Refinement and Pilot Testing Social Networks for Encouraging Healthy Behaviors: The Social Pounds Off Digitally (Social POD) Study

Currently about 71% of adults in the US are considered overweight or obese. Overweight and obesity are associated with higher risk of developing many chronic diseases; however, health risks associated with overweight and obesity can be reduced by as little as a 3% to 5% reduction in weight. Mobile health (mHealth) has shown promise as a way to deliver weight loss interventions, yet maintaining participant engagement over time has been a challenge. The purpose of this study was to develop, refine, and pilot test the Social Pounds Off Digitally (POD) Android app for personalized health monitoring and interaction; revise the Social POD app based on participant feedback; and conduct a multi-site randomized clinical trial to pilot test the second iteration of the Social POD app. Overweight and obese adults with Android smartphones (BMI 25-49.9 kg/m2; N=9) were recruited for a two-month weight loss pilot intervention and iterative usability testing of the Social POD app. The app prompted participants via notification to track daily weight, diet, and PA behaviors. Participants received the content of the behavioral weight loss intervention via podcast. In order to re-engage infrequent users, the app prompted frequent app users to select one of three messages to send to infrequent users targeting one of three behavioral theory constructs: 1) social support, 2) self-efficacy, or 3) negative outcome expectations. Body weight and dietary intake (two 24-hr recalls) were assessed at baseline and two months. All participants attended one of two focus groups to provide feedback on use of the app. Based on the usability testing, the Social POD app was refined and a point-based incentive system was incorporated into the app and used in a larger randomized controlled trial. Overweight and obese adults (N=51, mean BMI=34.7 ± 6.0, 38% black) in Charleston and Columbia, SC who owned an Android phone or tablet were recruited to participate in a 12-week behavioral weight loss intervention delivered via mobile app and podcast. All participants received the behavioral content of the weight loss intervention via twice weekly podcasts and were randomized to download and use either a standard calorie tracking app (Fat Secret) or the Social POD app. Main outcomes included kilograms lost at 12-weeks and secondary outcomes included change in psychosocial variable scores from pre- to post-test, association between points earned and percent weight loss at 12-weeks, and reengagement based on message-type received. Following the usability testing participants lost a mean of -0.94 kg (±2.22 kg, p=0.24) and consumed significantly fewer kcals post-intervention (1570±508 kcal/day) as compared to baseline (2384±993 kcal/day, p=0.01). Mean number of app entries was 77.2 ± 73.8 per person with a range of 2 to 219. Messages selected and sent to infrequent users targeting social support were sent most frequently (n=32, 46%), followed by self-efficacy (n=29, 40%), and negative outcome expectations (n=10, 14%). Themes from the focus groups included functionality issues, revisions to the messaging system, and the addition of a point system with rewards for achieving goals. Participant attrition for the RCT was 12% (n=3 experimental and n=3 comparison). Experimental group participants lost significantly more weight (-5.3kg, CI: vi i -7.5, -3.0) than comparison group participants (-2.23kg, CI: -3.6, -1.0; p=0.02) and had a greater reduction in BMI (p=0.02). These outcomes were significant for both intentionto- treat (using baseline observation carried forward) and complete case. While there were significant differences in final positive outcome expectations scores between groups [4.56 experimental, 3.57 comparison (scale range from 1 to 7, maximum); p=0.04], other secondary outcomes (e.g., caloric intake and social support) were not significantly different by group assignment while controlling for baseline values. Among experimental group participants only, total points earned significantly predicted percent weight loss (B=-0.02, p=0.01). In addition, higher scores for the conscientiousness personality trait was significantly associated with total points earned (B=9.07, p=0.03), but other personality characteristics and demographics were not. Messages most frequently sent to infrequent users of the Social POD app were social support (n=119), followed by outcome expectations (n=99), and then messages targeting self-efficacy (n=97). There was a significant difference between the type of message received and re-engagement among infrequent users (p=0.03) with self-efficacy messages prompting the most engagement (n=7), followed by outcome expectation messages (n=5) and social support messages (n=1). In conclusion, use of the Social POD app led to greater weight loss than a standard diet-tracking app (Fat Secret). This mobile health intervention has the potential to be widely disseminated to reduce the risk of chronic disease associated with overweight and obesity

Sandra Helps You Learn: The More You Walk, The More Battery Your Phone Drains

Emerging continuous sensing apps introduce new major factors governing phones' overall battery consumption behaviors: (1) added nontrivial persistent battery drain, and more importantly (2) different battery drain rate depending on the user's different mobility condition. In this paper, we address the new battery impacting factors significant enough to outdate users' existing battery model in real life. We explore an initial approach to help users understand the cause and effect between their physical activity and phones' battery life. To this end, we present Sandra, a novel mobility-aware smartphone battery information advisor, and study its potential to help users redevelop their battery model. We perform an extensive explorative study and deployment for 30 days with 24 users. Our findings reveal what they essentially learned, and in which situations they found Sandra very helpful. We share the lessons learned to help in the design of future mobility-aware battery advisors.1

THE USE OF DISTRACTION: DOOMSCROLLING, LOSING TIME, AND DIGITAL WELL-BEING IN PANDEMIC SPACE-TIMES

In the space-times of the COVID-19 global health crisis, how have our relationships with smartphones changed? How do popular discourses designate mundane engagements with digital technologies as healthy or unhealthy, and how are these notions of wellness practiced? This thesis draws upon an online survey of smartphone users residing in Kentucky, and a review of marketing, journalistic, and academic literature to establish current understandings of ‘digital well-being’. The paper then analyzes interviews with Kentucky smartphone users who were asked to track their screen time for a one-week period. This project reveals normative conceptions of well-being and the role of smartphone and screen time metrics in producing ideas of digital wellness. The thesis draws upon health geographies, disability studies, media studies, and STS to argue that the common heuristics of digital wellness are insufficient to either understand or improve subjective well-being, and that a relational and ecological analysis of ‘digital well-being’ allows us to re-evaluate normative prescriptions of care. Mobilizing theories of attention and neoliberal biopolitics, the paper connects normative notions of attentiveness and wellness to demonstrate a specific assemblage of ‘digital well-being,’ and theorizes distraction as a set of ambivalent, unruly practices which might disrupt it

Understanding digital relationships with smartphones: A psychoanalytic perspective

With the latest data informing us that 78% of UK adults now own a smartphone and that most young people report accessing digital media through a smartphone themselves it is evident that the smartphone as a digital device has become a ubiquitous everyday object. With the rate of growth of digital technologies, it is difficult to research the impact of smartphones on our way of relating to ourselves and others without a constant feeling of playing catch-up. The author uses a mixed methodology design to gain a better understanding of the nature of the human-smartphone relationship which might allow us to think more about what underpins our relationship with digital media rather than how we use it at any given point in time. This paper reviews the literature from both non-psychoanalytic and psychoanalytic perspectives to explore the more unconscious aspects of the relationship that are being actively engaged. The author then undertakes a short autoethnographic study of his own relationship with his smartphone and conducts a focus group of training child psychotherapist to gather personal experience of the human-smartphone relationship and the implications of how the presence of the smartphone in the consulting room impacts upon the practice of child and adolescent psychoanalytic psychotherapy. Findings suggest that all smartphone users, children and adults, are being encouraged to develop an unconscious intimate attachment with the smartphone which is reflective of the mother-infant relationship and it proposes that the smartphone is experienced as a digital pseudo-breast which is designed to not be given up

Embedding mobile learning into everyday life settings

The increasing ubiquity of smartphones has changed the way we interact with information and acquire new knowledge. The prevalence of personal mobile devices in our everyday lives creates new opportunities for learning that exceed the narrow boundaries of a school’s classroom and provide the foundations for lifelong learning. Learning can now happen whenever and wherever we are; whether on the sofa at home, on the bus during our commute, or on a break at work. However, the flexibility offered by mobile learning also creates its challenges. Being able to learn anytime and anywhere does not necessarily result in learning uptake. Without the school environment’s controlled schedule and teacher guidance, the learners must actively initiate learning activities, keep up repetition schedules, and cope with learning in interruption-prone everyday environments. Both interruptions and infrequent repetition can harm the learning process and long-term memory retention. We argue that current mobile learning applications insufficiently support users in coping with these challenges. In this thesis, we explore how we can utilize the ubiquity of mobile devices to ensure frequent engagement with the content, focusing primarily on language learning and supporting users in dealing with learning breaks and interruptions. Following a user-centered design approach, we first analyzed mobile learning behavior in everyday settings. Based on our findings, we proposed concepts and designs, developed research prototypes, and evaluated them in laboratory and field evaluations with a specific focus on user experience. To better understand users’ learning behavior with mobile devices, we first characterized their interaction with mobile learning apps through a detailed survey and a diary study. Both methods confirmed the enormous diversity in usage situations and preferences. We observed that learning often happens unplanned, infrequently, among the company of friends or family, or while simultaneously performing secondary tasks such as watching TV or eating. The studies further uncovered a significant prevalence of interruptions in everyday settings that affected users’ learning behavior, often leading to suspension and termination of the learning activities. We derived design implications to support learning in diverse situations, particularly aimed at mitigating the adverse effects of multitasking and interruptions. The proposed strategies should help designers and developers create mobile learning applications that adapt to the opportunities and challenges of learning in everyday mobile settings. We explored four main challenges, emphasizing that (1) we need to consider that Learning in Everyday Settings is Diverse and Interruption-prone, (2) learning performance is affected by Irregular and Infrequent Practice Behavior, (3) we need to move From Static to Personalized Learning, and (4) that Interruptions and Long Learning Breaks can Negatively Affect Performance. To tackle these challenges, we propose to embed learning into everyday smartphone interactions, which could foster frequent engagement with – and implicitly personalize – learning content (according to users’ interests and skills). Further, we investigate how memory cues could be applied to support task resumption after interruptions in mobile learning. To confirm that our idea of embedding learning into everyday interactions can increase exposure, we developed an application integrating learning tasks into the smartphone authentication process. Since unlocking the smartphone is a frequently performed action without any other purpose, our subjects appreciated the idea of utilizing this process to perform quick and simple learning interactions. Evidence from a comparative user study showed that embedding learning tasks into the unlocking mechanism led to significantly more interactions with the learning content without impairing the learning quality. We further explored a method for embedding language comprehension assessment into users’ digital reading and listening activities. By applying physiological measurements as implicit input, we reliably detected unknown words during laboratory evaluations. Identifying such knowledge gaps could be used for the provision of in-situ support and to inform the generation of personalized language learning content tailored to users’ interests and proficiency levels. To investigate memory cueing as a concept to support task resumption after interruptions, we complemented a theoretical literature analysis of existing applications with two research probes implementing and evaluating promising design concepts. We showed that displaying memory cues when the user resumes the learning activity after an interruption improves their subjective user experience. A subsequent study presented an outlook on the generalizability of memory cues beyond the narrow use case of language learning. We observed that the helpfulness of memory cues for reflecting on prior learning is highly dependent on the design of the cues, particularly the granularity of the presented information. We consider interactive cues for specific memory reactivation (e.g., through multiple-choice questions) a promising scaffolding concept for connecting individual micro-learning sessions when learning in everyday settings. The tools and applications described in this thesis are a starting point for designing applications that support learning in everyday settings. We broaden the understanding of learning behavior and highlight the impact of interruptions in our busy everyday lives. While this thesis focuses mainly on language learning, the concepts and methods have the potential to be generalized to other domains, such as STEM learning. We reflect on the limitations of the presented concepts and outline future research perspectives that utilize the ubiquity of mobile devices to design mobile learning interactions for everyday settings.Die Allgegenwärtigkeit von Smartphones verändert die Art und Weise wie wir mit Informationen umgehen und Wissen erwerben. Die weite Verbreitung von mobilen Endgeräten in unserem täglichen Leben führt zu neuen Möglichkeiten des Lernens, welche über die engen Grenzen eines Klassenraumes hinausreichen und das Fundament für lebenslanges Lernen schaffen. Lernen kann nun zu jeder Zeit und an jedem Ort stattfinden: auf dem Sofa Zuhause, im Bus während des Pendelns oder in der Pause auf der Arbeit. Die Flexibilität des mobilen Lernens geht jedoch zeitgleich mit Herausforderungen einher. Ohne den kontrollierten Ablaufplan und die Unterstützung der Lehrpersonen im schulischen Umfeld sind die Lernenden selbst dafür verantwortlich, aktiv Lernsitzungen zu initiieren, Wiederholungszyklen einzuhalten und Lektionen in unterbrechungsanfälligen Alltagssituationen zu meistern. Sowohl Unterbrechungen als auch unregelmäßige Wiederholung von Inhalten können den Lernprozess behindern und der Langzeitspeicherung der Informationen schaden. Wir behaupten, dass aktuelle mobile Lernanwendungen die Nutzer*innen nur unzureichend in diesen Herausforderungen unterstützen. In dieser Arbeit erforschen wir, wie wir uns die Allgegenwärtigkeit mobiler Endgeräte zunutze machen können, um zu erreichen, dass Nutzer*innen regelmäßig mit den Lerninhalten interagieren. Wir fokussieren uns darauf, sie im Umgang mit Unterbrechungen und Lernpausen zu unterstützen. In einem nutzerzentrierten Designprozess analysieren wir zunächst das Lernverhalten auf mobilen Endgeräten in alltäglichen Situationen. Basierend auf den Erkenntnissen schlagen wir Konzepte und Designs vor, entwickeln Forschungsprototypen und werten diese in Labor- und Feldstudien mit Fokus auf User Experience (wörtl. “Nutzererfahrung”) aus. Um das Lernverhalten von Nutzer*innen mit mobilen Endgeräten besser zu verstehen, versuchen wir zuerst die Interaktionen mit mobilen Lernanwendungen durch eine detaillierte Umfrage und eine Tagebuchstudie zu charakterisieren. Beide Methoden bestätigen eine enorme Vielfalt von Nutzungssituationen und -präferenzen. Wir beobachten, dass Lernen oft ungeplant, unregelmäßig, im Beisein von Freunden oder Familie, oder während der Ausübung anderer Tätigkeiten, beispielsweise Fernsehen oder Essen, stattfindet. Die Studien decken zudem Unterbrechungen in Alltagssituationen auf, welche das Lernverhalten der Nutzer*innen beeinflussen und oft zum Aussetzen oder Beenden der Lernaktivität führen. Wir leiten Implikationen ab, um Lernen in vielfältigen Situationen zu unterstützen und besonders die negativen Einflüsse von Multitasking und Unterbrechungen abzuschwächen. Die vorgeschlagenen Strategien sollen Designer*innen und Entwickler*innen helfen, mobile Lernanwendungen zu erstellen, welche sich den Möglichkeiten und Herausforderungen von Lernen in Alltagssituationen anpassen. Wir haben vier zentrale Herausforderungen identifiziert: (1) Lernen in Alltagssituationen ist divers und anfällig für Unterbrechungen; (2) Die Lerneffizienz wird durch unregelmäßiges Wiederholungsverhalten beeinflusst; (3) Wir müssen von statischem zu personalisiertem Lernen übergehen; (4) Unterbrechungen und lange Lernpausen können dem Lernen schaden. Um diese Herausforderungen anzugehen, schlagen wir vor, Lernen in alltägliche Smartphoneinteraktionen einzubetten. Dies führt zu einer vermehrten Beschäftigung mit Lerninhalten und könnte zu einer impliziten Personalisierung von diesen anhand der Interessen und Fähigkeiten der Nutzer*innen beitragen. Zudem untersuchen wir, wie Memory Cues (wörtl. “Gedächtnishinweise”) genutzt werden können, um das Fortsetzen von Aufgaben nach Unterbrechungen im mobilen Lernen zu erleichtern. Um zu zeigen, dass unsere Idee des Einbettens von Lernaufgaben in alltägliche Interaktionen wirklich die Beschäftigung mit diesen erhöht, haben wir eine Anwendung entwickelt, welche Lernaufgaben in den Entsperrprozess von Smartphones integriert. Da die Authentifizierung auf dem Mobilgerät eine häufig durchgeführte Aktion ist, welche keinen weiteren Mehrwert bietet, begrüßten unsere Studienteilnehmenden die Idee, den Prozess für die Durchführung kurzer und einfacher Lerninteraktionen zu nutzen. Ergebnisse aus einer vergleichenden Nutzerstudie haben gezeigt, dass die Einbettung von Aufgaben in den Entsperrprozess zu signifikant mehr Interaktionen mit den Lerninhalten führt, ohne dass die Lernqualität beeinträchtigt wird. Wir haben außerdem eine Methode untersucht, welche die Messung von Sprachverständnis in die digitalen Lese- und Höraktivitäten der Nutzer*innen einbettet. Mittels physiologischer Messungen als implizite Eingabe können wir in Laborstudien zuverlässig unbekannte Wörter erkennen. Die Aufdeckung solcher Wissenslücken kann genutzt werden, um in-situ Untestützung bereitzustellen und um personalisierte Lerninhalte zu generieren, welche auf die Interessen und das Wissensniveau der Nutzer*innen zugeschnitten sind. Um Memory Cues als Konzept für die Unterstützung der Aufgabenfortsetzung nach Unterbrechungen zu untersuchen, haben wir eine theoretische Literaturanalyse von bestehenden Anwendungen um zwei Forschungsarbeiten erweitert, welche vielversprechende Designkonzepte umsetzen und evaluieren. Wir haben gezeigt, dass die Präsentation von Memory Cues die subjektive User Experience verbessert, wenn der Nutzer die Lernaktivität nach einer Unterbrechung fortsetzt. Eine Folgestudie stellt einen Ausblick auf die Generalisierbarkeit von Memory Cues dar, welcher über den Tellerrand des Anwendungsfalls Sprachenlernen hinausschaut. Wir haben beobachtet, dass der Nutzen von Memory Cues für das Reflektieren über gelernte Inhalte stark von dem Design der Cues abhängt, insbesondere von der Granularität der präsentierten Informationen. Wir schätzen interaktive Cues zur spezifischen Gedächtnisaktivierung (z.B. durch Mehrfachauswahlfragen) als einen vielversprechenden Unterstützungsansatz ein, welcher individuelle Mikrolerneinheiten im Alltag verknüpfen könnte. Die Werkzeuge und Anwendungen, die in dieser Arbeit beschrieben werden, sind ein Startpunkt für das Design von Anwendungen, welche das Lernen in Alltagssituationen unterstützen. Wir erweitern das Verständnis, welches wir von Lernverhalten im geschäftigen Alltagsleben haben und heben den Einfluss von Unterbrechungen in diesem hervor. Während sich diese Arbeit hauptsächlich auf das Lernen von Sprachen fokussiert, haben die vorgestellten Konzepte und Methoden das Potential auf andere Bereiche übertragen zu werden, beispielsweise das Lernen von MINT Themen. Wir reflektieren über die Grenzen der präsentierten Konzepte und skizzieren Perspektiven für zukünftige Forschungsarbeiten, welche sich die Allgegenwärtigkeit von mobilen Endgeräten zur Gestaltung von Lernanwendungen für den Alltag zunutze machen

DEVELOPMENT AND USABILITY TESTING OF QUIT4HEALTH, A SMOKING CESSATION SMARTPHONE APP FOR YOUNG ADULTS

: Tobacco use is the leading cause of death in the United States. As of 2016, 23.5% of American 18-25 year olds reported having used cigarettes in the last month compared to 20.2% of adults and only 3.4% of adolescents. Due to the efficacy and widespread general use of mobile technology today, mobile-phone health, or mHealth apps, have become increasingly popular methods of delivering smoking cessation programs. However, there is a lack of evidence in regards to the quality and the effectiveness of using mHealth to deliver smoking cessation interventions to young adults. This study aims to fill this gap to a certain extent by providing evidence for the usability and quality of Quit4Helath, an interactive smoking cessation mobile phone aimed predominantly at young adults. Methods: Participant

Performing algorithmic power: 'Dysconnect' as digital political dramaturgy

This Practice-led PhD conducts a research enquiry into how dramaturgical practices can be used to challenge the ‘power of algorithms’ and facilitate political agency. The central argument is that algorithmic power can be challenged through a dramaturgical form that itself ‘performs algorithmically’. By entering into the networks and deploying the same coding structures through which algorithmic power operates, such a dramaturgical form seeks to provide audiences with discomforting experiences that illuminate power structures, invite reflection and provoke action. This thesis is pursued through the development and analysis of Dysconnect, an interactive theatre app that acts as a playing device for seven individual ‘podplays’. The app generates algorithmically constructed ‘digital side effects’ that mimic and enact algorithmic power over the listener in order to invite reflection and action. Dysconnect instantiates a ‘digital political dramaturgy’. This is presented as a novel dramaturgical framework that combines a dispersed dramaturgy, a dramaturgy of visibility, political dramaturgies and digital side effects. The thesis contributes to knowledge by developing and defining the concept of a ‘podplay’, developing a ‘digital political dramaturgy’ as a way of challenging algorithmic power, and creating Dysconnect, a new form of app theatre

Design revolutions: IASDR 2019 Conference Proceedings. Volume 2: Living, Making, Value

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 2 includes papers from Living, Making and Value tracks of the conference