In response to the rise in opioid-related deaths, communities across Ontario have developed opioid or overdose response plans to address issues at the local level. Public Health Ontario (PHO) leads ...the Community Opioid / Overdose Capacity Building (COM-CAP) project, which aims to reduce overdose-related harms at the community level by working with communities to identify, develop, and evaluate capacity building supports for local needs around overdose planning. The 'From Design to Action' co-design workshop used a participatory design approach to engage communities in identifying the requirements for capacity building support.
A participatory approach (co-design) provided opportunity for collaborative discussion around capacity building needs at the community level. The co-design workshop included three structured collaborative activities to 1) prioritize scenarios that illustrated various challenges associated with community overdose response planning, 2) prioritize the challenges within each scenario and 3) prioritize the supports to address each of these challenges. It was conducted with fifty-two participants involved in opioid/overdose-related response plans in Ontario. Participatory materials were informed by the results of a situational assessment (SA) data gathering process, including survey, interview, and focus group data. A voting system, including dot stickers and discussion notes, was applied to identify priority supports and delivery mechanisms.
At the workshop, key challenges and top-priority supports were identified, for development and implementation. The prioritized challenges were organized into five categories of capacity building supports addressing: 1) stigma & equity; 2) trust-based relationships, consensus building & on-going communication; 3) knowledge development & on-going access to information and data; 4) tailored strategies and plan adaptation to changing structures and local context; and 5) structural enablers and responsive governance.
Using a participatory approach, the workshop provided an opportunity for sharing, generating, and mobilizing knowledge to address research-practice gaps at the community level for opioid response planning. The application of health design methods such as the 'From Design to Action' co-design workshop supports teams to gain a deeper understanding of needs for capacity building as well as illustrating the application of participatory approaches in identifying capacity building needs for complex public health issues such as the overdose crisis.
The COVID-19 pandemic has shifted the work environment to a new reality of remote work and virtual collaboration. This shift has occurred in various work settings with an impact on spaces, ...approaches, applied techniques, and tools. This has resulted in the broad use of virtual tools in the health care sector to avoid physical encounters and in-person interactions that will likely outlast the COVID-19 pandemic. Developing effective virtual approaches requires the knowledge and skills of using digital technologies collaboratively combined with a deep understanding of the context or contexts in which these approaches may be used. The implementation of virtual health design methods, including web-based co-design, has increased to meet the realities of COVID-19 restrictions and is likely to outlast them. Adapting the use of co-design methodologies to a virtual configuration requires rethinking methods of collaboration and communication, adapting to virtual environments, and creating new methods of engagement and facilitation. With this viewpoint, we reviewed the current work on co-design (in person and web based) to propose techniques for the design, planning, and implementation of web-based co-design. We propose 7 considerations that may enable web-based co-design projects in the health care sector. The key considerations that affect the success of a web-based co-design approach should be considered in the process of planning, developing, and conducting web-based co-design sessions. These include facilitation, collaboration, accessibility and equity, communication, sensemaking, tangible tools and games, and web-based research ethics. We illustrate this work with a case study of co-design for an emergency department discharge tool developed during the pandemic.
Residential hospices are often purpose-built to enhance the experience of patients and families. However, there has been relatively little research on ambient and sensory experiences of patients and ...families. This study explored the ambient and sensory experience of residents and families in a residential hospice. Hospice users participated in personalizing environments and experiences, adapting and developing rituals, and enjoying the experience (including smells and sounds) of communal spaces and private rooms. Opportunity for developing new rituals, in particular, suggests an environment supportive of sense of control, social support, and positive distractors. The design of an inpatient hospice can offer a platform through which to support the delivery of flexible care practices, providing opportunities for personal expression, shared experiences, and the maintenance or development of rituals.
Different communities, organizations, and people hold different views on their own and others wellbeing. It is often challenging to balance different perspectives during the design process when the ...truth of medicine is competing with the truth of social media and the everyday experience of wellbeing of patients, caregivers, family and friends. In the context of the Masters of Health Design at ---, we develop students’ competency in working with truth through challenging students to engage with multiple ‘truths’ in the design process, engaging deliberately in identifying and working with multiple truth regimes as part of a problem based learning approach. This includes how truth regimes impact the understanding of a challenge area, techniques for engaging with stakeholders, communicating and developing concepts, and the process of seeking and working with feedback for refining and iterating, and finally in communicating project solutions. By engaging in problem based learning, students are exposed to the real challenges of different stakeholder perspectives and in particular how different truth regimes serve to impact what counts as legitimate knowledge and legitimate knowledge representation.
Different communities, organizations, and people hold different views on their own and others' wellbeing. It is often challenging to balance different perspectives during the design process when the ...truth of medicine is competing with the truth of social media and the everyday experience of wellbeing of patients, caregivers, family and friends. In the context of the Masters of Health Design at OCAD University (OCAD U), we develop students' competency in working with truth through challenging students to engage with multiple 'truths' in the design process, engaging deliberately in identifying and working with multiple truth regimes as part of a problem based learning approach. This includes how truth regimes impact the understanding of a challenge area, techniques for engaging with stakeholders, communicating and developing concepts, and the process of seeking and working with feedback for refining and iterating, and finally in communicating project solutions. By engaging in problem based learning, students are exposed to the real challenges of different stakeholder perspectives and in particular how different truth regimes serve to impact what counts as legitimate knowledge and legitimate knowledge representation.
The goal of Electronic Remote Blood Issue (ERBI) is to increase the safety and efficiency of blood issuing in surgery suites. Like many healthcare information technologies (HIT), there is limited ...evidence of the impact of ERBI on safety and efficiency, and relatively little information on factors affecting errors and adaptation of work practices during implementation. This dissertation describes a human factors approach, informed by socio-technical perspectives on HIT, to the study of ERBI in three hospital operating suites and (i) the impact of ERBI on safety and efficiency, (ii) learning, adaptation and use of ERBI, and (iii) staff perspectives on ERBI. Findings are that: nursing staff experience ERBI differently from other staff roles; staff develop adaptations in work practice in response to constraints imposed by the design of ERBI and task constraints; sites differ in areas (i and ii, above) except the time it took sites to adapt to ERBI (3-4 months); and, that there is evidence of efficiency gains for blood use with ERBI at one of three sites. In addressing the intended aims of ERBI systems to increase safety and efficiency of blood issue and delivery, this dissertation provides some evidence of efficiency and safety gains when ERBI is successfully implemented. It also highlights barriers and enablers to successful implementation, identifying areas where further study may be needed, including workload factors impacting nursing staff experiences and adaptation to new technology, factors impacting error recovery in critical safety situations such as blood issuing, and representing dimensions and dynamics of transactional processes such as blood issuing for inclusion in systems design. Reflecting on the approach taken for the study of ERBI in this dissertation, the research highlights adaptation behaviours and experiences of ERBI that suggest a resiliency approach to be appropriate for understanding and designing HIT for blood unit issue, and highlights the value of a socio-technical approach in providing proxy measures for error, revealing diversity of experiences of implementation, and providing actionable design recommendations for implementation and design of ERBI systems.
Workshop abstract: HCI research in healthcare Sellen, Kate; Furniss, Dominic; Chen, Yunan ...
CHI '14 Extended Abstracts on Human Factors in Computing Systems,
04/2014
Conference Proceeding
Theory has an important place in HCI research in healthcare. However, resources on this area are spread across different multidisciplinary journals. It is timely for the community to reflect on the ...classic, modern, and contemporary theories they use, to map where strengths and weaknesses lie, and where emerging opportunities are unfolding. This workshop aims to encourage dialogue and exchange of ideas with examples of current and emerging theory in HCI and healthcare to support researchers and practitioners as they address the challenges and opportunities of this domain. We aim to produce a journal special issue to map the state of the art in this area.
The people-prototype problem Sellen, Katherine M.; Massimi, Micheal A.; Lottridge, Danielle M. ...
Proceedings of the SIGCHI Conference on Human Factors in Computing Systems,
04/2009
Conference Proceeding
When gathering feedback about an envisioned system, prototypes communicate design ideas to user groups. However, it is unclear how user responses are affected by prototype format. We conducted a 2x2 ...quasi-experiment (video /storyboard format x older and younger user groups) to test for an interaction between prototype format and user group. We found a significant interaction between prototype format and responses across user groups. Our results indicate that differences in user responses can be misinterpreted as the result of user group characteristics. We advise using multiple prototype formats to counteract a 'media effect'. Alternatively, we advise using storyboards for a smaller 'media effect'.
Human milk provides a very wide range of nutrients and bioactive components, including immune factors, human milk oligosaccharides, and a commensal microbiota. These factors are essential for ...interconnected processes including immunity programming and the development of a normal infant gastrointestinal microbiome. Newborn immune protection mostly relies on maternal immune factors provided through milk. However, studies dealing with an in-depth profiling of the different immune compounds present in human milk and with the assessment of their natural variation in healthy women from different populations are scarce. In this context, the objective of this work was the detection and quantification of a wide array of immune compounds, including innate immunity factors (IL1β, IL6, IL12, INFγ, TNFα), acquired immunity factors (IL2, IL4, IL10, IL13, IL17), chemokines (IL8, Groα, MCP1, MIP1β), growth factors IL5, IL7, epidermal growth factor (EGF), granulocyte colony-stimulating factor, granulocyte-macrophage colony-stimulating factor, TGFβ2, and immunoglobulins (IgA, IgG, IgM), in milk produced by healthy women of different ethnicities living in different geographic, dietary, socioeconomic, and environmental settings. Among the analyzed factors, IgA, IgG, IgM, EGF, TGFβ2, IL7, IL8, Groα, and MIP1β were detected in all or most of the samples collected in each population and, therefore, this specific set of compounds might be considered as the "core" soluble immune factors in milk produced by healthy women worldwide. This approach may help define which immune factors are (or are not) common in milk produced by women living in various conditions, and to identify host, lifestyle, and environmental factors that affect the immunological composition of this complex biological fluid.
www.ClinicalTrials.gov, identifier NCT02670278.
Objectives
Establishment and development of the infant gastrointestinal microbiome (GIM) varies cross‐culturally and is thought to be influenced by factors such as gestational age, birth mode, diet, ...and antibiotic exposure. However, there is little data as to how the composition of infants' households may play a role, particularly from a cross‐cultural perspective. Here, we examined relationships between infant fecal microbiome (IFM) diversity/composition and infants' household size, number of siblings, and number of other household members.
Materials and methods
We analyzed 377 fecal samples from healthy, breastfeeding infants across 11 sites in eight different countries (Ethiopia, The Gambia, Ghana, Kenya, Peru, Spain, Sweden, and the United States). Fecal microbial community structure was determined by amplifying, sequencing, and classifying (to the genus level) the V1–V3 region of the bacterial 16S rRNA gene. Surveys administered to infants' mothers identified household members and composition.
Results
Our results indicated that household composition (represented by the number of cohabitating siblings and other household members) did not have a measurable impact on the bacterial diversity, evenness, or richness of the IFM. However, we observed that variation in household composition categories did correspond to differential relative abundances of specific taxa, namely: Lactobacillus, Clostridium, Enterobacter, and Klebsiella.
Discussion
This study, to our knowledge, is the largest cross‐cultural study to date examining the association between household composition and the IFM. Our results indicate that the social environment of infants (represented here by the proxy of household composition) may influence the bacterial composition of the infant GIM, although the mechanism is unknown. A higher number and diversity of cohabitants and potential caregivers may facilitate social transmission of beneficial bacteria to the infant gastrointestinal tract, by way of shared environment or through direct physical and social contact between the maternal–infant dyad and other household members. These findings contribute to the discussion concerning ways by which infants are influenced by their social environments and add further dimensionality to the ongoing exploration of social transmission of gut microbiota and the “old friends” hypothesis.
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