Millions of people now use non-clinical Large Language Model (LLM) tools like ChatGPT for mental well-being support. This paper investigates what it means to design such tools responsibly, and how to operationalize that responsibility in their design and evaluation. By interviewing experts and analyzing related regulations, we found that designing an LLM tool responsibly involves: (1) Articulating the specific benefits it guarantees and for whom. Does it guarantee specific, proven relief, like an over-the-counter drug, or offer minimal guarantees, like a nutritional supplement? (2) Specifying the LLM tool's "active ingredients" for improving well-being and whether it guarantees their effective delivery (like a primary care provider) or not (like a yoga instructor). These specifications outline an LLM tool's pertinent risks, appropriate evaluation metrics, and the respective responsibilities of LLM developers, tool designers, and users. These analogies - LLM tools as supplements, drugs, yoga instructors, and primary care providers - can scaffold further conversations about their responsible design.

Technologies that facilitate communication between older adults and those around them have the potential to strengthen older adults' connections with their support network. In this paper, we present findings from interviews with 16 older adult participants in the United States about their social network composition and related technology use during a challenging life event, the COVID-19 pandemic, which saw a decrease of in-person meetings and increase in communication technology adoption. Using the convoy model of social relations, we sought to better understand the roles different technologies play in older adults' social connections. Participants chose what communication tools to use depending on social and situational contexts and overcame accessibility issues to adopt new technologies that supported continued engagement with their support networks. However, when others positioned technologies as ways for the older adults to receive social support, they resisted. A more comprehensive view of older adults' evolving social convoys can help designers and researchers better create technologies that help expand and maintain older adults' social support networks. Further, to facilitate older adults' social connectivity, the design of technology should encourage older adults' support networks to see those older adults as support providers, not just potential support recipients.

The current structures of global health are steeped in power inequities, where funding, leadership, “evidence-based ideas” and supporting research typically originate from the West. I am directly motivated by the recognition that digital health interventions can support better health outcomes yet are often poorly fit to context and culture, overengineered with good intentions, and lack measurable impact. This work explores developing a critical reflexive practice to support global health practitioners in critiquing their vantage points, assumptions, and decisions. The idea is that cultivating this practice at individual, community and institutional levels can spark change through more epistemologically diverse designs and implementations of global health interventions, and more specifically for digital health interventions.

Historically, crafts have been associated with women's small-scale creative production in the home, equated with hobbies or amateur production, and devalued in comparison to both art and industrial production. During its early years, Etsy was seen as a champion of "handmade", bringing visibility to crafts and providing economic value. This paper presents results of a qualitative study with 18 small online sellers of Etsy platform. Our study shows that Etsy's sociotechnical design results in a high burden of invisible labor for sellers, including categories of labor not replicated by other online platforms. These new categories include negotiation and articulation work around defining and defending "handmade" products, understanding one's intellectual property and how (and whether) to defend that IP elsewhere on the platform, understanding working of platform algorithms and adapting to changing platform regulations. Our findings provide new ways to frame the challenges faced by producers/sellers on emerging marketplace platforms.

In recent years, privacy and data rights have garnered growing attention in public discourse, policy making, and scholarly research. New data protection laws are being rolled out globally to codify data rights and ensure individual control over how personal data is shared and used. This evolving landscape presents several opportunities and challenges for healthcare. In this case study, we outline a design research agenda that emerged from the practical needs of an open source community focused on digital health software for community health in low- and middle-income countries. We situate this case study in the global landscape of data regulations, and the call for responsible data practices that go above and beyond regulatory compliance. We share findings from the formative stages of our multi-stage design process, which include a scoping literature review and a reframing of institutional policies and procedures. A primary contribution of our case study is that it offers an example of the institutional ‘pre-work’ necessary to make sense of the complex data protection landscape, and to chart a path forward for designing software that better supports responsible data practices. This case study also articulates the important role for digital health designers and implementers in operationalizing patient data rights.

This paper addresses the challenges associated with innovating in the midst of a crisis, especially in the area of healthcare and medical device development. A case study is presented that follows the progression of a commercialization stage prototype into a validated tool for use during the Ebola outbreak in West Africa in 2014-2016. An electronic drop counter was subjected to usability and environmental testing to adapt it for medication management in Ebola Treatment Units. The case study demonstrates the crucial role that relationships and partnerships play in transitioning technological innovations into clinical environments, how logistical challenges can be mitigated, and the importance of achieving alignment between clinical needs and subsequent technical and contextual validation that prioritizes patient safety and outcomes. As a result of years of work including and following the detailed case study, we conclude by suggesting generalized best-practices and lessons for adapting a technology to disaster preparedness or crisis situations.

The easy availability of material on the Web means that students are increasingly turning to electronic resources for research purposes. While many resources that are accessible electronically parallel familiar print resources and are, often, simply online versions of familiar databases and catalogs, there exists a large quantity of information that rests outside familiar frameworks for published research. The authors of this paper work as a professor and an engineering librarian respectively, and in our work we have watched as both undergraduate and graduate students struggle to adapt to an increasingly electronic environment for research. As students come to rely on the Internet to access resources, they are often not critical consumers of information, and they often do not differentiate among resources gained via universitysubscribed databases versus resources that reside outside such databases and are part of the ‘open’ Web.

Designing portable, affordable, and effective medical devices for underserved areas and populations can improve access to healthcare and improve health outcomes when done well, but can also carry risks when not designed with contexts and constraints in mind. In this paper, we present a design research case study that illustrates how to use a cross-functional approach in order to design medical devices that meet regulatory standards as well as human needs common in resource-constrained settings. The project focuses on an early prototype of a low cost, portable dialysis device being developed for the Indian market. We use this case to argue for the need for deep interdisciplinary expertise across a variety of domains and argue that design research can act as a bridge across disciplines to help reduce risk, inform development advance commercialization efforts, and create products well geared for the unique needs of low resource medical environments - generally, anything outside of well-funded hospitals.

BackgroundHIV serodiscordant couples are at heightened risk of HIV transmission when attempting to conceive, yet reproductive goals can outweigh concerns about HIV exposure. Safer conception strategies support fertility desires while minimizing HIV transmission risk and novel mHealth tools can optimize their use. The objective of this analysis is to examine the feasibility and usability of short message service (SMS) messages and a mobile application to support safer conception for HIV serodiscordant couples.MethodsWe enrolled 74 heterosexual HIV serodiscordant couples with immediate pregnancy desires into a pilot safer conception intervention study in Thika, Kenya. Prior to pregnancy, women received daily 6-item SMS surveys to capture fertility indicators (e.g., menses, basal body temperature) and sexual behavior. The intervention also provided daily oral pre-exposure prophylaxis (PrEP) for the HIV-negative partner and in-depth counseling to accompany publicly-provided antiretroviral therapy (ART) for the HIV-infected partner. Couples attended monthly visits until pregnancy occurred. We measured PrEP use with medication event monitoring system (MEMS) caps and ART use via quarterly viral load quantification. We imported SMS, MEMS, and viral load data into an Android tablet application designed specifically for this setting for couples to view during clinic visits and included predictions of peak fertility days using SMS data. We used descriptive statistics to summarize SMS response data and developed a Google Analytics platform to monitor tablet application usage during follow-up. We also conducted semi-structured interviews with a purposive sample of 5 healthcare providers and 19 couples. Qualitative data were analyzed using a modified constant comparative approach to identify themes related to mHealth intervention feasibility and acceptability.ResultsIn our sample, 34 (45.9%) couples had an HIV-infected female partner. The median age of the female partner was 30 years [interquartile range (IQR), 27-35 years], education was 10 years (IQR, 8-12 years), and partnership duration was 3 years (IQR, 2-7 years). Couples were followed for a median of 218 days (IQR, 116-348 days) prior to pregnancy. Participants completed 13,181 of 16,905 (78.0%) SMS surveys surveys sent with a median of 167 completed surveys (IQR, 74-299) per participant. Most participants completed at least 75% of the total SMS messages received (N=58; 77.3%). The tablet application was opened by counselors 1,806 times during the study period (March 2016 through April 2018). In qualitative interviews, the SMS messages were reportedly easy to respond to and "part of the daily routine". Few participants had concerns about message confidentiality. mHealth tools were also found to be acceptable for tracking fertility indicators and enhancing provider-patient communication.ConclusionsmHealth strategies are feasible to use and acceptable to support the delivery of safer conception intervention services among HIV serodiscordant couples in Kenya.

Transportation is a crucial resource that links people to jobs, social networks, community and services. The transit dependent -- those who do not own private vehicles -- occupy a unique position. They are expert in their knowledge of public transportation while vulnerable to the failures and limitations of transit. This paper presents the results of a study that is aimed at understanding the lived experience of transit dependent riders. Using a framework of structuration theory as an analytic lens, we provide a thematic analysis of qualitative data including interviews with socially connected groups of people and video diaries. The results demonstrate the expertise that transit dependent riders have about transit and its policies and how they deploy that expertise in productive and cunning ways to make the system work for them. The analysis of this data resulted in three categories of agency to consider when designing for vulnerable populations: resourcefulness, reciprocity and powerlessness. The paper concludes by advocating for a human-centered approach to designing systems in community informatics and offers a set of guiding questions for designers of information and communication technologies (ICTs) to consider, especially with regards to vulnerable populations.

Ultrasound imaging is an effective tool for identifying maternal mortality risk factors. However, the high cost of ultrasound devices and the scarcity of ultrasound training are two major barriers to adoption in the developing world. To address these barriers, we have designed an inexpensive ultrasound system with an integrated contextual help system. Our device is targeted at increasing the diagnostic capabilities of midwives—often central medical figures in resource-constrained communities. The user interface is designed to meet the needs of midwives with minimal training who will be using the system in remote areas. We describe how our integrated contextual help system will supplement a midwife’s conceptual foundation of diagnostic ultrasound through appropriate and adaptive scaffolding. In addition, we identify several future opportunities for incorporating computer vision and intelligent user interfaces to assist the user in performing tasks and adapt to the user’s changing educational needs. In the future, we hope our device will be deployed at a low cost to receptive developing regions, requiring minimal training to use. Author

Health workers in understaffed and overstrained low-resource environments suffer from complex and demanding workloads. We discuss three mobile health (mHealth) deployments in India, Kenya, and Zimbabwe that we designed to assist frontline health workers. Drawing on rich empirical findings, we describe how we situated the technology, how the workplace relationships were reconfigured as a result, and how the projects grew organically beyond their intended scope. We adopt a reflexive approach to analyze how these projects address longevity as a critical shared goal and discuss how they negotiated the durability of technologies, resulting organizational stability, and sustained community engagement.

Cultures of making, customization and repair have gained recent visibility within the CSCW literature due to the alternative framings of design and use they present. This panel brings together scholars across human-computer interaction, interaction design, information studies, and science and technology studies to examine the forms of social organization and technological production that come from maker and repair collectives.

Participatory Design (PD) is increasingly applied in marginalized and low-resource communities. This paper looks at how Community Based Participatory Research (CBPR) can inform future PD work in these politically contested spaces. We distinguish between these approaches through two participatory photo visual methods: photo elicitation and photovoice. We conclude with suggestions for integrating principles from CBPR into PD to lead to more impactful work with marginalized and low-resource communities.

Telecenters, libraries, schools, and other public places where people access computer technology generally must decide which information and communication technologies (ICTs) to make available to the public. These decisions are often made based on a conception of which ICT uses are worthwhile, and often venues end up privileging instrumental uses—when people use the technology as an instrument toward productive goals—over non-instrumental uses, such as gaming or chatting. Users, on the other hand, do not necessarily make these distinctions and they switch seamlessly across multiple types of activities with technology. While public ICT providers must demonstrate good stewardship of public monies, when they privilege activities such as word processing a job application but not gaming or social networking, they constrain how people integrate technology meaningfully into their lives. This article presents the results of a study that investigated assumptions about the benefits of instrumental versus non- instrumental computer uses. Our findings indicate that people who use computers largely for non-instrumental purposes are generally as capable with the computers as those who use them for instrumental purposes, that people who largely use computers for these non-instrumental purposes are gaining skills that translate to instrumental tasks, and that dictating policy across largely software and tool-driven definitions of what constitutes “serious” or “worthwhile” uses of technology (and allocating public money to support access to such technology uses) does not match how individuals see themselves as users of these tools.