Envisioning a Decolonial Digital Mental Health

The field of digital mental health is making strides in the application of technology to broaden access to care. We critically examine how these technology-mediated forms of care might amplify historical injustices, and erase minoritized experiences and expressions of mental distress and illness. We draw on decolonial thought and critiques of identity-based algorithmic bias to analyze the underlying power relations impacting digital mental health technologies today, and envision new pathways towards a decolonial digital mental health. We argue that a decolonial digital mental health is one that centers lived experience over rigid classification, is conscious of structural factors that infuence mental wellbeing, and is fundamentally designed to deter the creation of power differentials that prevent people from having agency over their care. Stemming from this vision, we make recommendations for how researchers and designers can support more equitable futures for people experiencing mental distress and illness

The case for open science: rare diseases.

The premise of Open Science is that research and medical management will progress faster if data and knowledge are openly shared. The value of Open Science is nowhere more important and appreciated than in the rare disease (RD) community. Research into RDs has been limited by insufficient patient data and resources, a paucity of trained disease experts, and lack of therapeutics, leading to long delays in diagnosis and treatment. These issues can be ameliorated by following the principles and practices of sharing that are intrinsic to Open Science. Here, we describe how the RD community has adopted the core pillars of Open Science, adding new initiatives to promote care and research for RD patients and, ultimately, for all of medicine. We also present recommendations that can advance Open Science more globally

Bringing light into the dark side of digitalization : consequences, antecedents, and mitigation mechanisms

As digital technologies permeate all aspects of our professional and private lives, digitalization causes profound changes for individuals, organizations, and societies. The use of digital technologies makes many activities easier, safer, faster, or more comfortable. In addition to many positive changes, digital technologies are also associated with numerous risks and side effects. The use of digital technologies might come along with severe negative consequences for individuals, organizations, and societies. The negative consequences can be triggered by various antecedents. In addition to identifying the negative consequences of digitalization and their antecedents, it is particularly important to develop appropriate mitigation mechanisms. This dissertation provides novel insights for IS researchers to better understand the negative consequences of using digital technologies. It contains a broad overview of the risks and side effects of digitalization and investigates related antecedents and mitigation mechanisms. To reach this goal, regarding research methods, this dissertation relies on the structured analysis of (scientific) literature and (expert) interviews as well as the analysis and interpretation of empirical data. Chapter 2 contributes to the research on the negative consequences of digitalization. Section 2.1 provides a comprehensive multi-level taxonomy of the risks and side effects of digitalization (RSEDs). Section 2.2 builds on Section 2.1 and is a substantial expansion and improvement of Section 2.1. The iterative taxonomy development process was complemented by four additional cycles. The final taxonomy comprises 11 RSEDs and their 39 subtypes. Both articles show that there is a wide range of risks and side effects of digitalization that need to be explored in more detail in the future. Chapter 3 focuses on the antecedents of digitalizations negative consequences. Section 3.1 sheds light on individuals concerns towards automated decision-making. The concerns are derived from academic literature and semi-structured interviews with potential users of algorithm-based technologies. Section 3.2 focuses on the evaluation of specific mHealth app features by potential users in Germany and Denmark. The study draws on survey data from both countries analyzed using the Kano method. Further, it comprises a quartile-based sample split approach to identify the underlying relationships between users characteristics and their perceptions of the mHealth app features. The results show significant differences between Germans and Danes in the evaluation of the app features and demonstrate which of the user characteristics best explain these differences. Both articles shed light on possible antecedents of negative consequences (i.e., user dissatisfaction, non-use) and thus contribute to a better understanding of the occurrence of negative consequences. Chapter 4 shows exemplary mitigation mechanisms to cope with the negative consequences of digitalization. Section 4.1 takes an organizational perspective and identifies data privacy measures that can be implemented by organizations to protect the personal data of their customers and address their privacy concerns. These measures were evaluated by analyzing data from two independent online surveys with the help of the Kano method. Section 4.2 focuses on an individual perspective by presenting the concept of a privacy bot that contributes to strengthening the digital sovereignty of internet users. With the help of the privacy bot, page-long privacy statements can be checked against previously stored individual data protection preferences. Both articles provide appropriate mitigation mechanisms to cope with users privacy concerns. These two examples show that there are a variety of ways to counter the risks and side effects of digitalization. The research articles included in this dissertation identify various risks and side effects of digitalization that need to be explored in more detail in future research. The two articles on antecedents help to better understand the occurrence of negative consequences of digitalization. The development of appropriate countermeasures, two of which are exemplified in this dissertation, should result in the benefits of digital technologies outweighing their risks.Da digitale Technologien alle Bereiche unseres beruflichen und privaten Lebens durchdringen, bewirkt die Digitalisierung tiefgreifende Veränderungen für Individuen, Organisationen und Gesellschaften. Viele Aktivitäten werden durch den Einsatz digitaler Technologien einfacher, sicherer, schneller oder bequemer. Neben vielen positiven Veränderungen sind digitale Technologien aber auch mit zahlreichen Risiken und Nebenwirkungen verbunden. Der Einsatz digitaler Technologien kann mit schwerwiegenden negativen Folgen für Individuen, Organisationen und Gesellschaften einhergehen. Diese negativen Folgen können durch verschiedene Einflussfaktoren ausgelöst werden. Zusätzlich zur Identifizierung der negativen Folgen der Digitalisierung und ihrer Ursachen ist es besonders wichtig, geeignete Schutzmaßnahmen zu entwickeln. Diese Dissertation liefert neue Erkenntnisse für IS-Forscher:innen, um die negativen Folgen der Nutzung digitaler Technologien besser zu verstehen. Sie enthält einen breiten Überblick über die Risiken und Nebenwirkungen der Digitalisierung und untersucht die damit verbundenen Ursachen und Schutzmaßnahmen. Um dieses Ziel zu erreichen, stützt sich die Dissertation forschungsmethodisch auf die strukturierte Analyse von (wissenschaftlicher) Literatur und (Expert:innen-)Interviews sowie auf die Auswertung und Interpretation empirischer Daten. Kapitel 2 leistet einen Beitrag zur Forschung über die negativen Folgen der Digitalisierung. Abschnitt 2.1 liefert eine umfassende mehrstufige Taxonomie der Risiken und Nebenwirkungen der Digitalisierung (RSEDs). Abschnitt 2.2 baut auf Abschnitt 2.1 auf und ist eine wesentliche Erweiterung und Verbesserung von Abschnitt 2.1. Der iterative Taxonomieentwicklungsprozess wurde durch vier weitere Zyklen ergänzt. Die endgültige Taxonomie umfasst 11 RSED und 39 Untertypen. Beide Artikel zeigen, dass es ein breites Spektrum an Risiken und Nebenwirkungen der Digitalisierung gibt, das in Zukunft noch genauer erforscht werden muss. Kapitel 3 befasst sich mit den Ursachen der negativen Folgen der Digitalisierung. Abschnitt 3.1 beleuchtet die Bedenken von Individuen gegenüber automatisierten Entscheidungen. Die Bedenken wurden aus wissenschaftlicher Literatur und halbstrukturierten Interviews mit potenziellen Nutzer:innen algorithmusbasierter Technologien abgeleitet. Abschnitt 3.2 konzentriert sich auf die Bewertung spezifischer Funktionen von mHealth-Apps durch potenzielle Nutzer in Deutschland und Dänemark. Die Studie basiert auf Umfragedaten aus beiden Ländern, die mit der Kano-Methode analysiert wurden. Darüber hinaus umfasst sie einen quartil-basierten Stichproben-Split-Ansatz, um die zugrundeliegenden Beziehungen zwischen den Merkmalen der Nutzer (z.B. Bedenken hinsichtlich des Datenschutzes) und ihrer Wahrnehmung der Funktionen von mHealth-Apps zu ermitteln. Die Ergebnisse zeigen signifikante Unterschiede zwischen Deutschen und Dänen bei der Bewertung der App-Funktionen und zeigen, welche der Nutzermerkmale diese Unterschiede am besten erklären. Beide Artikel beleuchten mögliche Ursachen negativer Folgen (z.B. Unzufriedenheit der Nutzer, Nichtnutzung) und tragen so zu einem besseren Verständnis des Auftretens negativer Folgen bei. Kapitel 4 zeigt beispielhafte Schutzmaßnahmen zur Bewältigung der negativen Folgen der Digitalisierung. Abschnitt 4.1 nimmt eine organisationale Perspektive ein und identifiziert Datenschutzmaßnahmen, die von Unternehmen umgesetzt werden können, um die personenbezogenen Daten ihrer Kund:innen zu schützen und deren Datenschutzbedenken zu berücksichtigen. Diese Maßnahmen wurden durch die Analyse von Daten aus zwei unabhängigen Online-Umfragen mit Hilfe der Kano-Methode evaluiert. In Abschnitt 4.2 wird eine individuelle Perspektive eingenommen, indem das Konzept eines Privacy Bots vorgestellt wird, der zur Stärkung der digitalen Souveränität von Internetnutzer:innen beiträgt. Mithilfe des Privacy Bots können seitenlange Datenschutzerklärungen mit zuvor gespeicherten individuellen Datenschutzpräferenzen abgeglichen werden. Beide Artikel beschreiben geeignete Schutzmaßnahmen, um den Datenschutzbedenken der Nutzer:innen gerecht zu werden. Diese beiden Beispiele zeigen, dass es eine Vielzahl von Möglichkeiten gibt, den Risiken und Nebenwirkungen der Digitalisierung zu begegnen. Die in dieser Dissertation enthaltenen Forschungsartikel zeigen verschiedene Risiken und Nebenwirkungen der Digitalisierung auf, die in der zukünftigen Forschung noch genauer untersucht werden müssen. Die beiden Artikel zu den Ursachen helfen, das Auftreten von negativen Konsequenzen der Digitalisierung besser zu verstehen. Die Entwicklung geeigneter Schutzmaßnahmen, von denen zwei in dieser Dissertation beispielhaft vorgestellt werden, sollte dazu führen, dass die Vorteile der digitalen Technologien ihre Risiken überwiegen

A Data Science approach to behavioural change: large scale interventions on physical activity and weight loss

This PhD thesis is a quantitative investigation combining Behaviour Change Science with a Data Science approach in search of more effective large scale, multi-component behavioural interventions for health and well-being. There is limited evidence about how technology-based interventions (including those using wearable physical activity monitors and apps) are efficacious for increasing physical activity and nutrition. The relevance of this research is the systematic approach to overcome previous studies’ limitations in method and measurement: restricted research about multi-component interventions, limited analysis about the impact of social networking, the inclusion of components without sufficient evidence about the components’ effectiveness, the absence of a control group(s), small sample sizes, subjective physical activity reporting, among other limitations. The research was done in conjunction with Tictrac Ltd as the industrial partner, and the UCL Centre for Behaviour Change. Tictrac Ltd builds platforms for the collection and aggregation of personal data generated by the users’ devices and mobile apps. The collaboration with the UCL Centre for Behaviour Change has been instrumental to design, implement, evaluate and analyse behaviour change interventions that impact wellbeing and health. The thesis comprises three areas of research: 1. Computational platforms for large scale behavioural interventions. To support this research, computational platforms were designed, built, deployed and used for randomised behavioural interventions with control groups. The interventions were implemented as experiments related to the behavioural impact on physical activity, weight loss and change in diet. / 2. Behaviour change experiments. The two experiments use the Behaviour Change Wheel framework for behaviour change, intervention design and evaluation. A Data Science approach was used to test hypotheses, determine and quantify the effect of the fundamental intervention components and their interactions. The effective use of tracking devices and apps was determined by comparing the results of ‘structured intervention’ –vs- those of the control group. / Experiment 1: Large scale intervention in a corporate wellness setting. Multi-component behavioural intervention with: control group, self-defined goals, choice architecture and personal dashboards for physical activity and weight loss. The analysis covers network effects of social interactions, the role of being explicit about a type of goal, the impact of making part of team, among other relevant outcomes. / Experiment 2: Identification of critical factors of a technology-based intervention. Multi-component behavioural intervention with simultaneous target behaviours related to weight loss and physical activity, inspired by factorial design for the determination of critical factors and effective components. The analysis comprises: components’ interactions (coach, challenge, team, action plans, forum), non-linear relationships (BMI, change in diet habit), five personality traits, among other relevant results. / 3. Frameworks for future large scale interventions in behaviour change. The implementation of both experiments required an applied use of theoretical and practical principles for the design of the experimental computational platforms. As a result, two frameworks were suggested for future interventions: an implementation framework and a data strategy framework

Artificial intelligence technologies and compassion in healthcare: A systematic scoping review

BackgroundAdvances in artificial intelligence (AI) technologies, together with the availability of big data in society, creates uncertainties about how these developments will affect healthcare systems worldwide. Compassion is essential for high-quality healthcare and research shows how prosocial caring behaviors benefit human health and societies. However, the possible association between AI technologies and compassion is under conceptualized and underexplored.ObjectivesThe aim of this scoping review is to provide a comprehensive depth and a balanced perspective of the emerging topic of AI technologies and compassion, to inform future research and practice. The review questions were: How is compassion discussed in relation to AI technologies in healthcare? How are AI technologies being used to enhance compassion in healthcare? What are the gaps in current knowledge and unexplored potential? What are the key areas where AI technologies could support compassion in healthcare?Materials and methodsA systematic scoping review following five steps of Joanna Briggs Institute methodology. Presentation of the scoping review conforms with PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews). Eligibility criteria were defined according to 3 concept constructs (AI technologies, compassion, healthcare) developed from the literature and informed by medical subject headings (MeSH) and key words for the electronic searches. Sources of evidence were Web of Science and PubMed databases, articles published in English language 2011–2022. Articles were screened by title/abstract using inclusion/exclusion criteria. Data extracted (author, date of publication, type of article, aim/context of healthcare, key relevant findings, country) was charted using data tables. Thematic analysis used an inductive-deductive approach to generate code categories from the review questions and the data. A multidisciplinary team assessed themes for resonance and relevance to research and practice.ResultsSearches identified 3,124 articles. A total of 197 were included after screening. The number of articles has increased over 10 years (2011, n = 1 to 2021, n = 47 and from Jan–Aug 2022 n = 35 articles). Overarching themes related to the review questions were: (1) Developments and debates (7 themes) Concerns about AI ethics, healthcare jobs, and loss of empathy; Human-centered design of AI technologies for healthcare; Optimistic speculation AI technologies will address care gaps; Interrogation of what it means to be human and to care; Recognition of future potential for patient monitoring, virtual proximity, and access to healthcare; Calls for curricula development and healthcare professional education; Implementation of AI applications to enhance health and wellbeing of the healthcare workforce. (2) How AI technologies enhance compassion (10 themes) Empathetic awareness; Empathetic response and relational behavior; Communication skills; Health coaching; Therapeutic interventions; Moral development learning; Clinical knowledge and clinical assessment; Healthcare quality assessment; Therapeutic bond and therapeutic alliance; Providing health information and advice. (3) Gaps in knowledge (4 themes) Educational effectiveness of AI-assisted learning; Patient diversity and AI technologies; Implementation of AI technologies in education and practice settings; Safety and clinical effectiveness of AI technologies. (4) Key areas for development (3 themes) Enriching education, learning and clinical practice; Extending healing spaces; Enhancing healing relationships.ConclusionThere is an association between AI technologies and compassion in healthcare and interest in this association has grown internationally over the last decade. In a range of healthcare contexts, AI technologies are being used to enhance empathetic awareness; empathetic response and relational behavior; communication skills; health coaching; therapeutic interventions; moral development learning; clinical knowledge and clinical assessment; healthcare quality assessment; therapeutic bond and therapeutic alliance; and to provide health information and advice. The findings inform a reconceptualization of compassion as a human-AI system of intelligent caring comprising six elements: (1) Awareness of suffering (e.g., pain, distress, risk, disadvantage); (2) Understanding the suffering (significance, context, rights, responsibilities etc.); (3) Connecting with the suffering (e.g., verbal, physical, signs and symbols); (4) Making a judgment about the suffering (the need to act); (5) Responding with an intention to alleviate the suffering; (6) Attention to the effect and outcomes of the response. These elements can operate at an individual (human or machine) and collective systems level (healthcare organizations or systems) as a cyclical system to alleviate different types of suffering. New and novel approaches to human-AI intelligent caring could enrich education, learning, and clinical practice; extend healing spaces; and enhance healing relationships.ImplicationsIn a complex adaptive system such as healthcare, human-AI intelligent caring will need to be implemented, not as an ideology, but through strategic choices, incentives, regulation, professional education, and training, as well as through joined up thinking about human-AI intelligent caring. Research funders can encourage research and development into the topic of AI technologies and compassion as a system of human-AI intelligent caring. Educators, technologists, and health professionals can inform themselves about the system of human-AI intelligent caring

Development and evaluation of a novel virtual agent-based app for patients with colorectal cancer: A mixed methods study

Background and aim: Information support is an integral part of cancer care, but its provision can be problematic in busy health settings. The aim of this project was to develop and evaluate a health app to facilitate the provision of information support in newly diagnosed patients with colorectal cancer (CRC). Instead of delivering information using text, three animated embodied virtual agents (VAs) were deployed. The VAs were formulated after patients’ treating clinicians (male oncologist, female nurse and female pharmacist) to explore the role of familiarity, which has not been addressed in previous research. Study methods: A multi-stage development process was followed for the app, which was provided to the study participants before the beginning of their treatment. A convergent parallel mixed methods design involving pre- and post-exposure questionnaires (adapted versions of the Toronto Information Needs Questionnaire and the System Usability Scale), app usage data and semi-structured interviews was deployed to evaluate the intervention. Results and discussion: The app was acceptable by the end users and had a good degree of usability (mean System Usability Scale score=73.89). The information content was appropriate and met patients’ demands to a moderate extent; this was because patients utilised other information sources (e.g., printed material) to address their needs. Incorporating supportive functions such as a medicinal calendar in addition to the information content emerged as an important aspect. The inclusion of VAs was deemed to be appropriate. The VAs fostered a sense of presence, added trustworthiness to the information content and were perceived as more interactive than reading text. Having a VA representing a familiar clinician was favoured by most users. The vast majority of patients perceived the VAs as cartoon figures and suggested that they should be improved to look realistic in order to give the impression of having an exchange with a real person. Natural voices were preferred over synthetic speech. Conclusion: VA-based mHealth interventions are an acceptable way of supporting patients with CRC. Appropriate consideration should be given to the requirements of the intended user audience to design acceptable interventions that reflect their needs

Characteristics and quality of physical activity apps which provide feedback on user affect. A systematic review and evaluation of public and academic apps

Despite its benefits to both physical and mental health, physical activity levels worldwide remain low and new solutions for behaviour change must be sought. Smartphone apps are extremely popular and prevalent across the population, however their quality is still questionable. Physical activity produces an acute ‘feel good’ effect and intervention designers should consider the role that affect (mood) plays in uptake and maintenance of behaviours. It is timely to examine the use of affect as a motivator for physical activity, using new tools that allow real-time capture of both affect and physical activity (smartphones). The existence, characteristics and quality of physical activity apps that provide feedback on affect were explored in this thesis A mixed methods approach, comprising a systematic review (study 1) and a systematic evaluation (study 2) was taken. Data collection methods included both quantitative and qualitative assessments, using pre-existing and fit-for purpose tools. Twenty-two physical activity apps that provided feedback on affect were identified. Apps often failed to target groups most at risk of poor physical activity levels. Feedback on affect was performed in a variety of ways. Quality of apps, based on 13 criteria, was mixed. Recommendations are made for researchers, app developers and funders, including the need for development of high quality physical activity apps incorporating and emphasising affective benefits, consideration of archiving processes for developed apps once development ceases, and collaboration between researchers, developers and users when designing apps

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

Exploring and Designing Embodied Mindfulness-based Interactive Technologies For Mental Wellbeing

Mindfulness practices have become increasingly popular due to their significant benefits for mental wellbeing. However, the required skills to sustain and regulate attention are challenging to develop. Both the benefits and the challenges of mindfulness training have attracted a growing Human-Computer Interaction (HCI) interest in designing interactive technologies for mindfulness. Most mindfulness-based technologies employ metaphorical mappings of mindfulness states to support awareness of such states and facilitate attention regulation, although the rationale for such mappings is seldom articulated. This thesis addresses this shortcoming, drawing on first-person experiences and embodied metaphors of mindfulness practices to design novel multi-sensory technologies for mental wellbeing. This work concentrates on focused attention mindfulness (FAM) practices which involve sustaining selective attention moment by moment on a chosen object, and are considered the most widely accessible among novices. In particular, the research presented in this thesis is structured around two distinct FAM practices, in 6 different but interrelated studies. On the one hand, mandala colouring illustrates a nonstatic FAM practice with an external object of attention. On the other hand, sitting meditation represents a static FAM practice with an internal object of attention. The first and second study investigate in-depth mandala colouring, respectively, by interviewing 21 people who regularly engage with this practice and through an autoethnographic and heuristic evaluation of the 14 top-ranked mandala colouring apps. Findings informed the development of Anima, a peripheral colour palette materialising EEG-based mindfulness states onto colours for mandala colouring. In the third study, Anima’s design solutions were evaluated with 12 experienced participants. The fourth study follows a research-through design and material speculation approach to understand the role of body during meditation with 24 experts. This is extended in the fifth study, in which the 16 most popular meditation apps are evaluated through auto-ethnography. An identified opportunity of designing for the physical sensations that arise during meditation was considered through the design of the WarmMind, that provide warmth patterns on the upper body. The WarmMind prototype was evaluated in the fifth study, through a user study with 10 participants experiencing thermal metaphors for mapping meditation states on the upper-body. Besides the technological design contributions of Anima and WarmMind, the contributions of this thesis include the concepts of intricate confines to scaffold mindful movement to support non-static FAM practices with an external object of attention, and interoceptive interaction to facilitate focusing inwards during meditation to support static FAM practices with an internal object of attention; as well as a framework built on embodied metaphor theories to designing meditation technologies. Collectively, these studies highlight the value of the human body in mindfulness-based technologies in HCI, as well as theoretical and methodological contributions to designing around mindfulness for mental wellbeing in HCI

A multi-sited ethnography of the decolonization of mobile media among Guaraní

Els moviments de drets indígenes d'Amèrica Llatina lluiten contra les hegemonies colonials que impregnen la vida contemporània. Mitjançant l'anàlisi particular dels pobles guaranís i les seves estratègies avançades, aquesta tesi aporta les primeres evidències sobre les implicacions de la descolonització dels serveis de comunicació mòbil. La tesi se centra en la política de les formes de comunicació interpersonal, un tema habitualment oblidat en els estudis sobre mitjans de comunicació indígenes. Adopta un enfocament crític i multilocal que combina la col·laboració comunitària amb l'anàlisi d'economia política. Els resultats comminen a qüestionar els discursos tecnooptimistes de la inclusió digital i a analitzar com la desigualtat condiciona la influència cívica sobre els mitjans. Cal destacar les connexions que aquesta tesi estableix entre factors clau que afecten la capacitat individual de decidir (o agència individual) sobre els serveis mòbils en el cas de les anomenades "perifèries digitals".Los movimientos de derechos indígenas de América Latina luchan contra las hegemonías coloniales que impregnan la vida contemporánea. Mediante el análisis particular de los pueblos guaraníes y sus estrategias avanzadas, esta tesis aporta las primeras evidencias sobre las implicaciones de la descolonización de los servicios de comunicación móvil. La tesis se centra en la política de los modos de comunicación interpersonal, un tema habitualmente ignorado en los estudios sobre medios de comunicación indígenas. Adopta un enfoque crítico y multilocal que combina la colaboración comunitaria con el análisis de economía política. Los resultados conminan a cuestionar los discursos tecnooptimistas de la inclusión digital y a analizar cómo la desigualdad condiciona la influencia cívica sobre los medios. Destacan las conexiones que esta tesis establece entre factores clave que afectan a la agencia o capacidad individual de decidir sobre los servicios móviles en el caso de las llamadas "periferias digitales".Indigenous rights movements in Latin America are fighting to overturn the colonial hegemonies that continue to pervade contemporary life on the continent. The Guaraní people, for instance, have devised advanced strategies to decolonize mobile media services through local ownership. While most research on indigenous media focuses on the activities of organizations and the nature of media content, this thesis draws attention to the politics surrounding indigenous people's means of interpersonal communication and provides unprecedented evidence regarding the implications of decolonizing mobile media services. The results of this research, which adopts a critical, multi-sited approach that combines community-based collaboration with an analysis of the political economy, compel us to question the techno-optimism inherent to digital inclusion discourse and to further explore how inequalities shape civic influence on the media. Most significantly, this research ties together key factors that affect the individual agency of those at the so-called "digital margin" over their mobile media services