Faith institutions provide social support and community care for many in the United States (U.S.). Notably, churches with predominantly Black populations have served as a site for social change and care provision, historically and in contemporary society. However, the pandemic has emphasised how localising these care networks in physical spaces can limit access to social support. Information and communication technologies offer opportunities for expanding access to care in these communities. However, integrating care networks into online contexts remains a challenge for many churches, and the potential for technology to expand these networks is not well understood. Through interviews and focus groups with nine church members, we explore how hybrid faith communities that bridge offline and online contexts can enable social support and care provision. Our findings highlight care network structures in Black churches, barriers to embedding these networks online and strategies for building more seamless hybrid support systems.

Over 55 million adults worldwide have dementia, a syndrome characterized by deterioration in cognitive functioning. Screening for mild cognitive impairment is important to identify dementia early to facilitate diagnosis and initiate treatment that may modify the disease trajectory. However, standard cognitive screening tools are time-consuming, require expert administration, and make people feel as if they are being tested and are thus potentially stigmatizing. Consequently, standard cognitive screening tools are underutilized, and dementia is often identified much later in the disease process leading to greater health-related and societal harms. We explored cognitive ability assessments using virtual agents, in which assessments are made during conversational dialogues. We evaluated four strategies for the assessment of cognitive ability in a sample of 41 individuals with varying cognitive ability, comparing each strategy to scores on the Mini Mental Status Exam (MMSE), the gold standard clinical screening tool for cognitive impairment. One of the four conversational strategies demonstrated significant agreement with the MMSE, with a sensitivity of 92.3% and a specificity of 48.3% for identification of impairment compared to the MMSE. Participants reported moderate levels of satisfaction with the agent-based conversational assessment. This approach could be used to identify individuals warranting more evaluation for possible cognitive impairment.

HCI researchers have increasingly examined how social context shapes health behaviors. Much of this work operates at the interpersonal level. Communities such as churches play important roles in supporting wellbeing and addressing health inequities. While some work has investigated creating digital health tools for religious populations, few have explicitly focused on the incorporation of community support in the form of prayer support. Embedding health interventions in any community has the potential to support or challenge the community’s dynamics. We report on findings from interviews with 17 church members who used a church-based mHealth application over a 4-week period and provide guidelines for developers based on these results. Through their use of the system, participants characterized several community dynamics including a desire for social intimacy, communicating care, creating opportunities for fellowship, maintaining privacy and discretion, and building community connections, and how these dynamics influence their aspirations for a church-based health app.

Churches have historically played an important role in Black American communities, catalyzing the pursuit of aims such as social justice, community organization, and health promotion. However, researchers have rarely examined how technology can support an assets-based approach to these efforts, nor the implications of race, traditions, and history when creating such systems. Addressing this gap, we conducted research with two predominantly Black churches to explore health promotion design opportunities. We used photovoice, a research method where participants led their own data collection and analysis. Participants provided nuanced descriptions of the racial and ethnic identities of their communities, and how church history and aspirations for the future impacted these identities. Our findings characterize tensions between tradition and ‘modernization,’ implications for technology design, and the need for a temporal approach to understanding communities. We conclude with broader implications for studying the intersection of race and religion in community technology design.

Churches play a major role in providing social support to address health inequities within Black communities, in part by connecting members to key organizations and services. While public health has a history of disseminating interventions in faith communities, little work has explored the use of crowdsourcing to tailor interventions to the unique culture of each church community. Following Community Based Participatory Research principles, we partnered with two predominantly Black churches, and report on a series of three participatory design sessions with nine participants. We developed a novel storyboarding method to explore how crowdsourcing could promote health in these faith-based communities. Our findings characterize existing supports within the church community, and how church social structures impact member access to these supports. We further identify motivations to engage with a church-situated health application, and how these motivations translate to crowdsourcing tasks. Finally, we discuss considerations for public health crowdsourcing tasks.

Culturally informed design for virtual agents has been shown to positively impact health outcomes when tailored to target audiences. We present a participatory design methodology for culturally tailoring virtual agents. Investigators worked with key informants from our target population, members of predominantly Black church communities, to design culturally-relevant and sensitive virtual agent health promotion interventions. In the first participatory session, key informants designed agents to assist them with different aspects of their lives, providing input on agent appearance and agent functionality. In a second design session, participants re-wrote the content of a health conversation with an agent, to include personally-relevant content related to their community (e.g., religious and scriptural references). We report design principles for religious tailoring derived from these studies. We conducted a validation study to assess the effects of applying these principles to agents that promoted two health behaviors, finding that participants responded very positively to the tailored agents.

Research on the psychology of humor indicates that humor can increase the impact of persuasive messages in certain circumstances, suggesting that virtual agents could use humor to improve the effectiveness of motivational counseling with users. To explore this idea, we developed two virtual agents that attempt to motivate users to perform healthy behaviors - either to increase exercise or fruit and vegetable consumption - and systematically vary whether they use humor or not in their counseling conversations. Human-authored jokes were selected from a large corpus based on the nature of the humor (empathetic affiliative humor that serves to build relational closeness), health topic relevance, and subjective ratings of funniness, as well as relevance to user stage of behavior change. We evaluated our agents in a two-treatment counterbalanced within-subjects experiment, where participants interacted with a humorous and non-humorous agent motivating either exercise or healthy diet. We found the interaction with the humorous agent led to a significantly greater change in motivation to engage in the target behavior than interacting with the non-humorous agent.

Conversational humanoid robots are being increasingly used for health education and counseling. Prior research provides mixed indications regarding the best modalities to use for these systems, including user inputs spanning completely constrained multiple choice options vs. unconstrained speech, and embodiments of humanoid robots vs. virtual agents, especially for potentially sensitive health topics such as breastfeeding. We report results from an experiment comparing five different interface modalities, finding that all result in significant increases in user knowledge and intent to adhere to recommendations, with few differences among them. Users are equally satisfied with constrained (multiple choice) touch screen input and unconstrained speech input, but are relatively unsatisfied with constrained speech input. Women find conversational robots are an effective, safe, and non-judgmental medium for obtaining information about breastfeeding.