This paper explores opportunities and challenges for data-driven advocacy to support home care workers, an often overlooked group of low-wage, frontline health workers.First, we investigate what data to collect and how to collect it in ways that preserve privacy and avoid burdening workers.Second, we examine how workers and advocates could use collected data to strengthen individual and collective advocacy efforts.Our qualitative study with 11 workers and 15 advocates highlights tensions between workers' desires for individual and immediate benefits and advocates' preferences to prioritize more collective and long-term benefits.We also uncover discrepancies between participants' expectations for how data might transform advocacy and their on-the-ground experiences collecting and using real data.Finally, we discuss future directions for data-driven worker advocacy, including combining different kinds of data to ameliorate challenges, leveraging advocates as data stewards, and accounting for workers' and organizations' heterogeneous goals.

We present a qualitative study that investigates the implications of current and near-future AI deployment for home care workers (HCWs), an overlooked group of frontline healthcare workers. Through interviews with 22 HCWs, care agency staff, and worker advocates, we find that HCWs do not understand how AI works, how their data can be used, or why AI systems might retain their information. HCWs are unaware that AI is already being utilized in their work, primarily via algorithmic shift-matching systems adopted by agencies. Participants detail the risks AI poses in sensitive care settings for HCWs, patients, and agencies, including threats to workers' autonomy and livelihoods, and express concerns that workers will be held accountable for AI mistakes, with the burden of proving AI's decisions incorrect falling on them. Considering these risks, participants advocate for new regulations and democratic governance structures that protect workers and control AI deployment in home care work.

Home care workers (HCWs) are professionals who provide care to older adults and people with disabilities at home. However, HCWs are vulnerable and especially susceptible to wage theft, or not being paid their legally-entitled wages in full by their employers. Prior work has examined other low-wage work settings to show how technology is designed and deployed has the potential to both cause and address wage theft. We extend this work by examining the relationship between technology and wage theft in the home care context. We collaborated closely with a local grassroots organization to conduct interviews with workers and labor, legal, and payroll experts. We uncovered how the complex, volatile, and diverse nature of home care complicates the errors in time-tracking systems. Through design provocations and focus groups with workers and experts, we also investigated the potential of technology as a part of broader efforts to curb wage theft through educating and empowering isolated HCWs. While we found that approachable design could reduce errors in existing systems, make employer processes more transparent, and help workers exchange knowledge to build collective power, we also discuss concerns around burden, privacy, and accountability when designing technologies for HCWs and other low-wage workers.

In recent years, there has been a growing focus on HCI research in non-western contexts, attracting junior researchers from diverse backgrounds to actively engage in this global community. However, there are limited avenues for junior researchers to learn the unwritten practices and nuances of the research process. Our workshop addresses this need through a 3-hour coaching session where junior researchers are paired with experienced senior researchers to work on a concrete research task of the junior researcher’s choice, providing valuable mentorship and guidance.

Home health aides are paid professionals who provide long-term care to an expanding population of adults who need it. However, aides' work is often unrecognized by the broader caregiving team despite being in demand and crucial to care---an invisibility reinforced by ill-suited technological tools. In order to understand the invisible work aides perform and its relationship to technology design, we interviewed 13 aides employed by home care agencies in New York City. These aides shared examples that demonstrated the intertwined nature of both types of invisible work (i.e., emotions- and systems-based) and expanded the sociological mechanisms of invisibility (i.e., sociocultural, sociolegal, sociospatial) to include the sociotechnical. Through these findings, we investigate the opportunities, tensions, and challenges that could inform the design of tools created for these important, but often overlooked, frontline caregivers.

Frontline health workers provide essential services for their communities, but much of their work remains invisible—undervalued and underappreciated. Examining this invisible work ensures new technologies do not amplify or reinforce inequitable power structures, especially as governments and organizations push to digitize health work processes. We build on a burgeoning conversation by studying how invisible work manifests and how this invisibility can be challenged in two contexts of frontline health: home health aides in New York City, USA and Accredited Social Health Activists (ASHAs) in Uttar Pradesh, India. We highlight three shared manifestations of invisible work: (1) work done outside of the workers’ boundaries (2) work done to gain and share knowledge and (3) work done to manage relationships. These common categories are experienced differently in the two contexts, raising nuances to consider when designing technology for frontline health workers. We discuss these nuances and other tensions through concrete examples of how workers can escalate feedback and conflicts, quantify implicit expertise about patients, or build more awareness of their situation. Our paper guides the creation of technologies that take into account a more comprehensive understanding of the frontline health workers’ processes and highlight more of their contributions.

Response bias has been framed as the tendency of a participant's response to be skewed by a variety of factors, including study design and participant-researcher dynamics. Response bias is a concern for all researchers who conduct studies with people — especially those working with participants with disabilities. This is because these participants’ diverse needs require methodological adjustments and differences in disability identity between the researcher and participant influence power dynamics. Despite its relevance, there is little literature that connects response bias to accessibility. We conducted semi-structured interviews with 27 accessibility researchers on how response bias manifested in their research and how they mitigated it. We present unique instances of response bias and how it is handled in accessibility research; insights into how response bias interacts with other biases like researcher or sampling bias; and philosophies and tensions around response bias such as whether to accept or address it. We conclude with guidelines on thinking about response bias in accessibility research.

Despite the recent push toward using information and communication technologies (ICTs) to replace paper-based workflows, there remain many barriers to designing appropriate and deployable ICT solutions that replace paper. As a result, paper tools such as forms, charts, and graphs continue to be widely used, especially in developing regions. While paper is not without its drawbacks, its advantages are especially relevant to low-resource settings as paper tools require only a fraction of the development, deployment, and operational costs of software apps. In this paper, we investigate how paper tools can be improved and combined with ICTs so that low-resource organizations working in developing regions can benefit from the advantages of both types of tools. We perform an exploration of existing tools to design, printr, a system that integrates into existing paper-based workflows by allowing an organization to rapidly generate paper tools that can perform some functions typically associated with computation---addition, subtraction, lookup, visual feedback, and visualization --- without requiring the introduction of an ICT at the point of use. We compare two paper tools that printr produces with two mobile phone apps developed by a large NGO in Ghana and find comparable user performance between apps and generated paper tools.

The partograph is a paper-based tool that helps healthcare providers monitor births to identify and prevent obstructed labour. It is especially pertinent for nurses in remote healthcare centers conducting deliveries on amidst a lack of staff and resources. While the low-cost nature of the partograph creates a potential for impact in these settings, it is ultimately not being used, and many information communication technologies (ICTs) have been developed to address barriers to compliance. The process of attempting to adapt such an ICT to remote settings uncovered larger issues---more fundamental barriers surrounding partograph usage and rural childbirth that information technology cannot solve. This paper presents initial observations and subsequent analyses of these lessons from the field, emphasizing the importance of understanding quality of care during childbirth beyond the partograph.

Paper as a medium persists as the de facto standard for information collection, storage, and transfer in many low-resource developing contexts. Of these contexts, the microfinance industry continues to be fascinating in the ongoing ICTD conversation due, in part, to its elimination of paper by digitizing money transfers using mobile banking. This success invites scholars, designers, and industry practitioners to design technology solutions to eliminate the perceived inefficiencies of paper in microfinance and other industries. In this work, we take a step back to assess the role and value of paper in order to give designers pause when considering a blanket digitization of existing processes, norms, and transactions. Specifically, we study a microfinance ecosystem in the city of Tema in Ghana and find that paper passbooks are able to deliver valuable context-specific information to its owners that derive from the specific affordances of paper itself. Our findings encourage a more nuanced view of paper's place in microfinance, and consequently, in similar low-resource settings.