Inclusive Intelligent Learning Management System Framework

Machado, D. S-M., & Santos, V. (2023). Inclusive Intelligent Learning Management System Framework. International Journal of Automation and Smart Technology, 13(1), [2423]. https://doi.org/10.5875/ausmt.v13i1.2423The article finds context and the current state of the art in a systematic literature review on intelligent systems employing PRISMA Methodology which is complemented with narrative literature review on disabilities, digital accessibility and legal and standards context. The main conclusion from this review was the existing gap between the available knowledge, standards, and law and what is put into practice in higher education institutions in Portugal. Design Science Research Methodology was applied to output an Inclusive Intelligent Learning Management System Framework aiming to help higher education professors to share accessible pedagogic content and deliver on-line and presential classes with a high level of accessibility for students with different types of disabilities, assessing the uploaded content with Web content Accessibility Guidelines 3.0, clustering students according to their profile, conscient feedback and emotional assessment during content consumption, applying predictive models and signaling students at risk of failing classes according to study habits and finally applying a recommender system. The framework was validated by a focus group to which experts in digital accessibility, information systems and a disabled PhD graduate.publishersversionpublishe

A Formal Approach to Computer Aided 2D Graphical Design for Blind People

The growth of computer aided drawing systems for blind people (CADB) has long been recognised and has increased in interest within the assistive technology research area. The representation of pictorial data by blind and visually impaired (BVI) people has recently gathered momentum with research and development; however, a survey of published literature on CADB reveals that only marginal research has been focused on the use of a formal approach for on screen spatial orientation, creation and reuse of graphics artefacts. To realise the full potential of CADB, such systems should possess attributes of usability, spatial navigation and shape creation features without which blind users drawing activities are less likely to be achieved. As a result of this, usable, effective and self-reliant CADB have arisen from new assistive Technology (AT) research. This thesis contributes a novel, abstract, formal approach that facilitates BVI users to navigate on the screen, create computer graphics/diagrams using 2D shapes and user-defined images. Moreover, the research addresses the specific issues involved with user language by formulating specific rules that make BVI user interaction with the drawing effective and easier. The formal approach proposed here is descriptive and it is specified at a level of abstraction above the concrete level of system technologies. The proposed approach is unique in problem modelling and syntheses of an abstract computer-based graphics/drawings using a formal set of user interaction commands. This technology has been applied to enable blind users to independently construct drawings to satisfy their specific needs without recourse to a specific technology and without the intervention of support workers. The specification aims to be the foundation for a system scope, investigation guidelines and user-initiated command-driven interaction. Such an approach will allow system designers and developers to proceed with greater conceptual clarity than it is possible with current technologies that is built on concrete system-driven prototypes. In addition to the scope of the research the proposed model has been verified by various types of blind users who have independently constructed drawings to satisfy their specific needs without the intervention of support workers. The effectiveness and usability of the proposed approach has been compared against conventional non-command driven drawing systems by different types of blind users. The results confirm that the abstract formal approach proposed here using command-driven means in the context of CADB enables greater comprehension by BVI users. The innovation can be used for both educational and training purposes. The research, thereby sustaining the claim that the abstract formal approach taken allows for the greater comprehension of the command-driven means in the context of CADB, and how the specification aid the design of such a system

Web interaction environments : characterising Web accessibility at the large

Tese de doutoramento, Informática (Engenharia Informática), Universidade de Lisboa, Faculdade de Ciências, 2012Accessibility quality on the Web is essential for providing a good Web experience to people with disabilities. The existence of virtual ramps aid these users grasping and interacting withWeb content, just like the experience of those who are unimpaired. However, more often than not, Web pages impose accessibility barriers, usually centred on the unavailability of tailored content to specific perceptual abilities (e.g., textual description of images, enabling grasping information with assistive technologies), as well as on proper HTML structural elements that adequate the semantics of a Web page. When evaluating the accessibility quality of Web pages, the resulting analysis is often focused on a small sample set (e.g., a single Web page or a selection of pages from a Web site). While this kind of analysis gets the gist of accessibility quality, it misses the big picture on the overall accessibility quality of the Web. This thesis addresses the challenge of observing accessibility phenomena on the Web, through the experimental evaluation of large collections of Web pages. This resulted on new findings about the accessibility quality of the Web, such as its correlation with HTML element count, and the erroneous perception of accessibility quality by developers. Small-scale experiments have been verified also at large scale, such as the correlation between the usage of HTML templates and accessibility quality. Based on the challenges raised by the experimental evaluation, this thesis proposes a novel approach for large scale Web accessibility evaluation based on Linked Data, as well as the establishment of metrics to assess the truthfulness and coverage of automated evaluation methods.A qualidade da acessibilidade é um factor crucial para as pessoas com deficiências terem uma boa experiência de interacção com a Web.A qualidade da acessibilidade é um factor crucial para as pessoas com deficiências terem uma boa experiência de interacção com a Web. A existência de rampas virtuais ajuda estas pessoas a compreender e interagir com conteúdos Web, a par do que o utilizador comum já experiencia. Porém, a maioria das páginas Web ainda contêm barreiras à acessibilidade. Estas barreiras centram-se normalmente na indisponibilidade de conteúdos perceptíveis por diferentes tipos de capacidades (e.g., descrições textuais de imagens), bem como no uso incorrecto de elementos HTML de acordo com a semântica de uma página Web. Nos dias de hoje, a avaliação da qualidade de acessibilidade de páginas Web é ainda efectuada em pequena escala (e.g., uma página Web ou, no melhor caso, um conjunto de páginas representativas de um sítio Web). Apesar deste tipo de avaliações resultarem na compreensão de alguns fenómenos do estado da acessibilidade na Web, ainda não se sabe qual o seu impacto em larga escala. Esta tese discute os principais desafios na observação da acessibilidade da Web, tendo por base um conjunto de avaliações experimentais de colecções de grande dimensão de páginas Web. Destes estudos destacam-se as seguintes contribuições e resultados:a diferença drástica na interpretação dos avisos resultantes de avaliações de acessibilidade Web: um dos resultados principais da avaliação experimental em larga escala destaca a diferença na interpretação dos avisos (warnings) da aplicação de técnicas da norma WCAG, onde a interpretação optimista (i.e., a visão da maioria dos criadores de páginas Web) se distancia amplamente da interpretação conservadora (onde os avisos são interpretados como erros); a correlação entre a qualidade da acessibilidade de uma página Web e a sua complexidade: este mesmo estudo de larga escala revelou uma correlação entre a complexidade de uma página Web (no que diz respeito ao número de elementos HTML que contém) e a qualidade da acessibilidade. Quanto menor a complexidade de uma página Web, mais certa se torna a alta qualidade da acessibilidade dessa página; o benefício do uso de templates e sistemas de gestão de conteúdos na melhoria da acessibilidade de páginas Web: em ambos os estudos experimentais de acessibilidade foi detectada uma correlação entre a qualidade de acessibilidade das páginas Web e o uso de templates e sistemas de gestão de conteúdo. Esta propriedade foi verificada quer em pequena escala (sobre uma colecção de páginas Web da Wikipedia), quer em larga escala; o incumprimento das regras mais elementares e mais conhecidas da acessibilidade: estes estudos experimentais permitiram também verificar que, apesar de toda a envagelização e educação sobre as questões de acessibilidade na Web, a maioria das regras de acessibilidade são incessantemente quebradas pela maioria das páginas Web.Esta problemática verifica-se, em particular, nas regras de cumprimento de acessibilidade mais conhecidas, tal como por exemplo a disponibilidade de textos alternativos a conteúdos multimédia. Com base nestas experiências e resultados, esta tese apresenta um novo modelo de estudo da acessibilidade na Web, tendo por base o ciclo de estudos da Web em larga escala. Deste modelo resultaram as seguintes contribuições: um modelo para a avaliação distribuída de acessibilidade Web, baseado em propriedades tecnológicas e topológicas: foi concebido um modelo de avaliação de acessibilidade Web que permite a concepção de sistemas de avaliação com base em propriedades tecnológicas e topológicas. Este modelo possibilita, entre outras características, o estudo da cobertura de plataformas e avaliadores de acessibilidade, bem como da sua aplicação em larga escala; uma extensão às linguagens e modelos EARL e Linked Data, bem como um conjunto de definições para extrair informação destes: este modelo de avaliação de acessibilidade Web foi sustentado também pela sua concretização em linguagens e modelos já existentes para o estudo de acessibilidade (EARL) e da Web em larga escala (Linked Data), permitindo assim a sua validação; definição dos limites da avaliação de acessibilidade Web: por fim, este modelo de avaliação de acessibilidade permitiu também delinear uma metodologia de meta-avaliação da acessibilidade, na qual se poderão enquadrar as propriedades dos avaliadores de acessibilidade existentes. Todas estas contribuições resultaram também num conjunto de publicações científicas, das quais se destacam: Rui Lopes and Luís Carriço, A Web Science Perspective of Web Accessibility, in submission for the ACM Transactions on Accessible Computing (TACCESS), ACM, 2011; Rui Lopes and Luís Carriço, Macroscopic Characterisations of Web Accessibility, New Review of Hypermedia and Multimedia – Special Issue on Web Accessibility. Taylor & Francis, 2010; Rui Lopes, Karel Van Isacker and Luís Carriço, Redefining Assumptions: Accessibility and Its Stakeholders, The 12th International Conference on Computers Helping People with Special Needs (ICCHP), Vienna, Austria, 14-16 July 2010; Rui Lopes, Daniel Gomes and Luís Carriço, Web Not For All: A Large Scale Study of Web Accessibility, W4A: 7th ACM International Cross-Disciplinary Conference on Web Accessibility, Raleigh, North Carolina, USA, 26-27 April 2010; Rui Lopes, Konstantinos Votis, Luís Carriço, Dimitrios Tzovaras, and Spiridon Likothanassis, The Semantics of Personalised Web Accessibility Assessment, 25th Annual ACM Symposium on Applied Computing (SAC), Sierre, Switzerland, 22-26 March, 2010 Konstantinos Votis, Rui Lopes, Dimitrios Tzovaras, Luís Carriço and Spiridon Likothanassis, A Semantic Accessibility Assessment Environment for Design and Development for the Web, HCI International 2009 (HCII 2009), San Diego, California, USA, 19-24 July 2009 Rui Lopes and Luís Carriço, On the Gap Between Automated and In-Vivo Evaluations of Web Accessibility, HCI International 2009 (HCII 2009), San Diego, California, USA, 19-24 July 2009; Rui Lopes, Konstantinos Votis, Luís Carriço, Spiridon Likothanassis and Dimitrios Tzovaras, Towards the Universal Semantic Assessment of Accessibility, 24th Annual ACM Symposium on Applied Computing (SAC),Waikiki Beach, Honolulu, Hawaii, USA, 8-12 March 2009; Rui Lopes and Luís Carriço, Querying Web Accessibility Knowledge from Web Graphs, Handbook of Research on Social Dimensions of Semantic Technologies, IGI Global, 2009; Rui Lopes, Konstantinos Votis, Luís Carriço, Spiridon Likothanassis and Dimitrios Tzovaras, A Service Oriented Ontological Framework for the Semantic Validation of Web Accessibility, Handbook of Research on Social Dimensions of Semantic Technologies, IGI Global, 2009; Rui Lopes and Luís Carriço, On the Credibility of Wikipedia: an Accessibility Perspective, Second Workshop on Information Credibility on the Web (WICOW 2008), Napa Valley, California, USA, 2008; Rui Lopes, Luís Carriço, A Model for Universal Usability on the Web, WSW 2008: Web Science Workshop, Beijing, China, 22 April 2008; Rui Lopes, Luís Carriço, The Impact of Accessibility Assessment in Macro Scale Universal Usability Studies of the Web, W4A: 5th ACM International Cross-Disciplinary Conference on Web Accessibility, Beijing, China, 21-22 April 2008. Best paper award; Rui Lopes, Luís Carriço, Modelling Web Accessibility for Rich Document Production, Journal on Access Services 6 (1-2), Routledge, Taylor & Francis Group, 2009; Rui Lopes, Luís Carriço, Leveraging Rich Accessible Documents on the Web, W4A: 4th ACM International Cross-Disciplinary Conference on Web Accessibility, Banff, Canada, 7-8 May 2007.Fundação para a Ciência e a Tecnologia (FCT, SFRH/BD/29150/2006

Making intelligent systems team players: Case studies and design issues. Volume 1: Human-computer interaction design

Initial results are reported from a multi-year, interdisciplinary effort to provide guidance and assistance for designers of intelligent systems and their user interfaces. The objective is to achieve more effective human-computer interaction (HCI) for systems with real time fault management capabilities. Intelligent fault management systems within the NASA were evaluated for insight into the design of systems with complex HCI. Preliminary results include: (1) a description of real time fault management in aerospace domains; (2) recommendations and examples for improving intelligent systems design and user interface design; (3) identification of issues requiring further research; and (4) recommendations for a development methodology integrating HCI design into intelligent system design

EyeRing: A Finger-Worn Input Device for Seamless Interactions with Our Surroundings

Finger-worn interfaces remain a vastly unexplored space for user interfaces, despite the fact that our fingers and hands are naturally used for referencing and interacting with the environment. In this paper we present design guidelines and implementation of a finger-worn I/O device, the EyeRing, which leverages the universal and natural gesture of pointing. We present use cases of EyeRing for both visually impaired and sighted people. We discuss initial reactions from visually impaired users which suggest that EyeRing may indeed offer a more seamless solution for dealing with their immediate surroundings than the solutions they currently use. We also report on a user study that demonstrates how EyeRing reduces effort and disruption to a sighted user. We conclude that this highly promising form factor offers both audiences enhanced, seamless interaction with information related to objects in the environment.Singapore University of Technology and Design. International Design Center (IDC grant IDG31100104A)Singapore University of Technology and Design. International Design Center (IDC grant IDD41100102A

Special Libraries, August 1980

Volume 71, Issue 8https://scholarworks.sjsu.edu/sla_sl_1980/1006/thumbnail.jp

Towards Human-centered Explainable AI: A Survey of User Studies for Model Explanations

Explainable AI (XAI) is widely viewed as a sine qua non for ever-expanding AI research. A better understanding of the needs of XAI users, as well as human-centered evaluations of explainable models are both a necessity and a challenge. In this paper, we explore how HCI and AI researchers conduct user studies in XAI applications based on a systematic literature review. After identifying and thoroughly analyzing 97core papers with human-based XAI evaluations over the past five years, we categorize them along the measured characteristics of explanatory methods, namely trust, understanding, usability, and human-AI collaboration performance. Our research shows that XAI is spreading more rapidly in certain application domains, such as recommender systems than in others, but that user evaluations are still rather sparse and incorporate hardly any insights from cognitive or social sciences. Based on a comprehensive discussion of best practices, i.e., common models, design choices, and measures in user studies, we propose practical guidelines on designing and conducting user studies for XAI researchers and practitioners. Lastly, this survey also highlights several open research directions, particularly linking psychological science and human-centered XAI

헬스케어 서비스에서 데이터 기반 커뮤니케이션을 위한 디자인 연구

학위논문(박사)--서울대학교 대학원 :융합과학기술대학원 융합과학부(디지털정보융합전공),2020. 2. 이중식.스마트폰과 웨어러블 기기의 보급으로 인해 환자 생성 건강 데이터(Patient-Generated Health Data; PGHD)가 크게 증가하였고, 이는 의사-환자 의사 소통을 개선하여 데이터 중심으로 발전 할 수있는 새로운 기회를 제공했다. PGHD를 사용한 데이터 중심 커뮤니케이션을 통해 환자와 의사는 기존 임상 데이터를 보완하여 이해의 차이를 메울 수 있으며, 환자 건강에 대한 포괄적인 관점도 획득할 수 있다. 그러나, 이러한 새로운 유형의 데이터와 기술을 기존 의료 커뮤니케이션에 통합하는 데에는 여전히 어려움이 남아 있다. 환자는 종종 데이터 수집에 대한 참여와 동기를 잃어버리며, 이에 따라 수집한 데이터는 불완전해지는 문제가 발생한다. 또한 PGHD가 온전하게 수집 되더라도 의사와 환자는 의료 관행에서 이러한 데이터를 활용하는 데 어려움을 겪게 된다. 또한, 시간과 정보의 부족으로 인해 현재 워크 플로우에서 환자와 의사 모두가 PGHD를 통해 협업하는 것은 매우 어려운 일로 알려져 있다. HCI 연구 관점에서, PGHD를 활용 한 데이터 중심 통신을 지원하는 시스템을 설계하면 이러한 과제를 해결할 수 있는 잠재력이 있으며, 이는 데이터 수집(collection), 표현(representation), 해석(interpretation) 및 협업(collaboration)의 네 가지 설계 공간(design space)에서 추가적인 탐색을 요구한다. 따라서, 이 논문에서는 시스템 설계 및 현장 배포 연구를 수행하여, 각 설계 공간에서 해결되지 않은 질문을 탐색하고 경험적 연구 결과 및 설계 지침을 제공하는 것을 목표로 한다. 먼저, 데이터 수집에 대한 설계 공간의 연구로서, 접근성 높은 데이터 추적 도구가 환자가 다양한 유형의 PGHD, 특히 식사 데이터를 수집하는 데 어떤 도움을 줄 수 있는지에 대해 연구하고자 하였다. 이를 위해, 접근성 높은 데이터 추적 도구인 mFood Logger을 디자인한 후, 20 명의 환자와 6 명의 임상의를 대상으로 실증적 연구를 수행했다. 그 결과, 환자와 임상의가 데이터 기반 커뮤니케이션을 위해 원하는 데이터 유형이 무엇인지 파악할 수 있었고, 임상적 맥락에서 데이터를 수집 할 때의 난점과 기회를 발견했다. 둘째, 임상의를 위한 데이터 표현을 파악하기 위해, 18명의 다양한 이해 관계자(e.g., 임상의, EMR 개발자)와 참여적 디자인(participatory design) 프로세스를 통해 PGHD를 표시하는 DataMD를 설계하고 구현했다. 참여적 디자인 워크샵을 통해 알아낸 것은, 의료적 상황의 제약 때문에 임상의가 원하는 데이터 표현 방식이 효율성과 친숙함으로 수렴된다는 점이었다. 임상의는 학습에 걸리는 시간 문제로 인해 새로운 시각화 방법을 사용하지 않았고, 한 번에 많은 양의 데이터를 보고 싶어했다. 이러한 요구 사항을 고려하여, 다양한 유형의 PGHD가 한 눈에 보여지며, 여러 가지 임상 상황을 고려한, DataMD를 설계하고 구현했다. 셋째, 데이터 기반 커뮤니케이션의 중요한 측면으로서, 환자를 위한 데이터 해석 전략을 제시하여 효과적인 데이터 해석을 돕는 설계 지침을 제공합니다. 20명의 만성 질환 환자와의 인터뷰를 통해, 환자들이 PGHD를 해석할 때, 논리적 증거가 아닌 자신의 과거 경험에 강하게 의존한다는 점을 밝혀냈다. 환자들은 자신의 신념과 경험에 따라 여러 데이터 사이의 관계를 가정하며, 이를 확인하기 위해 네 가지의 데이터 해석 전략을 구사했다. 이러한 이해는 설계자와 연구원이 데이터 해석을 지원하는 시스템 설계를 발전시키는 데 도움이 될 수 있다. 마지막으로, 데이터를 통한 협업을 지원하기 위해 앞선 연구에서 디자인한 시스템을 기반으로 PGHD를 공유하고 활용함으로써, 임상의와 환자가 어떻게 협업하는지를 조사하고자 했다. 환자의 데이터 수집 및 해석을 돕는 앱인 MyHealthKeeper와 임상의를 위한 인터페이스인 DataMD로 구성된 통합 시스템을 임상 현장에 배포했다. 80명의 외래환자와의 임상시험 결과에 따르면 PGHD를 통한 협력으로 환자가 행동 변화에 성공할 수있었다. 또한, 앱 사용 로그에 따르면 환자는 직접적인 상호 작용 없이도 임상의와 원격으로 협업 할 수도 있는 것으로 나타났다. 이러한 결과를 바탕으로, 이 연구에서는 임상의와 환자 사이의 협력을 지원할 수있는 주요 기회가 기존 임상 워크플로우에 PGHD 사용을 통합하는 것에 있음을 제시한다. 앞선 연구들을 통해, 데이터 기반 커뮤니케이션을 위한 디자인이 환자와 의사가 PGHD를 통해 협업하는 데 도움이 될 수 있음을 발견했다. PGHD가 네 개의 설계 공간 내에서 기존 의사-환자 통신을 데이터 중심 통신으로 개선 할 수있는 방법을 개념화함으로써, 이 연구는 환자와 의사 간의 데이터 기반 커뮤니케이션을 위한 디자인이 어떻게 도출되어야 하는지에 대한 새로운 시각을 제공할 것으로 기대한다. 이 작업은 HCI, CSCW과 건강 정보학 커뮤니티의 경험적 이해를 높이고, 실용적인 설계 지침을 제공하며, 이론적 확장에 기여한다. 또한, 이 연구는 향후 다른 분야에서 데이터 기반 커뮤니케이션을 지원하는 시스템의 설계가 어떻게 이뤄져야 하는지에 대한 기초를 제공한다.The prevalence of smartphones and wearable devices has led to a dramatic increase in patient-generated health data (PGHD). The growing interest in PGHD has offered new opportunities to improve doctor-patient communication to become more data-driven. Data-driven communication using PGHD enables patients and physicians to fill in gaps between understandings by supplementing existing clinical data, as well as providing a more comprehensive picture of ongoing patient health. However, challenges in integrating such new types of data and technologies into existing healthcare communications remain. Patients often lose their engagement and motivation in data collection, resulting in incomplete data. Even if PGHD is wholly collected, physicians and patients encounter challenges in utilizing such data--representation and interpretation--in healthcare practices. Furthermore, it is challenging for both patients and physicians to collaborate through PGHD in the current workflow due to the lack of time and information overload. From the HCI research perspective, designing a system supporting data-driven communication utilizing PGHD has the potential to address such challenges, which calls for further exploration in four design spaces: data collection, representation, interpretation, and collaboration. Therefore, in this dissertation work, I aim to explore unsolved questions in each design space by conducting a series of design and deployment studies and provide empirical findings and design guidelines. In the design space of data collection, I investigated how the semi-automated tracking tool can support patients to track various types of PGHD, especially food journaling. With the design of mFood Logger, a semi-automated data tracking tool, I conducted an empirical study with 20 patients and 6 clinicians. I identified desired data types for data-driven communication from the patients' and clinicians' sides and uncovered the challenges and opportunities in collecting data within clinical contexts. I was able to understand the feasibility and acceptability of PGHD in clinical practices, as well as clinicians' presence--either remotely or in-person--as an enabler that encourages patients to keep tracking PGHD in the longer-term. Incorporating critical topics regarding data collection from the literature and findings from my work, I discuss the applicability of PGHD and data tracking modes. To support data representation for clinicians, I designed and implemented DataMD that displays PGHD, considering situational constraints through a participatory design process with 18 various stakeholders (e.g., clinicians, EMR developers). Through the participatory design workshop, I found that the ways of data representation that clinicians desired converged to efficiency and familiarity due to the situational constraints. Clinicians wanted to see a large amount of data at once, avoiding using novel visualization methods due to the issue of learnability. Considering those requirements, I designed and implemented DataMD, in which various types of PGHD are represented with considerations of clinical contexts. I discussed the role of data representation in data-driven communication. As the critical aspect of data-driven communication, I present different data-interpretation strategies from patients, providing design guidelines to help effective data-interpretation. By conducting interviews with 20 chronic disease patients, I found that they shaped their interests and assumptions by incorporating prior experiences rather than logical evidence. I also identified four data-interpretation strategies: finding evidence to confirm assumptions, discrediting data to preserve initial assumptions, discovering new insights, and deferring drawing hasty conclusions from data. These understandings help designers and researchers advance the design of systems to support data-interpretation. Lastly, to support collaboration via data, I demonstrate how clinicians and patients collaborate by sharing and utilizing PGHD based on the system I designed. I deployed the integrated system consisting of a patient app, MyHealthKeeper, and a clinician interface, DataMD. I investigated how the system could support collaboration via data. Clinical outcomes revealed that collaboration via PGHD led patients to succeed in behavior change. App usage log also showed that patients could even remotely collaborate with clinicians without direct interactions. Findings from these studies indicate that the key opportunities to facilitate collaboration between clinicians and patients are the integration of data prescriptions into the clinician's workflow and intervention based on natural language feedback generated within clinical contexts. Across these studies, I found that the design for data-driven communication can support patients and physicians to collaborate through PGHD. By conceptualizing how PGHD could improve the existing doctor-patient communication to data-driven communication within four design spaces, I expect that this work will shed new light on how the design should be derived for data-driven communication between patients and physicians in the real world. Taken together, I believe this work contributes to empirical understandings, design guidelines, theoretical extensions, and artifacts in human-computer interaction, computer-supported cooperative work, and health informatics communities. This work also provides a foundation for future researchers to study how the design of the system supporting data-driven communication can empower various users situated in different contexts to communicate through data in other domains, such as learning, beyond the context of healthcare services.1 Introduction 1 1.1 Background 1 1.2 Motivation 4 1.3 Topics of Interest 5 1.3.1 Design Spaces 5 1.3.2 Research Scope 11 1.4 Thesis Statements and Research Questions 13 1.5 Thesis Overview 15 1.6 Contribution 18 1.6.1 Empirical research contributions 18 1.6.2 Artifacts contributions 18 1.6.3 Theoretical contributions 19 2 Conceptual Background & Related Work 20 2.1 Data-driven Communication in Healthcare Services 20 2.1.1 Concept of Doctor-Patient Communication 21 2.1.2 Brief History of Patient-Centered Approach 25 2.1.3 Emergence of Patient-Generated Health Data 27 2.2 Four Design Spaces for Data-Driven Communication 30 2.2.1 Data collection 34 2.2.2 Data Representation 41 2.2.3 Data Interpretation 47 2.2.4 Collaboration via Data 50 3 Data Collection: Study of mFood Logger 54 3.1 Motivation 55 3.2 Preliminary Work & Tool Design 57 3.2.1 Clinical Requirements for Data Collection 57 3.2.2 Design of Data Collection Tool: mFood Logger 60 3.3 Study Design 63 3.3.1 Participants 63 3.3.2 StudyProcedure 64 3.4 Results 69 3.4.1 PatientSide 69 3.4.2 ClinicianSide 76 3.5 Limitations & Conclusion 80 3.6 Chapter 3 Summary 81 4 Data Representation: Design of DataMD 83 4.1 Motivation 84 4.2 Preliminary Work 86 4.2.1 Workflow Journey Maps 87 4.2.2 DesignGoals 89 4.3 Study Design 90 4.3.1 Participants 91 4.3.2 ParticipatoryDesignworkshop 91 4.4 Results 92 4.4.1 DesignRequirements 92 4.4.2 Implementation: DataMD 98 4.5 Limitations & Conclusion 102 4.6 Summary of Chapter4 102 5 Data Interpretation: Data-Interpretation Strategies 103 5.1 Motivation 103 5.2 Study Design 106 5.2.1 Participants 106 5.2.2 Study Procedure 108 5.2.3 Data Analysis 110 5.3 Results 111 5.3.1 Change of Interest in Data 111 5.3.2 Assumptions on Relationships between Data Types 113 5.3.3 Data-InterpretationStrategy 117 5.4 Limitations & Conclusion 124 5.5 Summary of Chapter5 125 6 Collaboration via Data: Deployment Study 126 6.1 Motivation 127 6.2 System Design 128 6.2.1 MyHealthKeeper: Patient App 128 6.2.2 DataMD: Clinician Interface 132 6.3 Study Design 133 6.3.1 Participants 134 6.3.2 Procedure 135 6.4 Data Analysis 138 6.4.1 Statistical Analysis of Clinical Outcomes 139 6.4.2 App Usage Log 139 6.4.3 Observation Data Analysis 139 6.5 Results 140 6.5.1 Behavior Change 140 6.5.2 Data-Collection & Journaling Rate 144 6.5.3 Workflow Integration & Communication Support 146 6.6 Limitations & Conclusion 150 6.7 Summary of Chapter6 151 7 Discussion 152 7.1 Towards a Design for Data-Driven Communication 152 7.1.1 Improve Data Quality for Clinical Applicability 153 7.1.2 Support Accessibility of Data Collection 154 7.1.3 Understand Clinicians Preference for Familiar Data Representation. 157 7.1.4 Embrace Lived Experience for Rich Data Interpretation 158 7.1.5 Prioritize Workflow Integration for Successful Data-Driven Communication 163 7.1.6 Consider Risks of Using Patient-Generated Health Data in Clinical Settings 165 7.2 Opportunities for Future Work 166 7.2.1 Leverage Ubiquitous Technology to Design Data CollectionTools 166 7.2.2 Provide Data-Interpretation Guidelines for People with Different Levels of Literacy and Goals 169 7.2.3 Consider Cultural Differences in Data-Driven Communication 170 8 Conclusion 173 8.1 Summary of Contributions 173 8.2 Future Directions 175 8.3 Final Remarks 176Docto