Using Speech Agents for Mood Logging within Blended Mental Healthcare: Mental Healthcare Practitioners' PerspectivesMood logging, where people track mood-related data, is commonly used to support mental healthcare. Speech agents could prove beneficial in supporting mood logging for clients. Yet we know little about how Mental Healthcare Practitioners (MHPs) view speech as a tool to support current care practices. Through a thematic analysis of semi-structured interviews with 15 MHPs, we show that MHPs see opportunities in the convenience, and the data richness that speech agents could afford. However, MHPs also saw this richness as noisy, with using speech potentially diminishing a client's focus on mood logging as an activity. MHPs were wary of overusing AI-based tools, expressing concerns around data ownership, access and privacy. We discuss the role of speech agents within blended care, outlining key considerations when using speech for mood logging in a blended mental healthcare context.2024OCOrla Cooney et al.Intelligent Voice Assistants (Alexa, Siri, etc.)Mental Health Apps & Online Support CommunitiesCUI
Between Rhetoric and Reality: Real-world Barriers to Uptake and Early Engagement in Digital Mental Health InterventionsDigital mental health interventions (DMHIs) have potential to provide effective and accessible care to entire populations, but low client uptake and engagement are significant problems. Few prior studies explore the lived experiences of non-engagers, because reaching this population is inherently difficult. We present an observational inquiry into the barriers to sign-up and early use of a DMHI, along with reasons for initial interest in the DMHI. We collected 205 online questionnaire responses and 20 interviews from self-referring participants across four healthcare ecosystems in the UK and US. Questionnaire results revealed that uncertainty about DMHI usefulness and usability were the main barriers to uptake, whereas forgetting about it, not finding time for it and not finding it useful were the main barriers to early engagement. Participants reported multiple reasons for considering the DMHI, reflecting the contextual, subjective nature of mental health. Our thematic analysis generated themes around (1) the need for human connection, (2) the impact of self-stigma on help-seeking, (3) the lack of knowledge around DMHIs and psychological therapy, (4) the desire for personally relevant care, and (5) the fluctuating, perennial nature of mental health. We discuss implications for DMHI design, implementation and future research, as well as transdisciplinary opportunities.2024JJJacinta Jardine et al.Mental Health Apps & Online Support CommunitiesDIS
Exploring the Design of Generative AI in Supporting Music-based Reminiscence for Older AdultsMusic-based reminiscence has the potential to positively impact the psychological well-being of older adults. However, the aging process and physiological changes, such as memory decline and limited verbal communication, may impede the ability of older adults to recall their memories and life experiences. Given the advanced capabilities of generative artificial intelligence (AI) systems, such as generated conversations and images, and their potential to facilitate the reminiscing process, this study aims to explore the design of generative AI to support music-based reminiscence in older adults. This study follows a user-centered design approach incorporating various stages, including detailed interviews with two social workers and two design workshops (involving ten older adults). Our work contributes to an in-depth understanding of older adults’ attitudes toward utilizing generative AI for supporting music-based reminiscence and identifies concrete design considerations for the future design of generative AI to enhance the reminiscence experience of older adults.2024YJYucheng Jin et al.Hong Kong Baptist UniversityGenerative AI (Text, Image, Music, Video)Mental Health Apps & Online Support CommunitiesReproductive & Women's HealthCHI
Using Thematic Analysis in Healthcare HCI at CHI: A Scoping ReviewCHI papers researching healthcare human-computer interaction (HCI) are increasingly reporting the use of "thematic analysis" (TA). TA refers to a range of flexible and evolving approaches for qualitative data analysis. Its increased use demonstrates a change in research practices, and with that the emergence of new local standards. We need to understand and reflect upon these emerging local practices, including departures from what is advocated as quality TA practice more generally. Toward this, we conducted a scoping review of a decade of CHI publications (2012 - 2021) that researched healthcare and termed their analysis approach "thematic analysis"; 78 papers reporting a total of 100 TAs were included. We contribute a description of 1) the contexts in which TA is being used, 2) the TA approaches being conducted, and 3) how TA is being reported. Drawing on this, we discuss opportunities to improve research practice when using TA in healthcare HCI.2023RBRobert Bowman et al.Trinity College DublinMental Health Apps & Online Support CommunitiesUser Research Methods (Interviews, Surveys, Observation)CHI
Investigating Clutching Interactions for Touchless Medical Imaging SystemsTouchless input could transform clinical activity by allowing health professionals direct control over medical imaging systems in a sterile manner. Currently, users face the issues of being unable to directly manipulate imaging in aseptic environments, as well as needing to touch shared surfaces in other hospital areas. Unintended input is a key challenge for touchless interaction and could be especially disruptive in medical contexts. We evaluated four clutching techniques with 34 health professionals, measuring interaction performance and interviewing them to obtain insight into their views on clutching, and touchless control of medical imaging. As well as exploring the performance of the different clutching techniques, our analysis revealed an appetite for reliable touchless interfaces, a strong desire to reduce shared surface contact, and suggested potential improvements such as combined authentication and touchless control. Our findings can inform the development of novel touchless medical systems and identify challenges for future research.2022SCSean Cronin et al.Trinity College DublinFull-Body Interaction & Embodied InputSurgical Assistance & Medical TrainingBiosensors & Physiological MonitoringCHI
Public Views on Digital COVID-19 Certificates: a Mixed Methods User StudyThe COVID-19 pandemic has led governments worldwide to introduce various measures restricting human activity and mobility. Along with the administration of COVID-19 vaccinations and rapid testing, socio-technological solutions such as digital COVID-19 certificates have been considered as a strategy to lessen these restrictions and allow the resumption of routine activities. Using a mixed methods approach – a survey (n=1008) and 27 semi-structured interviews – this study explores the attitudes of residents in the Republic of Ireland towards the idea of introducing digital COVID-19 certificates. We examine the topics of acceptability, fairness, security and privacy of COVID-related personal data, and practical considerations for implementation. Our study reveals the conditional and contextual nature of the acceptability of digital certificates, identifying specific factors that affect it, associated data practices, and related public concerns and expectations of such technologies.2022LNLeysan Nurgalieva et al.Aalto UniversityPrivacy by Design & User ControlPrivacy Perception & Decision-MakingSustainable HCICHI
The TAC Toolkit: Supporting Design for User Acceptance of Health Technologies from a Macro-Temporal PerspectiveUser acceptance is key for the successful uptake and use of health technologies, but also impacted by numerous factors not always easily accessible nor operationalised by designers in practice. This work seeks to facilitate the application of acceptance theory in design practice through the Technology Acceptance (TAC) toolkit: a novel theory-based design tool and method comprising 16 cards, 3 personas, 3 scenarios, a virtual think-space, and a website, which we evaluated through workshops conducted with 21 designers of health technologies. Findings showed that the toolkit revised and extended designers' knowledge of technology acceptance, fostered their appreciation, empathy and ethical values while designing for acceptance, and contributed towards shaping their future design practice. We discuss implications for considering user acceptance a dynamic, multi-stage process in design practice, and better supporting designers in imagining distant acceptance challenges. Finally, we examine the generative value of the TAC toolkit and its possible future evolution.2022CNCamille Nadal et al.Trinity College DublinMental Health Apps & Online Support CommunitiesPrototyping & User TestingCHI
The Experience of Guided Online Therapy: A Longitudinal, Qualitative Analysis of Client Feedback in a Naturalistic RCTInternet-delivered Cognitive Behavioural Therapy (iCBT) is an effective treatment for depression and anxiety disorders. However longitudinal qualitative research into the client's subjective experience of this form of treatment 'in the wild' is relatively scarce. We present an analysis of secondary outcomes in a naturalistic RCT conducted within the UK's Improving Access to Psychological Therapies programme. We evaluated clients' expectations, experience, and context of usage of iCBT, across three timepoints. Results are discussed in terms of the creation of a therapeutic space online, the impact of hope, expectations and personal factors on the therapeutic experience, iCBT as "therapy on the go" and developing skills for life. While iCBT on the whole provides a positive, supportive and therapeutic experience for clients, the study identified managing expectations, polarized preferences, momentary help-seeking and long-term support as important aspects of the experience to consider in future design.2020JJJacinta Jardine et al.SilverCloud HealthMental Health Apps & Online Support CommunitiesCHI
Understanding Client Support Strategies to Improve Clinical Outcomes in an Online Mental Health InterventionOnline mental health interventions are increasingly important in providing access to, and supporting the effectiveness of, mental health treatment. While these technologies are effective, user attrition and early disengagement are key challenges. Evidence suggests that integrating a human supporter into such services mitigates these challenges, however, it remains under-studied how supporter involvement benefits client outcomes, and how to maximize such effects. We present our analysis of 234,735 supporter messages to discover how different support strategies correlate with clinical outcomes. We describe our machine learning methods for: (i) clustering supporters based on client outcomes; (ii) extracting and analyzing linguistic features from supporter messages; and (iii) identifying context-specific patterns of support. Our findings indicate that concrete, positive and supportive feedback from supporters that reference social behaviors are strongly associated with better outcomes; and show how their importance varies dependent on different client situations. We discuss design implications for personalized support and supporter interfaces.2020PCPrerna Chikersal et al.Carnegie Mellon UniversityElectrical Muscle Stimulation (EMS)Agent Personality & AnthropomorphismMental Health Apps & Online Support CommunitiesCHI
Exploring and Designing for Memory Impairments in DepressionDepression is an affective disorder with distinctive autobiographical memory impairments, including negative bias, overgeneralization and reduced positivity. Several clinical therapies address these impairments, and there is an opportunity to develop new supports for treatment by considering depression-associated memory impairments within design. We report on interviews with ten experts in treating depression, with expertise in both neuropsychology and cognitive behavioral therapies. The interviews explore approaches for addressing each of these memory impairments. We found consistent use of positive memories for treating all memory impairments, the challenge of direct retrieval, and the need to support the experience of positive memories. We aim to sensitize HCI researchers to the limitations of memory technologies, broaden their awareness of memory impairments beyond episodic memory recall, and inspire them to engage with this less explored design space. Our findings open up new design opportunities for memory technologies for depression, including positive memory banks for active encoding and selective retrieval, novel cues for supporting generative retrieval, and novel interfaces to strengthen the reliving of positive memories.2019CQChengcheng Qu et al.Lancaster UniversityCognitive Impairment & Neurodiversity (Autism, ADHD, Dyslexia)CHI
Engagement with Mental Health Screening on Mobile Devices: Results from an Antenatal Feasibility StudyPerinatal depression (PND) affects up to 15% of women within the United Kingdom and has a lasting impact on a woman's quality of life, birth outcomes and her child's development. Suicide is the leading cause of maternal mortality. However, it is estimated that at least 50% of PND cases go undiagnosed. This paper presents the results of the first feasibility study to examine the potential of mobile devices to engage women in antenatal mental health screening. Using a mobile application, 254 women attending 14 National Health Service midwifery clinics provided 2,280 momentary and retrospective reports of their wellbeing over a 9-month period. Women spoke positively of the experience, installing and engaging with this technology regardless of age, education, wellbeing, number of children, marital or employment status, or past diagnosis of depression. 39 women reported a risk of depression, self-harm or suicide; two-thirds of whom were not identified by screening in-clinic.2019KDKevin Doherty et al.Trinity College DublinMental Health Apps & Online Support CommunitiesCHI
HCI and Affective Health: Taking stock of a decade of studies and charting future research directionsIn the last decade, the number of articles on HCI and health has increased dramatically. We extracted 139 papers on depression, anxiety and bipolar health issues from 10 years of SIGCHI conference proceedings. 72 of these were published in the last two years. A systematic analysis of this growing body of literature revealed that most innovation happens in automated diagnosis, and self-tracking, although there are innovative ideas in tangible interfaces. We noted an overemphasis on data production without consideration of how it leads to fruitful interventions. Moreover, we see a need to promote ethical practices for involvement of people living with affective disorders. Finally, although only 16 studies evaluate technologies in a clinical context, several forms of support and intervention illustrate how rich insights are gained from evaluations with real patients. Our findings highlight potential for growth in the design space of affective health technologies.2019PSPedro Sanches et al.KTH Royal Institute of Technology in StockholmMental Health Apps & Online Support CommunitiesCHI