Systematic review of smartphone-based passive sensing for health and wellbeing

OBJECTIVE: To review published empirical literature on the use of smartphone-based passive sensing for health and wellbeing. MATERIAL AND METHODS: A systematic review of the English language literature was performed following PRISMA guidelines. Papers indexed in computing, technology, and medical databases were included if they were empirical, focused on health and/or wellbeing, involved the collection of data via smartphones, and described the utilized technology as passive or requiring minimal user interaction. RESULTS: Thirty-five papers were included in the review. Studies were performed around the world, with samples of up to 171 (median n = 15) representing individuals with bipolar disorder, schizophrenia, depression, older adults, and the general population. The majority of studies used the Android operating system and an array of smartphone sensors, most frequently capturing accelerometry, location, audio, and usage data. Captured data were usually sent to a remote server for processing but were shared with participants in only 40% of studies. Reported benefits of passive sensing included accurately detecting changes in status, behavior change through feedback, and increased accountability in participants. Studies reported facing technical, methodological, and privacy challenges. DISCUSSION: Studies in the nascent area of smartphone-based passive sensing for health and wellbeing demonstrate promise and invite continued research and investment. Existing studies suffer from weaknesses in research design, lack of feedback and clinical integration, and inadequate attention to privacy issues. Key recommendations relate to developing passive sensing strategies matching the problem at hand, using personalized interventions, and addressing methodological and privacy challenges. CONCLUSION: As evolving passive sensing technology presents new possibilities for health and wellbeing, additional research must address methodological, clinical integration, and privacy issues. Doing so depends on interdisciplinary collaboration between informatics and clinical experts

Instagram Power Users and their Effect on Social Movements

poster abstractSocial movements, complex systems of informal but organized relationships that pursue a shared goal of social change, have existed for decades. Since the advent of the Internet, technology and social media have increasingly played a role in social movement development. Recent research indicates that “power users” influential users with higher audience engagement are an important faction of users on social media. Power users have been identified on Facebook and Twitter, but not on Instagram. Instagram is a particularly interesting platform to study as it differs from Facebook and Twitter in that it’s imagebased, can be anonymous, and likely appeals to a different demographic of users than those who primarily use Facebook or Twitter. We hypothesize that power users will be an identifiable segment on Instagram and that they can and do play a vital role in the success of social movement mobilization. This research seeks to build on reallife social movements, social movement theory, and social media research to gain a deeper understanding of online activism and the role of the power user. Due to the prominence of images on this social network, examining the role of Instagram in social movements will likely speak to the role of emotion in social movements. This lack of such discussion is a major critique of social movement theory. This study aims to first identify and define the "power users" on Instagram posting about social movements, then to understand the attitude and behaviors of these "power users" and how it differs from average users. We will do this by identifying patterns in Instagram content about social movements, "power" and "average" user survey results. We will also examine the posts through the analysis of images, captions, number of likes and other metrics. The results will inform subsequent research about Instagram that has been scarce

Advocacy in Mental Health Social Interactions on Public Social Media

Indiana University-Purdue University Indianapolis (IUPUI)Health advocacy is a social phenomenon in which individuals and collectives attempt to raise awareness and change opinions and policies about health-related causes. Mental health advocacy is health advocacy to advance treatment, rights, and recognition of people living with a mental health condition. The Internet is reshaping how mental health advocacy is performed on a global scale, by facilitating and broadening the reach of advocacy activities, but also giving more room for opposing mental health advocacy. Another factor contributing to mental health advocacy lies in the cultural underpinnings of mental health in different societies; East Asian countries like South Korea have higher stigma attached to mental health compared to Western countries like the US. This study examines interactions about schizophrenia, a specific mental health diagnosis, on public social media (Facebook, Instagram, and Twitter) in two different languages, English and Korean, to determine how mental health advocacy and its opposition are expressed on social media. After delineation of a set of keywords for retrieval of content about schizophrenia, three months’ worth of social media posts were collected; a subset of these posts was then analyzed qualitatively using constant comparing with a proposed model describing online mental heath advocacy based on existing literature. Various expressions of light mental health advocacy, such as sharing facts about schizophrenia, and strong advocacy, showcasing offline engagement, were found in English posts; many of these expressions were however absent from the analyzed Korean posts that heavily featured jokes, insults, and criticisms. These findings were used to train machine learning classifiers to detect advocacy and counter-advocacy. The classifiers confirmed the predominance of counter-advocacy in Korean posts compared to important advocacy prevalence in English posts. These findings informed culturally sensitive recommendations for social media uses by mental health advocates and implications for international social media studies in human-computer interaction

Think-aloud evaluation of mobile information technology for older adults with chronic heart failure

poster abstractChronic heart failure (CHF) is a complex disease that often requires continuous medical attention.CHF is globally prevalent, especially among older adults. With more healthcare taking place in homes, controlling and managing the symptoms and progression of CHF depends critically on self-care behaviors such as medication taking and nutrition management by elderly patients. Based on Human Factors analysis of data gathered from interviews, surveys and in-home observations, our team designed Engage, a mobile, health information technology (HIT) tool customized for use by older adults with CHF. Engage is primarily envisioned to provide support for self-care and includes functionality designed and evaluated such as the: (1) logging daily values; (2) setting and monitoring daily self-management goals related to food intake and physical activities; (3) learning more information on self-care topics such as nutrition; and (4) visualizing collected information. Our team conducted an initial exploratory evaluation of Engage used think-aloud testing (in a controlled lab setting) with 5 older patients with CHF. Evaluation sessions involved patients using Engage’s functionalities based on hypothetical scenarios. Patients completed tasks guided by scripted instructions with each evaluation session being video recorded to capture user expectations and Engage’s usability. Results revealed design recommendations that will be tested in subsequent iterations of Engage. Our initial evaluation also pointed to the patients’ perceived benefits and barriers in using Engage over a 30-day period

Computational Exploration of Gerontology-Related Topics Shared on Social Media Platform Twitter

Twitter, a popular Internet social media platform, has become a significant medium for sharing information and ideas about various topics, including aging and older adults. While studies have been conducted to examine stigma or perception about specific diseases such as Alzheimer’s disease and seizure on Twitter, there has been little effort to identify general themes of Twitter posts related to aging and older adults. This exploratory study attempts to answer this need by conducting a topic analysis of posts shared on Twitter posts about aging and older adults in English. We collected 328,568 English posts from Twitter posted between 07/01/18 and 07/31/18 using 19 English keywords referring to older adults. We analyzed this whole dataset as well as a subset of posts explicitly including aging-related hashtags, such as #olderadults. We used data mining methods (including Latent Dirichlet Allocation) in computing environment MATLAB to discover topics emerging from these two sets. Among posts with explicit aging-related hashtags, the most recurrent topics were family (relation with children and grandchildren, commemoration), community (resources, looking after older adults), health (disease-specific, public health, home care, formal and informal caregivers), politics and policies (insurance/pension, new laws), and news involving older adults (e.g., crimes on/by older adults). The analysis of the larger dataset additionally uncovered posts promoting pornography featuring older females and posts sharing general Internet content featuring older adults (e.g., YouTube videos). We also share the methodological challenges we encountered and practical recommendations for gerontological researchers interested in using social media data to inform new research

User-Centered Evaluations with Older Adults: Testing the Usability of a Mobile Health System for Heart Failure Self-Management

Many older adults living with heart failure struggle to follow recommended self-management routines. To help older adults with heart failure more effectively and efficiently self-manage their disease, we developed Engage, a mobile health application promoting the performance, logging, and sharing of routine self-management behaviors. This paper reports on the usability evaluation of the Engage system with 15 older adults with heart failure and informal caregivers. In two phases, participants used Engage during a task-based usability test (n=5) and a scenario-based usability test (n=10). Usability and performance data were assessed through video-recorded observation and the administration of the system usability scale (SUS) and NASA Task Load Index (TLX). We found that task-based testing was useful in quickly identifying problems within our application, but scenario-based testing elicited more valuable feedback from older adults. A comparison of the different evaluation methods used and the discussion of the challenges encountered provide multiple implications for the practice of usability testing of mobile health products with older adults

How Image-Based Social Media Websites Support Social Movements

The Internet has disrupted the traditional progression of social movements. We explore common characteristics of image-based activism on Instagram by qualitatively analyzing 300 Instagram posts from three social movements: Black Lives Matter, the battle against defunding Planned Parenthood, and the backlash against the Indiana Religious Freedom Restoration Act. We found that common types of images emerged among the three social movements, indicating a possible underlying pattern in social movement content posted on Instagram. Users also engage in workarounds to leverage Instagram toward a collective goal, going beyond the features offered by the platform to communicate their message. These findings have implications for future work studying social movement theories online

Impact of the capping layers on lateral confinement in InAs/InP quantum dots for 1.55 um laser applications srudied by magneto-photoluminescence.

We have used magnetophotoluminescence to study the impact of different capping layer material combinations (InP, GaInAsP quaternary alloy, or both InP and quaternary alloy) on lateral confinement in InAs/InP quantum dots (QDs) grown on (311)B orientated substrates. Exciton effective masses, Bohr radii, and binding energies are measured for these samples. Conclusions regarding the strength of the lateral confinement in the different samples are supported by photoluminescence at high excitation power. Contrary to theoretical predictions, InAs QDs in quaternary alloy are found to have better confinement properties than InAs/InP QDs. This is attributed to a lack of lateral intermixing with the quaternary alloy, which is present when InP is used to (partially) cap the dots. The implications of the results for reducing the temperature sensitivity of QD lasers are discussed. ©2005 American Institute of Physic

Patient-centered Design Grounded in User and Clinical Realities: Towards Valid Digital Health

Valid design of patient-centered digital health or health information technology (IT) systems is based on a thorough and accurate understanding of both “user reality” and “clinical reality.” Type 1 Design Error (User-Reality Error) occurs when designers do not accommodate user characteristics, tasks, context of use, needs, or preferences. Type 2 Design Error (Clinical-Reality Error) occurs when designers do not accommodate the clinical reality, including biomedical knowledge, clinical workflows, and organizational requirements. Both types of errors can invalidate the design, leading to products being rejected by patient end-users or their healthcare delivery systems, product non-use or inappropriate use, and risk of harm. This paper describes our attempts to achieve valid health IT design and avoid the two design errors. We performed iterative, patient-centered design to prototype a mobile application, Power to the Patient (P2P), supporting heart failure self-care management. Our multidisciplinary team of human factors, cardiology, and design experts developed and iteratively refined requirements based on data collection, review, and testing with patient research participants, a patient advisory board, a clinical advisory board, and experts on the team. We describe our process and reflect on working with multiple stakeholders toward the goal of valid health IT design

Naturalistic Decision Making in Everyday Self-care Among Older Adults With Heart Failure

BACKGROUND: Every day, older adults living with heart failure make decisions regarding their health that may ultimately affect their disease trajectory. Experts describe these decisions as instances of naturalistic decision making influenced by the surrounding social and physical environment and involving shifting goals, high stakes, and the involvement of others. OBJECTIVE: This study applied a naturalistic decision-making approach to better understand everyday decision making by older adults with heart failure. METHODS: We present a cross-sectional qualitative field research study using a naturalistic decision-making conceptual model and critical incident technique to study health-related decision making. The study recruited 24 older adults with heart failure and 14 of their accompanying support persons from an ambulatory cardiology center. Critical incident interviews were performed and qualitatively analyzed to understand in depth how individuals made everyday health-related decisions. RESULTS: White, male (66.7%), older adults' decision making accorded with a preliminary conceptual model of naturalistic decision making occurring in phases of monitoring, interpreting, and acting, both independently and in sequence, for various decisions. Analyses also uncovered that there are barriers and strategies affecting the performance of these phases, other actors can play important roles, and health decisions are made in the context of personal priorities, values, and emotions. CONCLUSIONS: Study findings lead to an expanded conceptual model of naturalistic decision making by older adults with heart failure. In turn, the model bears implications for future research and the design of interventions grounded in the realities of everyday decision making