Frontline workers (FLWs) in gender-based violence (GBV) service provision regularly engage in intense emotional labor to provide survivors of GBV with essential, often life-saving, services. However, FLWs experience intense burnout, resulting in turnover rates as high as 50% annually and a critical loss of services for survivors. In order to design digital burnout interventions in a context where so few exist, we recruited 15 FLWs for a 3-stage qualitative study where they used two existing applications to reflect on, and reimagine, concrete design features necessary to address FLW burnout in GBV service provision. We contribute important findings regarding designing specifically for empathy-based stress (EBS) in frontline work contexts, preferences for activities, desired interactivity, among other requirements for interventions. We synthesize our design recommendations through an example scenario of a collaborative just-in-time adaptive intervention (co-JITAI) system that integrates peer-based support that can adapt to users' changing needs and contexts over time.

The number of older adults who are homebound with depressive symptoms is increasing. Due to their homebound status, they have limited access to trained mental healthcare support, which leaves this support often to untrained family caregivers. To increase access, a growing interest is placed on using technology-mediated solutions, such as voice-assisted intelligent personal assistants (VIPAs), to deliver mental health services to older adults. To better understand how older adults and family caregivers intend to interact with a VIPA for mental health interventions, we conducted a participatory design study during which 6 older adults and 7 caregivers designed VIPA-human dialogues for various scenarios. Using conversation style preferences as a starting point, we present aspects of human-likeness older adults and family caregivers perceived as helpful or uncanny, specifically in the context of the delivery of mental health interventions, which helps inform potential roles VIPAs can play in mental healthcare for older adults.

Frontline workers (FLWs) provide essential services necessary for a functioning society, but the nature of their work contributes to their high rates of burnout. This burnout impacts not only their own health, but also has dire consequences for the people most in need of their services. Digital interventions for burnout may provide scalable, accessible, and cost-effective care. However, such interventions have been designed to intervene at the individual-level and have been inadequate in sustainably alleviating burnout. In addition, these interventions have not considered how we might integrate more effective organizational-level strategies or reflect FLWs' own experiences and the unique contexts of frontline work in their design. One important, yet understudied, domain of frontline work that experiences high rates of burnout is gender-based violence (GBV) service provision in nonprofit organizations. Using a community-based participatory research approach, we ran 8 co-design workshops with FLWs and supervisors from various nonprofit GBV organizations in a large metropolitan city in the United States to understand their experiences, hopes, and perceptions of technology for burnout support within their organizations. We found that participants greatly valued their support systems and supervisory relationships at work. And while there was a desire to use technology as support tools for burnout, participants were wary of how it could conflict with these support systems and important organizational values. We contribute a multilevel framework for digital burnout interventions and argue for a methodological shift to an assets-based approach, reframing the future of research and design of burnout interventions to center and reflect the needs, values, and lived experiences of FLWs.

People with dementia (PwD) often present verbal agitation such as cursing, screaming, and persistently complaining. Verbal agitation can impose mental distress on informal caregivers (e.g., family, friends), which may cause severe mental illnesses, such as depression and anxiety disorders. To improve informal caregivers' mental health, we explore design opportunities by interviewing 11 informal caregivers suffering from verbal agitation of PwD. In particular, we first characterize how the predictability of verbal agitation impacts informal caregivers' mental health and how caregivers' coping strategies vary before, during, and after verbal agitation. Based on our findings, we propose design opportunities to improve the mental health of informal caregivers suffering from verbal agitation: distracting PwD (in-situ support; before), prompting just-in-time maneuvers (information support; during), and comfort and education (social & information support; after). We discuss our reflections on cultural disparities between participants. Our work envisions a broader design space for supporting informal caregivers' well-being and describes when and how that support could be provided.

Wearables are a potentially vital mechanism for individuals to monitor their health, track behaviors, and stay connected. Unfortunately, both price and a lack of consideration of the needs of low-SES communities have made these devices inaccessible and unusable for communities that would most substantially benefit from their affordances. To address this gap and better understand how members of low-SES communities perceive the potential benefits and barriers to using wearable devices, we conducted 19 semi-structured interviews with people from minority, high crime rate, low-SES communities. Participants emphasized a critical need for safety-related wearable devices in their communities. Still, existing tools do not yet address the specific needs of this community and are out of reach due to several barriers. We distill themes on perceived useful features and ongoing obstacles to guide a much-needed research agenda we term ’Equityware’: building wearable devices based on low-SES communities’ needs, comfortability, and limitations.

Patient work encompasses a challenging set of activities necessary for learning about and managing chronic conditions over time. Many patient-centered health technology interventions focus on supporting types of patient work, such as symptom tracking, medication adherence, and information sharing between patients and providers. However, people may not always follow, or may actively resist, the activities prescribed by their formal patient role. In this paper, we present three case studies about patients with different chronic conditions to critically reflect on the types of patient behavior commonly taken up in health technology design as acts of "noncompliance." Detailing conflicts that emerge when patients are caught between meeting their personal needs and following clinical best practices, we show how everyday life and health system goals are often misaligned in ways that can't be easily reconciled through current design approaches. As a way forward, we argue for alternative ways of understanding the tensions routinely shaping people's healthcare experiences. We introduce the term care frictions as a sensitizing concept useful for helping designers reframe "noncompliant" behaviors as legitimate forms of patient work. Our paper also offers design considerations-both on challenges and generative possibilities-for future CSCW research seeking to support a wider breadth of patient behavior. In this, we call attention to the value of designer and researcher reflexivity in making visible the problematic assumptions in health technology design that can lead to social and emotional patient harms.

Major depressive disorder is a debilitating disease affecting 264 million people worldwide. While many antidepressant medications are available, few clinical guidelines support choosing among them. Decision support tools (DSTs) embodying machine learning models may help improve the treatment selection process, but often fail in clinical practice due to poor system integration.

The user study is a fundamental method used in HCI. In designing user studies, we often use compensation strategies to incentivize recruitment. However, compensation can also lead to ethical issues, such as coercion. The CHI community has yet to establish best practices for participant compensation. Through a systematic review of manuscripts at CHI and other associated publication venues, we found high levels of variation in the compensation strategies used within the community and how we report on this aspect of the study methods. A qualitative analysis of justifications offered for compensation sheds light into how some researchers are currently contextualizing this practice. This paper provides a description of current compensation strategies and information that can inform the design of compensation strategies in future studies. The findings may be helpful to generate productive discourse in the HCI community towards the development of best practices for participant compensation in user studies.

Data scientists frequently analyze data by writing scripts. We conducted a contextual inquiry with interdisciplinary researchers, which revealed that parameter tuning is a highly iterative process and that debugging is time-consuming. As analysis scripts evolve and become more complex, analysts have difficulty conceptualizing their workflow. In particular, after editing a script, it becomes difficult to determine precisely which code blocks depend on the edit. Consequently, scientists frequently re-run entire scripts instead of re-running only the necessary parts. We present ProvBuild, a tool that leverages language-level provenance to streamline the debugging process by reducing programmer cognitive load and decreasing subsequent runtimes, leading to an overall reduction in elapsed debugging time. ProvBuild uses provenance to track dependencies in a script. When an analyst debugs a script, ProvBuild generates a simplifed script that contains only the information necessary to debug a particular problem. We demonstrate that debugging the simplified script lowers a programmer's cognitive load and permits faster re-execution when testing changes. The combination of reduced cognitive load and shorter runtime reduces the time necessary to debug a script. We quantitatively and qualitatively show that even though ProvBuild introduces overhead during a script's first execution, it is a more efficient way for users to debug and tune complex workflows. ProvBuild demonstrates a novel use of language-level provenance, in which it is used to proactively improve programmer productively rather than merely providing a way to retroactively gain insight into a body of code.

Healthcare providers play a critical role in the management of a chronic illness by providing education about the disease, recommending treatment options, and developing care plans. However, when managing a rare disease, patients and their primary caregivers often work with healthcare systems that lack the infrastructure to diagnosis, treat, or provide education on the disease. Little research has explored care coordination practices between patients, family members, and healthcare providers under these circumstances. With the goal of identifying opportunities for technological support, we conducted qualitative interviews with the primary caregivers of children with a rare neurodegenerative disorder, ataxia-telangiectasia. We report on the responsibilities that the primary caregivers take on in response to care teams' lack of experience with the illness, and the ways in which an online health community supports this care coordination work. We also describe barriers that limited participants' use of the online health community, including the emotional consequences of participation and information overload. Based on these findings, we discuss two promising research agendas for supporting rare disease management: facilitating primary caregivers' care coordination tasks and increasing access to online community knowledge.

Following a cancer diagnosis, patients must cope with numerous physical, emotional, and practical challenges. While health information exists to help patients learn how to manage these challenges, health information seeking often declines over time, recalling information is difficult, and limited time with healthcare providers can leave patients feeling uninformed about their illness. We designed MyPath to overcome these information access challenges. The mobile system offers personalized, dynamic, and trusted health information recommendations to help patients learn about and manage their cancer. Through a seven-month deployment study with breast cancer patients, we found that use of the application encouraged proactive health management behaviors, and identified factors that motivated technology adoption and abandonment. We discuss the implications of these results for facilitating use of mHealth tools by a rural patient population and the importance of scaling support to a large range of information needs. We use this work to demonstrate the value of personalized health information systems and to motivate future CSCW research developing personalized support systems for other health situations with complex information access models.

Most devices today are developed adhering to a one-user paradigm. Yet within households, couples are often sharing devices and accounts. In this paper we take an in-depth look at sharing practices and preferences of cohabiting couples, and discuss the nuances of existing practices surrounding accounts and devices. We present a qualitative interview and diary study with ten couples, consisting of 20 individual interviews, and individual 8-day diaries. Dichotomous access models do not reflect the sharing practices of our couples; in which intent, access, and utilization all characterized sharing behaviors. We present a detailed description of the intentional and unintentional sharing practices our participants used in their day to day interactions and discuss the different challenges that particularly one type of content pose in terms of issues of privacy. We discuss implications for accounts and devices based on the ways in which content was shared and hidden among collocated couples. We provide a structured account of these sharing practices to inform the design of multi-user settings within future technologies.

An overwhelming variety of communication channels are available to consumers. Here, we present an overview of the aspects that need to be accounted for when intimate partners select a communication channel. We present interviews with 10 cohabiting couples (20 participants) and an 8-day diary study of communication and coordination. Using reported instances of within-couple communication, triggered by relationship-oriented or practical household needs, we identify why particular channels are chosen or sequenced. Extending media richness critiques, we identify additional factors that influence communication choice such as intimate knowledge of the others' habits, possibilities to add emotional meaning, and couples' shared needs as an identifiable unit. We also extend the notion of network effects on channel choice, and discuss the ecology of channel, networks, devices and device settings involved between partners. Finally, channel choice is not an all-or-nothing game; multiple channels can, and must, co-exist.

As technologies such as personal health records and symptom trackers become more common, we are seeing an increase in patients actively engaging in health tracking behaviors. Patient collected data can provide valuable insight for healthcare providers, particularly in the area of breast cancer. Thus far, little work has examined whether the health information that patients are willing to track and share aligns with the information needs of healthcare providers. Our work provides a comparison between the health information sharing preferences of breast cancer patients, doctors and navigators. We identify discrepancies between stakeholders' preferences, such as patients' hesitation to share feelings of loneliness, signifying where technology can play an important role in helping patients prioritize the health information shared with providers. We present design implications from this work to guide the development of future health information sharing tools that consider the differing needs of healthcare stakeholders.

Health information management for cancer care is a challenging and personal process that changes over time based on one's needs, goals, and health status. While technologies supporting health information management appear promising, we do not fully understand how health information tools fit into patients? daily lives. To better understand the opportunities and usage barriers of these tools, we designed and deployed a mobile, tablet-based health management aid: My Journey Compass. After one month of use, we interviewed twelve breast cancer patients to investigate their initial patterns of adoption, adaptation, use and non-use. We found that developing a tool that was customizable, mobile, and integrated into the patients' healthcare system resulted in a set of surprising uses by breast cancer patients for a wide variety of tasks. Our study demonstrates the potential for health management tools to improve the cancer care experience and for HCI research to influence existing healthcare systems.

Cancer navigation programs help patients overcome emotional, financial, and logistical challenges not typically addressed by the medical system. In this paper, we provide a detailed description of a rural cancer navigation organization, specifically detailing the roles collaboration and technology play in supporting navigation work. Examining navigation from a CSCW perspective, we see that navigation is a collaborative care system requiring coordination with patients, providers, and other navigators. Our study reveals a number of design opportunities for supporting navigation in the areas of resource monitoring, knowledge transfer, case management, long term navigation, and development of best practices. Supporting cancer navigation will be a critical step towards improving the healthcare experience for cancer patients.

This qualitative study of parents in financially depressed communities in westside Atlanta examines parents' access to information technology and out-of-school learning resources through five dimensions of digital divide: technical apparatus, autonomy, social support, skill, and purpose. The context of this study is a broader research agenda to explore how technology impacts parents' knowledge and use of out-of-school learning resources for their children in low socioeconomic status neighborhoods. The findings contribute to a growing body of research on marginalized groups and provide a rich description of parents' digital access and technology practices in the context of education. Finally, we identify design implications that are specific to this community and can be extended to similar populations to support parents in finding more learning opportunities.