Self-Tracking to Do Less: An Autoethnography of Long COVID That Informs the Design of Pacing Technologies

Long COVID is a post-viral illness where symptoms are still experienced more than three months after an infection of COVID 19. In line with a recent shift within HCI and research on self-tracking towards first-person methodologies, I present the results of an 18-month long autoethnographic study of using a Fitbit fitness tracker whilst having long COVID. In contrast to its designed intentions, I misused my Fitbit to do less in order to pace and manage my illness. My autoethnography illustrates three modes of using fitness tracking technologies to do less and points to the new design space of technologies for reducing, rather than increasing, activity in order to manage chronic illnesses where over-exertion would lead to a worsening of symptoms. I propose that these "pacing technologies"should acknowledge the interoceptive and fluctuating nature of the user's body and support user's decision-making when managing long-term illness and maintaining quality of life. © 2023 Owner/Author.

Designing an Artifact to Empower Chronic Patients for Monitoring Health During a Pandemic: A COVID-19 Screening App

Chronic diseases have been declared as an invisible epidemic by the World Health Organization (WHO, 2005). Over the past fifty years, the prevalence of chronic conditions has increased, leading to the disease burden caused by cancer, cardiovascular diseases, diabetes, musculoskeletal conditions, and mental and substance use disorders (DOH, 2021). Chronic patients need to reimagine how they will empower themselves to effectively manage and monitor their health and wellbeing in a COVID-19 era, when frequent in-person health care visits will no longer be feasible. In this study, we propose the features for the design of a mobile based application that will aid chronic patients and end-users to self-manage and monitor their health during the pandemic era. Based on an empirical investigation involving pharmacists and researchers, we designed and developed a prototype capable of empowering chronic patients. This study particularly focuses on how technological interventions can help chronic patients to self-manage and monitor their health and wellbeing related to COVID-19 where the user expectations are met with less attrition rates. © 2023 IEEE Computer Society. All rights reserved.

Understanding Cultural Influence on Perspectives Around Contact Tracing Strategies

Contact tracing, a major way to curb COVID-19 and other epidemics, has been employed worldwide, with human interviewing and proximity tracing technology as two major approaches. While previous research has contributed some understanding of people's perspectives on contact tracing technology, much of this is based in single countries or regions where technology has been deployed. To understand how culture influences people's perceptions toward human tracing and digital tracing, we replicated a mixed-methods survey study conducted in the U.S. in South Korea and compared participants' perspectives. South Korean participants preferred digital tracing to human tracing, contrasting with the U.S. context where no strong preference was observed. We discuss how observed differences in perspective align and contrast with the country's typical cultural dimensions, such as high power distance, informing the perspective that human tracing will have greater accuracy. We emphasize the need for culturally designing contact tracing technology to highlight personal benefits regardless of cultural dimensions, and leverage technology to support social interaction in human tracing. © 2022 Owner/Author.

Enhancing Self-protection: What Influences Human’s Epidemic Prevention Behavior during the COVID-19 Pandemic

Under the circumstance of the rapid spread of the COVID-19 pandemic, enhancing human’s awareness of self-protection is one practical method to slow down the epidemic. In this study, we utilize mobile sensing to track human activity and guide human’s epidemic prevention behavior by gamified feedback techniques by our developed application. Virtually, human’s self-protection awareness is affected by many factors and the measures to enhance people’s self-protection behavior against the epidemic COVID-19 has always been an unresolved issue. In order to search for factors that influence human’s self-protection behavior, we analyzed the relationships between various human activities and the percentage complete of human’s self-protection behavior and we have extracted some more general conclusions from the results. Based on our data analysis results, we also made some proposals to enhance self-protection behavior. Meanwhile, our study illustrates the effectiveness of the method that analyzes human self-protection behavior through mobile sensing. Our study also validates the effectiveness of persuasive technology on human’s self-protection behavior against the COVID-19 pandemic and therefore we advocate enhancing human’s self-protection awareness through external intervention and guidance by smart device. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

'Friendly' and 'noisy surveillance' through MapMyRun during the COVID-19 pandemic.

This paper considers the nature of social surveillance through the physical activity tracking app MapMyRun and examines how this was experienced during the COVID-19 pandemic during the UK and USA summer 2020 lockdowns. In contributing to debates in digital geographies around the entanglements of the fleshy and digital body, the paper responds to calls for research to recognise the increasing sociality of self-tracking (Couture, 2021), specifically considering how, during the COVID-19 pandemic, these apps offered a form of connection during a time of isolation. Using data from email and video interviews, I argue that whilst a Foucauldian account of surveillance can be used as a point of departure, it is limited in accounting for the social aspects of self-tracking. I therefore propose that applying Robinson's (2000) concept of 'noisy surveillance' to self-tracking is useful for understanding the messiness of surveillance in terms of the complications and noisiness involved in interactions in digital spaces, as well as the opportunities for performance management online particularly during lockdown.

Effectiveness of Digital Forced-Choice Nudges for Voluntary Data Donation by Health Self-trackers in Germany: Web-Based Experiment.

BACKGROUND: Health self-tracking is an evidence-based approach to optimize health and well-being for personal self-improvement through lifestyle changes. At the same time, user-generated health-related data can be of particular value for (health care) research. As longitudinal data, these data can provide evidence for developing better and new medications, diagnosing rare diseases faster, or treating chronic diseases. OBJECTIVE: This quantitative study aims to investigate the impact of digital forced-choice nudges on the willingness of German health self-trackers to donate self-tracked health-related data for research. This study contributes to the body of knowledge on the effectiveness of nonmonetary incentives. Our study enables a gender-specific statement on influencing factors on the voluntary donation of personal health data and, at the same time, on the effectiveness of digital forced-choice nudges within tracking apps. METHODS: We implemented a digital experiment using a web-based questionnaire by graphical manipulation of the Runtastic tracking app interface. We asked 5 groups independently to indicate their willingness to donate tracked data for research. We used a digital forced-choice nudge via a pop-up window, which framed the data donation request with 4 different counter values. We generated the counter values according to the specific target group needs identified from the research literature. RESULTS: A sample of 919 was generated, of which, 625 (68%) were women and 294 (32%) were men. By dividing the sample into male and female participants, we take into account research on gender differences in privacy tendencies on the web and offline, showing that female participants display higher privacy concerns than male participants. A statistical group comparison shows that with a small effect size (r=0.21), men are significantly more likely (P=.04) to donate their self-tracked data for research if the need to take on social responsibility is addressed (the prosocial counter value in this case-contributing to society) compared with the control group without counter value. Selfish or pseudoprosocial counter values had no significant effect on willingness to donate health data among male or female health self-trackers in Germany when presented as a forced-choice nudge within a tracking app. CONCLUSIONS: Although surveys regularly reveal an 80% to 95% willingness to donate data on average in the population, our results show that only 41% (377/919) of the health self-trackers would donate their self-collected health data to research. Although selfish motives do not significantly influence willingness to donate, linking data donation to added societal value could significantly increase the likelihood of donating among male self-trackers by 15.5%. Thus, addressing the need to contribute to society promotes the willingness to donate data among male health self-trackers. The implementation of forced-choice framing nudges within tracking apps presented in a pop-up window can add to the accessibility of user-generated health-related data for research.

Using an Individual-Centered Approach to Gain Insights From Wearable Data in the Quantified Flu Platform: Netnography Study.

BACKGROUND: Wearables have been used widely for monitoring health in general, and recent research results show that they can be used to predict infections based on physiological symptoms. To date, evidence has been generated in large, population-based settings. In contrast, the Quantified Self and Personal Science communities are composed of people who are interested in learning about themselves individually by using their own data, which are often gathered via wearable devices. OBJECTIVE: This study aims to explore how a cocreation process involving a heterogeneous community of personal science practitioners can develop a collective self-tracking system for monitoring symptoms of infection alongside wearable sensor data. METHODS: We engaged in a cocreation and design process with an existing community of personal science practitioners to jointly develop a working prototype of a web-based tool for symptom tracking. In addition to the iterative creation of the prototype (started on March 16, 2020), we performed a netnographic analysis to investigate the process of how this prototype was created in a decentralized and iterative fashion. RESULTS: The Quantified Flu prototype allowed users to perform daily symptom reporting and was capable of presenting symptom reports on a timeline together with resting heart rates, body temperature data, and respiratory rates measured by wearable devices. We observed a high level of engagement; over half of the users (52/92, 56%) who engaged in symptom tracking became regular users and reported over 3 months of data each. Furthermore, our netnographic analysis highlighted how the current Quantified Flu prototype was a result of an iterative and continuous cocreation process in which new prototype releases sparked further discussions of features and vice versa. CONCLUSIONS: As shown by the high level of user engagement and iterative development process, an open cocreation process can be successfully used to develop a tool that is tailored to individual needs, thereby decreasing dropout rates.

Usage of eHealth/mHealth Services among Young Czech Adults and the Impact of COVID-19: An Explorative Survey.

Various mHealth/eHealth services play an increasingly important role in healthcare systems and personal lifestyle management. Yet, the relative popularity of these services among the young population of the Czech Republic was not known. Therefore, we carried out an on-line survey with a convenience sample (n = 299) of young adults aged 18-29 and living in the Czech Republic. To this end, we adapted the survey instrument which was previously used in a similar study conducted in a different cultural context (Hong Kong). In our study, we found out that health tutorial activities (i.e., acquiring information on diet, exercise, fitness) were the most common among our respondents (M = 2.81, SD = 1.14). These were followed by health information seeking activities (i.e., acquiring information on medical problems) (M = 2.63, SD = 0.89) and medical services (i.e., the eHealth/mHealth services that provide infrastructural support, such as ePrescription and doctor appointment organizers) (M = 2.18, SD = 0.97). Based on the grouping according to gender and existing health condition, pairwise comparisons showed statistically significant differences. We also briefly analyzed the influence of the COVID-19 pandemic on the examined activities. Based on their relative popularity, we suggest leveraging the potential of health tutorial activities to improve public health.

Comparison of Mobile Health Technology Use for Self-Tracking Between Older Adults and the General Adult Population in Canada: Cross-Sectional Survey.

BACKGROUND: The burden of population aging and chronic conditions has been reported worldwide. Older adults, especially those with high needs, experience social isolation and have high rates of emergency visits and limited satisfaction with the care they receive. Mobile health (mHealth) technologies present opportunities to address these challenges. To date, limited information is available on Canadian older adults' attitudes toward and use of mHealth technologies for self-tracking purposes-an area that is increasingly important and relevant during the COVID-19 era. OBJECTIVE: This study presents contributions to an underresearched area on older adults and mHealth technology use. The aim of this study was to compare older adults' use of mHealth technologies to that of the general adult population in Canada and to investigate the factors that affect their use. METHODS: A cross-sectional survey on mHealth and digital self-tracking was conducted. A web-based questionnaire was administered to a national sample of 4109 Canadian residents who spoke either English or French. The survey instrument consisted of 3 sections assessing the following items: (1) demographic characteristics, health status, and comorbidities; (2) familiarity with and use of mHealth technologies (ie, mobile apps, consumer smart devices/wearables such as vital signs monitors, bathroom scales, fitness trackers, intelligent clothing); and (3) factors influencing the continued use of mHealth technologies. RESULTS: Significant differences were observed between the older adults and the general adult population in the use of smart technologies and internet (P<.001). Approximately 47.4% (323/682) of the older adults in the community reported using smartphones and 49.8% (340/682) indicated using digital tablets. Only 19.6% (91/463) of the older adults using smartphones/digital tablets reported downloading mobile apps, and 12.3% (47/383) of the older adults who heard of smart devices/wearables indicated using them. The majority of the mobile apps downloaded by older adults was health-related; interestingly, their use was sustained over a longer period of time (P=.007) by the older adults compared to that by the general population. Approximately 62.7% (428/682) of the older adults reported tracking their health measures, but the majority did so manually. Older adults with one or more chronic conditions were mostly nontrackers (odds ratio 0.439 and 0.431 for traditional trackers and digital trackers, respectively). No significant differences were observed between the older adults and the general adult population with regard to satisfaction with mHealth technologies and their intention to continue using them. CONCLUSIONS: Leveraging mHealth technologies in partnership with health care providers and sharing of health/well-being data with health care professionals and family members remain very limited. A culture shift in the provision of care to older adults is deemed necessary to keep up with the development of mHealth technologies and the changing demographics and expectations of patients and their caregivers.