Testing in Translation: Conducting Usability Studies With Transnational Users

What do we mean by usability in everyday life? For us, everyday life implies the series of choices and decisions that happen each day as people are trying to get things done. These things are often taken for granted, they might seem mundane, they may be overlooked. Usability inhabits everyday life in the documents used by a Vietnamese mother of two young children, having recently moved to the United States, and navigating the healthcare system in a new country for the first time. Usability shows up again as a Chinese couple considers whether or not to move out of their father’s home in a Seattle neighborhood, but wonder how it might impact the family’s ability to afford health insurance

Community-Based User Experience: Evaluating the Usability of Health Insurance Information With Immigrant Patients

User experience (UX), a common practice in corporate settings, is new for many nonprofit organizations. This case study details a community-based research project between nonprofit staff at a community health center and UX professionals to improve the design and usability of a document designed to help immigrant patients sign up for health insurance. UX professionals may need to adapt and be flexible with their efforts, but can offer valuable skills to community partners. Research questions: (1) What are the information needs and barriers faced by immigrant populations signing up for health insurance? (2) How does a usability study, adapted to meet the needs of immigrant populations, inform the design of a supplemental guidebook about health insurance? (3) What are the challenges and opportunities when engaging in community-based UX research projects? Situating the case: Other community-based research projects in technical communication and UX point to the need for a clear conceptualization of participation, a strong partnership with nonprofits, and the need to develop meaningful and actionable insights. Furthermore, when conducting studies with immigrant populations, the role of the translator on the research team is crucial. Methodology: As a community-based research project focused on the collaborative generation of practical knowledge, we conducted a usability study with 12 participants in two language groups, Chinese and Vietnamese, to evaluate the design and usability of a guidebook designed to provide guidance about enrolling in a health insurance plan. Data were analyzed to identify usability concerns and used to inform a second iteration of the guidebook. About the case: Immigrant populations struggle to sign up for health insurance for a variety of reasons, including limited English and health insurance literacy. As a result, a nonprofit community health center developed a guidebook to support immigrant populations. Version 1 of this guidebook was evaluat- d in a usability study, with results showing that users struggled to correctly choose a plan, determine their eligibility, and interpret abstract examples. As a result, Version 2 was designed to support the in-person experience, reduce visual complexity, and support patients\u27 key questions. Conclusions: Community-based UX collaborations can amplify the expertise of UX and nonprofit professionals. However, UX methods may need to be adapted in community-based projects to better incorporate local knowledge and needs

Expert Yet Vulnerable: Understanding the Needs of Transit Dependent Riders to Inform Policy and Design

Transportation is a crucial resource that links people to jobs, social networks, community and services. The transit dependent -- those who do not own private vehicles -- occupy a unique position. They are expert in their knowledge of public transportation while vulnerable to the failures and limitations of transit. This paper presents the results of a study that is aimed at understanding the lived experience of transit dependent riders. Using a framework of structuration theory as an analytic lens, we provide a thematic analysis of qualitative data including interviews with socially connected groups of people and video diaries. The results demonstrate the expertise that transit dependent riders have about transit and its policies and how they deploy that expertise in productive and cunning ways to make the system work for them. The analysis of this data resulted in three categories of agency to consider when designing for vulnerable populations: resourcefulness, reciprocity and powerlessness. The paper concludes by advocating for a human-centered approach to designing systems in community informatics and offers a set of guiding questions for designers of information and communication technologies (ICTs) to consider, especially with regards to vulnerable populations

Expert yet vulnerable: Understanding the needs of transit dependent riders to inform policy and design

Transportation is a crucial resource that links people to jobs, social networks, community and services. The transit dependent -- those who do not own private vehicles -- occupy a unique position. They are expert in their knowledge of public transportation while vulnerable to the failures and limitations of transit. This paper presents the results of a study that is aimed at understanding the lived experience of transit dependent riders. Using a framework of structuration theory as an analytic lens, we provide a thematic analysis of qualitative data including interviews with socially connected groups of people and video diaries. The results demonstrate the expertise that transit dependent riders have about transit and its policies and how they deploy that expertise in productive and cunning ways to make the system work for them. The analysis of this data resulted in three categories of agency to consider when designing for vulnerable populations: resourcefulness, reciprocity and powerlessness. The paper concludes by advocating for a human-centered approach to designing systems in community informatics and offers a set of guiding questions for designers of information and communication technologies (ICTs) to consider, especially with regards to vulnerable populations

Practice of ALARA in the pediatric interventional suite

As interventional procedures have become progressively more sophisticated and lengthy, the potential for high patient radiation dose has increased. Staff exposure arises from patient scatter, so steps to minimize patient dose will in turn reduce operator and staff dose. The practice of ALARA in an interventional radiology (IR) suite, therefore, requires careful attention to technical detail in order to reduce patient dose. The choice of imaging modality should minimize radiation when and where possible. In this paper practical steps are outlined to reduce patient dose. Further details are included that specifically reduce operator exposure. Challenges unique to pediatric intervention are reviewed. Reference is made to experience from modern pediatric interventional suites. Given the potential for high exposures, the practice of ALARA is a team responsibility. Various measures are outlined for consideration when implementing a quality assurance (QA) program for an IR service

Gastric variceal bleeding caused by an intrahepatic arterioportal fistula that formed after liver biopsy: a case report and review of the literature

An intrahepatic arterioportal fistula is a rare cause of portal hypertension and variceal bleeding. We report on a patient with an intrahepatic arterioportal fistula following liver biopsy who was successfully treated by hepatectomy after unsuccessful arterial embolization. We also review the literature on symptomatic intrahepatic arterioportal fistulas after liver biopsy. A 48-year-old male with bleeding gastric varices and hepatitis B virus-associated liver cirrhosis was transferred to our hospital; this patient previously underwent percutaneous liver biopsies 3 and 6 years ago. Abdominal examination revealed a bruit over the liver, tenderness in the right upper quadrant, and splenomegaly. Ultrasonographic examination, computed tomography, and angiography confirmed an arterioportal fistula between the right hepatic artery and the right portal vein with portal hypertension. After admission, the patient suffered a large hematemesis and developed shock. He was treated with emergency transarterial embolization using microcoils. Since some collateral vessels bypassed the obstructive coils and still fed the fistulous area, embolization was performed again. Despite the second embolization, the collateral vessels could not be completely controlled. Radical treatment involving resection of his right hepatic lobe was performed. For nearly 6 years postoperatively, this patient has had no further episodes of variceal bleeding

Shining a light on agency: Examining responses to resource constraints to uncover opportunities for design

People employ creative ways to overcome the challenges of daily life. The construct of agency is a productive area of inquiry when considering how people respond to these challenges. Exploring moments of agency provides an embodied understanding of people’s motivations and helps reveal the structural and technological barriers they encounter every day. We propose a framework of agency and three corresponding categories: resourcefulness, resilience, and powerlessness. This framework was developed while working with data from two design ethnographies: one in Bishkek, Kyrgyzstan and the other in Seattle, Washington

Designing and Evaluating the Mobile Experience Through Iterative Field Studies

This experience report describes using iterative field studies to design and evaluate the mobile experience of soundtransit.org. One study aimed to evaluate the design of paper prototypes early in the design process and another study was conducted to test the implementation of an interactive prototype. In this report, we share our experience to provide readers with lessons that can be applied to conducting their own mobile field studies. Finally, we describe some of the broader impacts that have resulted from this work