Tamara Peyton

Paging “Dr. Google”: Does Technology Fill the Gap Created by the Prenatal Care Visit Structure? Qualitative Focus Group Study With Pregnant Women

Background The prenatal care visit structure has changed little over the past century despite the rapid evolution of technology including Internet and mobile phones. Little is known about how pregnant women engage with technologies and the interface between these tools and medical care, especially for women of lower socioeconomic status. Objective We sought to understand how women use technology during pregnancy through a qualitative study with women enrolled in the Women, Infants, and Children (WIC) program. Methods We recruited pregnant women ages 18 and older who owned a smartphone, at a WIC clinic in central Pennsylvania. The focus group guide included questions about women’s current pregnancy, their sources of information, and whether they used technology for pregnancy-related information. Sessions were audiotaped and transcribed. Three members of the research team independently analyzed each transcript, using a thematic analysis approach. Themes related to the topics discussed were identified, for which there was full agreement. Results Four focus groups were conducted with a total of 17 women. Three major themes emerged as follows. First, the prenatal visit structure is not patient-centered, with the first visit perceived as occurring too late and with too few visits early in pregnancy when women have the most questions for their prenatal care providers. Unfortunately, the educational materials women received during prenatal care were viewed as unhelpful. Second, women turn to technology (eg, Google, smartphone applications) to fill their knowledge gaps. Turning to technology was viewed to be a generational approach. Finally, women reported that technology, although frequently used, has limitations. Conclusions The results of this qualitative research suggest that the current prenatal care visit structure is not patient-centered in that it does not allow women to seek advice when they want it most. A generational shift seems to have occurred, resulting in pregnant women in our study turning to the Internet and smartphones to fill this gap, which requires significant skills to navigate for useful information. Future steps may include developing interventions to help health care providers assist patients early in pregnancy to seek the information they want and to become better consumers of Internet-based pregnancy resources.

Every pregnancy is different: designing mHealth for the pregnancy ecology

This paper presents the results of an ongoing study into the potential role of mobile or wireless health applications for targeting the prevention of excessive gestational weight gain in pregnant lower-income American women. Informed by a qualitative study of pregnant womens experiences, we develop a set of design requirements for designing mobile health (mHealth) interventions related to healthy pregnancies. We identify a disconnection between physical activity and food tracking application design paradigms, and the reality of pregnant womens lives and capacities. We introduce the concept of an individualized pregnancy ecology, which provides an alternative paradigm for design of health and wellness management tools for lower-income pregnant women.

Transitioning Adolescents and Young Adults With Sickle Cell Disease From Pediatric to Adult Health Care: Provider Perspectives.

The transition from pediatric to adult health care is often challenging for adolescents and young adults with sickle cell disease (SCD). Our study aimed to identify (1) measures of success for the transition to adult health care; and (2) barriers and facilitators to this process. We interviewed 13 SCD experts and asked them about their experiences caring for adolescents and young adults with SCD. Our interview guide was developed based on Social-Ecological Model of Adolescent and Young Adult Readiness to Transition framework, and interviews were coded using the constant comparative method. Our results showed that transition success was measured by health care utilization, quality of life, and continuation on a stable disease trajectory. We also found that barriers to transition include negative experiences in the emergency department, sociodemographic factors, and adolescent skills. Facilitators include a positive relationship with the provider, family support, and developmental maturity. Success in SCD transition is primarily determined by the patients’ quality of relationships with their parents and providers and their developmental maturity and skills. Understanding these concepts will aid in the development of future evidence-based transition care models.

YouthTube: Youth Video Authorship on YouTube and Vine

What kinds of content do children and teenagers author and share on public video platforms? We approached this question through a qualitative directed content analysis of over 250 youth-authored videos filtered by crowdworkers from public videos on YouTube and Vine. We found differences between YouTube and Vine platforms in terms of the age of the youth authors, the type of collaborations witnessed in the videos, and the significantly greater amount of violent, sexual, and obscene content on Vine. We also highlight possible differences in how adults and youths approach online video sharing. Specifically, we consider that adults may view online video as an archive to keep precious memories of everyday life with their family, friends, and pets, humorous moments, and special events, while children and teenagers treat online video as a stage to perform, tell stories, and express their opinions and identities in a performative way.

Playing with leadership and expertise: military tropes and teamwork in an arg

Ad-hoc virtual teams often lack tools to formalize leadership and structure collaboration, yet they are often successful. How does this happen? We argue that the emergence of leadership and the development of expertise occurs in the process of taking action and in direct response to a lack of structure. Using a twinned set of eight modality sliders, we examine the interactions of fourteen players in an alternate reality game. We find that players adopted military language and culture to structure and arrange their play. We determine that it is critical to account for the context of play across these modalities in order to design appropriately for effective in-game virtual organizing.

Do It for the Viewers!: Audience Engagement Behaviors of Young YouTubers

Online user-generated video sharing communities, such as YouTube, are becoming more popular than conventional studio-produced content. These communities provide every user with the opportunity to create and promote their own video content---a compelling venue for children and teenagers to share their stories and voices. In this study, we investigate the practices of youth video creators on YouTube. To do so, we conducted a content analysis of the audience engagement practices of 100 youth author channels, comparing them to adult and professional YouTubers when appropriate. We found that most youth authors are aware of and actively engage with their imaginary or real audiences on YouTube. They emulate the conversational and audience engagement practices seen in professional quality YouTube channels, but may not have the video editing or other meta-content skills or experience to do so. Based on our findings, we point to a number of implications for future research and design in this space.

Information, sharing and support in pregnancy: addressing needs for mHealth design

Early pregnancy education and social support is crucial for women, in order to enable them to achieve a healthy pregnancy weight. Opportunities exist for mobile health support applications (mHealth) to aid in pregnancy health management. We present preliminary results of our study of lower-income pregnant American women, in order to understand the design need and challenges for potential mHealth interventions for pregnancy. We find that existing apps ignore the crucial role of the spouse, overstate the need for social sharing with strangers and fail to provide targeted and individualized information about early pregnancy.

My Mobile Health, My Mobile Life: methods for designing health interventions with adolescents

For adolescents with chronic health conditions, transition from pediatric to adult patient care is often haphazard, leading to gaps in care, lapses in treatment adherence, and unnecessary hospitalizations. A typical approach to addressing transition failures is to offer clinic-based programs that guide adolescents and their families through the process, but these initiatives are costly, may not appeal to adolescents, and have limited reach due to geographic constraints. In this study design paper, we describe our ongoing efforts in the participatory design of a mobile technology-based intervention that may overcome limitations of traditional approaches. We contribute a series of recommendations for conducting human-computer interaction research with adolescents who have chronic illnesses.

Pregnancy Ecologies As Teachable Moments For The Lifecourse: Changing The mHealth Design Paradigm

I investigate the potential for mobile health communication and social collaboration technologies (mHealth) to have a positive impact on pregnancy for lower-income American women. Recognizing that pregnancy is more than medical health, I set out to understand what pregnancy is for this population and how the embodied experience of pregnancy impacts womens lives. I have initiated a mixed methods study, which uses focus groups, interviews, information landscape analysis and social media discourse analysis. From the preliminary focus group and interview data, I have created a structuring health concept that I call the pregnancy ecology, accounting for the multi-faceted experience of pregnancy as a transformational event. The future work will incorporate all of the data into a holistic health ecology concept for pregnancy. Using this concept, I intend to design and build a mHealth app that treats pregnancy as a teachable moment for health, wellness and social support throughout the lifecourse.

The militarization of teamwork in alternate reality gaming

This ongoing research project examines ad-hoc virtual teamwork in playful environments. Our results suggest that alternate reality game (ARG) players devise leadership structures spontaneously over short periods of time, in response to a lack of formal structure. In the ARG we studied, teams self-structured around tropes of military culture, going so far as to adopt military ranks to describe team roles and individual statuses. Our findings have implications for effective in-game virtual organizing, and for the design of gameful environments.