Beki Grinter

Archive for the ‘wellness informatics’ Category

More on an Academic Blog

In academia, academic management, C@tM, computer science, crafts and craftiness, discipline, empirical, European Union, France, HCI, ICT4D, research, social media, wellness informatics on September 14, 2010 at 9:27 pm

I’ve written about academic blogging before, but recently I was asked some questions.

1) How did you get into doing a blog?
It was quite by accident. A colleague of mine created a private blog to capture her experiences of conducting fieldwork. She was using her blog to create a forum where she could get feedback from others and reflect on what she was learning. So I received an invitation to create an account and I did, and then I thought it would be an interesting experiment. It’s turned out to be an interesting experiment indeed.

Early on, my blog was unread and largely just a private (although entirely public) experiment. When I started pushing my posts to facebook and twitter it got more public. Another way I acquired audience was through timely posts where I just happened to have an early hit in Google searches. Another way, and this turns on my research interests, was to prepare a commentary on a Facebook meme. Using my research expertise I commented on the importance of this.

2) What is your blog about?
My blog is a mixture of topics. I’m aware that this is rather different from other blogs and I wonder whether it affects the readership. On the other hand, it’s a creative outlet and also within the scope of my research, so exploration is important.

Two persistent non-work themes:

  • Cross cultural adventures, for example, being British in the U.S. and encounters with my accent and living in France and coping with culture shock.
  • My family from whom I learnt skills that have morphed into my off-script crafting hobbies and a passion for family history and the way it transforms history from monarchy and war into ones of poverty and survival.

Work-related topics fall into four categories.

3) How much work is doing a blog?
As much as you want it to be!

When I’m writing about non-work related topics, the posts come pretty quickly and the only thing they do is share something with colleagues and friends. Although, like facebook, they start very interesting conversations. For example, the one about the convict in my family started discussions with several work colleagues at Georgia Tech and beyond. I’d written about it partially to document the journey of discovery and detective work that is genealogy, but by sharing it broadly I got not just advice on how to learn more, but also on literature that would help set context.

The work related ones take longer. Some of them do double duty, for example, I needed to synthesize the literature in ICT4D, and I was going to give a report about the workshop so I needed to have some means to collect all that information together. My blog helps me think about making arguments, it complements and extends my two decades of research experience. It’s not just a set of notes I draw on, but because it’s simultaneously unreviewed but read by scholars it improves my arguments.

4) What impact has it had on your professional life?
My colleagues in Computer Science and beyond have enthusiastically responded to my blog. The strength in diversity of topics has been that people have asked me to write on a variety of issues. I’ve been asked to discuss the disciplinary devolution, and asked to review manuscripts on this topic. I’ve written posts on writing for conferences and had others not explicitly invited picked up by the conference organization. I’ve been tweeted and retweeted. While I have not been asked to write about my cross-cultural experiences, I’ve had face to face conversations about them. This is also true of the sexual harassment post, it generated lots of community support.

5) How would you advise a student concerning the advantages and disadvantages of academic blogging?
I tried to answer this, and then decided that I would answer it in the form of some different questions.

What do I write about?
Things you’d feel comfortable with an audience of a) your Dad whose an academic b) your Mum who started her own business (intelligent layman with interest in “application”) c) your community of practice and d) anyone else reading. Perhaps you could explain a paper in your field? Assume that the authors are in your audience and as its been published the members of your community have not deemed to be serious.

Perhaps you could write about the related work in your area. Synthesis is a challenge in academic writing. Related work is not a stream of text that describes each paper in turn. It synthesizes the results from multiple papers, groupings form pro and con arguments that help make your case. The case is a) the aggregate findings that your research builds on and extends b) the novelty of your approach and c) the contribution of your research. Synthesis is also an exercise in being inclusive and humble, how do you engage and invest a community in your results otherwise/

What about your experiences in graduate school? What are your time management strategies? What do you know about the Ph.D. program at various points in the program.

Anonymous versus known?
There are good reasons to write an anonymous blog. Anonymity supports candor. Career experiences can fit into this category. The downside of anonymity is that no-one knows you. When it comes to your research, it’s good to be associated with it! Academic branding requires being able to associate a name to the research brand.

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Local Health Systems

In C@tM, empirical, ICT4D, research, wellness informatics on April 26, 2010 at 12:43 pm

Browsing Ghana’s Ashesi University College website I found the following course.

Sociology: Traditional Medicine
The course is intended to throw light on the structure, function and practice of Africa traditional medicine and its relationship with modern (scientific/western) medicine. By the end of this course, students will be conversant with African traditional medicine and attempts made to incorporate it in primary health care. The course will:

  • Give an insight into African Traditional Medicine
  • Elucidate the pattern of articulation between different persuasions/types of traditional medicinal practice.
  • Determine the nature of interrelationships between traditional and modern medicine.

This caused me to reflect on a question I asked at the CHI WISH workshop in the session on addressing disparities health systems for low income contexts. The panel was composed of a number of speakers who work in African contexts and so I asked them how they integrated indigenous systems of medicine/health and wellness practice into their research.

I asked the question, because I think it’s one that has not received enough attention. And yet, it’s going to turn out to be crucial. It shows itself to be crucial in the United States, because not everyone responds to the medical establishment in the same way. Public Health researchers argue that culturally focused interventions and information are crucial to having people take up and apply the knowledge in their daily lives. It’s even as simple as making nutrition advice relevant to the food consumption practices and traditions of a particular community.

The answers I got were interesting. One that most interested me was that I learnt that South Africa is integrating indigenous medicine into the offerings of the health service. I can’t find a good reference for this, but I did learn that part of it is to also prevent illegal and harmful medications being sold. The others focused on seeing is as part of the context of health and wellness, part of the overall picture of what it means to be in good health. And as yet, I do not hear any conversation about integrating these types of practices into Health ICTs. And it’s not just the practices themselves, it’s the people, organizations, and institutions that indigenous medicine has that also need to be integrated in to be holistic and representative.

I can’t help thinking that this will be an area which presses very hard on the definition of health. And it may challenge us to design systems that we don’t entirely agree with because that’s what the end-user wants. And of course it’ll counter generalisable solutions. Health is cultural and local, and indigenous medical systems and all that they imply highlight this property of health.

Wellness Informatics at CHI 2010

In research, wellness informatics on April 10, 2010 at 12:19 pm

Hi,

I’m blogging from the workshop I’m co-organizing today on Wellness Informatics. What am I learning?

Facebook is a potential mechanism for communicating wellness goals, but they don’t want seem boastful or over share and clutter up their friends facebook streams. What’s the sweet spot for using such pervasive systems then? It potentially varies by disease, by who they are sharing the information with. Facebook does not do selective sharing yet. Sean Munson et al. from the University of Michigan.

Germans’ definition of wellness includes relaxing, that’s an interesting take. WHO defines “health as a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” WHO 1948. Personal monitoring is now being combined with online communities, but for specific examples such as exercise, diet, or health records. And also finds that sharing and a sharing overload is a problem. Jochen Meyer at al. from OFFIS and U Oldenburg.

Robots could be a potential mechanism for promoting health and wellness, but the SERA project shows that the engagement with robots is complicated with respect to health. Study with British elders and a Nabaztag which they had for 10 days reports mixed results. Robots have complicated adoption curves. Tineke Klamer and colleagues from University Twente.

An exploratory study (desk research and initial visits) to senior centres to understand what programs are offered and the relationship between those and wellness for seniors. One benefit is that people meet new people and that reduces depression and isolation. Reminds me of the more holistic definition of wellness, not just disease prevention but a state of being. Also starting to see a continuum of participation, senior centre programs some times fail because there are not enough volunteers, i.e. a lack of participation. Facebook and online seems to flip the equation to one of too much participation. Thinking that this continuum is important to understanding for wellness. Seniors also seemed to want education at home rather than at the centre, and of course education… Lee et al from Motorola.

Sunny Consolvo of Intel presents long-term research from Intel on Houston and UbiFit Garden. Mobile phones for steps but also includes the social influence via easy sharing of supportive messages. Intel research Seattle and U Washington have a long history in this space. Lots of experiences, including knowing that pedometers are one of the most reliable and easy to work with physical monitoring device. Their experiences really strengthen our notion that temporality. It’s not just a systems experiment, but also how life changes and how learning by the individual changes. How do you sustain interest over time. Technology should account for relevant wellness behaviors an not artificially limit support to those that it can automatically infer. People focused on step count rather than taking exercise, you get more step counts walking than running. Systems have to account for irregularity, what if you get sick, well of course fitness changes. Also, the systems have to be able to go into various settings, so it has to be socially sensitive.

L. Pina from UCSD is focusing on sensing the environment at both a population and an individual level. What can you get from doing both? Particularly if you feed the population data back to an individual. It’s an exciting synthesis of the two. They have a variety of systems in place at this point all to try and help get data from the area to an individual so that they can make informed decisions about their health. For example, asthma management.

Garett Dworman questions the type of information that you can find on the Internet to help you manage your own wellness. Pushing out information to people so that they can make more informed decisions. It’s not just data, but synthesis of the data. Synthesis. Is Patients like me a possible site that’s doing this? But data in turn raises the question about mis-information. What does it mean when 2000 people get the wrong information because it was not regulated or filtered for accuracy. Reliability and accuracy is a challenge.

Gijs Geleijnse talked about a recommender system for recipes. But, you don’t want to experiment in the kitchen when you’re there, so the recommendations need to be close to the original recipe. Does that come back to the point about it’s got to work with people’s daily habits. So recommended recipes “tweek” the original to make it more healthy. Recipes also have to be nationally/culturally/locally tailored, since ingredients are hard to find outside of their place of origin. Also weights and measures vary. People who home cook have about 7-14 recipes in their home cooking repertoire.

Lucian Leahu presents a focus on wellness that includes mental illness, since it’s a rapidly growing area of health concern. Taking a focus on fear, what is healthy levels of fear, versus fear that becomes trauma. People seek fear because of the excitement, for some fear is a sign that a person has reached the limit of their bodies or minds, fear is also a resource, the sharing of stories that involve fear teach novices about what to fear, i.e. educates them about what are real dangers.

There’s a repeating theme of not being preachy. People don’t want to be lectured by technology.

Peggy Nachtigall is also focused on cooking and helping people to cook more healthy meals. Their system rate food not by nutritional values, but by colour codes. Green is healthy and red is not. Why, to make it easier for people to use. User testing focused on 40 users, all were women. Women appear to be on the front lines for wellness informatics, as caregivers and cooks. Cooking is also not just about ingredients, it’s also about skills. Understanding both aspects of cooking is essential.

Daniel Nicolalde. The Freshmen 15, that’s the 15 pounds that college students gain when they arrive at College. Students are a relevant population, as opposed to being a locally available population. They do not eat well, or apparently get enough sleep. Systems need to adapt. Adaption as goals change, as learning occurs, to remain engaging over time. Adaption is crucial because of the temporality of the system.

Winchester. Focused on African American communities with the goal of addressing health disparities. How could smart homes be a resource for wellness and health goals. Also a lens onto culturally empowered design. Wellness informatics should leverage readily available technologies (is there a tension between smart homes and readily available technologies?). Also makes the case that it’s not just about providing products, but also about coming up with a set of design methods and a framework to help guide other people in developing similar technologies. Also asks are the health communities focusing on IT fragmented? Health 2.0, Behavioral Informatics, Wellness Informatics, Consumer Health Informatics… how do we keep track of what’s happening?

Ekbia, begins by introducing the collaborative health paradigm where patients and providers are partners in their wellness. Makes a distinction between electronic medical record which mediated between patient and provider, to personal health records that are more collaborative in interaction. Again he’s focused on students, their health problems are not just serious but they are steadily growing. One challenge, they are at the point where they feel healthy and are invincible. At the same time they have no history of self-management of their health and wellness. Serious games for health, games that try to teach and educate but in an engaging and meaningful way. Gaming also part of an approach to learning in socially acceptable way.

Mayora discusses the dimensions of wellness. Again, it’s far more than just being healthy. It’s physical, cognitive, psychological, health, relationships with others, and the environment. Thats a lot to include in the design space, so they have (based on their experience) propose the following. Wellness needs to create consciousness of the wellness state, good habits should be created and bad ones gently corrected. People should not be working for the device, but towards the creation of habits. Design should be contagious, create the motivation for people to have a healthy lifestyle. Finally applications should be fun, that increases engagement. Why not include fun, the piano stairs which encourage people to take the stairs rather than the escalator.

Mamykina ended with a set of reflections about how two communities need to merge. The medical community brings a wealth of information and theories about how people engage with wellness over time that we could use for evaluation. We bring our understanding of technology and it’s human-centered design to the equation.

Our dreams, what would we be proud if we had solved….

  1. Find the key to using socio-computational mechanisms to improve health and wellness
  2. Reduce health disparities via technology
  3. Developing technologies that people use to go from intention to change to actual change

What would be different about health and wellness theories if we took interaction more seriously? We must move from one way direction to bidirectional.

I’ll write more later but that’s it for now.

Revisiting Visions

In academia, academic management, C@tM, discipline, HCI, ICT4D, research, social media, wellness informatics on June 3, 2009 at 4:23 pm

So who knew that a blog would encourage me to think harder.  Almost certainly some researchers I know, and I apologise to them profusely, but it’s still a new experience for me.

I wrote about vision (and strategy, but we never mention the latter without mentioning tactics). I said that I felt it didn’t come naturally to me, that I was more instinctual.  Beginning with instinct… here are the things that seem important to me.

  1. Wellness Informatics. I recently wrote about my version of this idea but its something I’ve been thinking about for about a year. The gist is that  health informatics (or more recently biomedical informatics) is largely (not completely, largely) focused on a medical response to health issues. But health and wellness are important partners. Wellness takes place in a community, and possibly without reference or interaction with the medical establishment. And what really triggered this idea for me was that in some communities, the medical establishment was a complex interaction. It depends from where you start.
  2. Human Network Interaction. I have a long standing interest in making the Internet/home network a better user experience. What the popularity of the Internet has successfully proved is that a network architecture/protocols designed for technical specialists is miserable for end-users at home, not to mention technically trained people at home. What Keith Edwards and Nick Feamster will tell you, and I agree, is that this situation is probably resolved when HCI moves “down the stack” i.e., when networking and HCI are co-designed to meet the unique constraints and opportunities presented by unmanaged environments.
  3. Narratives of Reach in ICTs. Paul Aoki first explained the importance of cross-cultural flows in computing. He made a compelling case that religious organizations are using ICTs not just to expand out of Westernized countries to emerging nations but vica versa. Research and conversations later, I understand that religion is a fascinating place to examine how emerging nations are using Information and Communications Technologies (ICTs) to expand into the West. One thing that’s important about this for me is that it turns a traditional narrative on its head. I participate in communities where ICTs are helping Western corporations expand their reach into emerging nations (heck I worked on such a project).
  4. Distributed Intelligence in Human-Robot Interaction. Robots are a fascinating computing platform (in so many ways). In the last few years a quiet revolution has occurred. Robots have always been a part of our collective narrative (e.g, in science fiction) but in the last few years they’ve been quietly moving out of our imagination, away from our screens, and into our homes. That’s a change… I think that this puts pressure on robotics, and on human-robot interaction to devise modalities by which we may interact. The focus seems, at least to me, on making robots more smart. And that’s a good thing, but I think it scopes the design space in limiting ways. Specifically, I think that if the design space accounts for how/why people want to engage with robots then it opens up the design space to a type of human-robot distribution of intelligence. And, I think that’s the relationship people actually seek with robots.

Each of these is clearly a product of the interactions I have with the students I work with. There are some interesting cross-cutting themes though.

One is instinctual: about looking at problems the other way around. Arguments frequently have a temporal-linear narrative. The last two sort of exhibit this property. Narratives about the expansion of ICTs have them reaching out from the rich, urban, industrialized, to the poor, rural, pre-industrialized. But it can be and is also the other way around. Arguments about intelligence dominate the rhetorics of robotics design, but what about arguments that propose emotional engagement. I’m not saying that dominant arguments/narratives don’t have their place, but I am saying that considering the possibility of what’s not there is well mind-opening.

Another example: decomposition. Software Engineers spend a significant amount of time focused on decomposing a problem into a series of modules that can be worked on individually. But if you think of software as a linear-temporal activity then the process of reassembling them, of creating the whole from the some of the parts, becomes much more visible. And I once argued that it was that process, the process of recomposition, that was why software engineering was so human-centered, it was the need to be able to put things together that drove a significant number of the collaborations required to keep all the individually separated parts in alignment so that they would fit back together again.

Funny I always think that I didn’t pay much/enough attention in John L. King’s class about argument morphology. Perhaps that’s not true. I thought my colleague LP was the one who was paying attention.

Another theme which I hardly know how to express is to do with considering the extremes. I’m not the first to think of that, nor would I claim to be. I have colleagues who have research that takes place in countries like Liberia, or among Atlanta’s urban homeless. We have called this computing at the margins. I feel that a lot of the projects I’m involved in have a feel of take something that works somewhere, in a particular context, and then watch it fail or change in a different context. That certainly describes the Home Networking research. I think it also describes the focus on religion. Religion is ubiquitous and a site for many interesting and diverse uses of ICTs, but it’s not a central topic in HCI. Well it wasn’t, we’re working on its inclusion. But why? Because it’s ubiquitous, because religious values have long shaped the appropriation and rejection of technologies, as well as been some of the major reasons driving adoption. And most importantly because it allows you to look at non-religious use in a different light. It is a new frame, a new perspective from which to re-examine what otherwise gets lost because it is assumed. It also captures my interest in Wellness Informatics. I’m far more interested in the cases where the relationship between the community and the medical establishment and its knowledge is not straightforward, because it reveals the all important hierarchies.

But, what pulls all this together? That’s the question I have going forward.

Wellness Informatics

In computer science, empirical, HCI, research, wellness informatics on June 2, 2009 at 7:25 pm

About a year ago, August last year, I started thinking about an area of research that I like to call wellness informatics.  It took me a while to understand how to situate it with respect to the very large and always growing space of health informatics. But, here’s what I think:

Wellness Informatics is a human-centered computing science focused on the design, development, deployment and evaluation of human facing technological solutions to promote and manage wellness acts such as the prevention of disease and the management of health. Wellness Informatics is a Computing Science because it requires hardware and software innovations in order to make devices that people can use anywhere and everywhere wellness occurs. Wellness Informatics is Human-Centered because it requires that those innovations are married with innovations in how the ICT communicates with the user, in ways that are psychologically, sociologically, culturally, and societally relevant—without which wellness will not be promoted and sustained.

Research in Wellness Informatics has already begun, but has not been systematically unified. This is a serious omission, and one that should be addressed. Wellness informatics complements but stands apart from Biomedical Informatics. Biomedical Informatics (including Health Informatics and Medical Informatics) has enjoyed an explosion of growth in activity as the possibilities of technologies for health have increased and as a growing recognition of the problems in health-care has been realised. According to recent definitions Biomedical Informatics is

“The meaning of the terms health informatics and medical informatics, and how also biomedical informatics, varies within and between different nations. Both terms — health informatics and medical informatics — will be used here interchangably in a broad and comprehensive manner, in terms of the discipline dealing with the systematic processing of data, information and knowledge in medicine and health care.” (Haux, 2006) p796.

Within Biomedical Informatics some common themes frequently emerge in the nature of the problems solved.

  1. Patient as source of information: Biomedical Informatics have tended to view patients as input data into the systems. Whether it’s tracking patients within the hospital, or integrating their health with financial data to learn more about healthcare costs, or in public health care informatics, using patient’s data in aggregate to track trends in disease, patients are inputs.
  2. Emphasis on population as appropriate level of granularity of data: Populations of various forms are often the appropriate level of granularity for data. Public Health Informatics exhibits this particularly well, with disease trend analysis being emblematic of the power of large-scale synthesis of patient data. Other populations also feature strongly in research directions. Biomedical Engineering focusing on developing classes of machines to support healthcare management of various diseases, classes of diagnosis and so forth. Populations associated with particular organizations, such as hospitals, also feature strongly in solutions in Biomedical Informatics.
  3. Healthcare establishment as the user of information: Biomedical Informatics has tended to prioritized the improvement of the healthcare profession. Systems are targetted at helping practitioners (i.e., hospitals, nurses, dentists, vetenarians, clinicians, public health professionals) improve the quality of care delivery and management through the timely provision of information. Other research has focused on improving the science behind practice, supporting the development of novel technologies (i.e., the discipline of biomedical engineering), improving the state of the science in medice (i.e., efforts to use ICTs to process and sequence large data sets and so forth—genomics).

An exception to this exists, within the space of Consumer Health Informatics which has advocated for a patient centered approach, viewing patients as consumers of various applications and the information contained therein. This patient oriented approach, however, still focuses on healthcare. Additionally, if Biomedical Informatics is seen as patient information flowing into the systems used by the healthcare establishment, than consumer health informatics is about the flow of information from the healthcare establishment to patients. Topics include the use of online medical resources, or the development of systems that patients and doctors can use together.

Consumer Health Informatics provides an important foundation for Wellness Informatics. The centrality of the patient as actively involved rather than data is shared among the disciplines. But Wellness Informatics focuses on promoting the use of ICTs to prevent illness and prolong life. Further, there is an additional focus on communities. It is not just a relationship between an individual and the healthcare establishment, although that is part of the process, but that the patient interacts with other people, in their physical world, to make sense of and consume information about how to be well. For example, it is often said that weight loss proceeds more effectively when a person joins a group who are collectively focused on that goal.

Wellness also requires a focus on culture and socio-economic status. Individuals’ cultural background plays a significant role in their orientation to a variety of matters. Food consumption is grounded in rituals. Beliefs about body shape and size have cultural originals. Wellness is also based on what individuals can afford, where they live, and what is available.

I also chose wellness because it suggests a different type of interactional arrangement particularly with the healthcare establishment. A focus on health, and on the treatment of diseases, places a centrality on the interactions between a person (a patient) and the health care establishment. Wellness may be triggered by the healthcare establishment (e.g., someone being advised to get more exercise) and it is scaffolded by the values and advice of the healthcare establishment (e.g., guides about what constitutes appropriate weight) but it may begin with an individual feeling that they need to make life adjustments borne out of their own personal sense or in conversation with friends and family. The healthcare establishment may only be involved as a resource to gain information (e.g., using the Internet to compute Body Mass Index as part of goal setting).