Managing Gestational Diabetes Mellitus (GDM) is a significant challenge for pregnant individuals. Constant self-monitoring, emotional burden, and the short and long-term implications of GDM make the overall pregnancy experience challenging for these individuals, requiring action, learning, and lifestyle adjustment to manage the pregnancy properly. Prior literature on GDM mostly focuses on the medical and health management of the condition. However, pregnant individuals with GDM often must actively learn and adapt lifestyle strategies quickly without much support. Through semi-structured interviews with 13 pregnant individuals diagnosed with GDM, we investigate how these individuals experience, explore, learn, and reflect on ways to live with and manage GDM. Using Kolb’s Learning Theory to analyze and structure our findings, we built on pregnant individuals’ concrete lived experiences and uncovered the challenges as they navigate the GDM journey, managing their changing relationship with food and supporting emotional well-being while living with an often stigmatized condition in an at-risk pregnancy. Our study contributes to the discussion on the design opportunities to facilitate experiential learning of pregnant individuals’ journey.

Professional designers often struggle to apply insights from HCI research in their work. To make academic knowledge more accessible to practitioners, HCI researchers have created translational design tools, such as design cards, that support the translation of research insights into design practice. Prior work explored design cards for behavior change, interaction design, personal health informatics, and the sharing economy. Our work complements prior research by exploring the design and use of translational design cards for social aspects of societal resilience through a two-stage study with 14 student designers and eight professional designers. Our findings provide an empirical understanding of the design cards’ generative value for incorporating research insights into the design process. Additionally, we discuss recommendations and highlight opportunities to enhance the design and use of the cards beyond societal resilience.

The COVID-19 pandemic has threatened disproportionately rural older adults’ health and well-being as they suffer from unique social exclusion due to a lack of services, such as transportation, communication infrastructure, healthcare, and social services. Although older adults can uniquely cope with pandemic adversity compared to younger adults, less attention has been directed to investigating the coping and resilience of rural older adults. To understand how diverse coping strategies impact the resilience of rural older adults, we conducted interviews with 26 rural and small-town older adults. Older adult participants adopted different coping strategies, such as following protective measures, keeping themselves busy, providing and receiving social support, and having a positive mindset. They experienced positive changes, such as increased interpersonal connectivity. Older adults’ individual-level coping processes are influenced by their social and physical environments. We explore design opportunities to support older adults’ resilient practices and harness their skills to facilitate community resilience.

Research on smart home monitoring for older adults has predominantly focused on systems whose data and alerts are directed towards family members, caregivers, or healthcare providers. Older adults have expressed interest in engaging with these systems by seeing and using their data, but they are often limited to a passive role as subjects of monitoring. This paper presents qualitative results of a longitudinal smart home project with older adults living independently in the community. Based on interviews conducted throughout the 2.5-year study with 12 participants, we report on their lived experiences of having the monitoring system in their homes and on how they reflected on the data collected by the system. The results show how participants were able to extract meaningful information from the monitoring data without finding the system invasive or intrusive. Specifically, older adults exhibited interest in data that they found indicative of living an active lifestyle, such as time spent outside the home. Drawing from critical literature on active aging, we discuss implications for incorporating peer comparisons to support reflection on personal health data without reinforcing a deficit narrative of aging.

Forgetfulness is a primary factor of medication nonadherence, a problem that contributes to worse health outcomes and increased mortality among people with chronic conditions. Common strategies to address forgetfulness, such as timed reminders, have limited effectiveness. However, there is limited information about why these strategies fail. To address this gap, we conducted interviews with people who take medications daily and miss doses at least twice a month. We contribute a state-based Medication Routine Framework composed of four states (Wellness, New Task, Erratic, and Disruption) in two axes (regularity and time scale). Because most nonadherence due to forgetfulness occurs in nonroutine states (i.e., Erratic and Disruption state), we argue that improving technology for medication adherence requires designing for these states. In this paper, we describe each state in detail and discuss opportunities for adapting medication reminder strategies to overcome the challenges of nonroutine states.

Aging in place technologies are designed to extend independence and autonomy in older adults, promoting quality of life and peace of mind. Prior work has described how adoption and continued use of these technologies are low when they are perceived as reinforcing aging stigma or reminding older adults of negative aspects of aging. Building on past research, we investigate older adults’ perceptions of four different kinds of aging in place technologies. Based on in-depth interviews with 18 older adults using a set of scenarios, we describe how different design characteristics contribute to perceived aging stigma. Additionally, we draw on Duner & Nordström’s classification of coping strategies to discuss how specific kinds of technology can best support older adults during different stages of the aging process.

People with multiple chronic conditions (MCC) often face complex and overwhelming conflicts in their personal health management. However, little is known about how technology can help users to address these challenges. Better understanding the practices involved in conflict resolution is necessary to guide the design of technology aiming to support this population. This interview study investigated the strategies seniors use to overcome conflicts involving different health issues, their self-care tasks, risks of another illness or complication, and their personal values. We report on the different strategies used to address these conflicts, such as seeking advice and information from different sources to prioritize and compromise. Compromising often involves purposefully deciding against conventional treatments or self-care activities. We argue that rich information and flexibility are required to support decision making in MCC self-care, and advocate for a holistic perspective in technology design for health management. These implications also apply to systems focused on a single illness, as many of their users might live with other conditions.

Telerehabilitation technology has the potential to support the work of patients and clinicians by collecting and displaying patients' data to inform, motivate, and support decision-making. However, few studies have investigated data-driven practices in telerehabilitation. In this qualitative study, we conducted interviews and a focus group with the use of data visualization probes to investigate the experience of stroke survivors and healthcare providers with game-based telerehabilitation involving physical and occupational therapy. We find that \hlstudy participants saw potential value in the data to support their work. However, they experienced challenges when interpreting data to arrive at meaningful insights and actionable information. Further, patients' personal relationships with their goals and data stand in contrast with clinicians' more matter-of-fact perspectives. Informed by these results, we discuss implications for telerehabilitation technology design.

The COVID-19 pandemic led to dire consequences globally, and it has been particularly challenging for older adults. They are at a higher risk of adverse outcomes of the disease \citecdc_covid. Older adults also use less technology than other age groups \citetech_old, so they mostly rely on in-person interactions and services for social support. However, disease mitigation efforts such as social distancing and self-quarantining severely limited in-person interactions, hindering older adults' social support during the COVID-19 crisis. In this paper, we present findings on social support realities from semi-structured interviews with older adults (N=15) living alone in community dwellings. We found that older adults' support roles, support sources, and support concerns evolve as they passed through this time of sweeping change. They are enthusiastic about providing support to people who are older and more vulnerable than themselves. At the same time, their needs for safety, autonomy, and independence create tensions around social support. We propose a framework to illustrate the evolving ecology of social support that can facilitate the holistic design of socio-technical support systems for older adults. We argue against the societal portrayal of older adults as vulnerable individuals. Rather, there is an opportunity to design support systems considering them as anchors in society. Towards that goal, we present design implications for future socio-technical support systems to empower older adults to age in place during a crisis.

Abstract Personal informatics tools can help users self-reflect on their experiences. When reflective thought occurs, it sometimes leads to negative thought and emotion cycles. To help explain these cycles, we draw from Psychology to introduce the concept of rumination—anxious, perseverative cognition focused on negative aspects of the self—as a result of engaging with personal data. Rumination is an important concept for the Human Computer Interaction community because it can negatively affect users’ well-being and lead to maladaptive use. Thus, preventing and mitigating rumination is beneficial. In this conceptual paper, we differentiate reflection from rumination. We also explain how self-tracking technologies may inadvertently lead to rumination and the implications this has for design. Our goal is to expand self-tracking research by discussing these negative cycles and encourage researchers to consider rumination when studying, designing, and promoting tools to prevent adverse unintended consequences among users.

Self-tracking data is often seen as a means to reflect and achieve a goal, usually focusing on positive insights and actions. Lately, some studies have discussed the negative consequences of self-tracking, suggesting that people interact with personal data in different ways. We explored how self-tracking activities and the emotional context characterize how people engage with personal health data through the analysis of a complex and emotionally-loaded use case: fertility self-tracking. We qualitatively analyzed patient-generated content in an online health community dedicated to fertility. We found five distinct types of engagement with data: positive, burdened, obsessive, trapped, and abandoning. Each of them is composed of an action and an emotional component that mutually influence each other. We discuss how the interplay of these components characterize a person's engagement with data, how the online forum made these issues visible, and how they are embedded in the self-tracking culture. We also provide insights into the implications of these issues for self-tracking tools. Finally, we hypothesize how people transition through the types of relationships with data, suggesting directions for future research in the area.

The last two decades have seen growing interest in promoting physical activities by using self-tracking technologies. Previous work has identified social interactions in self-tracking as a crucial factor in motivating users to exercise. However, it is unclear how integrating fitness features into complex pre-existing social network affects users' fitness tracking practices and social interactions. In this research, we address this gap through a qualitative study of 32 users of WeRun--a fitness plugin of the widely adopted Chinese mobile social networking service WeChat. Our findings indicate that sharing fitness data with pre-existing social networks motivates users to continue self-tracking and enhances their existing social relationships. Nevertheless, users' concerns about their online personal images lead to challenges around privacy. We discuss how our study could advance understanding of the effects of fitness applications built on top of pre-existing social networks. We present implications for future social fitness applications design.

Increasing demands for senior care raise the challenge of how to support independence in older adults while assisting their health management. Most seniors would like to age in place, but concerns about safety lead many to move to a place that can provide basic care support, such as a Continuing Care Retirement Community (CCRC). CCRCs provide different care levels for seniors, from independent living to nursing home. In this paper we examine how independent residents of a CCRC manage their health through a series of self-care and collaborative care activities. We interviewed 18 independent residents and five staff members of a CCRC. We have found that their care involves both external monitoring and self-care, and self-tracking is an integral part of self-care. These different forms of care are interconnected and complimentary. However, negative connotations associated with aging limit their effectiveness. Examining how these care practices function could inform the design of technology for a broader population of seniors aging in place.

Infertility is a global health concern that affects countless couples trying to conceive a child. Effective fertility treatment requires continuous monitoring of a wide range of health indicators through self-tracking. The process of collecting and interpreting data and information about fertility is complex, and much of the burden falls on women. In this study, we analyzed patient-generated content in a popular online health community dedicated to fertility issues. The objective was to understand the process in which women engage in tracking relevant information, and the challenges they face. Leveraging the Personal Informatics Model, we describe women's self-tracking experiences during their fertility cycles. We discuss how a complex and highly personalized context leads to responsibility, pressure, and emotional burden on women performing self-tracking activities, as well as the role of collaboration in creating individualized solutions. Finally, we provide implications for technologies aiming to support women with fertility care needs.