Tiffany C. Veinot

The eyes of the power company: Workplace information practices of a vault inspector

To date, LIS studies of workplace information practices have primarily focused on occupations that require a university education, and, consequently, little is known about the information practices of blue‐collar workers. This study uses a qualitative case study approach to examine the workplace information practices of a blue‐collar worker—a vault inspector at a hydroelectric utility company. Using social practice theory as a framework, this article argues that vault inspection is a practice involving situated judgment, embodiment, educated perception, finding and navigating, and classification. This article also asserts that the practice of vault inspection produces documents that act as “boundary objects” that dynamically connect disparate parts of the organization and meet a range of organizational information requirements. This suggests that vault inspection is an information practice.

Which Patients, and Where: A Qualitative Study of Patient Transfers from Community Hospitals

BackgroundInterhospital transfer of patients is a routine part of the care at community hospitals, but the current process may lead to suboptimal patient outcomes. A microlevel analysis of the processes of patient transfer has not earlier been carried out. Research DesignWe conducted semistructured qualitative interviews with care providers at 3 purposively sampled community hospitals to describe patient transfer mechanisms, focusing on perceptions of transfers and transfer candidates, choice of transfer destination, and perceived process. We interviewed physicians, nurses, and care technicians from emergency departments and intensive care units at the hospitals, and analyzed the resultant transcripts by content analysis. ResultsAppropriate triage and the transfer of patients was a highly valued skill at the community hospitals. On the basis of participant accounts, the transfer process had 4 components: (1) Identifying transfer-eligible patients; (2) Identifying a destination hospital; (3) Negotiating the transfer; and (4) Accomplishing the transfer. There were common challenges at each component across hospitals. Protocolization of care was perceived to substantially facilitate transfers. Informal arrangements played a key role in the identification of the receiving hospital, but patient preferences and hospital quality were not discussed as important in decision making. The process of arranging a patient transfer placed a significant burden on the staff of community hospitals. ConclusionsThe patient transfer process is often cumbersome, varies by condition, and may not be focused on optimizing patient outcomes. Development of a more fluid transfer infrastructure may aid in implementing policies such as selective referral and regionalization.

Following the “community” thread from sociology to information behavior and informatics: Uncovering theoretical continuities and research opportunities

The authors review five paradigms from the discipline of community sociology (functionalism, evolution, conflict, interactionism, and exchange) to assess their potential utility for understanding everyday life information behavior and technology use. Their analysis considers the ways in which each paradigm defines the concepts of community, information, and technology. It also explores the insights offered by each paradigm regarding relationships between community and both information and technology. Accordingly, the authors highlight the ways in which existing information behavior and informatics scholarship draws from similar conceptual roots. Key insights drawn from this research, as well as remaining gaps and research questions, are examined. Additionally, they consider the limitations of each approach. The authors conclude by arguing for the value of a vigorous research program regarding information behavior and technology use in communities, particularly that which takes the community as the central unit of analysis. They consider key questions that could drive such a research program, as well as potentially fruitful conceptual and methodological approaches for this endeavor.

How "Community" Matters for How People Interact With Information: Mixed Methods Study of Young Men Who Have Sex With Other Men

Background We lack a systematic portrait of the relationship between community involvement and how people interact with information. Young men who have sex with men (YMSM) are a population for which these relationships are especially salient: their gay community involvement varies and their information technology use is high. YMSM under age 24 are also one of the US populations with the highest risk of HIV/AIDS. Objective To develop, test, and refine a model of gay community involvement (GCI) factors in human-information interaction (HII) as applied to HIV/AIDS information among YMSM, specifically examining the role of Internet use in GCI and HII. Methods Mixed methods included: 1) online questionnaire with 194 YMSM; and 2) qualitative interviews with 19 YMSM with high GCI levels. Recruitment utilized social media, dating websites, health clinics, bars/clubs, and public postings. The survey included questions regarding HIV/AIDS–related information acquisition and use patterns, gay community involvement, risk behaviors, and technology use. For survey data, we tested multiple linear regression models using a series of community- and information-related variables as dependent variables. Independent variables included community- and information-related variables and demographic covariates. We then conducted a recursive path analysis in order to estimate a final model, which we refined through a grounded theory analysis of qualitative interview data. Results Four community-related variables significantly predicted how people interact with information (HII variables): 1) gay community involvement (GCI), 2) social costs of information seeking, 3) network expertise accessibility, and 4) community relevance. GCI was associated with significantly lower perceived social costs of HIV/AIDS information seeking (R 2=0.07). GCI and social costs significantly predicted network expertise accessibility (R 2=0.14). GCI predicted 14% of the variance in community relevance and 9% of the variance in information seeking frequency. Incidental HIV/AIDS information acquisition (IIA) was also significantly predicted by GCI (R 2=0.16). 28% of the variance in HIV/AIDS information use was explained by community relevance, network expertise access, and both IIA and information seeking. The final path model showed good fit: the RSMEA was 0.054 (90% CI: .000-.101); the Chi-square was non-significant (χ2(11)=17.105; P=.105); and the CFI was 0.967. Qualitative findings suggest that the model may be enhanced by including information sharing: organizing events, disseminating messages, encouraging safety, and referring and recommending. Information sharing emerged under conditions of pro-social community value enactment and may have consequences for further HII. YMSM with greater GCI generally used the Internet more, although they chatted online less. Conclusions HIV/AIDS–related HII and associated technology uses are community-embedded processes. The model provides theoretical mediators that may serve as a focus for intervention: 1) valuing HIV/AIDS information, through believing it is relevant to one’s group, and 2) supportive and knowledgeable network members with whom to talk about HIV/AIDS. Pro-social community value endorsement and information sharing may also be important theoretical mediators. Our model could open possibilities for considering how informatics interventions can also be designed as community-level interventions and vice versa.

Proceedings of the 1st ACM International Health Informatics Symposium

It is my great pleasure to welcome you to the inaugural meeting of ACM International Health Informatics Symposium (IHI). We envision IHI as ACMs premier community forum concerned with the application of computer and information science principles as well as information and communication technology to problems in healthcare, public health, the delivery of healthcare services and consumer health informatics aspects, and finally, the related social and ethical issues on the use of computing technology in the health informatics domain. We designed IHI to run as an annual showcase for exciting and innovative research on techniques and technologies developed in universities, hospitals, research labs, and companies all over the world. And here we are, in the very first meeting with a very strong program comprising oral and poster presentations, demos, a very distinguished keynote presentation, and a panel. I am humbled to have a chance to chair such a strong first meeting. When I was offered the General Chair position for this conference, I accepted with great anxiety, and the anxiety turned to horror when I realized what it really means to organize the very first meeting of a new conference series. One of my first challenges was to draft a budget for the conference. There were many questions that needed to be answered, and we did not have any basis for answering many of them, just our guesses and wish list. How many papers would we receive and include in the conference? How many people would attend our conference? How long the conference should be? Where it should be held? and so on. I am delighted to see that the communitys interest exceeded our estimates and we have received more than 240 submissions, from more than 30 countries, which enabled us to put together an excellent program. Putting together a conference is a team effort. I am extremely honored to work with such a group of talented and devoted individuals. You will find the complete list of organizers in the proceedings; here I will only name a few of them. I will start with the driving force behind this conference, our honorary general chair, Gang Luo, without his energy, commitment and persistence, we may not have had the IHI conference this year. I must also thank the program committee co-chairs Henrique Andrade and Neil R. Smalheiser for their invaluable contributions not only during the paper review process, but also for their help and comments regarding every aspect of the conference, including Henriques help to create the first version of our conference web site. Later on, Mehmet Deveci and Daby M. Sow took over that task, constantly improving the content with additional information and kept it up to date. Bugra Gedik diligently handled the registrations, while Alper Yilmaz made sure that we were always on track with our budget and assisted with all of the final logistics transactions. Organizing a conference in a different location from where I am based meant that I needed a devoted local arrangement chair, and I was lucky to know Baris E. Suzek he was on top of every single detail regarding the local arrangements. Xue-Wen Chen, Albert M. Lai, and Deepak Turaga have done tremendous job in publicizing our conference, at times with many one-to-one emails. Our proceedings chair Tiffany Veinot not only worked with Sheridan for proceedings, but also helped putting together the program booklet. Special thanks go to Donna Cappo and April Mosqus from ACM for their patience and help in answering our endless questions, to Adrienne Griscti for initiating the ACM-Sheridan Proceedings Service, assisted by Lisa Tolles, for taking care of processing the papers in a timely manner. Jinbo Bi was our contact person for sponsorship and she helped us secure generous support from IBM, Pacific Northwest National Laboratory, Indiana University, Google Research, Hidola, and Siemens. We are of course also grateful for our sponsors for their financial support. Last but not least, I would like to thank the authors for providing the content of the program and the program committee and external reviewers for their hard work in carefully reviewing all of the submissions and providing feedback to the authors. On behalf of the conference organizing committee, we hope you find many topics of interest in our program, and hope that you enjoy your stay in the Washington, DC metropolitan area. Umit V. Catalyurek IHI 2010 General Chair The Ohio State University, USA

A Relational Perspective on HIV/AIDS Information Behaviour in Rural Canada

Abstract To manage their health effectively, persons living with HIV/AIDS (PHAs) and their caregivers require reliable, up-to-date information about HIV/AIDS and its treatment. Access to timely health information is often a challenge for residents of remote or sparsely populated communities. In this paper we present findings from a research project conducted in three rural regions of Canada in which we investigated how rural PHAs, along with their formal and informal caregivers, exchange HIV/AIDS-related information and support. In the analysis of results, we use a conceptual framework taken from the literature of organizational learning. In particular, we consider how ideas about person-to-person information exchange that have emerged from social network studies in business settings, as well as how Etienne Wengers ideas about communities of practice apply to the health information behaviour of rural PHAs and their caregivers. The patterns of experience reported by study respondents illustrate the power of access to timely support from trusted informants, as well as the deepening of knowledge at the community level when interpersonal connections are consciously formed and maintained.

Integrating community-based participatory research and informatics approaches to improve the engagement and health of underserved populations

Abstract Objective We compare 5 health informatics research projects that applied community-based participatory research (CBPR) approaches with the goal of extending existing CBPR principles to address issues specific to health informatics research. Materials and methods We conducted a cross-case analysis of 5 diverse case studies with 1 common element: integration of CBPR approaches into health informatics research. After reviewing publications and other case-related materials, all coauthors engaged in collaborative discussions focused on CBPR. Researchers mapped each case to an existing CBPR framework, examined each case individually for success factors and barriers, and identified common patterns across cases. Results Benefits of applying CBPR approaches to health informatics research across the cases included the following: developing more relevant research with wider impact, greater engagement with diverse populations, improved internal validity, more rapid translation of research into action, and the development of people. Challenges of applying CBPR to health informatics research included requirements to develop strong, sustainable academic-community partnerships and mismatches related to cultural and temporal factors. Several technology-related challenges, including needs to define ownership of technology outputs and to build technical capacity with community partners, also emerged from our analysis. Finally, we created several principles that extended an existing CBPR framework to specifically address health informatics research requirements. Conclusions Our cross-case analysis yielded valuable insights regarding CBPR implementation in health informatics research and identified valuable lessons useful for future CBPR-based research. The benefits of applying CBPR approaches can be significant, particularly in engaging populations that are typically underserved by health care and in designing patient-facing technology.

Localizing chronic disease management: information work and health translations

Based on interviews with people who had diabetes, high blood pressure, and kidney disease in Flint, Michigan, we found people actively doing information work to manage their health in the face of poverty, potentially violent conditions, high stress, and a distrust of institutionalized medicine. More specifically, we observed people translating information into the context of their everyday lives. We present various translations of health information in the form of local strategies for chronic illness management. Study findings highlight initial implications to support health information services on a community level.

Technical infrastructure implications of the patient work framework

In their response to our original paper, “Transforming Consumer Health Informatics through a Patient Work Framework: Connecting Patients to Context,” Marceglia and colleagues propose an architecture that integrates the patient work framework into a higher-order framework linking consumer health informatics (CHI) applications and professional health information systems (designated by the authors as the health-Information Technology (IT) ecosystem).1 The purpose of our letter is threefold. First, we detail how an expanded understanding of the patient work framework already conceptually encompasses the larger contexts in which CHI use must occur. Second, we assert that meaningful application of the patient work perspective yields implications not only for integration with professional health information systems but also with the larger information infrastructures within the community. Third, we propose modifications to Marceglia and colleagues’ architecture to explicitly represent a “shared space” between CHI applications and professional health information systems; this space contains collaborative work and collaborative informatics. Our original patient work framework was intended to serve as a foundation for CHI design by enabling the understanding of people, their daily contexts, and their daily activities. As such, we limited the scope of our discussion to the immediate home and community environments of the …

Trying to Make Things Right Adherence Work in High-Poverty, African American Neighborhoods

Adherence to treatment recommendations for chronic diseases is notoriously low across all patient populations. But African American patients, who are more likely to live in low-income neighborhoods and to have multiple chronic conditions, are even less likely to follow medical recommendations. Yet we know little about their contextually embedded, adherence-related experiences. We interviewed individuals (n = 37) with at least two of the following conditions: hypertension, diabetes, and chronic kidney disease. Using an “invisible work” theoretical framework, we outline the adherence work that arose in patients’ common life circumstances. We found five types: constantly searching for better care, stretching medications, eating what I know, keeping myself alive, and trying to make it right. Adherence work was effortful, challenging, and addressed external contingencies present in high-poverty African American neighborhoods. This work was invisible within the health care system because participants lacked ongoing, trusting relationships with providers and rarely discussed challenges with them.