Developing ICT software that is useful and usable in a rural context poses many problems. One of the major difficulties is understanding the real needs of the end users and the constraints imposed by the rural environment. Many techniques exist in the field of Human Computer Interaction (HCI) that attempt to understand the needs of the end users but many are not useful in a rural context, or at least not when applied in a standard way. This paper presents some existing HCI research techniques that are applicable in a rural context and shows how they fit into the bridges.org ‘Real Access’ framework

Marsden, Dr Gary

Maunder, Mr AJ

Tucker, Mr WD

UCT Computer Science Research Document Archive

1Evaluating the relevance of the ‘Real Access’ criteria as a framework for rural HCI researchA. Maunder, G. MarsdenComputer Science DepartmentUniversity of Cape TownPrivate Bag Rondebosch 7701South AfricaW.D. TuckerComputer Science Department University of the Western CapePrivate Bag X17 Bellville 7535 South Africa+27 650 6300{amaunder, gaz}@cs.uct.ac.za+27 959 3010btucker@uwc.ac.zaABSTRACTDeveloping ICT software that is useful and usable in a rural context poses many problems. One of the major difficulties is  understanding the  real  needs of  the end users  and the constraints  imposed  by  the  rural  environment.  Many techniques exist in the field of Human Computer Interaction (HCI) that attempt to understand the needs of the end users but many are not useful in a rural context, or at least not when applied in a standard way. This paper presents some existing HCI research techniques that  are applicable  in  a rural context and shows how they fit  into the bridges.org ‘Real Access’ framework.      KeywordsUsability, Human Computer Interaction, rural development, Real Access criteria, ethnography, user centred designINTRODUCTIONHuman  Computer  Interaction  (HCI)  researchers  have developed  many  techniques  that  allow  one  to  produce software that is useful and usable by the end users. Many of these techniques originated from usability experiments that were conducted in developed world environments and may not be relevant in the developing world. bridges.org [2] feel that  solutions  that  have been successful  in the developed world  must  be  re-evaluated  before  being  deployed  in  a developing  world  context.  When  considering  a  heuristic (expert)  evaluation  [1],  it  is  clear  that  a  similar  re-evaluation will be necessary before this technique can be applied  to  a  rural  development  project.  A user  interface based purely on existing heuristics may not be successful when deployed in a rural setting because the heuristics do not incorporate any data relating to the end users and their environment.  Even  a  user  centred  technique,  such  as Participatory Design (PD) [6], must be re-evaluated before initiating  rural  PD  sessions.  Such  PD  sessions  may fail when faced with language and cultural differences that may exist between the researchers and the end users [1]. In this paper we discuss techniques that are more suited to  rural HCI research and show how the ‘Real Access’ criteria [2] provides  a  useful  framework for  evaluating and applying existing HCI research techniques.BACKGROUNDUser centred designUser centred design attempts to understand as much about the  user  and  the  tasks  that  they  need  to  perform.  This information  must  then  be  analysed  and  reflected  in  the design  of  the  system or  interface  [1].  Understanding  the needs  of  the  end  user  can  be  achieved  by  triangulating multiple  data-gathering  techniques.  These  include questionnaires, interviews, focus groups and workshops and finally, naturalistic observations.    Ethnographic methodsEthnography is  a naturalistic observational  technique that originated  from  social  science  research.  Ethnographic techniques  include  some  attractive  features  that  enable researchers to gather vast amounts of data about the user and  his  environment  [1].  It  has  also  proven  to  be particularly useful in rural development projects such as the MuTI  project  [3,4]  for  various  reasons.  Firstly, ethnographic studies tend to run for a longer period of time thus  enabling  relationships  to  develop  between the  users and the researchers [1]. Ultimately this will lead to a user who is less likely to feel intimidated even though they might not be computer literate. Dray and Siegel [5] comment on how  ethnographic  techniques  can  provide  valuable contextual  information,  e.g.  language  and  culture. Researchers  can  then  also  become aware  of  more  subtle issues  that  exist  within  their  work  environment,  thereby informing researchers of factors that are not evident at first glance. A contextual inquiryA contextual  inquiry is an ethnographic technique that  is based  on  an  apprenticeship  model  where  the  researcher works as an apprentice to the user [1]. This technique was not  utilised  as  a  data  capturing  technique  because  of  its LEAVE BLANK THE LAST 2.5 cm (1”) OF THE LEFT COLUMN ON THE FIRST PAGE FOR THE COPYRIGHT NOTICE.2highly focussed approach (in  terms of  time span and the intrusive  nature  of  an inquiry)  [1].  The  resulting models produced by a contextual inquiry may prove to be useful but need to be adapted for use with standard ethnographical techniques.  Examples  include  communication  and  work flow models.  The ‘Real Access’ Criteriabridges.org  [2]  has  published  a  set  of  guidelines  for Information  and  Communication  Technologies  (ICTs) destined  for  deployment  in  a  developing  world  context. These guidelines, called the ‘Real Access’ criteria, highlight what  they  believe  are  the  key  issues  that  need  to  be addressed if such ICT projects are to be successful. One of their firm beliefs is that developed world solutions may not be applicable,  or  even deployable,  in a developing world environment as they do not address contextual issues. For example, if we consider that a village in the rural Eastern Cape (South Africa) has limited Public Switched Telephone Network (PSTN) and cellular connectivity, then any web-based  solution  would not  be  viable,  even  though such a service may produce  positive results  when deployed in a developed world context. Broadly speaking the Real Access criteria [2] are arranged into 12 focus areas:• Physical access to ICT• Appropriate ICT• Human capacity and training• Integration into daily life• Locally relevant content and services• Trust in ICT• Socio-cultural factors• Macro economic environment• Public support and political will• Legal and regulatory framework• Affordability• Sustainability & the local economic environmentTHE REAL ACCESS HCI FRAMEWORKThe requirements driving the MuTI rural tele-health system [3,4] were evaluated through the lens of the Real Access guidelines [2], listed above. Initially, the appropriateness of ICT technologies such as VoIP and the legal and regulatory framework surrounding their use were topics of focus. We now wish  to  evaluate  the  relevance  of  the  Real  Access criteria as a framework for the design and evaluation of the MuTI  user  interface  and  comment  on  its  usefulness  for future rural HCI studies. This paper focuses on a subset of the  Real  Access  criteria,  namely  trust,  integration  and training. These have been chosen due to their relevance to the design and evaluation of  user  interfaces.  For each of these criteria, we consider one or more heuristics from HCI literature [1],  provide an example from the MuTI project and  then  evaluate  how the  heuristic  relates  to  the  Real Access criterion. Integration bridges.org  [2]  specifies  that  ICT  needs  to  be  carefully integrated into the daily lives of the end users. One Real Access criterion states that “ICT use must be integrated into people’s daily routine without being an additional burden.” bridges.org [2] warns ICT researchers and developers about producing  a  system that  is,  in  fact,  a  burden  to  the  end users.User-centred  approaches  such  as  ethnography  can  be guided by this criterion. The ethnographic data collected for the MuTI project was analysed, and enabled production of communication  and  work  flow  models.  These  models highlight work flows and communication paths that already exist,  thus  ensuring  that  the  ICT  will  be  applied  to  a communication pathway or work flow that is already part of the user’s daily routine. As an example, the MuTI prototype attempted to support remote consultation sessions between the  clinic  nurses  and  the  hospital  doctors.  After  the construction of a communication model, it was noted that the  consultation  communication  between  the  hospital doctors and nurses were almost non-existent.  Assessment Nursing Sister  Health Care Worker  Consultation Nursing Sister   Hospital assessment nurse  Mobile doctor  Hospital doctor  Lab technician  Speech translation Sample request App. details Request private consultation Request next patient Patient queue update Patient referral Request sample analysis Send clinic results --- Macro delays Request an appointment Patient information Appointment admin  Figure 1: MuTI communication modelThis  finding  was  confirmed  in  a  user  interview session when the  nurse  stated  that  she  rarely  needed  to  ask  the doctors  for  assistance,  despite  the existence of  the MuTI system.  Once  an  integrated  communication  pathway  or work flow has  been identified,  the focus can then safely 3shift to the design of the user interface to ensure integration at a lower level. Visibility of system status – The users are always aware of the current system status via appropriate feedback within a reasonable time [1]. The recipient (target) of a new MuTI message was not made sufficiently visible. The result was that the users had to search through various folders on the interface to find the new message. Such an interface design flaw can dramatically increase user frustration levels and may cause the system to become inefficient to use. This is particularly  relevant  when  considering  that  effective integration  of  the  system  into  a  user’s  busy  work  flow requires  that  the total  time required to  use the system is minimal. It  is  clear  that  existing HCI research techniques,  such as ethnographic field studies, can be integrated into the Real Access framework. The construction of communication and work  flow  models  (from  contextual  techniques)  ensured that the ICT was applied to an existing communication path or  work  flow,  and  that  high  level  integration  occurred. Researchers can then be confident that integration efforts at a  lower,  interface  level  will  not  be  nullified  by  a  false integration at a higher level.     TrustThe bridges.org [2] description of trust states that “People must have confidence in and understand the implications of the ICT they use.” Confidence or trust in a broader sense could  be  established  by  ensuring  that  the  users  and community  (the  people)  understand  the  purpose  of  the technology  and  that  its  benefits  are  advertised.  In  an example of trust relating to the MuTI system [3,4], ad-hoc conversations with the nurses revealed  that  they believed the system allowed the hospital  doctors  and managers  to monitor their activities. In effect, the nurses did not trust the system. If we expand on the notion of trust we see that it also relates to whether the users feel confident enough to use  the  system  or  if  they  feel  so  intimidated  by  the technology that they will not even make an attempt without expert guidance. With  the  Real  Access  notion  of  trust  in  mind,  we  now attempt to highlight how existing usability design principles can be used to establish trust  in the user  interface.  Each description  contains  a  definition  of  the  principle  and  an example where the principle impacted user trust. Feedback  –  The  interface  provides  the  user  with information about an action that  has been performed and what the system status is after the completion of that action [1].  A faulty MuTI presence indicator led the nurses into believing that the hospital was frequently offline. This error resulted in confusion such that the nurses were discouraged from using the real-time communication features. Accurate feedback can therefore be seen as an essential component in creating trust or confidence in a technology. Error prevention – The interface should attempt to prevent errors from occurring in the first place [1]. A clinic nurse accidentally deleted the ‘hospital’ contact from the MuTI address list. This was problematic in that there was no way for the nurses to recreate it without the IP address of the hospital machine. The system was rendered useless until a technical support member was able to re-create the contact. Trust  and  confidence  in  the  system  was  most  certainly jeopardised as the nurses were hesitant or nervous to use the system in fear of ‘breaking’ it.  MuTI training session observations  have  shown that  the  nurses  lack confidence when completing tasks and frequently seek assurance from the trainer that they are indeed performing a task correctly. Critical  errors  must be prevented if  the users are to gain confidence when using the system.   Error recovery – The interface must be able to describe the error in such a way that the user understands it and must present  the  user  with  ways  of  recovering  from  it  [1]. Referring  to  the  point  on  error  prevention,  it  was  not possible  for  the  nurses  to  recover  from a  deletion  of  a contact. No undelete or roll-back features existed and thus rendered the system almost useless until a technical support member arrived. The ability to recover from critical errors will  surely  improve  user  confidence  in  the  system  and possibly lead to a user who is less intimidated to use the system without assistance. Human capacity and trainingLastly, an understanding of ICTs and an extensive training program are regarded as essential components for any ICT development project [2]. bridges.org [2] outline this criteria by stating, “People must understand the benefits of ICT and its potential uses and have the training and skills necessary to use the ICT effectively.”The  MuTI  [3,4]  training  sessions  provided  valuable usability  information  about  the  prototype  interface  and system.  It  is  important  to  note  that  the  initial  training sessions focussed on the effective use of ICT and basic ICT literacy before being exposed to the MuTI software.  The training  ensured  that  the  users  gained  the  required knowledge and  skills  that  would  enable  them to  use  the MuTI  system  effectively.  Follow  up  training  sessions focussed on the MuTI software system and again aimed at providing the users with an appropriate set of skills. The example below shows how the MuTI training sessions provided  valuable  usability  data  concerning  the  process complexity of the MuTI asynchronous messaging features.Process  complexity  -  The  feedback  from  the  training sessions  (trainer  and  user  comments)  revealed  that  the nurses required additional training to effectively utilise the MuTI asynchronous messaging features. It was noted that the total time taken to create an asynchronous message was significantly higher than the total time taken to establish any synchronous  form  of  communication.   Typically,  a synchronous session could be established with two clicks of 4the  mouse  whereas  the  asynchronous  message  took  the nurses 20 minutes or more to construct. After  analysing  the  resultant  usability  data,  it  was discovered  that  the  mental  model  associated  with  the asynchronous  messaging features  was in  fact  much more complex than the model associated with the synchronous messaging features.  This  finding provided an explanation for why the nurses required additional training.    The MuTI training program has shown that such programs are effective in gathering usability data. The Real Access recommendation  to  implement  an  extensive  training program resulted  in  valuable  usability  information  being obtained. CONCLUSIONSThe development of ICT software that is applicable to users in  a  rural  setting  requires  the  researchers  to  spend  time understanding the users  context,  ie.  the  language,  culture and environment. The Real Access [2] criteria provides a useful framework for incorporating existing HCI research techniques  such  as  ethnography,  contextual  inquiry, heuristics  and  usability  design  principles  into  a  rural development project.      Finally, it is was shown that an ICT training program, as prescribed by the Real Access criteria, is needed as a means to bridge the knowledge and skills gap that exists when a rural user is exposed to an ICT system for the first time. Extensive training programs can produce vital usability data that can be integrated into the design of future interfaces. Training will empower the user,  building confidence and trust in an ICT system. The end result is a user who can utilise  the  ICT  technology  effectively,  understands  its relevance and potential uses and ultimately will be able to provide useful usability feedback about the system without feeling intimidated.  ACKNOWLEDGMENTSThis  research  was supported  by  many organizations  and people: both fellow researchers and community members. Resources were provided by the NRF, the South African National  Research  Foundation  through  its  THRIP  and Focus  Areas  programmes,  Telkom,  Siemens  SA,  Cisco Systems SA,  IDRC of  Canada  and  SANPAD,  the  South Africa — Netherlands Research Programme on Alternatives in  Development.   The  CSIR  Information  and Communications Technology Section introduced us to the first  rural  tele-health  site  and  provided  the  WiFi infrastructure that we used there.   Murray Pearson of the University of  Waikato helped  design and build  the WiFi network at the current site. The Eastern Cape-based NGO Transcape helped with training and technical support in the field, and offered invaluable feedback on the interface. The NGO bridges.org acted as a consultant on the applicability of the work.  REFERENCES1.J.  Preece,  H.  Sharp  and Y.  Rogers.  Interaction design: Beyond  human  computer  interaction.  John  Wiley  and Sons, (2002).2.bridges.org,  “Spanning  the  Digital  Divide  – Understanding  and  tackling  issues”,  (2003),  Available: http://www.bridges.org.3.M.  Chetty,  W.D.  Tucker  and  E.H.  Blake.  Developing Locally Relevant Applications for Rural Areas: A South African Example.  Proc.  Annual  research conference of  the  South  African  Institute  of  Computer  Scientists  and  Information Technologists, (SAICSIT 2004), Cape Town, South Africa, pp. 234-239.4.X.  Vuza  and  W.D.  Tucker.  An IP  based  Multi-Modal Semi-Synchronous  Rural  Tele-health  Service:  Adding Video  Messaging  and  Conferencing  to  MuTI.  Proc.  South  African  Telecommunications  Networks  & Applications Conference, (SATNAC 2004), Stellenbosch, South Africa, pp. II-289-290.5.S. Dray and D.A. Siegel. Learning from Latin America: Methodological  Lessons from Emerging Markets.  Proc.  Contextual Invention (2003), Bangalore, India, pp.  9-18.6.M.J.  Muller,  J.L. Blomberg, K.A. Carter, E.A. Dykstra, K.H.  Madsen  and  J.  Greenbaum  (1991).  Participatory Design in Britain and North America: Responses to the Scandinavian Challenge. Proc. ACM SIGCHI Conference on  Human  Factors  in  Computing  Systems, (CHI  ‘91), New Orleans, Louisiana, pp. 389-392.7.S. Dray, D.A. Siegel and P. Kotze,  Indra’s Net: HCI in the developing world.  Interactions (2003), 10(2), pp. 28-37.8.S.  Dray,  “Designing  for  the  Rest  of  the  World:  A Consultants Observation”,  Interactions (1996),  3(2),  pp. 15-18.

Evaluating the relevance of the 'Real Access' criteria as a framework for rural HCI research

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Evaluating the relevance of the 'Real Access' criteria as a framework for rural HCI research

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