using WhatsApp, to inform the design of future digital support services. Seven telephone interviews were conducted with five MMs and two project management team (PMT) members in February 2019. Interviews were analyzed using Interpretive Phenomenological Analysis (IPA). WhatsApp was found to have several key features that provided both positive and negative use considerations. WhatsApp eased communication among MMs and supported participation in group activities despite differing schedules and geographic locations. Challenges encountered with WhatsApp included: financial restrictions to data storage and continual access; self-confidence using technology; and security and privacy concerns. Peer-led digital communication is found to be acceptable and effective for women living with HIV. Understanding barriers and valued features of existing digital platforms increasingly used among potentially marginalized groups is vital for informing inclusive innovation

Privacy Unraveling Around Explicit HIV Status Disclosure Fields in the Online Geosocial Hookup App Grindr

mHealth applications ("apps") must be searched for and downloaded prior to use, creating a potential barrier to uptake. Integrating health interventions into existing online social environments removes this barrier. However, little is known about the effects of linking sensitive health information to existing online identities. Our qualitative analysis of online comments (n=192) explores the user views of an HIV intervention integrated into the geosocial hookup app Grindr. We find some HIV positive users report keeping their status private to reduce their stigma exposure, whilst others report publicly disclosing their status to avoid being stigmatised by others. Where users keep their status private, we find concerns that social assumptions may develop around these non-disclosures, creating a privacy unraveling effect which restricts disclosure choice. Using Peppet's four proposed limits to privacy unraveling, we develop a set of descriptive conceptual designs to explore the privacy respecting potential of these limits within this context and propose further research to address this privacy challenge

Ageing with Smartphones in Uganda: Togetherness in the dotcom age

Ageing with Smartphones in Uganda is based on a 16-month ethnography about experiences of ageing in a neighbourhood in a diverse neighbourhood in Kampala, Uganda. It examines the impact of smartphones and mobile phones on older people’s health and everyday lives as part of the global 'Anthropology of Smartphones and Smart Ageing' project. In taking the lens of the smartphone to understand experiences of ageing in this context, the monograph presents the articulation and practice of ‘togetherness in the dotcom age’. Taking a ‘convivial’ approach, which celebrates multiple ways of knowing about social life, Charlotte Hawkins draws from these expressions about cooperative morality and modernity to consider the everyday mitigation of profound social change. ‘Dotcom’ is understood to encompass everything from the influence of social media to urban migration and lifestyles in the city, to shifts in ways of knowing and relating. At the same time, dotcom tools such as mobile phones and smartphones facilitate elder care through, for example, regular mobile money remittances. This book explores how dotcom relates to older people’s health, in particular their care norms, social standing, values of respect and relatedness, and intergenerational relationships – both political and personal. It also re-frames the youth-centricity of research on the city and work, new media and technology, politics and service provision in Uganda. Through ethnographic consideration of everyday life and self-formation in this context, the monograph seeks to contribute to an ever-incomplete understanding of how we relate to each other and to the world around us

Ageing with Smartphones in Uganda: Togetherness in the Dotcom Age

In taking the lens of the smartphone to understand experiences of ageing in a diverse neighbourhood in central Kampala, Uganda, this ethnography presents the articulation and practice of ‘togetherness in the dotcom age’. Taking a situated and ‘convivial’ approach, which celebrates multiple and partial ways of knowing about sociality, the thesis draws from these vernacular concepts of cooperative morality and modernity to consider the everyday mitigation of wide-reaching social processes. Dotcom is understood to encompass everything from the influence of ICTs to urban migration and lifestyles in the city, to profound shifts in ways of knowing and relating. At the same time, dotcom tools such as mobile phones and smartphones facilitate elder care obligations despite distances, for example through regular mobile money remittances. Whilst phones are a global phenomenon, both the concept of dotcom and the way people creatively adapt and adopt their phones has to be understood in relation to specific contextual conditions. This thesis is concerned with how dotcom manifests in relation to older people’s health, their care norms, their social standing, their values of respect and relatedness, and their intergenerational relationships - both political and personal. It thus re-frames the youth-centricity of research on the city and work, new media and technology, politics and service provision in Uganda. Through ethnographic consideration of everyday life and self-formation in this context, the thesis seeks to contribute to an ever-incomplete understanding of ‘intersubjectivity’, how we relate to each other and to the world around us

Contextual and design factors that influence the use of consumer technologies for self-management of stress by teachers

Persistent psychosocial stress is endemic in the modern workplace, including amongst secondary school teachers in England. There is intense interest in the potential role of digital technology such as apps, wearables and online programmes to support stress management but insufficient understanding of how the contexts of teachers’ work influence their use. Using a constructivist paradigm, a series of qualitative studies was conducted to understand the influence of these contextual factors. First semi-structured qualitative interviews with teachers were thematically analysed to reveal the physical, social and cultural contextual constraints on teachers’ stress management. Then to enable teachers’ choice of consumer technology for the longitudinal study, an analytical study generated a populated taxonomy of self-management strategies for stress with digital support options. This was presented in workshops to enable some informed choice. Finally, the qualitative longitudinal summer term study explored eight teachers’ experiences of using their chosen technology in their daily lives. The pandemic meant interviews were online and teachers were mainly working from home. The study was extended with six participants into the autumn term when all teachers had returned to school premises. Cross-case analysis revealed the teachers’ experiences of using technology for stress management included the explanatory power of contextually mediated data, generating awareness, permission to self-care and empathy. The findings suggest implications for self-determination theory (SDT). Thematic analysis revealed facilitators and barriers to using the technology in the school context. There are associated implications for school wellbeing support and designers, and considerations for the Unified Theory of Acceptance and Use of Technology (UTAUT). This thesis’ main contributions include unique insight into teachers’ experiences of consumer technologies for workplace stress management and the technology features that facilitate self-care. Stress awareness derived from interaction with the technology and personal data gave teachers permission to self-care. Facilitators included brief, discreet interactions and contextually relevant prompts and information. Barriers to use included insufficient technology instructions, and contextual constraints of the relentless work culture, social stigma and lack of privacy. This thesis also documents an innovative process for developing and populating a taxonomy to facilitate technology selection, including specifically for teachers managing stress. Finally, it makes recommendations of interest to designers, school leaders and policy makers seeking to improve teachers’ ability to digitally support their stress self-management

Reflection and personal health informatics for people living with HIV

Recent advances in medicine mean that millions of people who are living with the Human Immunodeficiency Virus (HIV) can expect to live normal life spans. However, HIV, the medication prescribed to control the virus, and living with a stigmatized disease, are each associated with a wide array of negative impacts on the body and mind, and these present a challenge in an individual’s ability to self-manage their health information. A key aspect of self-management is self-understanding, and Personal Health Informatics (PHI) has the potential to help those living with HIV in understanding their health through reflection. However, there is little indication of the needs of people living with HIV and how PHI systems can best support them in reflecting on their health information. In order to fill this gap, this thesis aims to answer the overall research question: How can Personal Health Informatics systems support people living with HIV in reflecting on their personal health information? Answering this research question was approached in four parts: • The development of a synthesized model of the process of PHI, as means of understanding the context of PHI. • Interviews with HIV+ individuals were conducted to understand where there were opportunities for supporting reflection. • An analysis of an online forum was conducted to determine what people living with HIV were trying to reflect upon, what health information was being asked about, and how the community attempts to support them in reflecting on their health. • Two visual prototypes were designed to simulate community-aided reflection and support people living with HIV in reflecting on their personal health information. These were used during a user study to understand how reflection occurred. My research is the first to explore how to support HIV+ people in reflecting on their personal health information. The main contribution of this research is a detailed understanding of how PHI systems can support people living with HIV in reflecting on their health information. This main contribution is comprised of four smaller ones: • A six-stage process model of Personal Health Informatics • A detailed understanding of how people living with HIV currently track and reflect on their personal health information, and design implications for PHI systems to support them in reflection • An empirical understanding of community-aided reflection as it occurs in an online forum, alongside the identification of five common questions that people living with HIV seek help in online forums for reflecting upon, the information asked about, and how the community attempts to address the questions • A detailed depiction of how reflection occurs when using a prototype designed to simulate community-aided reflectio