Chronic diseases are the main drivers of rising healthcare costs in Europe. Over the last 30 years, the number of people with obesity has doubled. Reducing overweight and obesity is critical in tackling chronic diseases, as they are the primary risk factors for many chronic diseases. However, adherence to lifestyle interventions is low. Patient empowerment is strongly associated with improving adherence. Despite the potential of digital health to support the empowerment process, there is a lack of design knowledge for such systems that span multiple iterations of patient self-management and consultations. Such knowledge is essential as chronic diseases are iterative in nature and require continuous care. This study reports on a research-through-design project that aimed to improve adherence to treatment with the Digital Companion. The Digital Companion is an integrated system that facilitates the empowerment process by activating patients to participate in patient-centered consultations. We evaluate the Digital Companion in a naturalistic and formative evaluation. Analyzing the behavior of 27 patients when using the Digital Companion allowed us to formulate four socio-technical design principles that propose the design of patient empowerment systems to improve adherence in weight management.

Interacting with a conversational agent (CA) is becoming a major paradigm for human-technology interaction. Yet, ways for interacting with CAs are still forming, especially in situations involving more than one human. Starting an interaction with a CA might involve a wakeword and command. Alternatively, it could become active based on implicit requests and context information. Hence, CA designers face a serious dilemma: explicit commands disturb a natural conversation flow, while implicit requests might cause inadequate CA behavior. This study explores this dilemma and discusses observations from a project featuring a CA for financial advisory services. Advisors initially envisioned a CA that ''blends with the background'' and acts on context information. However, when engaging with a CA, they used conversational interactions in one part of the encounter and command-based interactions in another. We discuss this observation and contrast it against previous literature. This insight has implications for design and research.

CSCW and HCI research has a standing discourse on boundary negotiating artifacts and psychological ownership. Both concepts are attributed the potential to address the spreading chronic disease pandemic and rising healthcare costs. While CSCW has attended only to boundary negotiating artifacts to study patient-provider collaboration, the psychological ownership discourse primarily focuses on the perception of ownership over digital objects. Despite studies in both discourses reporting promising results, the concepts have been studied separately. Accordingly, the ways boundary negotiating artifacts relate to psychological ownership in healthcare interactions remain unclear. In this research-through-design study, we evaluate the Digital Companion as a technology-based boundary negotiating artifact. Our field study with 27 patients shows how the Digital Companion fosters psychological ownership in weight management by bridging domains and closing the loop between patient self-management and medical support in consultations. By understanding how boundary negotiating artifacts foster psychological ownership, we gain deeper insights into how patients assume and share ownership of their therapy plans. Our analysis uncovers the emergence of perceived shared ownership as BNAs create concordance between patients and physicians.

Conversational agents (CA) have drawn increasing interest from HCI research. They have become popular in different aspects of our lives, for example, in the form of chatbots as the primary point of contact when interacting with an insurance company online. Additionally, CA find their way into collaborative settings in education, at work, or financial advisory. Researchers and practitioners are searching for ways to enhance the customer's experience in service encounters by deploying CA. Since competence is an important treat of a financial advisor, they only accept CA in their interaction with clients if it does not harm their impression on the client. However, we do not know how the social presence of the CA affects this perceived competence. We explore this by evaluating three prototypes with different social presences. For this, we conducted a video-based online survey. In contrast to prior studies focusing on single human-computer interaction, our study explores CA in a dyadic setting of two humans and one CA. First, our results support the Computers-Are-Social-Actors paradigm as the CA with a strong social presence was perceived as more competent than the other two designs. Second, our data show a positive correlation between CA's and advisor's competence. This implies a positive impact of the CA on the service encounter as the CA and advisor can be seen as a competent team.