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

Participants Representing United States Racially and Ethnically Minoritized Communities in Research: How Can Mobile Health Technology Reduce Barriers to Enrollment in Cancer Clinical Trials?

The use of mobile health technology is increasingly being explored to improve the study design and the recruitment and retention of participants from underrepresented racial and ethnic groups in research in the United States. However, there is a paucity of studies examining whether such technology improves the enrollment of participants representing racially and/or ethnically minoritized groups in industry sponsored clinical trials across any therapeutic area, including oncology. Therefore, this study sought to determine how contemporary, mobile health technology is used to support participant recruitment for oncology clinical research studies sponsored by industry organizations and what effects its use has on clinical trial participants and potential participants representing U.S. racially and ethnically minoritized communities. A mixed-methods approach was taken to address the study’s research questions using data collected from experienced clinical research professionals, who described their experiences with mobile health technology as part of clinical trial design and execution across therapeutic areas, both generally and specifically to drive recruitment of participants representing racially and ethnically minoritized communities, including decision-making, challenges, and opportunities. Quantitative data was collected via an online survey of a total of 66 respondents, which was used to generate frequencies and key themes of responses. Qualitative data was also collected through 10, semi-structured interviews conducted with key informants and analyzed to highlight themes of emphasis. The results of this study suggest that implementing mobile health technology thoughtfully in clinical trial design and operational strategy shows promise in its ability to address barriers to enrollment and to improve the clinical trial experience for participants from U.S. racially and ethnically minoritized communities across therapeutic areas, including oncology. Moreover, they indicate that mobile health technology has the potential to evolve the manner and types of data collection conducted by industry sponsors of clinical research, which, in turn, may improve operational efficiency, the quality and breadth of safety and efficacy data collected, and, more broadly, contribute to greater health equity.Doctor of Public Healt

Sources of On-the-job Burnout and Protective Factors and Protective Reactions: The Voices of the Domestic Violence Enhanced Response Team (DVERT) Advocates

By Maria Racadio, Psychology; Batya Y. Rubenstein, University of Cincinnati; Michelle L. Wojcik, University of Cincinnati Advisor: Bonnie Fisher Abstract: Burnout is a psychological phenomenon that develops because of repeated exposure to work-related stressors. Previous research has well-documented that emotional exhaustion, reduced personal efficacy, and cynicism are among burnout\u27s negative consequences. Individuals in social service professions are at high risk for burnout, which can lead to decreased productivity and effectiveness at work, as well as mental and emotional strain. To examine on-the-job burnout experiences, interviews were conducted with 9 advocates from the Domestic Violence Enhanced Response Team (DVERT), a first-of-its kind collaboration between Women Helping Women (WHW), a Cincinnati-based non-profit organization, and Cincinnati Police Department. Thematic analyses from the transcribed interviews identified sources and indicators of burnout, as well as individual and organizational protective factors. Advocates also provided suggestions for addressing burnout and work-related stress. Drawing from our findings, recommendations for WHW to improve advocate work satisfaction and optimize their ability to serve survivors of domestic violence are presented

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

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

Catheter-related bloodstream infections in neonatal intensive care units

Central venous catheters (CVCs) are regularly used in intensive care units, and catheter-related bloodstream infection (CRBSI) remains a leading cause of healthcare-associated infections, particularly in preterm infants. Increased survival rate of extremely-low-birth-weight infants can be partly attributed to routine practice of CVC placement. The most common types of CVCs used in neonatal intensive care units (NICUs) include umbilical venous catheters, peripherally inserted central catheters, and tunneled catheters. CRBSI is defined as a laboratory-confirmed bloodstream infection (BSI) with either a positive catheter tip culture or a positive blood culture drawn from the CVC. BSIs most frequently result from pathogens such as gram-positive cocci, coagulase-negative staphylococci, and sometimes gram-negative organisms. CRBSIs are usually associated with several risk factors, including prolonged catheter placement, femoral access, low birth weight, and young gestational age. Most NICUs have a strategy for catheter insertion and maintenance designed to decrease CRBSIs. Specific interventions slightly differ between NICUs, particularly with regard to the types of disinfectants used for hand hygiene and appropriate skin care for the infant. In conclusion, infection rates can be reduced by the application of strict protocols for the placement and maintenance of CVCs and the education of NICU physicians and nurses

Fatores associados à infecção pelo uso do cateter central de inserção periférica em Unidade de Terapia Intensiva Neonatal

Estudo epidemiológico, longitudinal e analítico, desenvolvido em um hospital de Minas Gerais, com o objetivo de analisar os fatores associados à infecção pelo uso do cateter central de inserção periférica em recém-nascidos internados em unidade de terapia intensiva. A coleta dos dados foi realizada por meio de uma ficha estruturada, preenchida pelos profissionais e verificada pelos pesquisadores. Foram estudados 291 cateteres inseridos em 233 recém-nascidos. Os fatores associados à retirada por suspeita de infecção foram: prematuridade, peso ao nascer até 1.500 gramas, cateter de poliuretano, localização não centralizada do cateter e tempo de uso superior a 30 dias. Após ajuste multivariado, permaneceram independentemente associados: peso inferior a 2.500 gramas na inserção, reparo e tempo de uso do cateter. Conclui-se que fatores relacionados à prática dos profissionais contribuíram para a retirada dos cateteres, sinalizando para a necessidade de intervenções que melhorem a segurança e a eficácia em seu uso