Patient-provider communication is an important aspect of successful healthcare, as it can directly lead to positive health outcomes.Previous studies examined factors that facilitate communication between healthcare providers and patients in socially marginalized communities, especially developing countries, and applied identified factors to technology development.However, there is limited understanding of how providers work with patients from immigrant populations in a developed country.By conducting semistructured interviews with 15 providers working with patients from an immigrant community with unique cultural characteristics, we identified providers' effective communication strategies, including acknowledgment, community involvement, gradual care, and adaptive communication practices (i.e., adjusting the communication style).Based on our findings, we highlight cultural competence and discuss design implications for technologies to support health communication in immigrant communities.Our suggestions propose approaches for HCI researchers to identify practical, contextualized cultural competence for their health technology design.

Individuals resettled in a new environment often face challenges in accessing adequate healthcare services, particularly within the complex processes of outpatient clinic care. Cultural differences, language barriers, and low socioeconomic status contribute to these difficulties. While previous studies have identified barriers and proposed technology-mediated solutions for resettled populations, many focus on addressing deficits rather than building on the strengths these communities already possess, which limits the sustainability and relevance of these solutions in everyday life. We conducted two community-based participatory design workshops with 30 Hmong community members in a large metropolitan area in the US. Through this process, we identified four types of assets the community has gradually developed, including intergenerational support for health management and storytelling-based communication practices that facilitate relatable and culturally grounded interactions. We show how participatory design workshops can foster asset-based approaches, and discuss design implications for technologies that leverage patients' existing strengths to support their health management during outpatient visits.

Information is crucial to how people understand their mental health and well-being, and many turn to online sources found through search engines and social media. We present an interview study (n = 17) of participants who use online platforms to seek information about their mental illnesses. Participants use their personal information ecosystems in a cyclical process to find information. This cycle is driven by the adoption of new information and questioning the credibility of information. Privacy concerns fueled by perceptions of stigma and platform design also influence their information-seeking decisions. Our work proposes theoretical implications for social computing and information retrieval on information seeking in users’ personal information ecosystems. We offer design implications to support users in navigating personal information ecosystems to find mental health information.

Public stigma on the Human Immunodeficiency Virus (HIV) affects the physical and psychological wellbeing of those living with the condition in a severe way. There is work around the design of technology for medication adherence and HIV treatment. Yet, there is still a lack of empirical research that investigates how people could cope with stigma more effectively using technology. Thus, we obtained data from co-design workshops conducted remotely from the U.S. with 25 people living with HIV. Our findings foreground key needs and values via the discussion of features and functionality of speculative co-designed technologies that would allow people to leverage key stigma coping strategies. Based on these insights, we forward design implications for social media, which is the most common type of technology that people living with HIV currently use to cope with public stigma.

Millions of Americans forego medical care due to a lack of non-emergency transportation, particularly minorities, older adults, and those who have disabilities or chronic conditions. Our study investigates the potential for using timebanks—community-based voluntary services that encourage exchanges of services for “time dollars” rather than money—in interventions to address healthcare transportation barriers to seed design implications for a future affordable ridesharing platform. In partnership with a timebank and a federally qualified healthcare center (FQHC), 30 participants completed activity packets and 29 of them attended online workshop sessions. Our findings suggest that promoting trust between drivers and riders requires systems that prioritize safety and reliability; yet, there were discrepancies in the ability of the timebank and FQHC to moderate trust. We also found that timebank supports reciprocity, but healthcare transportation requires additional support to ensure balanced reciprocity. We explain these findings drawing from network closure and trust literature. Finally, we contribute design implications for systems that promote trust and facilitate relational over transactional interactions, which help to promote reciprocity and reflect participants’ values.

The rise of ridesharing platforms has transformed traditional transportation, making it more accessible for getting to work and accessing grocery stores and healthcare providers, which are essential to physical and mental well-being. However, such technologies are not available everywhere. Additionally, there is a scarcity of HCI work that investigates how vulnerable populations such as rural-dwelling people with HIV face and overcome transportation barriers. To extend past research, we conducted 31 surveys and 18 interviews with people living with HIV (22 surveys, 14 interviews) and their case coordinators (9 surveys, 4 interviews) in rural areas. Contrary to past research, we found that the use of alternative vehicles, extensive support networks, and nonprofit health organizations facilitated transportation. However, distance, the lack of trust and infrastructure, stigma, and other cultural underpinnings made popular forms of urban transportation unappealing. We contextualize our findings with prior research and contribute implications for future research and design.

Music therapists provide critical, evidence-based care to a diverse range of clients. However, despite their active role in empowering individuals affected by disability, stigma, grief, and trauma, music therapists remain understudied by the HCI community. We present the results of a mixed methods study of 10 interviewees and 20 survey respondents in the U.S., all of whom are practicing music therapists. Our results show that music therapists engage in technology-aided practices such as making personalized connections with clients, assisting in identity formation, encouraging musicking (music-making), and preserving legacies. Results also show that music therapists face key challenges such as environmental, societal, and financial constraints, including high workload, lack of awareness of the value of music therapy among the general community, and limited access to secure technologies for remote client care. In light of these challenges, we present a set of design implications for creating future technologies for music therapists. This work diverges from previous studies on music therapy technologies, which focus largely on interventions with music therapy clients, by highlighting the often-neglected perspectives from music therapists.

As people's offline and online lives become increasingly entwined, the sensitivity of personal information disclosed online is increasing. Disclosures often occur through structured disclosure fields (e.g., drop-down lists). Prior research suggests these fields may limit privacy, with non-disclosing users being presumed to be hiding undesirable information. We investigated this around HIV status disclosure in online dating apps used by men who have sex with men. Our online study asked participants (N=183) to rate profiles where HIV status was either disclosed or undisclosed. We tested three designs for displaying undisclosed fields. Visibility of undisclosed fields had a significant effect on the way profiles were rated, and other profile information (e.g., ethnicity) could affect inferences that develop around undisclosed information. Our research highlights complexities around designing for non-disclosure and questions the voluntary nature of these fields. Further work is outlined to ensure disclosure control is appropriately implemented around online sensitive information disclosures.

People living with HIV experience a high level of stigma in our society. Public HIV-related stigma often leads to anxiety and depression and hinders access to social support and proper medical care. Technologies for HIV, however, have been mainly designed for treatment management and medication adherence rather than for helping people cope with public HIV-related stigma specifically. Drawing on empirical data obtained from semi-structured interviews and design activities with eight social workers and 29 people living with HIV, we unpack the ways in which needs for privacy and trust, intimacy, and social support create tensions around key coping strategies. Reflecting on these tensions, we present design implications and opportunities to empower people living with HIV to cope with public HIV-related stigma at the individual level.

HIV status disclosure fields in online sex-social applications ("apps") are designed to help increase awareness, reduce stigma, and promote sexual health. Public disclosure could also help those diagnosed relate to others with similar statuses to feel less isolated. However, in our interview study (n=28) with HIV positive and negative men who have sex with men (MSM), we found some users preferred to keep their status private, especially when disclosure could stigmatise and disadvantage them, or risk revealing their status to someone they knew offline in a different context. How do users manage these tensions between health, stigma, and privacy? We analysed our interview data using signalling theory as a conceptual framework and identify participants developing 'signal appropriation' strategies, helping them manage the disclosure of their HIV status. Additionally, we propose a set of design considerations that explore the use of signals in the design of sensitive disclosure fields.

Researchers in HCI have typically relied on face to face (FtF) methods for recruitment and data collection in their research with people living with HIV, whereas social scientists have adopted computer-mediated approaches to address concerns about data validity and access to this stigmatized population. In this paper, we use the asynchronous remote community (ARC) research method to leverage HCI instruments in an online format. ARC successfully engaged people living with HIV in terms of participation and retention by providing a safe space to discuss their experiences. By expanding on past ARC studies, we contribute to an ongoing conversation about defining ARC and working towards increased data validity -- especially in stigmatized communities.