SCOPE: Examining Technology-Enhanced Collaborative Care Management of Depression in the Cancer Setting Collaborative care management is an evidence-based approach to integrated psychosocial care for patients with comorbid cancer and depression. Prior work highlights challenges in patient-provider collaboration in navigating parallel cancer care and psychosocial care journeys of these patients. We design and deploy SCOPE, a platform for technology-enhanced collaborative care combining a patient-facing mobile app with a provider-facing registry. We examine SCOPE through a total of 45 interviews with patients and providers conducted in SCOPE’s approximately 15 months of design and development and approximately 24 months of SCOPE’s deployment for actual care in 6 cancer clinics. We find that: (1) SCOPE supported patient engagement in its underlying collaborative care and behavioral activation interventions, (2) patient-generated data in SCOPE improved patient-provider collaboration between and within in-person sessions, (3) SCOPE supported providers in delivering care and improved care team collaboration, (4) experience with SCOPE created evolving expectations for collaboration around data, and (5) SCOPE’s deployment in actual care surfaced important implementation barriers. We discuss implications of our findings in terms of designing for engagement with behavioral health interventions, negotiating patient data sharing and provider responsiveness, supporting personalized self-tracking goals in evidence-based interventions, exploring the role of digital health navigators in technology-enhanced care, and the need for flexibility in aligning technology-supported interventions to patient needs.2025AMAnant Mittal et al.Palliative CareCSCW
Touchscreens in Motion: Quantifying the Impact of Cognitive Load on Distracted DriversThis study investigates the interplay between a driver's cognitive load, touchscreen interactions, and driving performance. Using an N-back task to induce four levels of cognitive load, we measured physiological responses (pupil diameter, electrodermal activity), subjective workload (NASA-TLX), touchscreen performance (Fitts' law), and driving metrics (lateral deviation, throttle control). Our results reveal significant mutual performance degradation, with touchscreen pointing throughput decreasing by over 58.1% during driving conditions and lateral driving deviation increasing by 41.9% when touchscreen interactions were introduced. Under high cognitive load, participants demonstrated a 20.2% increase in pointing movement time, 16.6% decreased pointing throughput, and 26.3% reduced off-road glance durations. We identified a prevalent "hand-before-eye" phenomenon where ballistic hand movements frequently preceded visual attention shifts. These findings quantify the impact of cognitive load on multitasking performance and demonstrate how drivers adapt their visual attention and motor-visual coordination when cognitive resources are constrained.2025XSXiyuan Shen et al.Head-Up Display (HUD) & Advanced Driver Assistance Systems (ADAS)In-Vehicle Haptic, Audio & Multimodal FeedbackUIST
ScreenAudit: Detecting Screen Reader Accessibility Errors in Mobile Apps Using Large Language ModelsMany mobile apps are inaccessible, thereby excluding people from their potential benefits. Existing rule-based accessibility checkers aim to mitigate these failures by identifying errors early during development but are constrained in the types of errors they can detect. We present ScreenAudit, an LLM-powered system designed to traverse mobile app screens, extract metadata and transcripts, and identify screen reader accessibility errors overlooked by existing checkers. We recruited six accessibility experts including one screen reader user to evaluate ScreenAudit's reports across 14 unique app screens. Our findings indicate that ScreenAudit achieves an average coverage of 69.2%, compared to only 31.3% with a widely-used accessibility checker. Expert feedback indicated that ScreenAudit delivered higher-quality feedback and addressed more aspects of screen reader accessibility compared to existing checkers, and that ScreenAudit would benefit app developers in real-world settings.2025MZMingyuan Zhong et al.University of Washington, Computer Science & EngineeringGenerative AI (Text, Image, Music, Video)Explainable AI (XAI)Visual Impairment Technologies (Screen Readers, Tactile Graphics, Braille)CHI
Deploying and Examining Beacon for At-Home Patient Self-Monitoring with Critical Flicker FrequencyChronic liver disease can lead to neurological conditions that result in coma or death. Although early detection can allow for intervention, testing is infrequent and unstandardized. Beacon is a device for at-home patient self-measurement of cognitive function via critical flicker frequency, which is the frequency at which a flickering light appears steady to an observer. This paper presents our efforts in iterating on Beacon’s hardware and software to enable at-home use, then reports on an at-home deployment with 21 patients taking measurements over 6 weeks. We found that measurements were stable despite being taken at different times and in different environments. Finally, through interviews with 15 patients and 5 hepatologists, we report on participant experiences with Beacon, preferences around how CFF data should be presented, and the role of caregivers in helping patients manage their condition. Informed by our experiences with Beacon, we further discuss design implications for home health devices.2025RLRichard Li et al.University of Washington, Paul G. Allen School of Computer Science & EngineeringChronic Disease Self-Management (Diabetes, Hypertension, etc.)Telemedicine & Remote Patient MonitoringBiosensors & Physiological MonitoringCHI
Exploring AI-Based Support in Speech-Language Pathology for Culturally and Linguistically Diverse ChildrenSpeech-language pathologists (SLPs) provide support to children with speech and language difficulties through delivering evaluation, assessment, and interventions. Despite growing research on how Artificial Intelligence (AI) can support SLPs, there is limited research examining how AI can assist SLPs in delivering equitable care to culturally and linguistically diverse (CLD) children with disabilities. Through interviews with 15 SLPs and a two-part survey study with 13 SLPs, we report on SLP challenges in delivering responsive care to CLD children with disabilities (i.e., unrepresentative materials, unreliable translation, insufficient support for language variations), areas for AI-based support, evaluations of how available AI performs in addressing these challenges, and bias assessments of AI-generated materials. We discuss implications of contextually unaware AI, the range of care in AI-prompting, tensions and tradeoffs of AI-based support, and honoring diverse representations in AI-generated materials. We offer considerations for SLPs using AI-based tools and general-purpose AI in their practice.2025ALAaleyah Lewis et al.University of Washington, Paul G. Allen School of Computer Science and EngineeringIntelligent Voice Assistants (Alexa, Siri, etc.)Generative AI (Text, Image, Music, Video)Cognitive Impairment & Neurodiversity (Autism, ADHD, Dyslexia)CHI
Inaccessible and Deceptive: Examining Experiences of Deceptive Design with People Who Use Visual Accessibility TechnologyDeceptive design patterns manipulate people into actions to which they would otherwise object. Despite growing research on deceptive design patterns, limited research examines their interplay with accessibility and visual accessibility technology (e.g., screen readers, screen magnification, braille displays). We present an interview and diary study with 16 people who use visual accessibility technology to better understand experiences with accessibility and deceptive design. We report participant experiences with six deceptive design patterns, including designs that are intentionally deceptive and designs where participants describe accessibility barriers unintentionally manifesting as deceptive, together with direct and indirect consequences of deceptive patterns. We discuss intent versus impact in accessibility and deceptive design, how access barriers exacerbate harms of deceptive design patterns, and impacts of deceptive design from a perspective of consequence-based accessibility. We propose that accessibility tools could help address deceptive design patterns by offering higher-level feedback to well-intentioned designers.2025ALAaleyah Lewis et al.University of Washington, Paul G. Allen School of Computer Science and EngineeringVisual Impairment Technologies (Screen Readers, Tactile Graphics, Braille)Universal & Inclusive DesignDark Patterns RecognitionCHI
``I want to think like an SLP'': A Design Exploration of AI-Supported Home Practice in Speech TherapyParents of children in speech therapy play a crucial role in delivering consistent, high-quality home practice, which is essential for helping children generalize new speech skills to everyday situations. However, this responsibility is often complicated by uncertainties in implementing therapy techniques and keeping children engaged. In this study, we explore how varying levels of AI oversight can provide informational, emotional, and practical support to parents during home speech therapy practice. Through semi-structured interviews with 20 parents, we identified key challenges they face and their ideas for AI assistance. Using these insights, we developed six design concepts, which were then evaluated by 20 Speech-Language Pathologists (SLPs) for their potential impact, usability, and alignment with therapy goals. Our findings contribute to the discourse on AI’s role in supporting therapeutic practices, offering design considerations that address the needs and values of both families and professionals.2025ADAayushi Dangol et al.University of Washington, Human Centered Design & EngineeringElectrical Muscle Stimulation (EMS)Agent Personality & AnthropomorphismAugmentative & Alternative Communication (AAC)CHI
Menopause Legacies: Designing to Record and Share Experiences of Menopause Across GenerationsMenopause is often overlooked or medicalized, consequently devaluing individual experiences and failing to support individuals experiencing this life event. Family dynamics, death, and taboo further mean that individuals often miss out on information that could help them contextualize their experiences. We examine participant experiences with menopause and explore designs of digital and non-digital legacies for sharing menopause experiences across generations. We conducted semi-structured interviews and design sessions with 17 participants who experienced or are experiencing menopause. We report participant information needs and sense-making practices, including what personalized information participants wish to pass down and preferred formats for intergenerational sharing. We discuss the potential of using storytelling and life-logging to create ``holistic'' memories of the menopause journey, to support self-reflection, and for using legacies to initiate conversations about marginalized health experiences. We identify future design and research opportunities for the HCI and CSCW communities to support intergenerational sharing of non-medicalized and stigmatized health experiences.2024SCShaan Chopra et al.Session 2g: Identity, Visibility and Care in Online SpacesCSCW
The Ability-Based Design Mobile Toolkit (ABD-MT): Developer Support for Runtime Interface Adaptation Based on Users' AbilitiesDespite significant progress in the capabilities of mobile devices and applications, most apps remain oblivious to their users' abilities. To enable apps to respond to users' situated abilities, we created the Ability-Based Design Mobile Toolkit (ABD-MT). ABD-MT integrates with an app's user input and sensors to observe a user's touches, gestures, physical activities, and attention at runtime, to measure and model these abilities, and to adapt interfaces accordingly. Conceptually, ABD-MT enables developers to engage with a user's "ability profile,'' which is built up over time and inspectable through our API. As validation, we created example apps to demonstrate ABD-MT, enabling ability-aware functionality in 91.5% fewer lines of code compared to not using our toolkit. Further, in a study with 11 Android developers, we showed that ABD-MT is easy to learn and use, is welcomed for future use, and is applicable to a variety of end-user scenarios.2024JKJunhan Kong et al.Motor Impairment Assistive Input TechnologiesCognitive Impairment & Neurodiversity (Autism, ADHD, Dyslexia)Universal & Inclusive DesignMobileHCI
MigraineTracker: Examining Patient Experiences with Goal-Directed Self-Tracking for a Chronic Health ConditionSelf-tracking and personal informatics offer important potential in chronic condition management, but such potential is often undermined by difficulty in aligning self-tracking tools to an individual's goals. Informed by prior proposals of goal-directed tracking, we designed and developed MigraineTracker, a prototype app that emphasizes explicit expression of goals for migraine-related self-tracking. We then examined migraine patient experiences in a deployment study for an average of 12+ months, including a total of 50 interview sessions with 10 patients working with 3 different clinicians. Patients were able to express multiple types of goals, evolve their goals over time, align tracking to their goals, personalize their tracking, reflect in the context of their goals, and gain insights that enabled understanding, communication, and action. We discuss how these results highlight the importance of accounting for distinct and concurrent goals in personal informatics together with implications for the design of future goal-directed personal informatics tools.2024YSYasaman S. Sefidgar et al.University of WashingtonChronic Disease Self-Management (Diabetes, Hypertension, etc.)Fitness Tracking & Physical Activity MonitoringCHI
Playing on Hard Mode: Accessibility, Difficulty and Joy in Video Game Adoption for Gamers with DisabilitiesVideo games often pose accessibility barriers to gamers with disabilities, yet there is no standard method for identifying which games have barriers, what those barriers are, and whether and how they can be overcome. We propose and explore three phases of the “game adoption process”: Discovery, Evaluation, and Adaptation. To advance understanding of how gamers with disabilities experience this process, the resources and strategies they use, and the challenges experienced, we conducted an interview study with thirteen gamers with disabilities with differing backgrounds. We then engage with existing theories of consequence-based accessibility, of difficulty, and of identity-based gaming to better understand how these processes manifest “access difficulty” and to characterize the experience of “disabled gaming.” Finally, we present design recommendations for game developers and distributors to better support gamers with disabilities in the game adoption process by engaging with community-made resources, supporting socially-created access, and creating customizable experiences with opportunities for unconventional play.2024JMJesse J Martinez et al.University of WashingtonAccessible GamingGame UX & Player BehaviorGame AccessibilityCHI
A Large-Scale Longitudinal Analysis of Missing Label Accessibility Failures in Android AppsWe present the first large-scale longitudinal analysis of missing label accessibility failures in Android apps. We developed a crawler and collected monthly snapshots of 312 apps over 16 months. We use this unique dataset in empirical examinations of accessibility not possible in prior datasets. Key large-scale findings include missing label failures in 55.6% of unique image-based elements, longitudinal improvement in ImageButton elements but not in more prevalent ImageView elements, that 8.8% of unique screens are unreachable without navigating at least one missing label failure, that app failure rate does not improve with number of downloads, and that effective labeling is neither limited to nor guaranteed by large software organizations. We then examine longitudinal data in individual apps, presenting illustrative examples of accessibility impacts of systematic improvements, incomplete improvements, interface redesigns, and accessibility regressions. We discuss these findings and potential opportunities for tools and practices to improve label-based accessibility.2022RFRaymond Fok et al.University of WashingtonVoice AccessibilityVisual Impairment Technologies (Screen Readers, Tactile Graphics, Braille)Universal & Inclusive DesignCHI
“They don’t always think about that”: Translational Needs in the Design of Personal Health Informatics ApplicationsPersonal health informatics continues to grow in both research and practice, revealing many challenges of designing applications that address people's needs in their health, everyday lives, and collaborations with clinicians. Research suggests strategies to address such challenges, but has struggled to translate these strategies into design practice. This study examines translation of insights from personal health informatics research into resources to support designers. Informed by a review of relevant literature, we present our development of a prototype set of design cards intended to support designers in re-thinking potential assumptions about personal health informatics. We examined our design cards in semi-structured interviews, first with 12 student designers and then with 12 health-focused professional designers and researchers. Our results and discussion reveal tensions and barriers designers encounter, the potential for translational resources to inform the design of health-related technologies, and a need to support designers in addressing challenges of knowledge, advocacy, and evidence in designing for health.2021SKSusanne Kirchner et al.University of WashingtonMental Health Apps & Online Support CommunitiesPrototyping & User TestingCHI
Parallel Journeys of Patients with Cancer and Depression: Challenges and Opportunities for Technology-Enabled Collaborative CareDepression is common but under-treated in patients with cancer, despite being a major modifiable contributor to morbidity and early mortality. Integrating psychosocial care into cancer services through the team-based Collaborative Care Management (CoCM) model has been proven to be effective in improving patient outcomes in cancer centers. However, there is currently a gap in understanding the challenges that patients and their care team encounter in managing co-morbid cancer and depression in integrated psycho-oncology care settings. Our formative study examines the challenges and needs of CoCM in cancer settings with perspectives from patients, care managers, oncologists, psychiatrists, and administrators, with a focus on technology opportunities to support CoCM. We find that: (1) patients with co-morbid cancer and depression struggle to navigate between their cancer and psychosocial care journeys, and (2) conceptualizing co-morbidities as separate and independent care journeys is insufficient for characterizing this complex care context. We then propose the parallel journeys framework as a conceptual design framework for characterizing challenges that patients and their care team encounter when cancer and psychosocial care journeys interact. We use the challenges discovered through the lens of this framework to highlight and prioritize technology design opportunities for supporting whole-person care for patients with co-morbid cancer and depression.2020JSJina Suh et al.Health, Caregiving, and ChatbotsCSCW
Scout: Rapid Exploration of Interface Layout Alternatives through High-Level Design ConstraintsAlthough exploring alternatives is fundamental to creating better interface designs, current processes for creating alternatives are generally manual, limiting the alternatives a designer can explore. We present Scout, a system that helps designers rapidly explore alternatives through mixed-initiative interaction with high-level constraints and design feedback. Prior constraint-based layout systems use low-level spatial constraints and generally produce a single design. Tosupport designer exploration of alternatives, Scout introduces high-level constraints based on design concepts (e.g.,~semantic structure, emphasis, order) and formalizes them into low-level spatial constraints that a solver uses to generate potential layouts. In an evaluation with 18 interface designers, we found that Scout: (1) helps designers create more spatially diverse layouts with similar quality to those created with a baseline tool and (2) can help designers avoid a linear design process and quickly ideate layouts they do not believe they would have thought of on their own.2020ASAmanda Swearngin et al.University of Washington360° Video & Panoramic ContentPrototyping & User TestingCHI
Robust Annotation of Mobile Application Interfaces in Methods for Accessibility Repair and EnhancementAccessibility issues in mobile apps make those apps difficult or impossible to access for many people. Examples include elements that fail to provide alternative text for a screen reader, navigation orders that are difficult, or custom widgets that leave key functionality inaccessible. Social annotation techniques have demonstrated compelling approaches to such accessibility concerns in the web, but have been difficult to apply in mobile apps because of the challenges of robustly annotating interfaces. This research develops methods for robust annotation of mobile app interface elements. Designed for use in runtime interface modification, our methods are based in screen identifiers, element identifiers, and screen equivalence heuristics. We implement initial developer tools for annotating mobile app accessibility metadata, evaluate our current screen equivalence heuristics in a dataset of 2038 screens collected from 50 mobile apps, present three case studies implementing runtime repair of common accessibility issues, and examine repair of real-world accessibility issues in 26 apps. These contributions overall demonstrate strong opportunities for social annotation in mobile accessibility.2018XZMingrui Ray Zhang et al.Visual Impairment Technologies (Screen Readers, Tactile Graphics, Braille)Universal & Inclusive DesignUIST