Data, Data Everywhere, and Still Too Hard to Link: Insights from User Interactions with Diabetes Apps

For those with chronic conditions, such as Type 1 diabetes, smartphone apps offer the promise of an affordable, convenient, and personalized disease management tool. How- ever, despite significant academic research and commercial development in this area, diabetes apps still show low adoption rates and underwhelming clinical outcomes. Through user-interaction sessions with 16 people with Type 1 diabetes, we provide evidence that commonly used interfaces for diabetes self-management apps, while providing certain benefits, can fail to explicitly address the cognitive and emotional requirements of users. From analysis of these sessions with eight such user interface designs, we report on user requirements, as well as interface benefits, limitations, and then discuss the implications of these findings. Finally, with the goal of improving these apps, we identify 3 questions for designers, and review for each in turn: current shortcomings, relevant approaches, exposed challenges, and potential solutions

A Visual Approach to Improving the Experience of Health Information for Vulnerable Individuals

Many individuals with low health literacy (LHL) and limited English proficiency (LEP) have poor experiences consuming health information: they find it unengaging, unappealing, difficult to understand, and un-motivating. These negative experiences may blunt, or even sabotage, the desired effect of communicating health information: to increase engagement and ability to manage health. It is imperative to find solutions to improve poor experiences of health information, because such experiences heighten vulnerability to poor health outcomes. We aimed to address a gap in the health literacy literature by studying the patient experience of health information and how visualization might be able to help. Our four studies involved patients presented with health information in various settings to improve understanding and management of their care. We used semi-structured interviews and observations to understand patient experiences of receiving personal health information in the hospital. We learned that the return of results is desired and has the potential to promote patient engagement with care. We developed a novel method to analyze LHL, LEP caregiver experience and information needs in the community setting. The novel method increased our understanding and ability to detect differences in experiences within the same ethnic group, based on language preference. Next, we interrogated the literature for a solution to easily communicate complicated health information to disinterested, LHL, LEP individuals. We found that visualizations can help increase interest, comprehension, support faster communication, and even help broach difficult topics. Finally, our findings were used to develop a novel prototype to improve experiences of consuming genetic risk information for those having LHL and LEP. Unlike traditional approaches that focus on communicating risk numbers and probabilities, the novelty of our approach was that we focused on communicating risk as a feeling. We achieved this by leveraging vicarious learning via real patient experience materials (e.g., quotes, videos) and empathy with an emotive relational agent. We evaluated and compared the prototype to standard methods of communicating genetic risk information via a mixed methods approach that included surveys, questionnaires, interviews, observations, image analysis, and facial analysis. Main outcome variables were perceived ease of understanding, comprehension, emotional response, and motivation. We employed t-tests, ANOVAs, directed content analysis, correlation, regression, hierarchical clustering, and Chernoff faces to answer the research questions. All variables were significantly different for the prototype compared to the standard method, except for motivation as rated by 32 LHL, LEP community members. Findings revealed that LHL, LEP individuals have difficulty appropriately processing standard methods of communicating risk information, such as risk numbers supported by visual aids. Further, appealing visuals may inappropriately increase confidence in understanding of information. Visualizations affected emotions, which influenced perceived ease of understanding and motivation to take action on the information. Comprehension scores did not correlate with perceived ease of understanding, emotional response, or motivation. Findings suggest that providing access to comprehensible health information may not be enough to motivate patients to engage with their care; providing a good experience (taking into account the aesthetics and emotional response) of health information may be essential to optimize outcomes

Improving physician–patient communication

This chapter looks at improving physician–patient communicatio

Patient Relationship Management (PRM) and AI: The role of Affective Computing

Dissertation presented as the partial requirement for obtaining a Master's degree in Information Management, specialization in Knowledge Management and Business IntelligenceArtificial Intelligence (AI) has been praised as the next big thing in the computing revolution, and it's been touted as a game-changer in a variety of fields, including healthcare. The increasing popularity of this technology is driving early adoption and leading to a lack of consideration of the patient perspective in its use, bringing new sources of distrust that come from the absence of human attributes. This study aims to address this problem by presenting a strategy in the area of affective computing that will combat this absence of empathy experienced by the patient during a medical process. To reach this goal, a Design Science Research Methodology will be followed. A preliminary literature study had already been completed, and the research topic and objectives had been established. In addition, to apply the artifact developments, a bot will be built and evaluated by a set of users. The increased awareness of these AI systems will, expectedly, stimulate their use. By adding new research into the affective computing field, it is also expected to contribute to the digital healthcare evolution and to encourage further scientific progress in this area

Conversational affective social robots for ageing and dementia support

Socially assistive robots (SAR) hold significant potential to assist older adults and people with dementia in human engagement and clinical contexts by supporting mental health and independence at home. While SAR research has recently experienced prolific growth, long-term trust, clinical translation and patient benefit remain immature. Affective human-robot interactions are unresolved and the deployment of robots with conversational abilities is fundamental for robustness and humanrobot engagement. In this paper, we review the state of the art within the past two decades, design trends, and current applications of conversational affective SAR for ageing and dementia support. A horizon scanning of AI voice technology for healthcare, including ubiquitous smart speakers, is further introduced to address current gaps inhibiting home use. We discuss the role of user-centred approaches in the design of voice systems, including the capacity to handle communication breakdowns for effective use by target populations. We summarise the state of development in interactions using speech and natural language processing, which forms a baseline for longitudinal health monitoring and cognitive assessment. Drawing from this foundation, we identify open challenges and propose future directions to advance conversational affective social robots for: 1) user engagement, 2) deployment in real-world settings, and 3) clinical translation

The chaotic nature of healthcare information systems: The need for transdisciplinary collaboration

Copyright @ 2013 EMCIS.This paper demonstrates one of the challenges of the healthcare information systems development, namely the chaotic nature of healthcare systems. Although the reliable evidence demonstrating the positive effects of health information systems on safety and quality remains inconclusive (a growing body of research revealing the unintended consequences and potentially error producing effects of health information systems’ implementation. Different arguments from the literature concerning the chaotic nature of healthcare, including but not limited to the nature of patients and disease have been presented. The requirements of new ways of systems design and the need for transdisciplinary dynamic teams within the requirements engineering phase as a start has been discussed. These arguments have been investigated in the context of an exploratory case addressing one of the advanced oncology centres in the US. This paper concludes that there is an important need to rethink healthcare information systems development method, which has to be in a dynamic ongoing manner for some major issues

Designing Motivational Interviewing Instruction Employing the First Principles of Instruction

Indiana University-Purdue University Indianapolis (IUPUI)Health care reform emphasizes prevention of chronic disease through the reduction of modifiable risk factors as a way to reduce health care costs, morbidity, and mortality. Motivational interviewing (MI) is an effective method of health behavior counseling. It has been used successfully applied in health related behavior change and self- management of chronic disease. The knowledge, skills, and attitude of MI are acquired through learning as other techniques used in the health professions. Nurse practitioner faculty need guidance on how to design instruction in MI that incorporates competencies and utilizes innovative strategies. Prescriptive instructional design theory utilizes knowledge from educational research to establish the steps in the design process. The purpose of this research was to apply prescriptive instructional theory to the design of effective, efficient, and engaging instruction in MI resulting in beginning proficiency in the NP students. A formative design was used for this study. The First Principles of Instruction served as the prescriptive design theory used in the design of instruction in MI. Data sources included the researcher’s design journal, observation during interaction with the instance, demographics of authentic users, authentic user reaction, and knowledge testing. Four cycles of design-redesign were completed. Results of the study point to improvements in the First Principles of Instruction. The instruction was effective, based on the improved scores from pretest to posttest on the Helpful Response Questionnaire. The improved scores also indicated an increase in knowledge of MI. Efficiency was not improved from pretest to posttest. The definition of efficiency as less time to completion of the task did not apply to MI communication skills. The First Principles of Instruction were useful in the design of the techniques of MI. However, there is little guidance for the affective component of MI such as empathy. The prescriptions of the First Principles of Instruction were useful in designing the instruction in MI. NP students indicated in post instruction interviews that engagement in the instruction was related to the relevance of the subject matter to practice and interactive exercises

Responsible research and innovation in science education: insights from evaluating the impact of using digital media and arts-based methods on RRI values

The European Commission policy approach of Responsible Research and Innovation (RRI) is gaining momentum in European research planning and development as a strategy to align scientific and technological progress with socially desirable and acceptable ends. One of the RRI agendas is science education, aiming to foster future generations' acquisition of skills and values needed to engage in society responsibly. To this end, it is argued that RRI-based science education can benefit from more interdisciplinary methods such as those based on arts and digital technologies. However, the evidence existing on the impact of science education activities using digital media and arts-based methods on RRI values remains underexplored. This article comparatively reviews previous evidence on the evaluation of these activities, from primary to higher education, to examine whether and how RRI-related learning outcomes are evaluated and how these activities impact on students' learning. Forty academic publications were selected and its content analysed according to five RRI values: creative and critical thinking, engagement, inclusiveness, gender equality and integration of ethical issues. When evaluating the impact of digital and arts-based methods in science education activities, creative and critical thinking, engagement and partly inclusiveness are the RRI values mainly addressed. In contrast, gender equality and ethics integration are neglected. Digital-based methods seem to be more focused on students' questioning and inquiry skills, whereas those using arts often examine imagination, curiosity and autonomy. Differences in the evaluation focus between studies on digital media and those on arts partly explain differences in their impact on RRI values, but also result in non-documented outcomes and undermine their potential. Further developments in interdisciplinary approaches to science education following the RRI policy agenda should reinforce the design of the activities as well as procedural aspects of the evaluation research

Evaluating empowerment and control of HE e-learning in a secure environment

With the increased spread of HE distance learning into a wide variety of contexts it is important for us to understand the factors involved in its successful deployment for students. E-learning has a great potential to support effective and empowering HE distance learning (Wilson, 2007; Adams, 2005; Hughes, 2005). However, within two secure environments, prisons and health service, the factors involved are complex. This paper reviews HE e-learning technology perceptions within these two contrasting contexts from 225 students' and stakeholders' perspectives. Previous research has detailed literature limitations on obtaining students' perspectives of e-learning (Conole et al, 2006). These limitations are compounded when other stakeholder perceptions are not integrated (Sun et al, 2007; Adams et al, 2005; Millen at al, 2002). This paper developed and applied an e-learning framework for student and stakeholder perceptions. This social psychological framework, is based on previous practice based e-learning studies and is used here to synthesise two large-scale case studies. The framework focuses on three concepts learner Access (e.g. learning design, technology design, physical access), Awareness (e.g. of resources, their usage and support for e-learning tasks) and Acceptability (e.g. trust, privacy, aesthetics, engagement). Students' and stakeholders' perceptions identified high levels of students' empowerment through e-learning whilst still requiring a further pedagogical tailoring and an awareness of support. However, serious problems within these contexts have identified blocks to e-learning through stakeholders perceptions and fears of acceptability (i.e. issues of risk and trust). Ultimately, through understanding competing perceptions and needs within these complex environments we can support the effective technological development, pedagogical design and deployment of e-learning systems

Wearable Computing for Health and Fitness: Exploring the Relationship between Data and Human Behaviour

Health and fitness wearable technology has recently advanced, making it easier for an individual to monitor their behaviours. Previously self generated data interacts with the user to motivate positive behaviour change, but issues arise when relating this to long term mention of wearable devices. Previous studies within this area are discussed. We also consider a new approach where data is used to support instead of motivate, through monitoring and logging to encourage reflection. Based on issues highlighted, we then make recommendations on the direction in which future work could be most beneficial