Erik Grönvall

Beyond self-monitoring: understanding non-functional aspects of home-based healthcare technology

Monitoring of health parameters in non-clinical settings is one strategy to address the increasingly aging population and age-related disabilities and diseases. However, challenges exist when introducing self-monitoring activities in peoples everyday life. An active lifestyle can challenge the appropriation of healthcare technologies and people with comorbidity may have diverse but co-existing monitoring needs. In this paper, we seek to understand home-based health monitoring practices to better design and integrate them into peoples everyday life. We perform an analysis of socio-technical complexities in home-based healthcare technologies through three case studies of self-monitoring: 1) pre-eclampsia (i.e. pregnancy poisoning), 2) heart conditions, and 3) preventive care. Through the analysis seven themes emerged (people, resources, places, routines, knowledge, control and motivation) that can facilitate the understanding of home-based healthcare activities. We present three modes of self-monitoring use and provide a set of design recommendations for future Ubicomp designs of home-based healthcare technology.

CareCoor: Augmenting the coordination of cooperative home care work

OBJECTIVESnThe present study aims to augment the network of home care around elderly. We investigate the nature of cooperative work between relatives and home care workers around elderly persons; present the CareCoor system developed to support that work; and report experiences from two pilot tests of CareCoor.nnnMETHODSnWe employed ethnographic fieldwork methods and conducted participatory design workshops to throw light on the nature of cooperative home care work, and to elicit implications for the design of an IT system that would support the work of relatives and home care workers around elderly persons. The design implications led to the development of a prototype, called CareCoor, which is accessible via a tablet PC and on the Internet. CareCoor was subsequently evaluated in two pilot tests. The first lasted a week and included three elderly, their next of kin and the affiliated home care workers, while the second test lasted for six weeks and involved five elderly people, their next of kin and relevant home care workers.nnnRESULTSnIn the paper we make three major points, namely, (1) home care work is highly cooperative in nature and involves substantial coordinative efforts on the part of the actors involved, (2) the network of care around elderly can be augmented with new technology that allows all members of the network to follow, influence and be a part of the cooperative care of the elderly, and (3) CareCoor, the prototype introduced in this study, shows promise as it was well received during test and evaluation.nnnCONCLUSIONnHome care work is increasingly important due to the ageing populations of Europe, the USA and large parts of Asia. Home care work between relatives and home care workers is inherently a cooperative effort, and can be facilitated and augmented by new information technology such as CareCoor. The pilot tests of CareCoor revealed promising results and will be further developed and evaluated in a larger test.

On participatory design of home-based healthcare

Participatory design (PD) activities in private homes challenge how we relate to the PD process, compared to PD in professional settings. Grounded in a project related to chronic dizziness among older people, we identified four challenges when performing PD with ill, weak users in their private homes. The challenges are (1) designing for, and negotiating knowledge about, the home, (2) ill, weak users and their participation in PD, (3) divergent interests of participants and (4) usable and sustainable post-project solutions. These challenges have to be carefully addressed, and we use them to reflect upon differences between a home-based PD process with non-workers, such as ours, and work-place projects, such as Utopia. Through this reflection, the paper contributes to a more general discussion on PD in non-work settings with weak users. Indeed, differences do exist between traditional PD projects in work settings, such as Utopia, and home-based PD with weak users especially in relation to knowledge about settings and how to reconcile differences in interests. The home as a place for (technology-assisted) treatment and PD must be carefully analyzed. Diverse interests and roles as well as possibilities for post-project solutions should be negotiated among all stakeholders.

Challenges and Opportunities for Collaborative Technologies for Home Care Work

This article offers an exploration of home care work and the design of computational devices in support of such work. We present findings from a field study and four participatory design workshops. Themes emerging from the findings suggest that home care work may be highly cooperative in nature and requires substantial articulation work among the actors, such as family members and care workers engaged in providing care for older adults. Although they provide home care for older adults in cooperation, family members and care workers harbour diverging attitudes and values towards their joint efforts. The themes emerging are used to elicit a number of design implications and to promote some illustrative design concepts for new devices in support of cooperative home care work.

Calendars: Time Coordination and Overview in Families and Beyond

This paper discusses how calendars and time coordination can be used across social and organizational borders, bridging between work and non-work, and between family coordination and external collaborators. The paper moves beyond family on-line calendars towards coordination and collaboration with professional caregivers and public authorities, and discusses how such shared calendars revitalize some of the very basic discussions of CSCW: The notion of shared goals in cooperative activities, the understanding of time and time-granularity in cooperation, common information spaces, and in particular boundary-crossing capacities and the holding back of information for fragmented exchange. Based on two cases, in which we have worked with sharing and coordination of time-resources in families on the one hand, and external parties such as external caregivers, employers and municipal authorities on the other, this paper will reopen these old CSCW debates. This paper questions if calendars, in particular family calendars should be designed based on shared goals and common interests. We argue that collaboration needs to be supported, even when families and their professional and amateur collaborators do not share the same goals, rhythms and routines.

Aerial tunes: exploring interaction qualities of mid-air displays

New types of interfaces are emerging in the form of shape changing and mid-air interfaces. However, little is known about how such interfaces are experienced and explored over time. This paper presents Aerial Tunes, a collaborative, tangible interface, based on balls hovering in mid-air, which can be manipulated individually, or collaboratively to explore and experiment with an ambient soundscape. We describe the design of Aerial Tunes and the technical challenges in constructing the prototype, Aerial Tunes exemplify how systems can be designed to support aesthetic experiences and promote enjoyment and excitement through a seemingly magical and unstable display, supporting explorative and tangible interaction coupled with sound feedback. Based on a four-week field study of the prototype at a public main library, we report how people experienced, investigated, interpreted and explored this interface. We describe the design intentions and qualities, which served to invite for exploration and resulted in multiple and diverse interpretations.

Creative interactive play for disabled children

The workshop addresses the emerging field of research on robotics, assistive technologies and interaction design promoting play for physically, visually, and hearing impaired children and for emotionally and mentally handicapped children. Interactive devices including toys, pets and educational tools as well as interactive collaborative environments may represent a unique opportunity for disable children to full engage in play and have fun. The Creative Interactive Play workshop presents a collection of innovative interactive technologies and case studies for inclusive play and discusses the challenges and opportunities they can bid to disabled children.

MediFrame: A Tablet Application to Plan, Inform, Remind and Sustain Older Adults' Medication Intake

Healthcare activities in private home settings that are not supervised by a healthcare professional can challenge older adults. To support such unsupervised care activities, an increasingly number of reminders and monitoring systems are designed. However, most of these systems target a specific treatment or a specific condition. In this paper, we discuss experiences from designing the tablet-based application MediFrame. MediFrame is a personal medication management system to support older adults in non-clinical settings such as the home. The paper describes the user-centered design process and the resulting tablet application. We show how MediFrame can be used to support adherence in medical treatments through fieldwork informed use scenarios. Based on early qualitative feedback, we also discuss lessons learned and how designers can support a holistic medication experience for an older adults everyday life.

Understanding challenges and opportunities of preventive blood pressure self-monitoring at home

The herein presented study explores socio-technical complexities that may occur when introducing preventive health-measurement technologies in older adults daily routines and everyday lives. Using mainly blood pressure measurements in private homes, the study applied qualitative and quantitative methods to understand existing challenges and uncover opportunities of self-monitoring technologies to support preventive healthcare activities among older adults. Emerging challenges from our study were: rule complexity for self-measuring, reliability of measurements, interpretation, understanding and health awareness, the sharing activity for prevention, motivational sources, the role of the doctor for prevention, older adults use of technology, the home as a distributed information space, and visualization of health data. An awareness of these challenges can help designers to develop better tools to support peoples preventive self-monitoring needs compared with existing solutions. Furthermore, supporting the active and informed citizen can improve older adults care abilities, awareness and activation towards preventive care.

Active surfaces: a novel concept for end-user composition

This paper describes the design process of a modular system for supporting physical and cognitive rehabilitation in the swimming pool. In such an environment, the therapist is called to creatively adapt rehabilitation protocols to the enhanced ability of the patients, often reacting to emerging behaviours enabled by the water. Therefore a strong technological requirement for such environment is to develop a modular system that can be configured and modified on the fly during the activity, exploiting the therapeutic properties of the water. To satisfy such a requirement the system of Active Surfaces has been developed. It consists of a number of position aware floating units, called tiles, able to communicate each other and to provide visual, acoustic and tactile feedback. By combining the different tiles the therapist can easily configure the dedicated tasks for the various typology of patients. The concept has been developed following the Palpable Computing approach, an innovative design paradigm complementing key features of ambient computing, such as invisibility and end-user composition of devices, with dual features (e.g., visibility and decomposition) that enable users to navigate, configure and influence the computing system.