Development of the concept of impact literacy through applying theory vs. intervention led approaches to adolescent sexual health intervention design

Despite an overall reduction in UK teenage conception rates since the 1999 Teenage Pregnancy strategy, rates remain high and sexually transmitted infections remain a public health issue. School sex education remains a primary source of sex and relationships information for young people, but there is varied quality in provision and limited opportunity to accommodate individual differences (such as gender and age). Young people can benefit from parental support in learning about sex and relationships, but parents can feel embarrassed and underequipped to talk with their children. There is clear scope to integrate socio-cognitive theory into provision to improve education and support to ultimately improve contraception use. Approaches to intervention development can be characterised as being rooted in a singular or expanded theory (‘theory led’), or focused on the problem and allowing the application of multiple theories (‘intervention led’). This portfolio presents seven outputs within the theme of sex education, each offering insights into how to improve adolescent sexual health. Two articles are presented within the ‘theory-led’ strand. The first article (Bayley, Brown, & Wallace, 2009) explores under 16s attitudes to emergency contraception within a Theory of Planned Behaviour (Ajzen, 1991) framework. Focus groups with 13-16 year olds (n=48) suggest that practical factors and attitudes may be more significant barriers for teenagers ambivalent about pregnancy, and that confidentiality is a concern for all young people. The second article (Bayley, Baines, & Brown, 2017) integrates these findings into an extended TPB survey (n=1378) on under 16 attitudes to condoms, the contraceptive pill and emergency contraception. Findings suggest three distinct predictive models of intention (36%, 18% and 23% respectively), with attitude, gender and anticipated regret common to each. Girls appear more strongly motivated and year 10 is a crucial stage for intention. Four outputs are presented under the ‘intervention-led’ strand. Output 3 (Newby, Bayley, & Wallace, 2011a) describes the process of using an Intervention Mapping (Eldredge, Markham, Kok, Ruiter, & Parcel, 2016) approach to develop a parents’ sex and relationships communication programme (“What Should We Tell the Children?”). In reflection of the challenge of recruiting fathers to this programme, Output 4 (Bayley, Wallace, & Choudhry, 2009) explores how to improve fathers’ engagement in parenting support. Results of focus groups, questionnaires and interviews (n=38) suggest practical difficulties, female oriented services and lack of organisational support present barriers to fathers’ access. In reflection of difficulties attending a group programme and the need to improve access, Output 5 (Bayley, Baines, & Brown, 2015) demonstrates the process of converting the group based “What Should We Tell the Children?” programme into an online Serious Game. Drawing this learning back into school based provision, Output 6 (Brown, Bayley, & Newby, 2012) applies Intervention Mapping to the development of a serious game for use in the classroom to prevent sexual coercion. Each of these outputs highlights a range of challenges and opportunities for generating real world benefit or ‘impact’. The final output (Bayley & Phipps, 2017a) draws together this learning into a new concept of ‘impact literacy’, emphasising the need to understand the how, what and who of impact to drive research into practice. The learning is also synthesised into two new models of impact literate health psychology interventions, combining best practice across theory, intervention and impact models to guide subsequent development and implementation

Teacher motivation as an enhancement to the first step to success early intervention program for children with tertiary level behavioral challenges.

The First Step to Success early intervention program (Walker, 1998) is a secondary prevention intervention that targets primary grade children with moderate or emerging behavior disorders. While the effectiveness of the First Step to Success early intervention program has been documented repeatedly (see Loman, Rodriguez, & Homer, 2010; Walker et aI., 2009), it has also been shown to be less effective with more severely disordered children and has a less dramatic impact on behavior in the home than in the school setting. Efforts to enhance the program\u27s effectiveness with even the most severely behaviorally disordered children have been undertaken, and completed. This research collaboration between the Oregon Research Institute and the University of Louisville examined the utility and feasibility of enhancements to the home and classroom components of the First Step to Success intervention. These enhancements, which rely heavily on the infusion of Motivational Interviewing (Miller & Rollnick, 2002) practices, broadened the ecological focus of the intervention and produced significant changes in the participating children and their families. The following dissertation examines enhancements focused on the classroom teacher\u27s use of praise to help replace the intervention\u27s systematic use of external reinforcers; and to reduce the attention for inappropriate behavior (reprimands) that often inadvertently maintains the challenging behavior teachers seek to eliminate. The resulting enhancement, hereafter referred to as the First Step Classroom Check-up, is largely based on the original work of Reinke, Lewis-Palmer, and Merrell (2008). An open multiple-case-study design (Meyers, Truscott, Meyers, Varjas & Collins, 2007) was used to investigate the intervention for the purpose of innovation and development. The observed increase in teachers\u27 use of praise and decreased reprimands, along with overall positive responses in terms of the interventions social validity, and positive child outcomes provide support for the integration of the Classroom Check-up (Reinke et al., 2008) into an Enhanced version of the First Step to Success Early Intervention Program. These outcomes also demonstrate the promise of future investigations ofthese interventions separately, and as combined and the probability that the efficacy of the intervention could be investigated

Accessibility of Health Data Representations for Older Adults: Challenges and Opportunities for Design

Health data of consumer off-the-shelf wearable devices is often conveyed to users through visual data representations and analyses. However, this is not always accessible to people with disabilities or older people due to low vision, cognitive impairments or literacy issues. Due to trade-offs between aesthetics predominance or information overload, real-time user feedback may not be conveyed easily from sensor devices through visual cues like graphs and texts. These difficulties may hinder critical data understanding. Additional auditory and tactile feedback can also provide immediate and accessible cues from these wearable devices, but it is necessary to understand existing data representation limitations initially. To avoid higher cognitive and visual overload, auditory and haptic cues can be designed to complement, replace or reinforce visual cues. In this paper, we outline the challenges in existing data representation and the necessary evidence to enhance the accessibility of health information from personal sensing devices used to monitor health parameters such as blood pressure, sleep, activity, heart rate and more. By creating innovative and inclusive user feedback, users will likely want to engage and interact with new devices and their own data

Designing Games to Collect Human-Subject Data

Applied games align the 'fun' of gameplay with real-world outcomes to achieve social good. For data collection outcomes (e.g. where games are used for experiments or citizen science) various templates and taxonomies for design have been proposed to achieve this alignment. However, existing approaches assume it is always possible to evaluate (and validate) collected data against either 'ground truth' or intersubjective consensus. On the contrary, a significant proportion of human-subjects research is concerned with datums that cannot be validated in this way, such as latent traits and beliefs (e.g. ice cream preference, which cannot be 'validated' against a correct value). Despite extensive knowledge from the social science methodological literature, we do not have comparable templates or taxonomies that can help to design and analyse data collection games for these kinds of data: we cannot yet turn experiments into 'elicitation games'. This thesis develops a theoretical model for such `elicitation games', using language elicitation as a case study. Elicitation games must satisfy requirements of validity and motivation. First, I survey validity threats characteristic of the use of games in experiments. Second, I construct a grounded theory of speech motivation to understand what motivates data-providing behaviours in applied games. Integrating these, I theoretically justify a generalised model of data elicitation in games: Intrinsic Elicitation. Finally, to identify which validity threats are of primary importance within this model, I run a series of controlled experiments comparing accuracy rates using a novel elicitation game for eliciting adjective order. This thesis contributes a framework for integrating game design and social science experimental concerns and how they may influence each other for the design and analysis of elicitation games. I find that games incentive rational players to misalign data to experimental outcomes. This can be solved by novel game designs that follow Intrinsic Elicitation

Playing with reality: A technocultural ethnography of pervasive gaming

Pervasive games are an experimental game design practice that engages with technology development and everyday space. These experiences range from technology experiments to avant-garde performances to explorative urban play. This PhD is an ethnographic exploration of two questions. First, how does the technocultural situation shape the history and future of pervasive games? Secondly, how does this technocultural situation shape and affect the enactment (the design, play and performance) and the core experience?This thesis is comprised of ethnographic research carried out at pervasive gaming festivals, analysis of games and interviews with designers, artists and technologists working in the field. It reflects a historical situation in an emerging and dynamic field of practice. The work develops a set of methods that uses the concepts of liminality, materiality and practice to inform an assemblage of data gathering and analysis techniques that are specifically intended to engage with new technocultural forms. This is intended to deliver an understanding of these forms in a wider cultural relationships as well as give insight into how they are experienced. It uncovers a framework of tensions that explain the underlying nature of the play experience and design of pervasive games.This research uncovers overlooked aspects of the practice of pervasive gaming. Firstly the ways in which the social and cultural background of the players and designers moulds the form, content and meta-narrative of these games. Secondly that the overlooked, and often unexpected or invisible, materiality of these games shapes the ways in which they have developed. The often unconsidered physical materials of the games take on rich and vital meanings through design and play. The relationship between designer and the mesh of object agencies have led the practice in unexpected directions and charted a trajectory away from technology experiment and into experience design exploration. It is in this wider context of the design of experiences that the practice will have the longest-term impact.

User-Environment Relations : A Postphenomenology of Virtual Reality

Innen HCI blir interaksjon tradisjonelt forstått som noe som skjer mellom de forhåndsantatte enhetene «menneskelig bruker» og «teknologisk objekt». Særlig tvinger omsluttende VR-teknologi oss til å revurdere disse antagelsene, ettersom den menneskelige brukeren og det virtuelle miljøet former hverandre gjensidig i relasjonene som konstitueres mellom dem. Postfenomenologien ser ut til å være en lovende kandidat for det å redegjøre for kompleksiteten til VR-mediering ettersom den tilbyr et mer helhetlig syn, og tar hensyn til hvordan teknologier tar del i konstitueringen av menneskers livsverdener. Ettersom virtuelle miljøer ikke bare er verktøy vi samhandler med eller bruker, men miljøer hvor vi eksisterer og som vi blir formet gjennom, ser postfenomenologien ut til å tilby et lovende perspektiv for å fremme vår forståelse av hvordan VR tar del i å endre vår opplevelse av hvem vi er i forhold til våre verdener. Denne doktorgradsavhandlingen undersøker hvordan postfenomenologi kan tas i bruk konstruktivt for å få en kvalitativ forståelse av brukeropplevelse i omsluttende VR-teknologi. Avhandlingen presenterer teoretiske, metodiske og empiriske bidrag. Teoretisk sett introduseres menneske-teknologi-relasjonen som VR utgjør som bruker-miljø-relasjoner. Gjennom en analyse av menneske-teknologi-relasjonen som VR utgjør, demonstreres det hvordan forskere kan dra nytte av en postfenomenologisk forståelse av VR, samt hvordan VR-mediet selv krever en revurdering av tradisjonelle postfenomenologiske kategorier av menneske-teknologi-relasjoner. Metodisk sett, foreslås «VR Go-along»-metoden som en passende tilnærming for å gi kvalitative vurderinger av brukeropplevelsen som mediert i de konstituerte bruker-miljø-relasjonene. Empirisk sett, presenterer avhandlingen en kvalitativ og utforskende «in-the-wild»-studie av omsluttende VR-bruk over to måneder, hvor «VR Go-along»-metoden brukes til å undersøke deltakernes brukeropplevelse slik de er mediert i de konstituerte bruker-miljø-relasjonene. Denne avhandlingen fungerer som en refleksiv redegjørelse av forfatterens undersøkelse om bruken av postfenomenologi for å gi en forståelse av mediering i omsluttende VR-teknologi. Den demonstrerer det gjensidig fordelaktige forholdet mellom postfenomenologi og omsluttende VR og illustrerer hvordan postfenomenologiske undersøkelser av omsluttende VR-mediering kan gjennomføres. Gjennom avhandlingen argumenteres det for at forskere kan få en mer helhetlig forståelse av hvordan VR medierer brukeropplevelse ved å se på hvordan brukeropplevelsen i omsluttende VR medieres i de konstituerte bruker-miljø-relasjonene. Bidraget til denne avhandlingen fungerer som en foreløpig undersøkelse av hvordan postfenomenologi kan brukes fruktbart innen HCI for å forstå og spørre om brukeropplevelsen i omsluttende VR og relasjonene som omsluttende VR gir opphav til.In HCI, interaction is traditionally understood as something that occurs between the pre-given entities of a human user and a technological object. The technology of Immersive Virtual Reality (VR), in particular, forces us to reconsider these presuppositions, as the human user and the virtual environment mutually shape each other in the relations constituted between them. Postphenomenology seems to be a promising candidate to account for the complexities of VR mediation as it takes a more holistic view, attending to how technologies mediate human beings' lifeworlds. As virtual environments are not just tools we interact with or use, but environments in which we exist and through which we are shaped, postphenomenology seems to offer a promising perspective for furthering our understanding of how VR takes part in altering our experience of who we are in relation to our worlds. This doctoral dissertation presents an inquiry into how postphenomenology can be constructively used to gain a qualitative understanding of user experience in Immersive VR. The dissertation presents theoretical, methodical and empirical contributions. Theoretically, the human-technology relation that VR constitute is introduced as user-environment relations. Through an analysis of the human-technology relation that VR constitutes, it is demonstrated how researchers can benefit from a postphenomenological understanding of VR as well as how VR prompts a reconsideration of traditional postphenomenological categories of human-technology relations. Methodically, it proposes the VR Go-along method as an approach to qualitatively assessing the user experience as mediated in the constituted user-environment relations. Empirically, this dissertation presents a qualitative and explorative in-the-wild study of Immersive VR use over two months, where the VR Go-along is utilised to inquire into the participants' user experience as mediated in the constituted user-environment relations. This dissertation serves as a reflexive account of the author's inquiry into the use of postphenomenology to provide an understanding of Immersive VR mediation. It demonstrates the mutually beneficial relationship between postphenomenology and Immersive VR and illustrates how postphenomenological inquiries into Immersive VR mediation can be conducted. Throughout the dissertation, it is argued that researchers can gain a more holistic understanding of how VR mediates user experience by attending to how the user experience in Immersive VR is mediated in the constituted user-environment relations. The contribution of this dissertation serves as a preliminary inquiry into how postphenomenology can be fruitfully employed in HCI to understand and inquire into the user experience in Immersive VR and the relations to which it gives rise.Doktorgradsavhandlin