An Examination of Motivation in Physical Therapy Through the Lens of Self-Determination Theory: Implications for Game DesignWhile it is widely assumed that games can engage patients in therapy through their inherent 'motivational pull', relatively little attention has been paid to what HCI games research can learn from strategies employed by therapists. We address this gap by leveraging Self-Determination Theory (SDT) and its mini-theories Basic Psychological Needs Theory and Organismic Integration Theory as a theoretical lens on physical therapy for children and adolescents. Results from in-depth interviews with twelve therapists show that they carefully adjust sessions to allow patients to experience competence, making more comprehensive adjustments than currently offered by games. Additionally, we highlight how therapists leverage their relationship with patients to support motivation, but struggle to reconcile meaningful experiences of autonomy with therapeutic goals. On this basis, we reflect on implications for researchers and designers who create games for physical therapy, and the potential of SDT to provide a foundation for game design and therapeutic practice.2023MAMaria Aufheimer et al.KU LeuvenVibrotactile Feedback & Skin StimulationSerious & Functional GamesFitness Tracking & Physical Activity MonitoringCHI
Challenges and Opportunities for Interactive Technology to Support Parents of HIV-Positive Children in Ethiopia in the Disclosure ProcessFearing stigma, parents often hide their children’s HIV diagnosis from them, and postpone disclosure, in turn negatively impacting children’s well-being. Our work explores whether interactive technology can support disclosure. In the first study, we examine disclosure experiences and the role of interactive technology from the perspective of HIV-positive children and parents. Through Thematic Analysis, we highlight how disclosure is linked with parents’ own experience of HIV, and that disclosure needs to be viewed as a process. On this basis, we contribute an experience prototype that guides parents through an incremental disclosure process using interactive storytelling. In a second study, we evaluate the prototype through interviews with six parents. Leveraging Interpretative Phenomenological Analysis, we show that the prototype has potential to transform how parents understand and approach disclosure. Based on our results, we present further design directions, and discuss the (limitations of the) role that technology can play in this context.2023ABAlemitu Mequanint Bezabih et al.KU LeuvenSpecial Education TechnologyEmpowerment of Marginalized GroupsCHI
Playful Reflection: Impact of Gamification on a Virtual Reality Simulation of BreastfeedingGamification is a popular technique to improve task engagement, and has broadly been deployed in health and education to a point where many users now expect gameful experiences in these settings. However, gamification has been criticised for being a potential obstacle to the experience of reflection. Motivated by this tension, our work examines how the addition of gamification to a Virtual Reality simulation of breastfeeding impacts player experience and reflection. Using a within-subjects design, we invited 34 participants to take part in a mixed-methods evaluation of a gamified and non-gamified variant of the simulation that included questionnaires and semi-structured interviews. Results show that gamification improved player experience and encouraged players to reflect on goal achievement and performance. However, it also diverted players' attention from nuances within the act of nursing. Drawing on our findings, we contribute considerations for the application of gamification in personal and sensitive settings such as breastfeeding.2023KTKymeng Tang et al.KU LeuvenSerious & Functional GamesEarly Childhood Education TechnologyCHI
Virtual Feed: Design and Evaluation of a Virtual Reality Simulation Addressing the Lived Experience of BreastfeedingBreastfeeding can be challenging, but it is difficult for antenatal education to convey issues associated with the lived experience of breastfeeding. In our work, we explore the potential of interactive simulations to support antenatal education, and present Virtual Feed, a Virtual Reality breastfeeding simulation for parents-to-be developed following a three-step process. (1) We created an experience prototype that features basic VR scenarios and a tangible baby, (2) we engaged in design sessions with 19 parents and parents-to-be to derive design implications to further refine the simulation, and (3) we evaluated the system through case studies to examine the perspectives of parents and parents-to-be on the simulation. Our results show that the simulation successfully engaged users and sparked curiosity, while also encouraging reflection about the challenges of breastfeeding. On this basis, we discuss challenges for the design of simulations with the purpose of supplementing antenatal education.2022KTKymeng Tang et al.KU LeuvenVR Medical Training & RehabilitationReproductive & Women's HealthCHI
Immersive Speculative Enactments: Bringing Future Scenarios and Technology to Life Using Virtual RealityIn this paper we present \textit{Immersive Speculative Enactments} (ISEs), a novel concept that extends conventional Speculative Enactments to Virtual Reality. Through ISEs, participants are immersed in a speculative world depicted by the designers and can engage with it in its truest envisioned form. We explore this concept via four scenarios with increasing technological uncertainty: a glimpse in the daily life of the parent of a newborn baby; a Mixed Reality experience supporting hybrid classrooms; two wearable devices that present a pet's emotional state and needs; and an enactment on the effect of communication delay across interplanetary distances. We discuss the concept of ISEs and contrast them to other forms of speculation, provide guidelines on how to design them, as well as reflecting on the challenges, limitations, and potential associated with the role of ISEs in the HCI discourse.2022ASAdalberto L. Simeone et al.KU LeuvenImmersion & Presence ResearchDesign FictionCHI
The Challenge of (Non-)Disclosure: Exploring the Lived Experience of Ethiopian Adolescents with HIV and Their Attitudes Toward Technology Adolescents in sub-Saharan Africa are at the epicenter of the global HIV epidemic. Yet, technology to support HIV management overwhelmingly focuses on adult medication adherence, neglecting the complex lives of adolescents in low-income regions. We present findings from interviews and focus groups that included twelve HIV-positive adolescents in Ethiopia, and eleven adults from their care circles. We leverage the Integrated Behavioral Model to examine the lived experience of HIV and the space for technology. Additionally, we present an inductive thematic analysis, which highlights non-disclosure as a central theme, i.e., adolescents remaining unaware of their HIV status. Drawing from these findings, we discuss how to account for (the lack of) disclosure in the design of technology to support HIV management, and reflect on whether technology could (and should) support the process. We further highlight the risks that researchers and designers need to be aware of when designing HIV management technology for this audience.2022ABAlemitu Mequanint Bezabih et al.KU LeuvenSpecial Education TechnologyMental Health Apps & Online Support CommunitiesChronic Disease Self-Management (Diabetes, Hypertension, etc.)CHI
Maker Technology and the Promise of Empowerment in a Flemish School for Disabled ChildrenMaker culture encourages do-it-yourself practices to create, repair, and repurpose technology. In Human-Computer Interaction (HCI) research, it is seen as a means of empowering people, providing affordable and customisable technology with potential to enrich areas such as education or assistive technology. To investigate this alleged potential, we performed an anthropological inquiry at an elementary school for disabled children that lasted one year, participating in everyday activities with students, teachers, and therapists. We observed ‘heterogeneity in a fluid environment’ and ‘creativity in the moment’ in an ‘endemically underfunded’ setting. We saw how technology is ‘injecting dependencies’, ‘reinforcing disability’, and ‘occupying time and space’, changing our view on the role that making can have. Leveraging Empowerment Theory, we highlight how (making) technology risks ignoring the intertwined dynamics between the individual, the organisational, and the community, and articulate points for reflection for technology in schools for disabled children for the HCI research community.2022BVBert Vandenberghe et al.KU LeuvenSpecial Education TechnologyEmpowerment of Marginalized GroupsCHI
Including the Experiences of Physically Disabled Players in Mainstream Guidelines for Movement-Based GamesMovement-based video games can provide engaging play experiences, and also have the potential to encourage physical activity. However, existing design guidelines for such games overwhelmingly focus on non-disabled players. Here, we explore wheelchair users’ perspectives on movement-based games as an enjoyable play activity. We created eight game concepts as discussion points for semi-structured interviews (N=6) with wheelchair users, and used Interpretative Phenomenological Analysis to understand their perspectives on physical activity and play. Themes focus on independent access, challenges in social settings, and the need for comprehensive adaptation. We also conducted an online survey (N=21) using the same game concepts, and thematic analysis highlighted the importance of adequate challenge, and considerations around multiplayer experiences. Based on these findings, we re-contextualize and expand guidelines for movement-based games previously established by Mueller and Isbister to include disabled players, and suggest design strategies that take into account their perspectives on play.2022LMLiam Mason et al.University of lincoln, University of lincolnSerious & Functional GamesGame AccessibilityCHI
Understanding the Role of Technology to Support BreastfeedingBreastfeeding brings benefits for newborns and parents, but can be a challenging process. In this paper, we leverage a mixed-methods approach that builds on the Integrated Behavioural Model (IBM) to explore parents' perspectives toward breastfeeding along with their lived experiences, and examine the role of technology in this setting. Results of twelve semi-structured interviews and 175 online survey responses suggest generally positive attitudes toward breastfeeding and good theoretical knowledge. This is combined with a complex lived experience of breastfeeding where main challenges are situated in practical, emotional, and environmental/societal aspects, which are currently not sufficiently recognised by technology that seeks to support breastfeeding. Building upon our findings, we present points for reflection for the design of technology to support breastfeeding, focusing on the importance of drawing from the lived experience of parents, and ensuring that technology not only casts breastfeeding as an individual but also as a collective effort.2021KTKymeng Tang et al.KU LeuvenUniversal & Inclusive DesignMental Health Apps & Online Support CommunitiesReproductive & Women's HealthCHI
A Critical Examination of Virtual Reality Technology in the Context of the Minority BodyVirtual Reality (VR) holds the promise of immersing people in virtual worlds. However, initial work on the relationship between VR and disability suggests that VR is a body-centric technology that poses barriers for disabled users. We supplement this work with a theoretical analysis of immersive VR through the lens of Surrogate Body theory, a concept from media theory for the structured examination of interactive media in use. Leveraging Critical Disability Studies, particularly the theory of the Minority Body, we explore the assumptions about bodies inherent in VR, and we reflect on implications of these assumptions when disabled people engage with the technology. Our findings show that VR is an inherently ableist technology that assumes a ‘corporeal standard’ (i.e., an ‘ideal’, non-disabled human body), and fails to adequately accommodate disabled people. We conclude with implications for HCI research on VR, and discuss design approaches that foster inclusive technology development.2021KGKathrin Gerling et al.KU LeuvenImmersion & Presence ResearchUniversal & Inclusive DesignGender & Race Issues in HCICHI
Experiencing Simulated Confrontations in Virtual RealityThe use of virtual reality (VR) to simulate confrontational human behaviour has significant potential for use in training, where the recreation of uncomfortable feelings may help users to prepare for challenging real-life situations. In this paper we present a user study (n=68) in which participants experienced simulated confrontational behaviour performed by a virtual character either in immersive VR, or on a 2D display. Participants reported a higher elevation in anxiety in VR, which correlated positively with a perceived sense of physical space. Character believability was influenced negatively by visual elements of the simulation, and positively by behavioural elements, which complements findings from previous work. We recommend the use of VR for simulations of confrontational behaviour, where a realistic emotional response is part of the intended experience. We also discuss incorporation of domain knowledge of human behaviours, and carefully crafted motion-captured sequences, to increase users' sense of believability.2021PDPatrick Dickinson et al.University of LincolnImmersion & Presence ResearchInteractive Narrative & Immersive StorytellingCHI
Virtual Reality Games for People Using WheelchairsVirtual Reality (VR) holds the promise of providing engaging embodied experiences, but little is known about how people with disabilities engage with it. We explore challenges and opportunities of VR gaming for wheelchair users. First, we present findings from a survey that received 25 responses and gives insights into wheelchair users' motives to (non-) engage with VR and their experiences. Drawing from this survey, we derive design implications which we tested through implementation and qualitative evaluation of three full-body VR game prototypes with 18 participants. Our results show that VR gaming engages wheelchair users, though nuanced consideration is required for the design of embodied immersive experiences for minority bodies, and we illustrate how designers can create meaningful, positive experiences.2020KGKathrin Gerling et al.Katholieke Universiteit LeuvenSocial & Collaborative VRAccessible GamingCHI
Design Goals for Playful Technology to Support Physical Activity Among Wheelchair UsersPlayful technology has the potential to support physical activity (PA) among wheelchair users, but little is known about design considerations for this audience, who experience significant access barriers. In this paper, we lever-age the Integrated Behavioural Model (IBM) to understand wheelchair users' perspectives on PA, technology, and play.First, we present findings from an interview study with eight physically active wheelchair users. Second, we build on the interviews in a survey that received 44 responses from a broader group of wheelchair users. Results show that the anticipation of positive experiences was the strongest predictor of engagement with PA, and that accessibility concerns act as barriers both in terms of PA participation and technology use. We present four design goals - emphasizing enjoyment,involving others, building knowledge and enabling flexibility - to make our findings actionable for researchers and designers wishing to create accessible playful technology to support PA.2019LMLiam Mason et al.University of LincolnMotor Impairment Assistive Input TechnologiesSerious & Functional GamesCHI