Participatory Design Research Articles

VIEWER: an extensible visual analytics framework for enhancing mental healthcare.

A proof-of-concept study aimed at designing and implementing Visual & Interactive Engagement With Electronic Records (VIEWER), a versatile toolkit for visual analytics of clinical data, and systematically evaluating its effectiveness across various clinical applications while gathering feedback for iterative improvements. VIEWER is an open-source and extensible toolkit that employs natural language processing and interactive visualization techniques to facilitate the rapid design, development, and deployment of clinical information retrieval, analysis, and visualization at the point of care. Through an iterative and collaborative participatory design approach, VIEWER was designed and implemented in one of the United Kingdom's largest National Health Services mental health Trusts, where its clinical utility and effectiveness were assessed using both quantitative and qualitative methods. VIEWER provides interactive, problem-focused, and comprehensive views of longitudinal patient data (n = 409870) from a combination of structured clinical data and unstructured clinical notes. Despite a relatively short adoption period and users' initial unfamiliarity, VIEWER significantly improved performance and task completion speed compared to the standard clinical information system. More than 1000 users and partners in the hospital tested and used VIEWER, reporting high satisfaction and expressed strong interest in incorporating VIEWER into their daily practice. VIEWER provides a cost-effective enhancement to the functionalities of standard clinical information systems, with evaluation offering valuable feedback for future improvements. VIEWER was developed to improve data accessibility and representation across various aspects of healthcare delivery, including population health management and patient monitoring. The deployment of VIEWER highlights the benefits of collaborative refinement in optimizing health informatics solutions for enhanced patient care.

Applying a Participatory Design Model-Making Engagement Activity to Understand How Different Stakeholders Envision Senior-Friendly Outdoor Gyms in Parks

Purpose: Population aging has led to an increased focus on creating outdoor gyms in parks for seniors. Twenty-five participants from a broad age spectrum, with different education levels, and with different role identities participated in the model-making engagement activity and semi-structured interviews in parks and university settings. Themes associated with participants’ choice of exercise apparatus, supportive environmental design, and spatial arrangement in the outdoor exercise space were identified. The three-dimensional models created by the participants provided visual insights into their envisioned senior-friendly outdoor gyms. The findings of this study provide valuable guidance for designing senior-friendly outdoor gyms in parks.

Development of an eHealth Intervention Including Self-Management for Reducing Sedentary Time in the Transition to Retirement: Participatory Design Study.

Having a great amount of sedentary time is common among older adults and increases with age. There is a strong need for tools to reduce sedentary time and promote adherence to reduced sedentary time, for which eHealth interventions have the potential to be useful. Interventions for reducing sedentary time in older adults have been found to be more effective when elements of self-management are included. When creating new eHealth interventions, accessibility and effectiveness can be increased by including end users as co-designers in the development process. The aim was to explore the desired features of an eHealth intervention including self-management for reducing sedentary time and promoting adherence to reduced sedentary time in older adults transitioning from working life to retirement. Further, the aim was to develop a digital prototype of such an eHealth intervention. The study used the participatory design approach to include end users, researchers, and a web designer as equal partners. Three workshops were conducted with 6 older adults transitioning to retirement, 2 researchers, and 1 web designer. Thematic analysis was used to analyze the data from the workshops. Participants expressed a desire for an easy-to-use eHealth intervention, which could be accessed from mobile phones, tablets, and computers, and could be individualized to the user. The most important features for reducing sedentary time were those involving finding joyful activities, setting goals, and getting information regarding reduced sedentary time. Participants expressed that the eHealth intervention would need to first provide the user with knowledge regarding sedentary time, then offer features for measuring sedentary time and for setting goals, and lastly provide support in finding joyful activities to perform in order to avoid being sedentary. According to the participants, an eHealth intervention including self-management for reducing sedentary time in older adults in the transition to retirement should be concise, accessible, and enjoyable. A digital prototype of such an eHealth intervention was developed. The developed eHealth intervention including self-management for reducing sedentary time in older adults transitioning to retirement is intended to facilitate behavior change by encouraging the user to participate in autonomously motivated activities. It uses several behavior change techniques, such as goal setting and action planning through mental contrasting and implementation intention, as well as shaping knowledge. Its active components for reducing sedentary time can be explained using the integrated behavior change model. Further research is needed to evaluate the feasibility and effectiveness of the eHealth intervention.

Organising digital twin in the built environment: a systematic review and research directions on the missing links of use and user perspectives of digital twin in Architecture, Engineering and Construction (AEC) sector

There has been growing interest in the adoption of advanced digital technologies in the Architecture, Engineering and Construction (AEC) sector, as shown by the increasing number of review studies on the adoption of Digital Twin (DT) in the sector. While previous reviews on DT in the AEC sector have emphasised the technical opportunities and challenges, reviews that take a specific organisational and management focus on the use of DT are lacking. In this systematic review, we close this gap by analysing 102 papers from three main scientific databases (Google Scholar, Scopus and Web of Science), which emphasise organisational and management aspects of using DT in the AEC sector across the project and asset lifecycle phases. The findings indicate that, whereas there is still a stronger focus on finding optimisations for various performance concerns (e.g. project efficiency, health and safety and maintenance performance), there is increasing awareness and interest in using DT to encourage collaboration and (end-)user participation. Despite this recognition, our review also identified a number of critical knowledge gaps on the use and user perspectives of DT, which includes how powerful computational tools can be developed into user-friendly interfaces to reduce complexity and increase accessibility to all stakeholders in the decision-making process, and how participatory design frameworks can be combined with structured feedback systems and standardised data access protocols in order to stimulate communication, continuous improvement, and data-driven decision making.

Reflections of Foster Youth Engaging in the Co-Design of Digital Mental Health Technology: Duoethnography Study.

Current research on digital applications to support the mental health and well-being of foster youth is limited to theoretical applications for transition-aged foster youth and support platforms developed without intentional input from foster youth themselves. Centering the lived expertise of foster youth in digital solutions is crucial to dismantling barriers to care, leading to an increase in service access and improving mental health outcomes. Co-design centers the intended end users during the design process, creating a direct relationship between potential users and developers. This methodology holds promise for creating tools centered on foster youth, yet little is known about the co-design experience for foster youth. Understanding foster youth's experience with co-design is crucial to identifying best practices, knowledge of which is currently limited. The aim of this paper is to reflect on the experiences of 4 foster youth involved in the co-design of FostrSpace, a mobile app designed through a collaboration among foster youth in the San Francisco Bay Area; clinicians and academics from the Juvenile Justice Behavioral Health research team at the University of California, San Francisco; and Chorus Innovations, a rapid technology development platform specializing in participatory design practices. Key recommendations for co-designing with foster youth were generated with reference to these reflections. A duoethnography study was conducted over a 1-month period with the 4 transition-aged former foster youth co-designers of FostrSpace via written reflections and a single in-person roundtable discussion. Reflections were coded and analyzed via reflexive thematic analysis. In total, 4 main themes were identified from coding of the duoethnography reflections: power and control, resource navigation, building community and safe spaces, and identity. Themes of power and control and resource navigation highlighted the challenges FostrSpace co-designers experienced trying to access basic needs, support from caregivers, and mental health resources as foster youth and former foster youth. Discussions pertaining to building community and safe spaces highlighted the positive effect of foster youth communities on co-designers, and discussions related to identity revealed the complexities associated with understanding and embracing foster youth identity. This duoethnography study highlights the importance of centering the lived expertise of co-designers throughout the app development process. As the digital health field increasingly shifts toward using co-design methods to develop digital mental health technologies for underserved youth populations, we offer recommendations for researchers seeking to ethically and effectively engage youth co-designers. Actively reflecting throughout the co-design process, finding creative ways to engage in power-sharing practices to build community, and ensuring mutual benefit among co-designers are some of the recommended core components to address when co-designing behavioral health technologies for youth.

Towards personalized immersive virtual reality neurorehabilitation: a human-centered design

BackgroundHead-mounted displays can be used to offer personalized immersive virtual reality (IVR) training for patients who have suffered an Acquired Brain Injury (ABI) by tailoring the complexity of visual and auditory stimuli to the patient’s cognitive capabilities. However, it is still an open question how these virtual environments should be designed.MethodsWe used a human-centered design approach to help define the characteristics of suitable virtual training environments for ABI patients. We conducted (i) observations, (ii) interviews with eleven neurorehabilitation experts, and (iii) an online questionnaire with 24 neurorehabilitation experts to examine how therapists modify current training environments to promote patients’ recovery in conventional sensorimotor neurorehabilitation settings. Finally, (iv) we involved eight neurorehabilitation experts in a participatory design workshop to co-create examples of IVR training environments.ResultsFive phases of the recovery process (Screening, Planning, Training, Reflecting, and Discharging) and six key themes describing the characteristics of suitable (physical) training environments (Specific, Meaningful, Versatile, Educational, Safe, and Supportive) were identified. The experts agreed that modulating the number of elements (e.g., objects, people) or distractions (e.g., background noise) in the physical training environment enables therapists to provide their patients with suitable conditions to execute functional tasks. Additionally, the experts highlighted the importance of developing IVR training environments that are meaningful and realistic.ConclusionsThrough consultations with neurorehabilitation experts, we gained insights into how therapists adjust physical training environments to promote the execution of functional sensorimotor tasks in patients with diverse cognitive capabilities. Their recommendations on how to modulate and make IVR environments meaningful may contribute to increased motivation and skill transfer. Future studies on IVR-based neurorehabilitation should involve patients themselves.

“Using Students’ L1 Would Become a Problem”: Practical Discrepancies and Ideological Challenges in Teacher candidates’ Translanguaging Pedagogy

ABSTRACT While previous studies have addressed shifts in teacher candidates’ (TCs) translanguaging stance and their pedagogical knowledge (PK), research in this area is still limited. Using a participatory research design, this study explored how a group of general education TCs implemented translanguaging and the underlying justifications for their practices. Data included lesson plans, reflections, and self-assessments. The findings indicate that although the TCs adopted an asset-based perspective in their reflections and self-assessments, their actual practices as revealed in the lesson plans reflected monolingual ideologies. Despite initial progress in understanding translanguaging, this discrepancy highlights the necessity of probing deeper into TCs’ translanguaging stances and language ideologies prior to focusing on pedagogical implementation. Our study suggests that to fully embrace the ideological and pedagogical shifts advocated by translanguaging, it is crucial to integrate translanguaging pedagogy throughout the teacher education program, including training for teacher educators who are not yet familiar with translanguaging.

Placemaking for inclusive public spaces in South African townships: a community-led approach

ABSTRACT Scholarly engagement on Southern Urban Theory offers an opportunity to analyze and deliberate case studies from cities in the South where planning practices provide useful evidence to support alternative approaches. The practice of placemaking presents a promising methodology for democratic planning in the form of a collaborative, process-orientated practice that reimagines public spaces through participatory design and community engagement. By making use of a case study example in South Africa (Cape Town), this paper positions placemaking within the discourse of southern urban theory and critically examines a community-led placemaking initiative and how participatory design processes effectively enhance local public spaces. The research challenged traditional ideologies of power and top-down planning approaches where change and action are initiated by authorities. It concluded that bottom-up initiatives to transform living environments not only capitalize on community buy-in but yield transformative processes possessing more longevity.

Value‐sensitive design of chatbots in environmental education: Supporting identity, connectedness, well‐being and sustainability

While offering the potential to support learning interactions, emerging AI applications like Large Language Models (LLMs) come with ethical concerns. Grounding technology design in human values can address AI ethics and ensure adoption. To this end, we apply Value‐Sensitive Design—involving empirical, conceptual and technical investigations—to centre human values in the development and evaluation of LLM‐based chatbots within a high school environmental science curriculum. Representing multiple perspectives and expertise, the chatbots help students refine their causal models of climate change's impact on local marine ecosystems, communities and individuals. We first perform an empirical investigation leveraging participatory design to explore the values that motivate students and educators to engage with the chatbots. Then, we conceptualize the values that emerge from the empirical investigation by grounding them in research in ethical AI design, human values, human‐AI interactions and environmental education. Findings illuminate considerations for the chatbots to support students' identity development, well‐being, human–chatbot relationships and environmental sustainability. We further map the values onto design principles and illustrate how these principles can guide the development and evaluation of the chatbots. Our research demonstrates how to conduct contextual, value‐sensitive inquiries of emergent AI technologies in educational settings. Practitioner notesWhat is already known about this topic Generative artificial intelligence (GenAI) technologies like Large Language Models (LLMs) can not only support learning, but also raise ethical concerns such as transparency, trust and accountability. Value‐sensitive design (VSD) presents a systematic approach to centring human values in technology design. What this paper adds We apply VSD to design LLM‐based chatbots in environmental education and identify values central to supporting students' learning. We map the values emerging from the VSD investigations to several stages of GenAI technology development: conceptualization, development and evaluation. Implications for practice and/or policy Identity development, well‐being, human–AI relationships and environmental sustainability are key values for designing LLM‐based chatbots in environmental education. Using educational stakeholders' values to generate design principles and evaluation metrics for learning technologies can promote technology adoption and engagement.

Mobility Challenges and Inclusive Solutions for People with Physical Disabilities in India

This study examines the complex mobility challenges encountered by individuals with physical disabilities in India and seeks to identify inclusive solutions that can improve their accessibility and autonomy. Significant barriers to their full societal participation include inadequate infrastructure, limited transportation options, societal stigma, economic constraints, and gaps in policy implementation. Utilizing a mixed-methods approach, this research incorporates surveys, interviews, and field observations to analyze these issues. The findings underscore the critical need for enhanced accessibility standards and their enforcement, increased investment in accessible transportation, greater affordability and availability of assistive devices, as well as inclusive educational and employment opportunities. Additionally, public awareness campaigns are essential to address social stigma. The research advocates for a comprehensive framework of inclusive solutions, which encompasses universal design principles, accessible transportation systems, assistive technologies, support services, policy advocacy, and participatory design methodologies. By adopting these strategies, India can foster a more inclusive and equitable society, enabling persons with physical disabilities to fully exercise their right to mobility and engage meaningfully in all facets of life. The researchers are collaborating with a prominent NGO active in the field of disability in Bengaluru, and a study involving beneficiaries of CSR Program driven in association of NGO partner is planned.

A systemic approach to identifying sustainable community-based interventions for improving adolescent mental health: a participatory group model building and design protocol

BackgroundThe deteriorating mental health of children and young people in the United Kingdom poses a challenge that services and policy makers have found difficult to tackle. Kailo responds to this issue with a community-based participatory and systemically informed strategy, perceiving mental health and well-being as a dynamic state shaped by the interplay of broader health determinants. The initiative works to explore, define and implement locally relevant solutions to challenges shaping the mental health and well-being of young people. Kailo unfolds in three stages within each locale. These stages encompass: “early discovery”, “deeper discovery and co-design” and “implementation”. This document delves into the participatory group model building and design protocol occurring in the “deeper discovery and co-design” stage of the project.MethodsParticipatory methods, such as group model building, are effective in articulating and building consensus on complex issues like the social determinants of adolescent mental health. This paper describes the protocol for application of group model building within the Kailo design process to develop causal loop diagrams and pinpoint leverage points for improving adolescent mental health. It also suggests a method for considering modifications to delivery within a unique project context and in alignment with participants’ needs. This paper sets out to define the approach and clarify the objectives these engagements aim to fulfil. The method adapts existing group model building (GMB) protocols for use in a community setting. The engagements will involve groups of local young people and existing community members. To assess the success of the session’s implementation post-delivery, the study utilizes existing frameworks for fidelity evaluations, which define a core and flex model.DiscussionThe method described enables an integration of diverse local understandings of complex processes which provides a platform for creating co-designed interventions. This protocol can be used to further strengthen research and design through incorporating complexity and participation into the formulation of contextually relevant policies and practices. The strengths and limitations of the approach are discussed.

Improving Cognitive Empathy Through Traumatic Brain Injury Experiential Learning: A Novel Mixed Methods Approach for Speech-Language Pathology Graduate Education.

The aim of this study was to gauge the impacts of cognitive empathy training experiential learning on traumatic brain injury (TBI) knowledge, awareness, confidence, and empathy in a pilot study of speech-language pathology graduate students. A descriptive quasi-experimental convergent parallel mixed methods design intervention pilot study (QUAL + QUANT) was conducted with a diverse convenience sample of 19 first- and second-year speech-language pathology graduate students who engaged in a half-day TBI point-of-view simulation. The simulation was co-constructed through a participatory design with those living with TBI based on Kolb's experiential learning model and followed the recommendations for point-of-view simulation ethics. After setting goals, participants engaged in four station activities completing cognitive communication activities of daily living, while experiencing manipulations to their sensory systems. Activities included reading while wearing goggles with blurred or double vision, listening with tinnitus and auditory processing disorder, and taking notes during a manipulated college lecture. Participants also interacted with an individual living with TBI and responded to targeted prompts throughout the day. Quantitative outcomes were measured using published TBI knowledge and empathy scales and analyzed with descriptive, parametric and nonparametric statistics, while qualitative data were analyzed through thematic analysis. Data were then triangulated through mixed methods. Mixed methods design quality was ensured by following the Mixed Methods Appraisal Tool (Hong et al., 2018). After experiential learning, significant increases in speech-language pathologist (SLP) TBI knowledge, empathy, and awareness of TBI symptom and symptom impacts were found. Many, but not all, participants also reported changes in clinical confidence. Cognitive empathy training using experiential learning appears to be a viable method to increase SLP knowledge, empathy, and symptom awareness for TBI clinical care. Future research should replicate the study with different types and locations of speech-language pathology graduate programs to consider TBI empathy training as a standard training method to improve both individual and provider outcomes. Individuals and families living with traumatic brain injury (TBI) say their providers lack necessary knowledge; do not seem to understand what living with TBI is like; and can be dismissive, uncaring, and lacking empathy. Health care providers do not automatically imagine the world from the patient's perspectives, to "walk in another's shoes"; it takes intentional effort and training. This project attempted to train those specific empathy skills for speech-language pathology graduate students through experiential learning. Experiential learning is a process where people engage in meaningful activities and spend lots of time reflecting on their experiences. Working with people living with TBI, we built a half-day workshop where 19 graduate students completed normal daily activities (such as texting, reading) through different stations that provided insights into what it may be like to have a TBI, such as wearing goggles to induce blurred or double vision, having ringing in their ears (tinnitus), and watching an overwhelming manipulated college video lecture. Afterward, participants listened to a person living with TBI and asked questions. This was important because engaging in activities without interacting with someone living with TBI misses a key idea about listening to and learning from individuals and families. We measured TBI knowledge, empathy, and confidence by looking at surveys pre- and posttraining and reading students' written reflections. Participants reported significant changes in how they think about brain injury and how they will provide clinical care for people living with TBI in the future. https://doi.org/10.23641/asha.28098254.

Co-creation of a gender responsive TB intervention in Nigeria: a researcher-led collaborative study

BackgroundIn Nigeria, men constitute over half of the people notified with tuberculosis (TB), experience longer delays before reaching care, and are estimated to account for two thirds of people who miss out on care. The higher TB risk and burden in men has implications for the whole population and reaching them earlier with TB services will reduce onward transmission in households, communities, and workplaces. The absence of a comprehensive guidance and the lack of substantial empirical evidence on TB care approaches that are responsive to the needs of men in Nigeria exacerbates this problem. Therefore, this research aimed to co-create a gender-responsive intervention for men in peri-urban communities in Nigeria.MethodsOur study utilised a researcher-led collaborative approach to engage local TB stakeholders including communities adversely affected by the disease to co-create a gender-responsive TB intervention. Between March and November 2022, we engaged 13 local TB stakeholders in a three-phase participatory intervention design process. This engagement involved two iterative cycles of Delphi research online, and an in-person workshop. In the first and second phases, participants described the potential impact of 15 listed interventions and prioritised combinations of nine interventions deemed to be effective in overcoming identified gendered barriers. Responses were analysed using a combination of qualitative framework approach, content analysis, and summary descriptive statistics assisted by NVivo software. Stakeholder consensus on a preferred intervention package was reached during the participatory workshop.ResultsOverall, participants prioritised approaches that sought to actively find and systematically screen men for TB including awareness creation as a crucial component. The stakeholders placed significant considerations on the synergy between interventions and their programmatic sustainability when making their final choices. Consequently, a complex intervention package comprising three components was developed. These included targeted awareness creation among men in communities; TB screening in male-dominated socio-cultural congregate settings; and the use of digital chest X-ray screening. Anticipated early outputs of this intervention included improved TB knowledge, increased care-seeking, reduced TB-related costs and TB stigma, and accelerated early diagnosis among men in Nigeria.ConclusionLeveraging the insights and experiences of local stakeholders through iterative engagements yielded consensus on a viable gender-responsive TB intervention.

Design Networks: A Social Network Analysis of a Participatory Design Process

The paper aims to describe the collaborative relationships that are woven into a design process open to a plurality of actors from various disciplinary, cultural and organisational backgrounds who play various roles. To this end, a Social Network Analysis (SNA) has been conducted on a participatory design process in a Brazilian school community, intended to develop a hyperlocal social network for sharing knowledge among the community and the inhabitants of the region. The analysis of the design process explores the visualisation potential of sociograms. As a result, the paper elaborates on the concept of ‘design networks’, a form of organisation that allows many codesign processes and especially participatory ones. It also identifies three processes that are articulated in these networks, namely, the processes of ‘designing’, ‘infrastructuring’ and ‘seeding’.

Transcending Transit Deserts: Participatory Design of Interactive Bicycling Advocacy Tools in an American City

Recent HCI research has focused on developing interactive technologies for cyclists and using technology to promote this activity. However, the community-building and advocacy aspects of cycling remain relatively unexplored. In this study, we explored the integration of urban cycling and participatory technology design to address transportation inequities and promote cycling advocacy in a US city characterized by infrastructural and social disparities. We engaged with nine bicycling advocates from five organizations in Baltimore, USA in participatory design activities to understand their motivations for promoting cycling in urban areas and how interactive technology can aid in creating a cyclist-friendly city. Along with the various practical motivations, we found the participants also promote cycling with a desire to challenge historical discriminatory practices and infrastructural inequalities and as a means of community building and identity expression. We identify three interconnected directions for future change: supporting ancillary bicycle infrastructure and DIY repair practices, changing perceptions through community engagement, and using technology to support community awareness and inclusion. We argue cycling can be a tool for resistance and identity shaping in this context, and participatory design can offer innovative directions for urban designers, policymakers, and system designers to strengthen efforts toward creating inclusive and equitable urban environments.

Tomatoes Die: A Design Fiction for Grassroots Climate AI

This design fiction proposes a panel session in the near future having environment and climate advocates share their stories of using artificial intelligence (AI) in their work. This work explores how the development of an embodied river persona, a farming assistant app, and a community hazard mapping tool could pose challenges and aid successes to respective local communities. Our design fiction highlights issues of design and development challenges that local organizations might face in a varied AI development for the environment. We explore questions around incorporating traditional knowledge, ethical participatory design models, and challenges of implementing and sustaining tools. Our work demonstrates how design fiction might be used to imagine AI for the climate challenge that considers people, place, and community.

Encouraging Sustainable Choices Through Socially Engaged Persuasive Recycling Initiatives: A Participatory Action Design Research Study

Encouraging Sustainable Choices Through Socially Engaged Persuasive Recycling Initiatives: A Participatory Action Design Research Study

Participatory Design in Colonial Contexts

Participatory Design in Colonial Contexts

DITTO: A Visual Digital Twin for Interventions and Temporal Treatment Outcomes in Head and Neck Cancer.

Digital twin models are of high interest to Head and Neck Cancer (HNC) oncologists, who have to navigate a series of complex treatment decisions that weigh the efficacy of tumor control against toxicity and mortality risks. Evaluating individual risk profiles necessitates a deeper understanding of the interplay between different factors such as patient health, spatial tumor location and spread, and risk of subsequent toxicities that can not be adequately captured through simple heuristics. To support clinicians in better understanding tradeoffs when deciding on treatment courses, we developed DITTO, a digital-twin and visual computing system that allows clinicians to analyze detailed risk profiles for each patient, and decide on a treatment plan. DITTO relies on a sequential Deep Reinforcement Learning digital twin (DT) to deliver personalized risk of both long-term and short-term disease outcome and toxicity risk for HNC patients. Based on a participatory collaborative design alongside oncologists, we also implement several visual explainability methods to promote clinical trust and encourage healthy skepticism when using our system. We evaluate the efficacy of DITTO through quantitative evaluation of performance and case studies with qualitative feedback. Finally, we discuss design lessons for developing clinical visual XAI applications for clinical end users.

Assessing participatory planning and design process for enhancing community sustainability: a case study of the Sustainable Built Environment Initiative in Michigan communities

Assessing participatory planning and design process for enhancing community sustainability: a case study of the Sustainable Built Environment Initiative in Michigan communities