We present a qualitative interview study that examines what happens when things do not go as planned with digital contraception. Through an analysis of 27 interviews with ongoing users of digital contraception at the time of the study, we convey participants’ accounts of their experiences regarding unplanned pregnancies or use of emergency contraception to avoid an unplanned pregnancy. Our analysis considers participants’ sense-making processes, and notably how they attended to questions of risk and responsibility. Finally, we depict how these participants came to continue using digital contraception after these experiences. Our study connects to ongoing conversations on technological failures in personal informatics and safety-critical systems. We emphasise that failure and success should not be used as a binary classification of long-term users’ relationships with self-tracking technology, which are intimate and critical. Rather, the sustained relation with an intimate technology is composed by several ‘failures’ which are interpreted, acted upon, and, ultimately, overcome.

Digital contraceptives are intimate technologies that support their users, and their partners, in preventing pregnancy. These technologies rely on basal body temperature data to predict ovulation and calculate a fertile window, where there is a risk of pregnancy if partners have unprotected sex. Although their use is shared and relational, these technologies are mainly designed for a primary user — the person who can become pregnant. We turn our attention to secondary users of digital contraception (i.e., sexual partners), specifically, Natural Cycles. We investigate how secondary users are designed for and how primary users imagine them to be. We contribute empirical insights on how secondary users are and are not involved in digital contraception and conclude with three design proposals describing how digital contraception tools could be designed to involve secondary users. We discuss how designing for secondary users of intimate technologies requires balancing their potential as co-users and adversaries.

This paper presents a bioinspired, multi-channel auditory signal encoder based on volatile memristors, designed to mimic the short-term adaptation behavior of the human auditory system. The system integrates a threshold generator with an asynchronous delta modulator (ADM) to dynamically adjust threshold voltages based on real-time memristor behavior. The encoder is implemented with standard 130nm CMOS technology, occupying a compact area of 0.44 mm × 0.185 mm per channel and consuming 299.85 μW per channel. The adaptive resolution of the encoder is validated in simulations using a memristor model derived from real device data, demonstrating adaptive output firing rates as a result of memristor resistance volatility. With a maximum delay of 45.25 ns for a 1 kHz sound input, the design is well-suited for spike-domain neuromorphic systems.

The memristor, as a cutting-edge nanodevice, has been studied for decades and gives rise to a wide range of applications across various fields. Although small signal analysis are crucial in circuit design and memristors exhibit unique Alternating Current (AC) features such as memimpedance, extensive research and reliable AC models are still lacking. This paper presents a memristor small-signal AC model that captures memimpedance effect by statistical modelling the complex impedance as a function of stimulus frequency and resistive state (RS). The model has been developed in Verilog-A and verified in Cadence Virtuoso Electronic Design Automation (EDA) tools. The proposed model can support small-signal analysis for hybrid CMOS/memristor circuits and systems, providing more realistic memristor AC behaviours. The modelled memimpedance signature is expected to enable more emerging circuit applications.

We present a large-scale, qualitative interview study that examines how an intimate technology within reproductive health comes to be chosen and trusted as a mode of contraception and how its use is shared between partners. We conducted 133 semi-structured interviews with primary users of Natural Cycles, focusing specifically on its use as a digital contraceptive. Our interpretive analysis, first, sheds light on perceptions of risks and benefits, along with how, and by whom, the decision to adopt Natural Cycles got made. Second, we discuss participants' and their partners' gradual development of trust in the system, and how this intertwines with interpersonal trust. Third, we consider the shared use of Natural Cycles, including partner involvement in temperature tracking, the sharing of intimate data, and navigating specific choices and risks regarding sex and contraception. We make a primarily empirical contribution to Computer Supported Cooperative Work (CSCW) research on shared uses of technology and the sharing of intimate data, and highlight avenues for future work to foster understanding of intimate technologies and their shared use in relational settings.

The concept of ‘bodywork´ refers to the work individuals undertake on their own bodies and the bodies of others. One aspect is attending to bodily needs, which is often overlooked in the workplace and HCI/CSCW research on work practices. Yet, this labour can be a significant barrier to work, consequential to work, and prone to spill over into other aspects of life. We present three empirical cases of bodywork: gig-based food delivery, shift work in hospitals and bars, and office-based knowledge work. We describe what attending to bodily needs at work entails and illustrate tactics employed so that work can be carried on, even when the body (or technology optimising it) breaks down. Arguing that all systems are bodily systems, we conclude with a call to acknowledge the centrality of bodies in all work and the roles technologies can play in supporting or constraining bodywork differently for different workers.

The ‘intimate horizons’ of algorithmic, self-tracking technologies have become increasingly important. These applications are no longer perceived as distant, instrumental entities, but offer a more affective and intimate experience. In this paper, we address the long-term experience of living with a digital contraception technology that utilizes self-tracking. We draw upon four design workshops with a total of 14 users of the app Natural Cycles to illustrate moments of ambivalent affects and oscillating relations. Based on our analysis, we concretize four dimensions of ambivalence in different scales and temporalities. We propose three strategies of designing with these unavoidable disruptions, conflicting feelings, and shifting relations to acknowledge users’ agentic engagements, nuanced dynamics of intimate self-tracking experiences, and users as embodied and affective beings. We contend that by attending to these existential ambivalences, digital contraceptive can become better configured to plural modes of life and long-term intimate relations that they engender.

Advances in intimate care technologies and on-body wearables are disrupting how and where we think about and care for our bodies. The boundaries between private and public are increasingly porous. This offers new sites for studying intimate care as technology-use-in-practice. We present a qualitative study on the use of breast pumps in the workplace, based on semi-structured interviews with 19 individuals. Through this, we contribute an illustration of the complexities in carrying out intimate care work at the workplace and what it means to be pumping at the workplace. Our analysis unpacks (in)visibility as a crucial tension in the use of breast pumps in the workplace. We discuss how (in)visibility of personal medical devices plays a mediating role in how individuals exercise bodily rights, and the norms of who fits into professional settings.

Limited interaction with professionals, infrastructural, and social constraints put barriers in providing holistic support to expectant and new mothers in low-resource settings. We examine the use of digital support groups facilitated through WhatsApp by a non-government organization in India. Complementing prior research, these digital peer support groups inform about an open public space created over a chat platform where rural communities and health professionals can engage. By qualitatively analyzing six months of interaction among 588 group members and collecting the experiences of the group moderators, we inform about how the support groups acted as an important source for compensating the gaps in the existing healthcare, providing reassurance support on routine health, explanation on test reports, validation and counseling support in ongoing treatments. We also derive implications for the future of digital support groups and the need for further research on the use of unplatformed design models in resource-constrained settings.

Care workers are increasingly using digital technology in their daily lives, for monitoring, financial compensation, training, coordination, and more. State and corporate actors have invested significant resources to enable this digital shift, particularly during the COVID-19 pandemic. However, care work has remained chronically underpaid, and continues to rely on women from minoritized and marginalized backgrounds. Our paper examines how care workers carefully navigate digitization, precarity, and complex social relationships, in an attempt to care for their communities and each other. We analyze the emerging digital ecosystem for frontline health workers in India during the COVID-19 pandemic where these dynamics have been highly visible. Our research draws attention to four interconnected ways in which workers practiced care, by directing their efforts towards survival, resilience, advocacy, and/or resistance. We suggest these also as care orientations that can be adopted by researchers and practitioners, to critically reflect on and direct technology design towards enabling more caring futures, for (and with) workers and communities.

In India and other developing countries, Community Health Workers (CHWs) provide the first line of care in delivering necessary maternal and child health services. In this work, we assess the training and skill-building needs of CHWs, through a mobile-based training intervention deployed for six months to 500 CHWs for conducting 144 training sessions in rural India. We qualitatively probed 1178 questions, asked by CHWs, during training sessions, and conducted a content analysis of the learning material provided to CHWs. Further, we interviewed 48 CHWs to understand the rationale of information seeking and perceptions of training needs. We present our understanding of the knowledge gaps of CHWs and how the current learning material and training methods are ineffective in addressing it. Our study presents design implications for HCI4D researchers for mobile learning platforms targeted towards CHWs. We also provide policy-level suggestions to improve the training of CHWs in India or a similar context.

Despite a crucial role in providing public health services, Community Health Workers (CHWs) remain disadvantaged in receiving effective skill-building opportunities. Due to the lack of health experts and appropriate infrastructure, it becomes challenging to provide training on a regular basis. Our aim is to investigate opportunities for designing technology-supported collaborative learning to compensate for the limited availability of instructors. We designed a mobile learning-based peer-led educational intervention, and conducted an eight week long between-group study with 120 CHWs across four districts of Delhi, India. We found that CHWs were able to participate and use the system on their own leading to significant knowledge gains and increased desire to learn. With little guidance, CHWs exhibited benefits of collaborative learning in terms of positive interdependence on each other and use of interpersonal skills. The informal peer learning environment encouraged CHWs to have discourses on deeper societal aspects e.g. their role in society.

Use of chatbots in different spheres of life is continuously increasing since a couple of years. We attempt to understand the potential of chatbots for breastfeeding education by conducting an Wizard-of-Oz experiment with 22 participants. Our participants included breastfeeding mothers and community health workers from the slum areas of Delhi, India. We prototyped our chatbot as an interactive question-answering application and analyzed users' interaction patterns, perceptions, and contexts of use. The chatbot use cases emerged primarily as the first line of support. The participants, especially the mothers, were enthusiastic with the opportunity to ask questions and get reliable answers. We also observed the influencing role of female relative, e.g. mothers-in-law, in breastfeeding practices. Our analysis of user information-seeking suggests that a majority of questions (88%) are of nature that can be answered by a chatbot application. We further observe that the queries are embedded deeply into myths and existing belief systems. Therefore requiring the designers to focus on subtle aspects for providing information such as positive reinforcement and contextual sensitivity. Further, we discuss, different societal and ethical issues associated with Chatbot usage for a public health topic such as breastfeeding education.

Voice forums are an effective intervention medium for marginalized communities to access information in a structured and localized manner. Users actively contribute by posting questions and responses in the form of audio messages, and thereby help in enriching the voice forum content. In order to build an audio library using the voice forums to disseminate information, significant manual effort is needed in analyzing and curating the data. This is one of the key impediments to the successful implementation of voice forums for knowledge dissemination and training.

The Healthcare system of India provides outreach services to the rural population with a key focus on the maternal and child health through its flagship program of Community Health Workers (CHWs). The program since its launch has reached a scale of over 900000 health workers across the country and observed significant benefits on the health indicators. However, traditional face to face training mechanisms face persistent challenge in providing adequate training and capacity building opportunities to CHWs which leads to their sub-optimal knowledge and skill sets. In this paper, we propose Sangoshthi, a low-cost mobile based training and learning platform that fits well into the environment of low-Internet access. Sangoshthi leverages the architecture that combines Internet and IVR technology to host real time training sessions with the CHWs having access to basic phones only. We present our findings of a four week long field deployment with 40 CHWs using both qualitative and quantitative methods. Sangoshthi offers a lively environment of peer learning that was well received by the CHW community and resulted into their knowledge gains (16%) and increased confidence levels to handle the cases. Our study highlights the potential of complementary training platforms that can empower CHWs in-situ without the need of additional infrastructure.

Interactive Voice Response (IVR) platforms have been widely deployed in resource-limited settings. These systems tend to afford asynchronous push interactions, and within the context of health, provide medication reminders, descriptions of symptoms and tips on self-management. Here, we present the development of an IVR system for resource-limited settings that enables real-time, synchronous interaction. Inspired by community radio, and calls for health systems that are truly local, we developed "Sehat ki Vaani". Sehat ki Vaani is a real-time IVR platform that enables hosting and participation in radio chat shows on community-led topics. We deployed Sehat ki Vaani with two communities in North India on topics related to the management of Type 2 diabetes and maternal health. Our deployments highlight the potential for synchronous IVR systems to offer community connection and localised sharing of experience, while also highlighting the complexity of producing, hosting and participating in radio shows in real time through IVR. We discuss the relative strengths and weaknesses of synchronous IVR systems, and highlight lessons learnt for interaction design in this area.