Participatory Design Process Research Articles

Abstract Su403: Iterative Simulation to Optimize Mechanical CPR Device Application

Mechanical chest compression devices (MCDs) are commonly used for in-hospital and emergency department (ED) cardiac arrest resuscitation. Manufacturer guidelines and educational materials demonstrate that in the prehospital setting, MCDs can be deployed with an interruption in CPR of less than 15 seconds. No similar materials exist for the in-hospital environment, where observational studies have noted median CPR interruptions of up to 40 seconds for MCD deployment. With the integration of extracorporeal CPR (eCPR) into OHCA systems of care, the need to transfer patients with ongoing CPR to MCDs in the ED is growing. To develop a hospital-specific procedure for receiving a patient in cardiac arrest and deploying the MCD with minimal no-flow time. We used an iterative participatory design process to develop a procedure for receiving patients in cardiac arrest from Emergency Medical Services (EMS). Tasks included transferring a patient, replacing defibrillator pads, and deploying the hospital MCD with minimal no-flow time. Participants including ED physicians, nurses, and respiratory therapists performed a series of simulations using a high-fidelity manikin, resuscitation equipment, and an MCD. Simulations were followed by focused debriefings, participant-directed modification of the working procedure, and repeat simulation until participants expressed satisfaction with the procedure. Participant roles were shuffled after each round. The primary outcome was the duration of CPR interruption required to deploy the MCD; change in this time over successive iterations was assessed using a Wilcoxon signed-rank test. The final procedure described a sequence of steps and responsibilities that participants deemed efficient and reproducible. Through seven simulation-debriefing cycles, CPR interruption associated with MCD deployment decreased from 19 to 10 seconds (p = 0.033). The most common failure modes that participants corrected during modifications involved needed equipment that was out of reach, obstructed provider positioning, and poorly defined roles. On subsequent days, two additional groups of on-shift ED providers deployed the MCD in less than 15 seconds following the developed procedure. Using an iterative design process, we created an MCD deployment procedure that minimized CPR interruptions and was acceptable to hospital staff. This represents an effective, low-cost methodology to design a process for transfer of care during CPR and MCD deployment.

Micropolitics in Participatory Processes: The Impact of Ablism and Other ‘Hidden’ Power Structures on Equitable Participation and Outcomes

Theoretical understandings of micropolitics and ablism provided a framework to analyze power relations and their impacts in a participatory design process. Micropolitics allowed a focus on small scale interactions and relational processes that impact outcomes of participation, and revealed the importance of problem framing and coalition building. We also found resistance to ablism through micropolitical strategies including: the sharing of experiential narratives; the use of expressive communication styles; and the development of alliances. These helped challenge norms of ablism in the deliberative process. Suggested practices for planners and facilitators who want to intervene in status quo ablest practices are identified.

Audio-Vibratory You-Are-Here Mobile Maps for People with Visual Impairments

Self-localization and wayfinding are challenging tasks for people with visual impairments (PVIs), severely impacting independent mobility. Visual “You-are-here” (YAH) maps are useful for assisting local wayfinding of sighted users. They are used to self-localize and display points of interest, landmarks and routes in the surroundings. However, these maps are not always available and rarely accessible to PVIs. Relying on an iterative participatory design process with eight end-users with visual impairments, we created a proof of concept of a mobile audio-vibratory YAH map. Our design is based on either a tablet or a smartphone to ensure a small and portable solution. A user study with ten PVIs showed that the audio-vibratory YAH map that we designed provides the user with a good understanding of the surroundings and wayfinding cues. Surprisingly, the results show that the audio-vibratory YAH map prototype was as usable as the control condition (audio-tactile YAH map with a tactile overlay), with similar user satisfaction and cognitive load. A follow-up field study with two participants showed the effectiveness of the prototype for assisting in crossroad understanding. To conclude, our innovative design of a mobile audio-vibratory YAH map can overcome the portability and printing issues associated with tactile overlays and can be an appropriate solution for assisting the pedestrian navigation of PVIs.

Serious Game Development for Public Health: Participatory Design Approach to COVID-19 Quarantine Policy Education.

Public health education plays a crucial role in effectively addressing infectious diseases such as COVID-19. However, existing educational materials often provide only foundational information, and traditional group education faces challenges due to social distancing policies. Addressing these gaps, our study introduces a serious game called "Flattening the Curve." This interactive experience immerses learners in the role of quarantine policy managers, offering unique insights into the effects and challenges of social distancing policies. The development of the game adhered to the SERES framework, ensuring a scientifically designed foundation. To achieve its learning objectives, the game incorporated learning and game mechanics including an agent-based infection model, a social distancing policy model, and an economic model, which were developed based on previous literature. After defining a broad concept of scientific and design foundations, we used a participatory design process. This study included 16 undergraduates and took place over one semester. Participants played the game, gave feedback, and answered surveys. The game was improved based on participants' feedback throughout the process. Participants' feedback was analyzed based on the Design, Play, and Experience framework. Surveys were conducted before and after the activity and analyzed to assess participants' evaluation of and satisfaction with the game. The game successfully achieved its learning objectives, encompassing a comprehensive understanding of infectious disease characteristics; the disease transmission process; the necessity and efficacy of quarantine policies and their delicate balance with economic factors; and the concept of flattening the curve. To achieve this, the game includes the following: (1) an agent-based infection model based on the modified Susceptible-Exposed-Infectious-Hospitalized-Recovered (SEIHR) model with five infectious disease scenarios; (2) a quarantine policy model with social distancing, travel control, and intensive care unit management; and (3) an economic model that allows users to consider the impact of quarantine policies on a community's economy. In response to participatory design feedback, the game underwent meticulous modifications, including refining game systems, parameters, design elements, the user interface, and interactions. Key feedback included requests for more scenarios and engaging yet simple game elements, as well as suggestions for improving the scoring system and design features. Notably, concerns about the fairness of the outcome evaluation system (star rating system), which could incentivize prioritizing economic activity over minimizing casualties, were raised and addressed by replacing the star rating system with a progress-based vaccine development system. Quantitative evaluation results reflect participants' positive assessments of the game through the learner-centric approach. The serious game "Flattening the Curve," developed through a participatory design approach, emerges as a valuable tool for public health education, particularly concerning social distancing policies. The game and its source code are openly accessible online, enabling widespread use for research and educational purposes.

Participatory Design of an Embodied Mixed Reality Experience Aimed to Assessing Individual and Collaborative Behaviors of Children

This study is part of a broader project exploring the integration of Mixed Reality (MR) in fostering prosocial behaviors among children, particularly focusing on interpersonal synchrony (IPS) and its impact on collaboration. IPS, the coordination of rhythmic movements among individuals, has been associated with improved group cohesion and prosocial behaviors, such as collaboration. Traditional assessments of prosociality typically involve structured play activities for dyads, making them difficult to adapt to other settings. To address these limitations, this research aims to design a flexible embodied MR experience that allows children to choose between collaborative or individual engagement, reflecting the natural dynamics of children's play interactions. For this purpose, we conducted an embodied participatory design (PD) and usability study with 50 children aged 8-10 years. We provide a detailed account on how the PD process was orchestrated and an evaluation of user-system interaction, children's perceptions of play modes, and experience satisfaction. The results show how the MR experience, codesigned with children, supports a free play environment, allowing children to choose their preferred play mode. This study highlights the potential of MR in psychological research and child development, providing a new avenue for assessing individual and collaborative behaviors in larger groups of children.

Designing Games for GDPR: Negotiating Understandings of GDPR in EU Schools

In this study we combine a participatory design process with a citizen science framing, to foster a dialogue on GDPR in the school. We focus on the perspective of students, approaching them as co-researchers, in designing and evaluating a series of apps, aimed at spreading knowledge on GDPR. We have created a design space between secondary school students in Denmark and Italy, to gather insights across different countries. Results show that approaching students as designers and testers enabled them to provide honest and concrete insights on their experience with GDPR. We identified a detachment related to their posting activities, caused by how social media platforms (SoMe) challenge the boundaries between their personal and school-related ecologies.

Designing Games for GDPR: Negotiating Understandings of GDPR in EU Schools.

In this study we combine a participatory design process with a citizen science framing, to foster a dialogue on GDPR in the school. We focus on the perspective of students, approaching them as co-researchers, in designing and evaluating a series of apps, aimed at spreading knowledge on GDPR. We have created a design space between secondary school students in Denmark and Italy, to gather insights across different countries. Results show that approaching students as designers and testers enabled them to provide honest and concrete insights on their experience with GDPR. We identified a detachment related to their posting activities, caused by how social media platforms (SoMe) challenge the boundaries between their personal and school-related ecologies.

Developing a Motion Sensor-Based Game to Support Frozen Shoulder Rehabilitation in Older Adults through a Participatory Design Approach.

Objective: Although some serious games have been developed for physical therapy, little work has been conducted through a participatory design approach. Therefore, a game prototype was developed, which involved related stakeholders in the design process. Materials and Methods: The iterative participatory design process was adopted with the input of 18 patients with frozen shoulder symptoms, 4 health professionals, 2 game designers, and 5 researchers in an iterative process to design, test, and evaluate the game prototype. In total, 17 patients participated in the interviews to explore their needs and desires for a serious game. The health professionals participated in the interviews to understand the medical requirement and experience pertaining to frozen shoulder and were included in the workshop to give feedback on the game prototype. At the conclusion of the iterative design process, a Kinect-based prototype game with three levels was used for a case study with one patient who was diagnosed with frozen shoulder and has been receiving medical treatment in the hospital. Results: Based on the outcomes derived from data collected among diverse stakeholders, the prototype game underwent iterative development by the team and was assessed by a participant with frozen shoulder symptoms. Findings revealed that the participant demonstrated enhanced shoulder mobility and a reduction in pain intensity, despite the lack of significant improvement for health-related quality of life. Nevertheless, the participant reported a positive experience with the prototype game. Conclusion: This study underscores the importance of involving diverse stakeholders in the development process to create more effective and user-centric serious games for rehabilitation. The participatory approach, exemplified by the prototype game, demonstrates potential improvements in both user experience and overall effectiveness during the rehabilitation process.

Improving transparency and quality assurance: Operationalising semi-automated data provenance tracking in a Trusted Research Environment

We present a prototype solution for improving transparency and quality assurance of the data linkage process through a data provenance dashboard designed to assist data analysts, researchers and information governance teams in authenticating and auditing data workflows within a trusted research environment (TRE). Building on prior research (Scheliga, et al., 2022), this work describes our first operationalised prototype tested in a real-world setting. The prototype development involved four stages: (1) Co-design of interfaces with end users for provenance data collection and visualisation, producing a low-fidelity design; (2) Extension and refinement of the Safe Haven Provenance (SHP) ontology (https://tre-provenance.github.io/SHP-ontology/releases/v0.2/index-en.html); (3) Design and implementation of mechanisms for semi-automated collection of data linkage provenance using the SHP ontology; (4) Implementation and user evaluation of the dashboard. A participatory design process with data analysts, researchers and information governance teams resulted in a low-fidelity prototype and was validated via public consultations to ensure it met public trust. The resulting prototype dashboard (https://tre-provenance.github.io/) was built as an offline desktop app to match the deployment TRE requirements. The interactive dashboard displays the data linkage information extracted from a knowledge graph described using the SHP ontology (e.g., modifications of datasets, data release) and results of rule-based validation checks (e.g., checking extracted data against researchers' specification). User evaluations confirmed the dashboard would contribute to better quality of data linkage. This project demonstrates the next stage in advancing transparency and quality assurance within TREs by semi-automating and systematising data tracking from ingress to egress in a single tool.

Workarounds as enabling factor in the use of assistive technology amongst white-collar workers with visual impairment

PurposeThis study aims to provide an explorative perspective on how workarounds – defined as practices that deviate from an official pathway to a target – delineate a decisive element for users with visual impairment to enable assistive technologies in the context of office work.Design/methodology/approachAn ethnographic study with in situ observation at participants’ work locations together with interviews was conducted to cater for the explorative nature of this study.FindingsThe study outlines three types of workarounds that can be distinguished into: (1) own investment into invisible work, (2) engaging support from colleagues and (3) the complete circumvention of technology use. It is furthermore discussed that workarounds remain largely unnoticed but yield the potential as an enabling factor for insights into the use of assistive technology (AT).Practical implicationsThe layered model of workarounds that locates them at the individual, social and organisational level can guide the design and analysis of enabling technologies in complex office work contexts. Technology designers can incorporate enquiries on workarounds into participatory or co-creative design processes. Information technology (IT) professionals and leaders of IT support teams can use this model to gain insights from workarounds into improvement opportunities for the effective integration of assistive technologies.Originality/valueThis study connects the concept of workarounds, which is deeply rooted in the tradition of workplace studies and computer-supported cooperative work (CSCW), with the practices of handling technology employed by knowledge workers with visual impairments to retain workability. This approach offers a novel perspective on the embeddedness of enabling technologies in the context of knowledge work. It highlights the intricate ways in which technology is integrated into daily work practices, thereby providing valuable insights into the intersection of AT and knowledge work.

Refining the Universal, School-Based OurFutures Mental Health Program to Be Trauma Informed, Gender and Sexuality Diversity Affirmative, and Adherent to Proportionate Universalism: Mixed Methods Participatory Design Process.

Mental disorders are the leading cause of disease burden among youth. Effective prevention of mental disorders during adolescence is a critical public health strategy to reduce both individual and societal harms. Schools are an important setting for prevention; however, existing universal school-based mental health interventions have shown null, and occasionally iatrogenic, effects in preventing symptoms of common disorders, such as depression and anxiety. This study aims to report the adaptation process of an established, universal, school-based prevention program for depression and anxiety, OurFutures Mental Health. Using a 4-stage process; triangulating quantitative, qualitative, and evidence syntheses; and centering the voices of young people, the revised program is trauma-informed; lesbian, gay, bisexual, transgender, nonbinary, queer, questioning, and otherwise gender and sexuality diverse (LGBTQA+) affirmative; relevant to contemporary youth; and designed to tailor intervention dosage to those who need it most (proportionate universalism). Program adaptation occurred from April 2022 to July 2023 and involved 4 stages. Stage 1 comprised mixed methods analysis of student evaluation data (n=762; mean age 13.5, SD 0.62 y), collected immediately after delivering the OurFutures Mental Health program in a previous trial. Stage 2 consisted of 3 focus groups with high school students (n=39); regular meetings with a purpose-built, 8-member LGBTQA+ youth advisory committee; and 2 individual semistructured, in-depth interviews with LGBTQA+ young people via Zoom (Zoom Video Communications) or WhatsApp (Meta) text message. Stage 3 involved a clinical psychologist providing an in-depth review of all program materials with the view of enhancing readability, improving utility, and normalizing emotions while retaining key cognitive behavioral therapy elements. Finally, stage 4 involved fortnightly consultations among researchers and clinicians on the intervention adaptation, drawing on the latest evidence from existing literature in school-based prevention interventions, trauma-informed practice, and adolescent mental health. Drawing on feedback from youth, clinical psychologists, and expert youth mental health researchers, sourced from stages 1 to 4, a series of adaptations were made to the storylines, characters, and delivery of therapeutic content contained in the weekly manualized program content, classroom activities, and weekly student and teacher lesson summaries. The updated OurFutures Mental Health program is a trauma-informed, LBGTQA+ affirmative program aligned with the principles of proportionate universalism. The program adaptation responds to recent mixed findings on universal school-based mental health prevention programs, which include null, small beneficial, and small iatrogenic effects. The efficacy of the refined OurFutures Mental Health program is currently being tested through a cluster randomized controlled trial with up to 1400 students in 14 schools across Australia. It is hoped that the refined program will advance the current stalemate in universal school-based prevention of common mental disorders and ultimately improve the mental health and well-being of young people in schools.

A Visual Environment for Data Driven Protein Modeling and Validation.

In structural biology, validation and verification of new atomic models are crucial and necessary steps which limit the production of reliable molecular models for publications and databases. An atomic model is the result of meticulous modeling and matching and is evaluated using a variety of metrics that provide clues to improve and refine the model so it fits our understanding of molecules and physical constraints. In cryo electron microscopy (cryo-EM) the validation is also part of an iterative modeling process in which there is a need to judge the quality of the model during the creation phase. A shortcoming is that the process and results of the validation are rarely communicated using visual metaphors. This work presents a visual framework for molecular validation. The framework was developed in close collaboration with domain experts in a participatory design process. Its core is a novel visual representation based on 2D heatmaps that shows all available validation metrics in a linear fashion, presenting a global overview of the atomic model and provide domain experts with interactive analysis tools. Additional information stemming from the underlying data, such as a variety of local quality measures, is used to guide the user's attention toward regions of higher relevance. Linked with the heatmap is a three-dimensional molecular visualization providing the spatial context of the structures and chosen metrics. Additional views of statistical properties of the structure are included in the visual framework. We demonstrate the utility of the framework and its visual guidance with examples from cryo-EM.

Synthesising the Outputs of Cognitive Work Analysis and Participatory Design Approaches to Identify Design Requirements: An Incident Reporting Tool Case Study

Identifying design requirements for new technologies is vitally important for successful uptake, yet few structured approaches exist to guide the process. Given increasing concerns regarding gig economy worker road safety, this study involved the use of Cognitive Work Analysis (CWA), alongside a participatory design process, to identify requirements for a novel, app-based incident reporting tool for gig economy workers. Study 1 involved a stakeholder workshop to refine a Work Domain Analysis model and define stakeholder requirements for the tool. Study 2 involved focus groups to identify barriers and facilitators to using the tool and a survey to inform the development of a Contextual Activity Template, in addition to identifying further barriers and facilitators. Design requirements for the tool were identified through synthesising the CWA outputs and themes identified from stakeholder and end user input.

Challenges and Opportunities of Using Metaverse Tools for Participatory Architectural Design Processes

Participatory design emerges as a proactive approach involving different stakeholders in design and decision-making processes, addressing diverse values and ensuring outcomes align with users’ needs. However, the inadequacy of engaging stakeholders with a spatial experience can result in uninformed and, consequently, unsuccessful design solutions in a built environment. This paper explores how metaverse tools can help enhance participatory design by providing new collaborative opportunities via networked 3D environments. A hybrid format (online and in situ) co-creation process was documented and analysed, targeting public space design in London, Hong Kong, and Lisbon. The participants collaborated to address a set of design requirements via a tailored metaverse space, following a six-step methodology (Tour, Discuss, Rate, Define, Action, and Show and Tell). The preliminary results indicated that non-immersive metaverse tools help strengthen spatial collaboration through user perspective simulations, introducing novel interaction possibilities within design processes. The technology’s still-existing technical limitations may be tackled with careful engagement design, iterative reviews, and participants’ feedback. The experience documented prompts a reflection on the role of architects in process design and mediating multi-stakeholder collaboration, contributing to more inclusive, intuitive, and informed co-creation.

Co-designing a wiki-based community knowledge management system for personal science.

Personal science is the practice of addressing personally relevant health questions through self-research. Implementing personal science can be challenging, owing to the need to develop and adopt research protocols, tools and methods. While online communities can provide valuable peer support, tools for systematically accessing community knowledge are lacking. The objective of this study is to apply a participatory design process involving a community of personal science practitioners to develop a peer-produced knowledge base that supports the needs of practitioners as consumers and contributors of knowledge. The process led to the development of the Personal Science Wiki, an open repository for documenting and accessing individual self-tracking projects while facilitating the establishment of consensus knowledge. After initial design iterations and a field testing phase, we performed a user study with 21 participants to test and improve the platform, and to explore suitable information architectures. The study deepened our understanding of barriers to scaling the personal science community, established an infrastructure for knowledge management actively used by the community and provided lessons on challenges, information needs, representations and architectures to support individuals with their personal health inquiries.

Promoting Children's Participation in a Participatory Design Process in a Rural School: A new role needed?

Promoting Children's Participation in a Participatory Design Process in a Rural School: A new role needed?

Qualitative futuring methods in communicative (inter)action: Exploring the development and deployment of the Future Synthesizer method

This contribution presents initial efforts to respond to the question: How do qualitative futuring methods enhance the design of participatory processes for regional and urban planning? This work makes use of futuring approaches and methods to help build individual and collective futures literacy. Doing so enables communities and their administrations to design, plan, construct, and develop the built environments for which they strive. We present efforts to develop and refine a qualitative (interactive) form of a futuring method called Future Synthesizer in community and classroom contexts. Future Synthesizer is premised on the communicative and collaborative potential generated when many sources of knowledge are represented and articulated by diverse stakeholders. The method facilitates the communicative structuring of interactive and strategic discussions between stakeholders through temporally ordered exchanges that link diverse forms of knowledge at participatory events. By integrating interactive and haptic components, our method helps participants articulate, illustrate, and negotiate the (inter)actions required to solve the complex problems brought to light through regional and urban planning processes. The efforts behind Future Synthesizer show potential to enhance future-oriented learning in a range of settings. However, since our experiences are in progress, there is much potential to develop the research in this contribution.

Sustainable innovations in rural housing: Strategies for efficiency, community engagement, and environmental harmony

This study delves into the multifaceted aspects of enhancing sustainability in rural dwellings, focusing on energy efficiency, the use of sustainable materials and construction techniques, and the pivotal role of community engagement and social sustainability. Through detailed quantitative analyses and case studies, we examine the effectiveness of various insulation materials, the integration of renewable energy sources, and the impact of energy management systems in reducing energy consumption and promoting sustainability. Additionally, we explore the benefits of utilizing local and recycled materials, incorporating green roofing and natural ventilation strategies, and implementing water conservation techniques. A significant portion of our research is dedicated to understanding the socio-economic impacts of these sustainable practices, including job creation, economic benefits, and the importance of education and capacity building within rural communities. Our findings highlight the substantial advantages of participatory design processes, demonstrating how they contribute to increased community satisfaction and the overall success of sustainability projects. The study underscores the critical importance of tailored, locally adapted solutions for rural sustainability and provides a comprehensive framework for stakeholders aiming to implement sustainable practices in rural development projects.

Designing a tool ensuring older patients the right medication at the right time after discharge from hospital– the first step in a participatory design process

BackgroundOn average, older patients use five or more medications daily, increasing the risk of adverse drug reactions, interactions, or medication errors. Healthcare sector transitions increase the risk of information loss, misunderstandings, unclear treatment responsibilities, and medication errors. Therefore, it is crucial to identify possible solutions to decrease these risks. Patients, relatives, and healthcare professionals were asked to design the solution they need.MethodsWe conducted a participatory design approach to collect information from patients, relatives, and healthcare professionals. The informants were asked to design their take on a tool ensuring that patients received the correct medication after discharge from the hospital. We included two patients using five or more medications daily, one relative, three general practitioners, four nurses from different healthcare sectors, two hospital physicians, and three pharmacists.ResultsThe patients’ solution was a physical location providing a medication overview, including side effects and interactions. Healthcare professionals suggested different solutions, including targeted and timely information that provided an overview of the patient’s diagnoses, treatment and medication. The common themes identified across all sub-groups were: (1) Overview of medications, side effects, and diagnoses, (2) Sharing knowledge among healthcare professionals, (3) Timely discharge letters, (4) Does the shared medication record and existing communication platforms provide relevant information to the patient or healthcare professional?ConclusionAll study participants describe the need for a more concise, relevant overview of information. This study describes elements for further elaboration in future participatory design processes aimed at creating a tool to ensure older patients receive the correct medication at the correct time.

Innovating the Local Plan through Co-Creation and the Public Sociology Approach toward Urban Regeneration: An Italian Case Study

This paper examines the role of social research and communication methodologies in fostering substantive democratic participation and policy co-production within the context of urban regeneration initiatives anchored in the United Nations Sustainable Development Goals. This research critically analyzes the “becoming public” of sociology and social research in participatory design processes related to traditional urban planning instruments at the local scale (Regulatory Plans) in the Italian context, specifically through the case study of the Municipality of Appignano. It questions the role of sociology in activating a competent public sphere and promoting deliberative democracy at urban and territorial design levels and whether we can identify the traits of public sociology in facilitating the different stages of these processes. This paper details a participatory process in Appignano that sought to innovate urban regeneration within complex legislative frameworks, emphasizing community engagement and interdisciplinary approaches. The findings reveal a community actively participating in the regeneration process, demonstrating a high level of agreement on various urban development strategies aimed at sustainability. This study underscores the capacity of public sociology to facilitate public debate and democratic dialogue and suggests that such participatory approaches can significantly contribute to sustainable and resilient urban development, highlighting the potential of sociology as a moral and political force in urban planning.