Home health aides (HHAs) provide necessary hands-on care to older adults and those with chronic conditions in their homes. Despite their integral role, HHAs experience numerous challenges in their ...work, including their ability to communicate with other health care professionals about patient care while caring for patients and access to educational resources. Although technological interventions have the potential to address these challenges, little is known about the technological landscape and existing technology-based interventions designed for and used by this workforce. We conducted a scoping review of the scientific literature to identify existing studies that have described, designed, deployed, or tested technology-based tools and apps intended for use by HHAs to care for patients at home. To complement our literature review, we conducted a landscape analysis of existing mobile apps intended for HHAs providing in-home care. We searched the following databases from their inception to October 2020: Ovid MEDLINE, Ovid Embase, Cochrane Library, and CINAHL (EBSCO). A total of 3 researchers screened the yield using prespecified inclusion and exclusion criteria. In addition, 4 researchers independently reviewed these articles, and a fifth researcher arbitrated when needed. Among studies that met the inclusion criteria, data were extracted and summarized narratively. An analysis of mobile health apps designed for HHAs was performed using a predefined set of terms to search Google Play and Apple App stores. Overall, 2 researchers independently screened the resulting apps, and those that met the inclusion criteria were categorized according to their intended purpose and functionality. Of the 8643 studies retrieved, 182 (2.11%) underwent full-text review, and 4.9% (9/182) met our inclusion criteria. Approximately half (4/9, 44%) of the studies were descriptive in nature, proposing technology-based systems (eg, web portals and dashboards) or prototypes without a technical or user-based evaluation of the technology. In most (7/9, 78%) papers, HHAs were just one of several users and not the sole or primary intended users of the technology. Our review of mobile apps yielded 166 Android and iOS apps, of which 48 (29%) met the inclusion criteria. These apps provided HHAs with one or more of the following functions: electronic visit verification (29/48, 60%), clocking in and out (23/48, 48%), documentation (22/48, 46%), task checklist (19/48, 40%), communication between HHA and agency (14/48, 29%), patient information (6/48, 13%), resources (5/48, 10%), and communication between HHA and patients (4/48, 8%). Of the 48 apps, 25 (52%) performed monitoring functions, 4 (8%) performed supporting functions, and 19 (40%) performed both. A limited number of studies and mobile apps have been designed to support HHAs in their work. Further research and rigorous evaluation of technology-based tools are needed to assess their impact on the work HHAs provide in patient’s homes.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Although family caregivers play a critical role in care delivery, research has shown that they face significant physical, emotional, and informational challenges. One promising avenue to address some ...of caregivers' unmet needs is via the design of digital technologies that support caregivers' complex portfolio of responsibilities. Augmented reality (AR) applications, specifically, offer new affordances to aid caregivers as they perform care tasks in the home.
This study explored how AR might assist family caregivers with the delivery of home-based cancer care. The specific objectives were to shed light on challenges caregivers face where AR might help, investigate opportunities for AR to support caregivers, and understand the risks of AR exacerbating caregiver burdens.
We conducted a qualitative video elicitation study with clinicians and caregivers. We created 3 video elicitations that offer ways in which AR might support caregivers as they perform often high-stakes, unfamiliar, and anxiety-inducing tasks in postsurgical cancer care: wound care, drain care, and rehabilitative exercise. The elicitations show functional AR applications built using Unity Technologies software and Microsoft Hololens2. Using elicitations enabled us to avoid rediscovering known usability issues with current AR technologies, allowing us to focus on high-level, substantive feedback on potential future roles for AR in caregiving. Moreover, it enabled nonintrusive exploration of the inherently sensitive in-home cancer care context.
We recruited 22 participants for our study: 15 clinicians (eg, oncologists and nurses) and 7 family caregivers. Our findings shed light on clinicians' and caregivers' perceptions of current information and communication challenges caregivers face as they perform important physical care tasks as part of cancer treatment plans. Most significant was the need to provide better and ongoing support for execution of caregiving tasks in situ, when and where the tasks need to be performed. Such support needs to be tailored to the specific needs of the patient, to the stress-impaired capacities of the caregiver, and to the time-constrained communication availability of clinicians. We uncover opportunities for AR technologies to potentially increase caregiver confidence and reduce anxiety by supporting the capture and review of images and videos and by improving communication with clinicians. However, our findings also suggest ways in which, if not deployed carefully, AR technologies might exacerbate caregivers' already significant burdens.
These findings can inform both the design of future AR devices, software, and applications and the design of caregiver support interventions based on already available technology and processes. Our study suggests that AR technologies and the affordances they provide (eg, tailored support, enhanced monitoring and task accuracy, and improved communications) should be considered as a part of an integrated care journey involving multiple stakeholders, changing information needs, and different communication channels that blend in-person and internet-based synchronous and asynchronous care, illness, and recovery.
Abstract
Although highly involved in heart failure (HF) patients’ care, home care workers (HCWs) lack HF training and are poorly integrated into the healthcare team. For its potential to address ...these challenges, we examined the role of technology among HCWs caring for HF patients. We conducted 38 interviews with key stakeholders. Overall, four themes emerged. Participants reported that technology is critical for HF care, but existing systems are outdated and ineffective. HCWs also have limited access to electronic resources. Technology, training, and principles of implementation science can be leveraged to improve HCWs’ experience in caring for HF patients and home healthcare delivery.
IMPORTANCE: Home health care workers care for community-dwelling adults and play an important role in supporting patients with confirmed and suspected coronavirus disease 2019 (COVID-19) who remain ...at home. These workers are mostly middle-aged women and racial/ethnic minorities who typically earn low wages. Despite being integral to patient care, these workers are often neglected by the medical community and society at large; thus, developing a health care system capable of addressing the COVID-19 crisis and future pandemics requires a better understanding of the experiences of home health care workers. OBJECTIVE: To understand the experiences of home health care workers caring for patients in New York City during the COVID-19 pandemic. DESIGN, SETTING, AND PARTICIPANTS: From March to April 2020, a qualitative study with 1-to-1 semistructured interviews of 33 home health care workers in New York City was conducted in partnership with the 1199SEIU Home Care Industry Education Fund, a benefit fund of the 1199 Service Employees International Union United Healthcare Workers East, the largest health care union in the US. Purposeful sampling was used to identify and recruit home health care workers. MAIN OUTCOMES AND MEASURES: Audio-recorded interviews were professionally transcribed and analyzed using grounded theory. Major themes and subthemes were identified. RESULTS: In total, 33 home health care workers employed by 24 unique home care agencies across the 5 boroughs of New York City participated. Participants had a mean (SD) age of 47.6 (14.0) years, 32 (97%) were women, 21 (64%) were Black participants, and 6 (18%) were Hispanic participants. Five major themes emerged: home health care workers (1) were on the front lines of the COVID-19 pandemic but felt invisible; (2) reported a heightened risk for virus transmission; (3) received varying amounts of information, supplies, and training from their home care agencies; (4) relied on nonagency alternatives for support, including information and supplies; and (5) were forced to make difficult trade-offs in their work and personal lives. CONCLUSIONS AND RELEVANCE: In this qualitative analysis, home health care workers reported providing frontline essential care, often at personal risk, during the COVID-19 pandemic. They experienced challenges that exacerbated the inequities they face as a marginalized workforce. Interventions and policies to better support these frontline health care professionals are urgently needed.
Our paper provides an enriched understanding of the relationship between research and practice through the study of practitioners variously engaged in field research on technology interventions in ...the context of global development. By conducting a qualitative inquiry with 33 practitioners from 26 global development organizations, we highlight how these practitioners have different goals, work practices, incentive structures, and expectations than researchers, making it challenging to co-create and coordinate productive and effective partnerships. Despite these challenges, practitioners in global development do appear to value and engage with research as they strive for positive impact across their target communities. Our analysis suggests that the domain of human-computer interaction for development (HCI4D) might benefit from engaging in "informed practice" through alignment with design-based implementation research (DBIR), which unites researchers and practitioners in their shared commitment to both research and practice, even if research and practice respectively remain their primary commitments. Our work provides CSCW and HCI4D researchers with new ways to conceptualize and navigate the above research-practice divide. We also emphasize the contribution such an approach might make to CSCW researchers beyond the context of global development, and more broadly concerned with making a positive societal impact with their work.
Digital Technologies and Intimate Partner Violence Freed, Diana; Palmer, Jackeline; Minchala, Diana Elizabeth ...
Proceedings of the ACM on human-computer interaction,
12/2017, Letnik:
1, Številka:
CSCW
Journal Article
Recenzirano
Odprti dostop
Digital technologies, including mobile devices, cloud computing services, and social networks, play a nuanced role in intimate partner violence (IPV) settings, including domestic abuse, stalking, and ...surveillance of victims by abusive partners. However, the interactions among victims of IPV, abusers, law enforcement, counselors, and others --- and the roles that digital technologies play in these interactions --- are poorly understood. We present a qualitative study that analyzes the role of digital technologies in the IPV ecosystem in New York City. Findings from semi-structured interviews with 40 IPV professionals and nine focus groups with 32 survivors of IPV reveal a complex set of socio-technical challenges that stem from the intimate nature of the relationships involved and the complexities of managing shared social circles. Both IPV professionals and survivors feel that they do not possess adequate expertise to be able to identify or cope with technology-enabled IPV, and there are currently insufficient best practices to help them deal with abuse via technology. We also reveal a number of tensions and trade-offs in negotiating technology's role in social support and legal procedures. Taken together, our findings contribute a nuanced understanding of technology's role in the IPV ecosystem and yield recommendations for HCI and technology experts interested in aiding victims of abuse.
This paper examines refugees' experiences with and perspectives on the digital identity systems used by humanitarian organizations to collect, manage, and share their personal data. Through a ...qualitative study with 198 refugees in Lebanon, Jordan, and Uganda, we show how existing humanitarian identity systems present numerous challenges for refugees. For example, we find that refugees have little to no knowledge of the institutional systems and processes through which their personal data are managed and used. In addition, refugees are typically not able to exercise agency with regard to data that are collected about them (e.g. given choices about the data collected). At the same time, we show how refugees make active efforts to negotiate the various identities available to them, consciously weighing the benefits and constraints associated with different statuses to maximize their access to services, eligibility for employment, and spatial mobility. We engage with Taylor's lens of data justice to make sense of our findings and conclude by highlighting the potential of feminist science and technology study frameworks to further develop theories of data justice that can support analysis of identification systems that serve the interests of the most vulnerable.
Nutrient-based meal recommendations have the potential to help individuals prevent or manage conditions such as diabetes and obesity. However, learning people's food preferences and making ...recommendations that simultaneously appeal to their palate and satisfy nutritional expectations are challenging. Existing approaches either only learn high-level preferences or require a prolonged learning period. We propose
, a personalized nutrient-based meal recommender system designed to meet individuals' nutritional expectations, dietary restrictions, and fine-grained food preferences. Yum-me enables a simple and accurate food preference profiling procedure via a visual quiz-based user interface and projects the learned profile into the domain of nutritionally appropriate food options to find ones that will appeal to the user. We present the design and implementation of Yum-me and further describe and evaluate two innovative contributions. The first contriution is an open source state-of-the-art food image analysis model, named
. We demonstrate FoodDist's superior performance through careful benchmarking and discuss its applicability across a wide array of dietary applications. The second contribution is a novel online learning framework that learns food preference from itemwise and pairwise image comparisons. We evaluate the framework in a field study of 227 anonymous users and demonstrate that it outperforms other baselines by a significant margin. We further conducted an end-to-end validation of the feasibility and effectiveness of Yum-me through a 60-person user study, in which Yum-me improves the recommendation acceptance rate by 42.63%.
The shutdown measures necessary to stop the spread of COVID-19 have amplified the role of technology in intimate partner violence (IPV). Survivors may be forced to endure lockdowns with their ...abusers, intensifying the dangers of technology-enabled abuse (e.g. stalking, harassment, monitoring, surveillance). They may also be forced to rely on potentially compromised devices to reach support networks: a dangerous dilemma for digital safety. This qualitative study examines how technologists with computer security expertise provided remote assistance to IPV survivors during the pandemic. Findings from 24 consults with survivors and five focus groups with technologist consultants show how remote delivery of technology support services raised three fundamental challenges: (1) ensuring safety for survivors and consultants; (2) assessing device security over a remote connection; and (3) navigating new burdens for consultants, including emotional labor. We highlight implications for HCI researchers creating systems that enable access to remote expert services for vulnerable people.
Prior research on technology use in the Global South suggests that people in marginalized communities frequently share a single device among multiple individuals. However, the data privacy challenges ...and tensions that arise when people share devices have not been studied in depth. This paper presents a qualitative study with 72 participants that analyzes how families in Bangladesh currently share mobile phones, their usage patterns, and the tensions and challenges that arise as individuals seek to protect the privacy of their personal data. We show how people share devices out of economic need, but also because sharing is a social and cultural practice that is deeply embedded in Bangladeshi society. We also discuss how prevalent power relationships affect sharing practices and reveal gender dynamics that impact the privacy of women's data. Finally, we highlight strategies that participants adopted to protect their private data from the people with whom they share devices. Taken together, our findings have broad implications that advance the CSCW community's understanding of digital privacy outside the Western world.
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