Author: Shweta Premanandan

New Publication! Introducing HealthCheck: A New Method for Evaluating Persuasive Mobile Health Apps

9 December 2024 / Shweta Premanandan

We’re excited to announce the publication of our latest research. HealthCheck: A Method for Evaluating Persuasive Mobile Health Applications led by Shweta Premanandan along with Åsa Cajander and Awais Ahmad from the HTO research group.

This new method addresses a crucial challenge in the fast-evolving world of mobile health (mHealth)—evaluating usability and persuasiveness in a way that aligns with agile development processes.

Published in the Health Informatics Journal, this study presents a usability evaluation method tailored for persuasive mHealth applications. Whether designed for caregivers or other health-related purposes, HealthCheck helps ensure these applications are user-friendly, effective, and engaging.

What is HealthCheck?

HealthCheck is a usability evaluation framework tailored to meet the challenges of developing persuasive mHealth applications in agile environments. Unlike traditional methods that may be resource-intensive or slow to provide feedback, HealthCheck delivers quick, actionable insights that help developers iteratively refine their applications.

What is HealthCheck About?

The method integrates established usability heuristics with principles of persuasive system design to evaluate critical aspects such as:

User Engagement: Ensuring that apps effectively motivate and sustain user interaction.
Personalization: Assessing how well apps adapt to individual user needs.
Usability in Agile Contexts: Supporting iterative development cycles with timely feedback.

HealthCheck also emphasizes the unique needs of informal caregivers, who often rely on such tools to manage complex caregiving tasks while balancing their own well-being.

How was HealthCheck Developed?

HealthCheck was developed using a rigorous Design Science Research (DSR) methodology. This process included:

Problem Identification: Recognizing the need for a usability evaluation method suited to persuasive mHealth apps in agile contexts.
Solution Design: Combining insights from existing usability and persuasive system heuristics.
Implementation: Testing the method using a prototype app (AnhörigCare) designed to support informal caregivers in Sweden.
Evaluation: Engaging seven experts in usability, UX, and eHealth to assess the method’s effectiveness.
Reflection and Improvement: Refining the method based on expert feedback to enhance its practicality and relevance.

Tested on AnhörigCare: eCoaching application for Informal Caregivers

To demonstrate its practical application, HealthCheck was tested with AnhörigCare, an e-coaching app designed for informal caregivers in Sweden. This case study showed how HealthCheck could identify areas for improvement, such as streamlining navigation, tailoring content, and enhancing user feedback, making the app more supportive and user-friendly. This test case underscores the method’s adaptability and value for a wide range of mHealth applications, beyond caregiving.

Key Insights from the Paper

Effective Heuristics: The HealthCheck framework includes a set of heuristics tailored for persuasive mHealth applications, such as ensuring clear feedback mechanisms, privacy protection, and user education.
Expert Validation: Feedback from usability experts demonstrated the method’s ability to identify and prioritize usability issues in a structured and efficient way.
Iterative Feedback: HealthCheck’s design supports agile development by enabling rapid cycles of evaluation and refinement.

Why does HealthCheck Matter?

The usability of mHealth applications is pivotal to their success, especially for informal caregivers who often juggle demanding responsibilities. HealthCheck offers a structured yet flexible way to ensure these applications are user-friendly, engaging, and effective in meeting their goals. By providing tailored feedback and highlighting actionable areas for improvement, the method helps developers create tools that truly make a difference.

What’s Next?

We hope HealthCheck will become a valuable tool for researchers, developers, and designers working on persuasive mHealth applications. We’d love to hear your thoughts and how you envision using HealthCheck in your projects!

Let us know in the comments or reach out directly.

New Publication: A Review of IT Applications Supporting Informal Caregivers

28 November 2024 / Shweta Premanandan

Informal caregivers—family and friends supporting loved ones with chronic illnesses or disabilities—play a critical role in our healthcare ecosystem. Yet, their contributions often go unnoticed, and they face challenges like stress, burnout, and a lack of resources. Our recent research, published in the Journal of Medical Internet Research (JMIR), reviews the literature and explores how IT applications can alleviate these burdens and empower caregivers. This study was led by Shweta Premanandan with Awais Ahmad, and Åsa Cajander from the HTO group among others. The purpose of this study was to conduct a scoping review to outline design recommendations for IT applications gathered from informal caregivers. In addition, this study presents evaluations of the use of IT applications by informal caregivers.

The methodological framework by Arksey and O’Malley (2005) for scoping reviews was followed for this review. A structured search was conducted across the PubMed, Scopus, IEEE Xplore Digital Library, Web of Science, and ACM Digital Library databases. In addition, reference list hand searches and keyword searches in Google Scholar were undertaken. Two reviewers independently identified articles for review and extracted the data. Conflicts were resolved through discussion, with a third reviewer consulted if consensus could not be attained. Thematic analysis was used to analyze the data.

With an aging population and stretched healthcare resources, informal caregivers are increasingly shouldering the responsibility of care. While rewarding, caregiving often leads to significant emotional and physical strain. IT applications offer a promising solution, acting as virtual assistants and support networks. However, these tools must be thoughtfully designed to address the unique and diverse needs of caregivers. A total of 82 articles were selected for the scoping review—44 (54%) related to design and 39 (48%) related to evaluation of IT applications.

What to include in these Caregiver Support Applications?

Easy Access to Information
Caregivers need quick, clear, and tailored advice. Good apps provide step-by-step guides, helpful tips, and even myth-busting facts to clear up common misconceptions.

Support Networks
Caring can feel lonely. Apps that connect caregivers to support groups or online communities help people share experiences, advice, and even a laugh.

Streamlining Tasks
Managing medications, tracking health updates, or coordinating with family members can get overwhelming. Apps that organize all this in one place save time and stress.

Caring for the Caregiver
Caregivers often forget to care for themselves. Some apps include features like relaxation exercises, gratitude journals, or tips on staying healthy.

Better Communication with Healthcare Professionals
Many caregivers need information or quick access to a healthcare professional or to share updates with doctors or navigate healthcare systems. Apps that simplify this communication help everyone stay on the same page.

Simple Tools for Daily Tasks
Reminders, user-friendly interfaces, and voice commands can make apps easier for caregivers to use, even if they’re not tech-savvy.

What caregivers think about these tools?

Most caregivers like the idea of using apps to help them. They appreciate:

Quick Access to Information: Being able to find answers right away.
Social Connections: Knowing they’re not alone.
Flexibility: Using the app when it fits their schedule.

But there are challenges, too. Some caregivers worry about:

Privacy: Will their data be safe?
Trust: Is the app’s information reliable?
Ease of Use: Older caregivers may struggle with complex apps.

Looking Ahead

As technology continues to evolve, so do the opportunities to create more impactful tools for caregivers. Our findings act as a starting point for designers to design IT applications for caregivers that not only ease caregiving tasks but also foster a supportive ecosystem for caregivers.

Let’s continue the conversation. What features would you like to see in future caregiving applications? Or any other comments. Share your thoughts with us!

NordiCHI 2024 Workshop – Design Methods in Connected Health

22 October 2024 / Shweta Premanandan

On 13 October 2024, a quiet Sunday, I had this incredible opportunity of organizing and leading a pre-conference NordiCHI workshop along with my colleagues Åsa Cajander, Sofia Ouhbi and Awais Ahmad focused on Design Methods in Connected Health. It was an exciting day filled with lively discussions, fresh ideas, and a lot of collaborative energy. We had a diverse group of participants, all bringing their expertise to explore how design approaches can be used and can influence the landscape of connected health. Here’s a rundown of how the day unfolded and some of the most memorable moments.

Setting the tone

We kicked off with a quick introduction and overview. We wanted to ensure that everyone felt comfortable and that we were all on the same page about the goals of the workshop. The idea was simple: explore how different design methods can be be used and influence connected health solutions, particularly in making them more human-centered and responsive to real-world challenges. As participants introduced themselves, it became clear that we had a diverse group with varied experience and expertise in the connected health field. This diversity added depth to our conversations, as everyone brought unique perspectives to the table, enriching our exploration of the challenges and opportunities in designing for connected health.

Diving Into Design Methods

The first part of the workshop revolved around several short presentations, each one offering a unique design scenario for connected health. After each presentation, we held a Q&A where the group could reflect, ask questions, and share their own thoughts. This wasn’t just a formal back-and-forth – it felt more like a natural, flowing conversation where everyone got involved. People were eager to discuss both the opportunities and the challenges of each approach.

The discussions brought up a wide range of opportunities and challenges related to designing in connected health. As a group, we identified the most important and relevant topics that resonated with the participants. From these discussions, we selected five key themes that stood out for their relevance to the ongoing work in connected health. These themes were chosen to be explored further in the next session, where participants would pair up and engage in deeper discussions during a gallery walk. This allowed for a more focused exchange of ideas and practical insights on each theme.

Interactive Reflections: The Gallery Walk

In the afternoon, we switched things up with a Gallery Walk. This was a chance for participants to physically move around in pairs, reflecting on the key themes that had emerged earlier. Participants paired up and stopped by different stations, jotting down their thoughts, questions, or even new insights on the topics that stood out to them.

This was one of the highlights for us. It was incredible to see how ideas that had been discussed briefly earlier in the day could spark deeper reflections when people had the chance to digest them in a different way. By the end, we had walls full of notes, suggestions, and thought-provoking questions that built on each other.

Bringing It All Together

The day didn’t end there! After the Gallery Walk, we spent time reflecting on how these design methods could be applied in real-world scenarios. People considered how they could integrate these insights into their own work, which led to a discussion about potential collaborations.

To keep the momentum going, we began drafting ideas for a joint research paper. By the end of the session, we had a rough outline for the paper, which will hopefully lead to future collaborations.

Wrapping Up

As we closed the workshop, we could see a sense of accomplishment among tha participants. We had discussed complex ideas, brought diverse perspectives to the table, and, most importantly, walked away with new connections and insights. The workshop was an amazing opportunity to dive deep into connected health design methods, and I’m already looking forward to where these discussions and ideas will take us next.

It’s always inspiring to see how people from different backgrounds can come together to innovate and push the boundaries of what’s possible in health care. Watch this space for updates on the collaborative paper.

My Upcoming PhD defense – ‘Care for Caregivers: Designing IT Applications for Informal Caregivers’

9 September 2024 / Shweta Premanandan

On Friday, September 13, 2024, at Uppsala University, I will defend my Ph.D. thesis titled Care for Caregivers: Designing IT Applications for Informal Caregivers. This research contributes to the field of Information systems and informal caregiving, focusing on how technology can be used to support informal caregivers—those who provide care to their relatives with illness or disabilities.

What is the Thesis About?

The thesis explores the development of IT applications to support informal caregivers. Informal caregiving often involves immense emotional, physical, and logistical challenges, all of which can take a toll on caregivers’ well-being. By identifying and analyzing the needs of caregivers, this research developed two primary IT solutions: an eCoaching platform and a web-based health application named Carer eSupport. These tools are designed to offer personalized guidance, resources, and support systems.

To design these applications, the thesis incorporates Persuasive Design and Positive Design approaches. Persuasive Design leverages behavioral psychology to encourage positive actions, while Positive Design focuses on enhancing emotional well-being. This research also critically analyzes their application in the caregiving context.

Why It Matters?

Caregivers play an essential yet often undervalued role in the healthcare system. They provide care, support, and comfort to their relatives in need, often with little formal training or external support. Despite the importance of their work, caregivers frequently struggle with balancing their responsibilities and maintaining their own well-being. This research highlights the crucial role that technology can play in supporting caregivers, providing them with accessible tools that can alleviate some of their burdens.

By addressing the needs of various caregiver groups, including native Swedish caregivers, immigrant caregivers, and those caring for patients with head and neck cancer, the thesis offers solutions that are tailored to the diverse needs of different populations.

Key Contributions

The thesis presents several key contributions based on interviews, focus groups, and evaluations conducted with caregivers and healthcare professionals:

Comparative Analysis: The thesis provides a comparative analysis of the Persuasive Systems Design (PSD) model and the Positive Design Framework for creating IT applications for informal caregivers. It highlights the strengths and weaknesses of both approaches, offers an in-depth reflection on their design processes, and evaluates their effectiveness in meeting caregivers’ needs. Additionally, it offers recommendations on when to use PSD or Positive Design based on the caregiving context and provides practical guidelines for integrating both approaches to balance functionality and emotional support.
Adaptation of Frameworks: The research adapts the PSD and Positive Design frameworks specifically for informal caregiving, highlighting their relevance and applicability to this context.
Ethical Considerations: The thesis discusses the ethical implications of using persuasive and positive design techniques.
Literature Mapping: A systematic literature review is provided, offering crucial design recommendations and identifying facilitators and barriers to the implementation of IT applications in informal caregiving.
Proposing IT Solutions: The development, exploration, and evaluation of IT applications are also key contributions, including an eCoaching platform and a web-based health application designed to address and support the complex roles of caregivers.

The Role of Technology in Caregiving: What It Can and Can’t Do

Supporting caregivers with technology is an exciting idea, but it’s important to remember that technology has its limits. Caregiving isn’t just about tasks—it’s about empathy, understanding, and human connection. While apps and digital tools can make things easier for caregivers by providing information, resources, and reminders, they can’t replace the care and warmth that come from a real human interaction.

The truth is, informal caregivers are often expected to do the work of healthcare professionals, even though they might not have the training, time, or resources. This puts a lot of stress on them, leading to burnout and, in some cases, poorer outcomes for the people they care for. And not everyone has access to a strong support system, making caregiving even harder for people in marginalized communities.

So, while technology can help caregivers by making their lives a bit easier, it shouldn’t be seen as a replacement for proper healthcare support. Caregivers need more than just apps; they need real, systemic support from the healthcare system. As we move forward, it’s crucial that research and policy work together to find better ways to take this burden off caregivers. Until then, IT applications can hope to provide some respite.

The Defense Day

On the day of the defense, the opponent, Professor Tone Bratteteig from University of Oslo, presents my research and then we engage in a discussion. This is followed by questions by the grading committee members and then the audience.

The defense will take place at 13.15 in room B115 at Ekonomikum, Uppsala University. I’m looking forward to it.

NordiCHI Workshop – Call for Participation

22 June 2024 / Shweta Premanandan

Design Methods in Connected Health

We are excited to invite you to our interactive workshop, which will explore and advance design methods for Connected Health applications.

Full day on 13 October 2024, On-site at Ekonomikum, Uppsala University

The Design Methods in Connected Health workshop aims to bring together researchers, practitioners, and designers in eHealth to explore innovative design approaches and philosophies that can enhance the user experience, accessibility, and overall effectiveness of electronic health technologies. Connected health is a multifaceted concept encompassing technology to improve healthcare delivery and patient outcomes. Design methods are processes and tools for creating effective user experiences in technology development.

This workshop will explore diverse design approaches from various fields, including Human-Computer Interaction (HCI), Information Systems (IS), Health Informatics, and Healthcare.

It aims to foster the exchange of ideas and methodologies across these domains. The aims and objectives include

to explore the diverse design methods in the context of eHealth applications,
to discuss the impact of design on user engagement, and overall health outcomes,
to share best practices and case studies of eHealth design implementations,
to foster collaboration between researchers and practitioners for future advancements in eHealth design, and
to collaborate on drafting a joint paper for a scientific journal, drawing upon the collective insights gained.

The workshop will explore design methods, analyzing their strengths and weaknesses to determine the most suitable approach for different situations. Through a mix of presentations, group discussions, and collaborative activities like a gallery walk (an activity where participants rotate through stations to evaluate and discuss ideas), participants will engage in a dynamic learning experience. The workshop culminates in a collaborative effort to draft a joint paper for a scientific journal, drawing upon the collective insights gained.

The workshop will be in person and will feature an introduction to various design practices used in the eHealth field using a fishbowl discussion method. This will be followed by discussions on these philosophies using an interactive method called Gallery Walk, which is an activity where participants rotate through stations to evaluate and discuss ideas. This is followed by a wrap-up session.

Who Should Attend?

Researchers in design and Connected Health.
UX designers specializing in Connected Health projects.
Healthcare professionals interested in developing Connected Health solutions.

What to Expect:

Interactive Sessions: Participate in engaging discussions and a “gallery walk” to critically assess and compare different design methods.
Collaborative Paper: Collaborate with other attendees to co-author a paper intended for publication in a scientific journal, leveraging the collective expertise and insights acquired during the workshop.
Sharpen Your Skills: Improve your understanding of Connected Health design methods and acquire actionable knowledge to create user-centric Connected Health solutions.

Submission

The submission should be a maximum of 3 pages long.

Format: Please use the ACM submission template.
Title and Author Information: Clear and descriptive title of the submission. Name(s), affiliation(s), and email address(es).
Abstract: 100-150 words. A brief overview of the design method, its context, and the key takeaways.
Introduction: Provide background information and relevance of the design method to Connected Health. Outline the specific areas or challenges or issues the method addresses in Connected Health.
Design Method Description: Describe the design method in detail. Outline the steps, tools, and techniques involved. Mention any theoretical or conceptual frameworks underpinning the method.
Application and Context: Describe a specific use case or example where the design method was applied. Provide context about how the method was implemented, including settings, participants, and any technological tools used. Discuss any challenges encountered during the application of the method.
Outcomes and Lessons Learned: Summarize the outcomes or results achieved through the application of the design method. Share key insights or lessons learned from the experience. Discuss how the design method impacted user engagement, accessibility, or health outcomes.
Discussion: Analyze the strengths and weaknesses of the design method. If applicable, compare with other design methods used in similar contexts. Suggest potential improvements or future applications of the method in Connected Health.
Conclusion: Recap the key points of the submission. Propose next steps for research or practice in Connected Health design.
Appendices (Optional): Any supplementary material, such as diagrams, detailed tables, or screenshots of the design method in action.

Important Dates:

Deadline Extended!

Deadline for Abstract Submission – 13 September 2024
Notification of Acceptance – 16 September 2024
Workshop Date – 13 October 2024

Email your submissions to: Shweta Premanandan (shweta.premanandan@im.uu.se), Awais Ahmad (awais.ahmad@it.uu.se)

Workshop Organizers:

Åsa Cajander, Department of Information Technology, Uppsala University (asa.cajander@it.uu.se)

Sofia Ouhbi, Department of Information Technology, Uppsala University (sofia.ouhbi@it.uu.se)

Shweta Premanandan, Department of Informatics and Media, Uppsala University (shweta.premanandan@im.uu.se)

Awais Ahmad, Department of Information Technology, Uppsala University (awais.ahmad@it.uu.se)

E-Coaching for Informal Caregivers: Building Resilience and Well-being

11 September 2023 / Shweta Premanandan

As we navigate through the complex experience of caregiving, it is often the informal caregivers, such as close friends or relatives, who become the unsung heroes of caregiving at home. These caregivers are the ones who provide the much-needed support and assistance that patients require to live life with some semblance of normalcy.

For informal caregivers, providing care for a loved one can be emotionally, physically, and mentally challenging. They often have to adapt to a new role as the primary caregiver, while also managing their own lives and responsibilities. Consequently, caregiving can take a toll on these caregivers’ well-being, with many experiencing stress and burnout. Interventions designed to provide support to these caregivers are thus crucial. To this end, our recent study identified important unmet needs of informal caregivers and provided design suggestions for a persuasive e-coaching application using the persuasive system design (PSD) model. The PSD model offers a systematic approach to designing IT interventions.

Using a qualitative research approach, we interviewed 13 informal caregivers and conducted a thematic analysis of the data. From this analysis, six needs were identified: monitoring and guidance, assistance in navigating formal care services, access to practical information without feeling overwhelmed, a sense of community, access to informal support, and the ability to accept grief. These needs formed the basis for suggested design features in an e-coaching application, using the PSD model.

However, we found that some needs could not be mapped using the existing PSD model. As such, we adapted the model to better address the needs of informal caregivers.

By identifying the needs of informal caregivers and providing design suggestions for an e-coaching application, this study offers support and hope for those navigating the challenging role of caregiving. The suggestions for e-coaching applications using the PSD model have the potential to ease the caregiving burden, as well as provide caregivers access to the support and resources they need to provide better care, which is an essential factor in improving both the caregiver’s well-being and the overall quality of care provided to patients. This study highlights the importance of providing support to informal caregivers and demonstrates the potential of technology-based interventions to improve caregivers’ lives. With further development and refinement, e-coaching applications designed based on the PSD model could become valuable tools for supporting and empowering informal caregivers.

Designing Persuasive eCoaching Application for Informal Caregivers in Sweden: My work in ENTWINE

20 April 2023 / Shweta Premanandan

As I sit down to reflect on my experience with ENTWINE Informal Care, I am filled with gratitude for the opportunities that this Marie Skłodowska Curie Innovative Training Network (MSCA-ITN) funded by the European Union Horizon2020 has provided me. It’s been a journey of growth, learning, and collaboration that has impacted my personal and professional life in ways I couldn’t have imagined. The program began in March 2019, but my journey with the ENTWINE project began in October 2019 when I moved to the beautiful island of Gotland in Sweden. I was thrilled to be a part of this program as informal caregiving was already interesting to me personally, given that I had been an informal caregiver for my father for over a year. So, I have a personal motivation to work in this area. I am also interested in the field of designing IT systems, and I was delighted to find that these two interests aligned so well in my project in ENTWINE.

One of the most exciting aspects of ENTWINE was the opportunity to work with other PhD students hosted across five different countries in Europe. You may read more about ENTWINE and the research done here. The cohort was diverse, and we all brought our unique experiences and perspectives to the table. The training courses offered through ENTWINE were invaluable in helping us develop the skills and knowledge needed to conduct high-quality research in the field of caregiving. We received training in areas such as caregiving, persuasive designing, positive technology research methods, entrepreneurship, and many more. The courses were rigorous and challenging, but they were also fun and engaging. It was clear that the program coordinators had put a lot of effort into designing a curriculum that would equip us with the skills and knowledge we needed to contribute positively in our respective fields. Another highlight of the program was the opportunity to work with multiple industry and academic partners. We had the chance to discuss our work and learn from them through dedicated research secondments. My secondments were at the University of Twente and the University of Oulu, where I spent three months each. These secondments helped shape my PhD and helped form good collaborations.

AnhörigCare: An eCoaching Application for Informal Caregivers in Sweden

My PhD work focuses on designing a persuasive eCoaching application (AnhörigCare) for informal caregivers in Sweden. ‘AnhörigCare’ means caring for ‘anhöriga’, the Swedish word for relatives. Informal caregivers are individuals who take care of their sick family members or friends suffering from a long-term illness. Caregiving can be difficult and can affect the well-being of the caregiver and they often experience stress and anxiety. As a result, my research focuses on designing an eCoaching application called AnhörigCare for caregivers in Sweden to support them in their caregiving activities and assist them in self-care.

‘AnhörigCare’ means caring for ‘anhöriga’, the Swedish word for relatives.

Persuasive System Design

AnhörigCare was designed using the Persuasive System Design (PSD) model. The PSD model is a comprehensive framework created to assist in designing systems that can impact users’ behavior. It offers designers a methodical approach to designing persuasive IT applications that are tailored to the specific needs of caregivers, making them more effective in assisting them to achieve their objectives. It also presents a structured design strategy for creating appealing and practical interventions. Additionally, the PSD model offers organized design principles that can be utilized by designers. This model proposes 28 design principles grouped into four dimensions: primary task support, dialogue support, credibility support, and social support. The first dimension, primary task support, aims to assist users in accomplishing their intended behavior. The second dimension, dialogue support, employs design principles that encourage users through feedback and interaction with the application. The third dimension, credibility support, employs techniques that enhance the application’s perceived credibility and trustworthiness by the user. The fourth and final dimension, social support, uses methods to leverage social influence (illustrated in the figure below).

The Design Process

AnhörigCare aims to provide access to practical information, access to formal services related to caregiving, and access to an online forum that can connect caregivers with each other to feel part of a community. This figure illustrates the activities in this project to design the final version of AnhörigCare.

We started with a review of literature. The extant literature points to access to information regarding caregiving, access to formal services to assist caregivers, feeling of community, words of acknowledgment and encouragement, self-care, and informal peer support as major needs of caregivers. The descriptions of their needs were compared with the persuasive design principles from the PSD model. Based on this match, design principles was chosen to meet their needs, creating the first version of AnhörigCare. Expert evaluations were then conducted on this version and changes to navigation and presentation of content were made. In the next step, we interviewed caregivers in Sweden to elicit their needs for an eCoaching application. Based on these needs we presented some design suggestions to further update AnhörigCare. After which we conducted design workshops with caregivers as a means to involve them in the design of AnhörigCare and finally a scenario-based user testing.

Based on the design workshops and user testing, the final design of AnhörigCare will be created. Here are some initial screenshots of AnhörigCare.

Watch this space for upcoming articles on this research!