Social activities in long-term care homes help promote residents’ wellbeing, but their effectiveness depends on residents’ engagement. To identify design opportunities for promoting meaningful engagement, we conducted an ethnographic study on organised activities in an Australian aged care home. We observed staff fostered engagement by initiating conversations, weaving residents’ backgrounds into interactions, and adapting activities to residents’ varying abilities. However, challenges included new staff members’ unfamiliarity with residents, multi-tasking, and insufficient support to engage excluded residents. Using a care ethics lens that includes relational, situated and empathetic features of care, we show that meaningful engagement is shaped by the ethical care practices embedded in staff-resident interactions and highlight opportunities for technologies to mitigate barriers hindering staff from providing ethical care in existing activities. These opportunities include: collecting and recording residents’ interests, providing conversation prompts, enhancing activity inclusiveness, and reducing language and cultural barriers.

Through a systematic literature review, we unravel current theorizing on private information disclosure (PID). We note that existing models of PID have mainly taken an individual-level perspective. In line with current understanding of privacy management, we posit that PID should be more systematically understood as a multilevel phenomenon, for two reasons. First, the disclosed information sometimes concerns multiple stakeholders beyond oneself. Second, disclosing private information can often be affected by hierarchically structured (nested) humans within social units. To this end, we propose a multilevel theoretical framework together with future recommendations, aimed at inspiring future multilevel PID research.

Technology can be valuable for providing social and emotional enrichment for people living in residential aged care, but its use is difficult to sustain because of the complexity of the aged care environment. This paper aims to advance understanding of care environments to inform the sensitive design of technologies for social benefit in those settings. We conducted an ethnographic study in which the researcher assisted a care home's leisure and lifestyle team over four weeks. This included supporting the use of video-calling for social connectedness. A decrease in the use of video-calling and an absence of other technology for enrichment in the setting were observed. This paper identifies barriers to effective use of technology for enrichment and the interplay of cultural factors. For technology to best support residents and staff, we recommend key design considerations that target cultural, psychological and physical support and that ensure technologies, when used appropriately, better fit within the environment.

Immersive virtual reality (VR) is being used as an enriching experience for people living in residential aged care, or nursing homes, where care staff play a critical role supporting clients to use VR. In HCI research concerned with technology use in aged care, however, the role of formal caregivers has received limited attention. We conducted interviews with 11 caregivers working in care homes that have implemented VR as part of the social program offered to residents. Our findings highlight tensions between the opportunities created by the immersive VR experience and the risks and challenges full immersion presents for people in aged care. In this paper, we draw on an ethics of care framework to make visible the care practices involved in facilitating VR in aged care homes, highlighting the care required to ensure that older adults experience benefits when using immersive VR, while risks and challenges are carefully managed.

This paper explores the extent to which gender bias is introduced in the deployment of automation for hiring practices. We use an interdisciplinary methodology to test our hypotheses: observing a human-led recruitment panel and building an explainable algorithmic prototype from the ground up, to quantify gender bias. The key findings of this study are threefold: identifying potential sources of human bias from a recruitment panel’s ranking of CVs; identifying sources of bias from a potential algorithmic pipeline which simulates human decision making; and recommending ways to mitigate bias from both aspects. Our research has provided an innovative research design that combines social science and data science to theorise how automation may introduce bias in hiring practices, and also pinpoint where it is introduced. It also furthers the current scholarship on gender bias in hiring practices by providing key empirical inferences on the factors contributing to bias.

Electronic medical records are increasingly used to store patient information in hospitals and other clinical settings. There has been a corresponding proliferation of clinical natural language processing (cNLP) systems aimed at using text data in these records to improve clinical decision-making, in comparison to manual clinician search and clinical judgment alone. However, these systems have delivered marginal practical utility and are rarely deployed into healthcare settings, leading to proposals for technical and structural improvements. In this paper, we argue that this reflects a violation of Friedman's "Fundamental Theorem of Biomedical Informatics," and that a deeper epistemological change must occur in the cNLP field, as a parallel step alongside any technical or structural improvements. We propose that researchers shift away from designing cNLP systems independent of clinical needs, in which cNLP tasks are ends in themselves-"tasks as decisions"-and toward systems that are directly guided by the needs of clinicians in realistic decision-making contexts-"tasks as needs." A case study example illustrates the potential benefits of developing cNLP systems that are designed to more directly support clinical needs.

Social robots have the potential to augment the care provided to older adults in residential aged care homes. However, social robots can only be valuable in aged care if care staff successfully incorporate them into their ongoing care practices beyond a limited research period. This study examines the benefits and challenges of using different types of social robots in real-world practices from care staff perspectives. We conducted semi-structured interviews with eleven staff members who have first-hand experience of employing robots in their work. Our findings highlight the entangled relationships among the actors in the older adult/carer/robot triad. We discuss the role of robots in supporting a mutually beneficial relationship between care staff and older adults, and how robopets and humanoid robots impact care staff in different ways. Finally, we offer recommendations for the future deployment of robots. We argue that sustainable deployment of robots in care practice might involve recognizing and promoting positive impacts for both human parties in the triad, and that the practice of using robots needs to align with the needs and interests of both caregivers and care recipients.

In this article, we show how a technology-mediated mental health therapy involving psycho-education, therapist moderators, and social networking can provide support for carers of young people with mental illness. This multi-faceted tool provides opportunities for users to adapt the system to their needs, leading us to refocus the goal of treatment adherence toward a relatively new phenomenon in HCI, concordance, which has not previously been examined in the HCI literature in relation to online mental-health tools. Concordance shares important links with the development of therapeutic alliance, which is centrally important to mental health therapy, and to Self-Determination Theory (SDT), which informed our approach to design. We present a three-month user study, which provides initial encouraging support for both the suitability of concordance as a lens for viewing user engagement and the idea that users can develop a therapeutic alliance with an online support system. This latter result is surprising as the phenomenon of therapeutic alliance generally describes a relationship between client and (human) clinician. Therapeutic alliance has previously been explored for face-to-face groups, and between individuals and online systems, but not for online groups. We show how even automated system behavior can encourage engagement from users and contribute to alliance formation, if the non-human parts of an online system are interactive. We argue that a design approach involving peer/moderator support as well as automated feedback, and which takes account of SDT, can provide support for therapeutic alliance.

Online Health Communities (OHCs) have become a popular avenue for people to share common concerns about a health topic. However, because users of these forums tend not to have formal medical training, they often cannot verify objectively the soundness of the advice provided. Thus, there is a need to understand better the mechanism through which people trust and utilise information found on these forums. In testing a theory-based trust model, we find that forum users accept advice more readily as they develop cognitive trust (trust based on a cognitive assessment) and/or affective trust (trust based on an emotional connection). Affective trust is also closely related to formation of relational closeness. This indicates that, while both forms of trust are important, the development of emotional connections provides for long-term OHCs interactions. Findings here, indicate that prior exchanges are not needed to access and utilise OHC community resources. However, trust (developed through prior exchanges) is required for a recipient to leverage the contributor’s social capital for information adoption and relational closeness. These findings allow the distribution of social capital to be viewed in terms of an asymmetrical model where it is possible to accept capital, in the form of advice, without first demonstrating trustworthiness. In the OHC setting the onus is on the contributor of advice to establish trustworthiness, whereas traditionally social capital theory requires receivers of capital to establish trust. These findings are important for site designers and provide insight to managers and developers of OHCs regarding the behaviours and motivations of forum users.

Although the use and prevalence of Web-based mental health applications have grown over the past decade, many of these services suffer high rates of attrition. This is problematic, as face-to-face support for mental health is limited. To determine appropriate design guidelines for increasing engagement, we conducted a study of First-Episode Psychosis (FEP) patients and reviewed theories on the use of existing online services. We produced a set of design goals, developed an online application that combined social networking and online therapy within a clinician-moderated site, and conducted a 6-week trial with a group of young FEP patients. The design goals, based on existing theory including Supportive Accountability and Positive Psychology, are operationlised through a model we call Moderated Online Social Therapy (MOST). The trial results indicate that our implementation achieved the design goals and that the MOST model can inform the development of more effective and engaging online therapies.

In a number of organisational settings where work is highly skilled but substantially routine, certain entrenched manual systems have resisted digitisation. These systems include card-based systems in emergency despatch, the paper flight progress strips system used in air traffic control, the Kanban system and whiteboard systems used in hospital wards. Research to understand or replace these systems has frequently regarded them as decision support systems (DSS). We report here a detailed case study of a manual whiteboard-based bed allocation system in the ICU of a large general hospital, which shows that the support it provides for users’ action choices cannot be validly conceived as decision support. This system and other effective manual systems may be better understood as a ‘situated choice support system’ (SCSS). Whereas DSS provide actors with a model of the action environment in order to support reasoning about the consequences of alternative actions, SCSS provide actors with structured work environments that reduce possible actions and cue-providing information resources to support a reactive choice between these limited alternatives. The findings warn of the danger of uncritically applying the DSS design paradigm to supporting action choice in skilled routine work, and provide an alternative design theory, which can potentially inform new ICT-based designs.

This research provides an analysis of the implementation of the "standards for the privacy of individually identifiable health information " (medical privacy rule) published in August 14, 2002 by the Department of Health and Human Services (HHS) following the issuing of a privacy rule by the Clinton administration in December 2000 and later support by the Bush administration. The privacy rule went into effect April 14, 2001, with compliance required by April 2003 for most health providing entities. The resulting legislation is designed to ensure that the business activity of health providers is subject to privacy regulation. In this research we examine the ability of health organisations to respond to the requirements of this legislation and illustrate that this ability is affected by the quality of their patient data and the structure and security of their databases. This paper suggests that compliance with the legislative provisions creates implications for information systems development and design which large public hospitals have so far failed to consider or act upon.

We examine the prescribing process in a hospital to see whether information systems failure contributes to the occurrence of prescribing errors. J.T. Reason's (1990) model of organisational failure suggests that this may be the case. Reason identified circumstances in work systems and processes where errors may occur. While Reason's model has been applied in a medical context, it has not previously been linked to errors which result from information systems failure. It is held, however, that the model can be used as a predictive tool, suggesting that prescribing errors have an increased likelihood of occurring if one or more of the types of failure identified in Reason's model are present in the existing information delivery process in a hospital. In this paper, we examine the application of Reason's model in predicting prescribing errors and then calculate the extent to which these errors are evident in the hospital ward under examination.