This work explores the acceptability of various persuasive design principles for pediatric users of a digital, asthma self-management solution. While persuasive design methods have been shown to motivate adherence to digital self-management, effective persuasion is highly context-dependent. The gap in research on persuasive design for younger users of asthma self-management applications raises the question of which persuasive principles are acceptable for this group’s unique context. This question is explored through the Persuasive Systems Design model. Based on interviews and workshop feedback from physicians, six persuasive principles were chosen for a redesign of an existing asthma self-management solution. The prototype was evaluated for potential acceptability by user proxies. The Personalization and Simulation persuasive principles were perceived as most acceptable for pediatric, digital asthma self-management. / Detta arbete undersöker hur pediatriska användare upplever acceptansen av övertygande designprinciper av ett digitalt självhanteringsstystem för astma. Även om övertygande designmetoder har visat sig motivera att man följer digital självhantering, är effektiv övertalning mycket kontextberoende. Den vetenskapliga kunskapsluckan rörande övertygande design för yngre användare väcker frågan om vilka designprinciper som anses vara acceptabla för denna grupps unika sammanhang. Denna fråga utforskas i detta arbete genom modellen för övertygande systemdesign. Baserat på intervjuer och workshops med läkare valdes sex övertygande designprinciper ut för att designas om för ett befintligt självhanteringssystem för astma. Designprototypen utvärderades med avseende på potentiell acceptans av användarproxys. Resultatet av undersökningen visade att personifierings- och simuleringsövertygande designprinciper uppfattades som mest acceptabla för pediatrisk, digital självhantering för astma.

Maternal morbidity and mortality are prevalent issues worldwide that profoundly affects low- and middle-income countries (LMICs) in Africa. Estimates vary, but by the end of 2015, at least 300,000 women died in LMICs due to preventable pregnancy and childbirth conditions. Pregnant women die from complications that could be detected and managed if they were able to receive early access to necessary health interventions. Mobile technology is increasingly common across the globe, including LMICs, and incorporating digital health technologies, especially mobile phone (mHealth) programs, can offer a possible solution to morbidity and mortality related to pregnancy. A literature review analyzing the impact of mHealth programs on maternal health was conducted from various online databases. Nineteen articles that were published in the last ten years and contained technology-based interventions used for maternal health were reviewed. Inclusion criteria included countries listed as low-income and middle-income in the 2017 World Bank list of economies. The studies suggest mHealth programs have the potential to reduce maternal morbidity and mortality by increasing knowledge of safe health practices for pregnant women, community health workers, and traditional birth attendants. Mobile health technology also provides crucial information to providers when complications arise and can improve health facility utilization leading to increased deliveries with skilled birth attendants. This reinforces the need for more mHealth initiatives to be implemented in LMICs, addressing the barriers and community characteristics to positively impact and reduce maternal death in these settings.

Human activity recognition based on wearable sensors’ data is quite an attractive subject due to its wide application in the fields of healthcare, wellbeing and smart environments. This research is also focussed on predictive performance comparison of machine learning algorithms for activity recognition from wearable sensors’ (MHEALTH) data while employing a comprehensive process. The framework is adapted from well-laid data science practices which addressed the data analyses requirements quite successfully. Moreover, an Analysis Tool is also developed to support this work and to make it repeatable for further work. A detailed comparative analysis is presented for five multi-class classifier algorithms on MHEALTH dataset namely, Linear Discriminant Analysis (LDA), Classification and Regression Trees (CART), Support Vector Machines (SVM), K-Nearest Neighbours (KNN) and Random Forests (RF). Beside using original MHEALTH data as input, reduced dimensionality subsets and reduced features subsets were also analysed. The comparison is made on overall accuracies, class-wise sensitivity and specificity of each algorithm, class-wise detection rate and detection prevalence in comparison to prevalence of each class, positive and negative predictive values etc. The resultant statistics have also been compared through visualizations for ease of understanding and inference. All five ML algorithms were applied for classification using the three sets of input data. Out of all five, three performed exceptionally well (SVM, KNN, RF) where RF was best with an overall accuracy of 99.9%. Although CART did not perform well as a classification algorithm, however, using it for ranking inputs was a better way of feature selection. The significant sensors using CART ranking were found to be accelerometers and gyroscopes; also confirmed through application of predictive ML algorithms. In dimensionality reduction, the subset data based on CART-selected features yielded better classification than the subset obtained from PCA technique.

This study examines the technology and appointment scheduling habits of older adults over the age of 55 through an exploratory sequential three phase mixed methods study. Phase One of this study examined features of ten existing mHealth applications through a qualitative content analysis, then a mHealth wireframe was developed from the app to replicate in addition to a redesigned version. Phase Two of the study was a thirty-four questions survey with 40 participants that inquired about their background with appointment scheduling, prior experience with technology, and demographics. After that, the mHealth applications were revised into two mHealth application prototypes. Lastly, Phase Three conducted a user test with the two mHealth prototypes through A/B testing with 15 participants. Findings from the survey showed the preferred method of scheduling an appointment among participants was primarily in-person or by phone. The user test revealed that some participants were willing to use a mHealth application to schedule an appointment if it was deemed easy to use. Recommendations for future research suggests that the iterative design process of a prototype with an underserved population would garner feedback inclusive of those older adults who are less tech savvy. The major contribution of this research was the development of the mHapps Framework which will be tested in a future study.

Stroke is a leading cause of death and disability worldwide [8], underscoring the need for effective digital solutions for stroke patients, caregivers, and healthcare professionals. Given that, this thesis aims to evaluate quality aspects of usability, accessibility, and readability of stroke-related mobile health (mHealth) applications, with the primary objective of identifying strengths and weaknesses to enhance user experience and app quality. This study assessed sixteen stroke-related apps through a comprehensive methodology, including accessibility testing with the Google Accessibility Scanner, Mobile Application Rating Scale (MARS) evaluation, heuristic evaluation, and readability assessment. Key findings indicate significant issues with touch target sizes and text contrast, which are crucial for users with impaired visionand motor skills. MARS evaluations revealed that “Constant Therapy” excelled in engagement and functionality due to its interactive features and personalized schedules. At the same time, “Stroke Recovery Predictor” and “Conversation Therapy Lite” scored lower due to limited functionality and unclear interfaces. The heuristic evaluation highlighted frequent violations of the visibility of system status and insufficient error messaging. Readability assessments showed a range of reading difficulty levels, with some apps lacking privacy policies that could be found either within the application or on the developer’s website. The study provides actionable recommendations for developers, such as improving touch target sizes, improving text contrast, increasing functional variety, optimizing navigation, and ensuring privacy policy transparency. Addressing these areas can significantly improve the usability and accessibility of stroke-related mHealth apps, ultimately supporting better health outcomes and quality of life for stroke survivors. Future research should involve more evaluators, use multiple assessment tools, and focus on specific types of stroke apps to refine the evaluation process and provide more targeted insights.

Syftet med uppsatsen var att undersöka hur man med hjälp av digital design kan stödja den psykiska hälsan hos individer i USA under Covid-19 pandemin. Covid-19 är den första pandemin som utspelar sig i ett utvecklat digitalt samhälle där både mHealth/telehealth-design är välstuderat. Studien undersöker specifikt hur designelement för en mHealth-applikation kanen mHealth-applikation kan stödja en stor grupp användare under en global pandemi. Uppsatsen undersöker hur design kan öka användandet av mHealth för att söka hjälp mot psykisk ohälsa, som uppstått på grund av isolering till följd av den amerikanska statens riktlinjer under Covid-19 pandemin. Med hjälp av tidigare forskning gällande designriktlinjer för mHealth-applikationer, inkluderande design och element att tänka på när man designar applikationer för psykisk ohälsa, framtogs en prototyp av en mHealth-applikation. Denna prototyp testades därefter av sex respondenter som alla lider av depression till följd av isolering. Efter think aloud-observation under testandet av prototypen genomfördes en kvalitativ intervju för att undersöka respondenternas upplevelse av applikationen. Resultatet av studien påpekar vikten av användarens integritet, inkluderande design och element som efterfrågats i tidigare studier av mHealth-applikationer. Dessa resultat stödjer också de åtaganden tidigare forskninglagt fram och i sin tur visar denna studie att en mobilapplikation kan designas föratt stödja människor med deras psykiska ohälsa i relation till Covid-19 isoleringen. / The goal of this thesis was to investigate how the use of digital design could help people with their mental health during the covid-19 pandemic. Covid-19 is the first and only pandemic where both mHealth and telehealth design has been well developed. Our thesis explores how design elements can increase the will of users to use mHealth applications, especially for users whose mental health has been impacted by covid-19 restrictions in the United States. Based on the scientific articles regarding mHealth design, a prototype was made. This includes inclusive design and design elements focused on people with mental health struggles. The prototype was tested by six users who all reported feeling down because of isolation during covid-19. During the study, users were asked to test the prototype and ‘think aloud’, followed by a qualitative interview to better understand the user’s experience, feelings, and thoughts on the prototype. The results show the importance of a patient's integrity, the importance of inclusive design, and the appreciation of certain design elements. The results are in line with results from previous research and offer evidence on how to design a mHealth application to support people with their mental health during a pandemic.

En 2015, avec 7 milliards d'usagers, le téléphone portable devient la technologie de communication la plus utilisée dans le monde. Du rappel de rendez-vous par SMS au glucomètre mobile, les systèmes de santé y recourent de manière croissante. Les programmes qui utilisent le téléphone portable pour améliorer la santé constituent un nouveau secteur de la télésanté appelé mHealth ou mSanté. Peu de recherches ont été réalisées sur leur déploiement en particulier dans les pays du Sud. A travers l'étude d'un programme global de santé maternelle au Ghana et Inde, la thèse apporte un premier regard sur ces dispositifs. S'appuyant sur une enquête multi-située et des méthodes de sociologie de la santé, des usages et d'analyse de discours, elle précise les assemblages sociotechniques propres à ces objets dans le champ biomédical mondialisé et se penche sur l'action effective des technologies mobiles sur la prise en charge et la santé des femmes ciblées. Cette triple approche permet de mettre en lumière les enjeux de pouvoir sous-jacents au développement de cette technologie dans les Suds. La thèse explore d'abord le modèle de « développement numérique » promu par les dispositifs de mSanté : un modèle qui établit une relation particulière aux savoirs et à la science, qui intègre l'expansion des technologies numériques d'une part et de leurs marchés d'autre part comme source de progrès et de croissance pour les Suds. Ce modèle techniciste et mercantile du développement reconduit des logiques impérialistes et déplace des inégalités Nord-Sud. Ensuite, la thèse analyse la place de l'information et des données de santé dans ces projets. Présentées comme le moyen principal de combattre la mortalité prématurée et de maintenir en bonne santé les populations, la responsabilisation du patient dans une logique consumériste et béhavioriste et la mise en données de la santé à des fins de surveillance caractérisent le dispositif étudié. L'enquête montre que le soin ne peut être entièrement capturé par des techniques d'encodage et de transmission et qu'en cherchant à rationaliser les services de santé à travers la sous-traitance du soin à des patients « informés » et à des personnels bon marché et précarisés, le dispositif technique dégrade les relations interpersonnelles indispensables au soin. Enfin, la thèse examine les rapports de pouvoir multiples dans lesquels s'inscrit la mSanté. Les acteurs de la mSanté déploient des programmes ciblant les femmes et entendent compenser des inégalités de genre grâce au téléphone portable, considéré comme un outil d'empowerment. Le dispositif étudié participe de cette tendance mais ne tient pas compte de la structure complexe des rapports de genre et propose de manière superficielle une inversion des rôles sans travailler sur les facteurs et les sphères de détermination. L'enquête multi-située montre comment loin d'annuler des relations inégalitaires, le dispositif technique transforme des inégalités de manière différente selon son contexte d'insertion. L'idée que les technologies numériques permettent une amélioration de la prise en charge, une diminution des disparités de santé et une optimisation des systèmes de santé a pris corps ces dernières années dans un ensemble de dispositifs techniques variés. Ainsi, la mSanté dans les pays en développement participe d'un mouvement plus général de globalisation et de technologisation de la biomédecine. L'analyse dépasse donc le cas de la téléphonie mobile pour montrer comment les technologies numériques participent à l'émergence de nouveaux pouvoirs, à la globalisation et à la mise en données de la santé, à la transformation du soin et des pratiques de santé. / With 7 billion mobile users in 2015, mobile phones became the most widespread communication technology worldwide. From appointment reminders by SMS to mobile glucometers, healthcare systems are increasingly using mobile technologies. However, the use of mobile technologies for health called « mhealth » or « mobile health » has not been well documented so far, especially in the Global South. Through the study of a global mHealth program on maternal health implemented in Ghana and India, this research offers a first glance at those devices. Based on an interdisciplinary approach combining sociology of health, users studies and discourse analysis, and a multisite ethnography conducted in Ghana and India, this dissertation describes those particular socio-technical assemblages deployed in a global biomedical context and details the specific impact of those mobile technologies on care provision and health practices for women targeted by those programs. This triple approach reveals power relations underlying the expansion of those new technical artefacts in the Global South. First of all, this work examines the model of « digital development » promoted by mHealth programs: a model that establishes a special relation to knowledge and science, that defines mobile connectivity and mobile market extension as key sources of progress and economic growth in the developing world. This technological and market-based model of development perpetuates imperialist dynamics and reshapes North-South inequalities. Moreover, the thesis studies the role of information and health data in those projets. Seen as central weapons to fight mortality and to preserve health for everyone, patient empowerment and data-driven health are strong characteristics of the studied device that increase the commodification and datafication of health. The research shows that care practices cannot be entirely captured by encoding and transmission techniques, by delegating care to the « digitally engaged patient » and to poorly trained-insecure-low-paid healthworkers, the project deteriorates interpersonal relationships that are essential for care practices. Finally, the thesis examines the multiple power issues at stake in mHealth projects. Those maternal programs are specifically targeting women and intend to compensate gender inequalities thanks to the alleged empowering effect of mobile phones. The studied program contributes to this trend and offers a shallow inversion of the traditional assignment of gender roles thus hardly taking into account the complexitiy of gender determination. This multisite research shows how the technical device far from erasing inequalities transforms them in different ways depending on its context of insertion. The idea that digital technologies contributes to improving care, reducing health disparities and optimizing health systems has taken shape in recent years in a diverse set of technical devices. mHealth or mobile Health is a particular vector of this global movement, which goes beyond the use of mobile phones, and shows how digital technologies contribute to the emergence of new powers, to the reorganization of care, to the globalization, the datafication and the commodification of health.

Το mHealth, η χρήση δηλαδή φορητών τεχνολογιών για την βελτίωση των παρεχόμενων υπηρεσιών υγείας, είναι σήμερα ένα από τα πιο ταχέως αναπτυσσόμενα πεδία της ηλεκτρονικής υγείας (eHealth). Ο αριθμός των επαγγελματιών υγείας που υιοθετούν έξυπνα κινητά τηλέφωνα (smartphones) για την εκτέλεση πληθώρας λειτουργιών αυξάνεται συνεχώς, εξαιτίας των δυνατοτήτων και της φορητότητας που αυτά παρέχουν. Ταυτόχρονα, τα σφάλματα στη φαρμακευτική αγωγή είναι από τα πιο συνηθισμένα ιατρικά λάθη με επιπτώσεις τόσο στην υγεία του ασθενούς όσο και στις δαπάνες στην υγεία. Η χορήγηση φαρμάκων είναι μια πολύπλοκη διαδικασία, καθώς απαιτεί από τον ειδικό της υγείας την ανάλυση πληθώρας παραγόντων και την ανάκτηση, επεξεργασία και διαχείριση μεγάλου όγκου πληροφορίας. Σύμφωνα με τη βιβλιογραφία, η χρήση τεχνολογιών πληροφορικής για την υποβοήθηση των επαγγελματιών υγείας στη λήψη αποφάσεων κατά τη συνταγογράφηση, μπορεί να συμβάλει σημαντικά στη μείωση των σφαλμάτων φαρμακευτικής αγωγής. Στο πλαίσιο της παρούσας διπλωματικής εργασίας, προχωρήσαμε στη διερεύνηση και αξιολόγηση των σημαντικότερων εφαρμογών έξυπνων κινητών συσκευών για το φάρμακο, με στόχο την εξαγωγή χρήσιμων συμπερασμάτων για τα χαρακτηριστικά και τις λειτουργίες που ενσωματώνουν. Ένα από τα βασικά συμπεράσματα της έρευνας ήταν η απουσία αντίστοιχης εφαρμογής για τα φάρμακα που είναι εγκεκριμένα από τον Εθνικό Οργανισμό Φαρμάκων (ΕΟΦ). Ως εκ τούτου, προχωρήσαμε στο σχεδιασμό και την ανάπτυξη εφαρμογής για τον έλεγχο ασυμβασιών μεταξύ φαρμάκων, η οποία παρέχει επιπλέον τη δυνατότητα προβολής πληροφοριών συνταγολογίου για τα φάρμακα του ΕΟΦ. Ο σχεδιασμός της εφαρμογής έγινε λαμβάνοντας υπόψη τις ανάγκες και τις απαιτήσεις μελλοντικών χρηστών, όπως οι επαγγελματίες υγείας και οι ασθενείς, προκειμένου να διασφαλιστεί η λειτουργικότητα και η ευχρηστία της. Η εν λόγω εφαρμογή προορίζεται για έξυπνες κινητές συσκευές που διαθέτουν λειτουργικό σύστημα Android, ενώ η πληροφορία που ενσωματώνει βασίζεται αποκλειστικά στο εθνικό συνταγολόγιο του ΕΟΦ. / Mobile Health or mHealth, namely the use of mobile and wireless technologies in order to improve health services and achieve health goals, is today one of the most rapidly expanding fields of electronic health (eHealth). The number of health professionals that adopt smartphones to perform multiple tasks, during their everyday medical practice, is increasing constantly. This is due to the fact that smartphones provide advanced computing capabilities and high portability. Simultaneously, medication errors are among the most common medical errors which have negative impact both for the health of the patient and the expenditure on health sector. Drug prescribing is quite a complex procedure, considering the fact that requires the health expert to analyze multiple factors and retrieve, process, manage and digest large volume of information. According to the literature, the use of information technologies to assist health professionals in decision-making when prescribing drugs, can contribute significantly to the reduction of medication errors. In the context of our work, we explored and evaluated the major smartphone applications for drugs, aiming to the extraction of useful conclusions about the features and functions that they incorporate. One of the research key findings was the absence of a corresponding application for the drugs that are approved by the National Drug Organization of Greece. Therefore, we design and develop an application for checking drug-drug interactions which additionally provides the ability to view national formulary information about drugs. The analysis and design of the application was implemented in collaboration with future users, such as health professionals and patients, in order to ensure that will meet their needs and requirements and at the same time will remain user friendly. This application is intended for Android smart mobile devices (e.g. smartphones, tablet PCs) and the information that integrates is solely based on the national formulary of the National Drug Organization of Greece.

There are high expectations regarding mobile technology and how it can be used to promote improvements in the quality and efficiency in healthcare. There appears to be a gap between the goals and strategy on the macro level and the micro level experiences of the usage of mobile devices among healthcare professionals.   The purpose of this study is to examine the perceptions, experiences and expectations of nursing care providers at two wards with regards to the recently implemented mobile platform COSMIC Nova Ward and other related IT artefacts. Special emphasis has been on COSMIC Nova Ward Tablet, a part of COSMIC Nova Ward, facilitated in iPad MINIs. It is designed to act as a tool to facilitate the provision of care and has been introduced at both the wards during a pilot project. Even though the two wards are similar in both practice and structure, the pilot project resulted in failure at one of the wards and a relative success at the other.   A comparative case study of the perceptions, experiences and expectations of the nursing personnel at the two wards was conducted in order to highlight the differences in the outcomes of the pilot project. By reflexively comparing these with theory, it was concluded that there are several factors other than adequacy of the IT system that determine the outcome of the implementation of a mobile platform in a clinical setting.   These findings were then compared with existing legislation and policies, in order to identify potential discrepancies between the nursing personnel’s usage of IT with the regional and national goals and strategy. It was then determined that there needs to be a clear connection between the usage of IT and the goals and strategy within healthcare.

Personer som lider av migrän har i de flesta fall någon gång funderat över vad som är den utlösande faktorn. Ibland vet de svaret, ibland är svaret inte lika tydligt. Att ha kunskap och förståelse över sin migrän kan öka chanserna till självhjälp och ökad empowerment. Patienterna har tillräcklig kunskap för att kunna ta beslut som bidra till en bättre hälsa för individen. Patienten hjälper således sig själv till ett bättre välmående utifrån den kunskap som patienten har om sig själv och sin sjukdom. För att skapa en förståelse och större kunskap för sin sjukdom kan det underlätta att dokumentera sina migränanfall. Dokumentationen kan sedan användas för att hitta en gemensam nämnare till anfallen. Att dokumentera migränanfall kan också kallas för att föra en migrändagbok. Migrändagböcker kan ordineras ut av hälso- och sjukvård i form av enklare dokumentation på pappersark. Det finns också digitala lösningar där personer som lider av migrän kan dokumentera in mer utförliga uppgifter om sin migränattack via olika migränappar som finns att ladda ner. En digital lösning ger större möjlighet till en rikare information om personens sjukdom, men saknar ofta anpassning för migränpatienters särskilda behov och upplevda problematik. Personer som lider av migrän kan uppleva problematik med att interagera med digitala skärmar. Att interagera med skärmar kan vara en bidragande orsak till ett sämre mående, vilket framkom i denna undersökning. Syftet med denna studie var att undersöka hur ett gränssnitt för en mobil hälsoapplikation för migränpatienter kunde utformas med fokus på empowerment och god användarupplevelse. För att ta reda på detta, genomfördes 7 stycken semistrukturerade intervjuer. Informanterna fick berätta om sina upplevelse av migrän, deras egen kunskap om sin sjukdom, samt tekniska aspekter om hur de vill interagera med mobilappar under tiden som de har migrän. Den data som uppkom utifrån intervjuerna analyserades sedan med hjälp av kvalitativ kodning som resulterade i fyra olika teman. Behovet visar att dokumentation av migränanfall genom mobilapplikationer ska ske med så lite interaktionstid med skärmen som möjligt. Dokumentation av migränanfall kan med fördel ske med hjälp av tal och ljud. Själva gränssnittet ska vara enkelt och simpelt med avskalade ikoner som tydligt ska gå att identifiera. Det ska finnas möjlighet att manuellt eller med automatiska inställningar dämpa ljuset på skärmen. Resultatet av undersökningen mynnade sedan ut i lämpliga gränssnittsförslag i form av mockuper. För framtida forskning rekommenderas att utföra användartester med utökade prototyper, för att undersöka huruvida de designförslag som tagits fram i denna studie upplevs som en god användarupplevelse och bidrar till empowerment. / People who suffer from migraines have probably at some point thought about what the triggering factor is. Sometimes the answer is clear, and sometimes it’s not that obvious. To have understanding and knowledge of their migraine can increase the chances of self-help and also higher levels of empowerment. With self-help, the patient can make better decisions based on the knowledge of the disease, which can lead to a better well-being. In order to establish an understanding and more knowledge about their illness, it can be helpful to document the migraine attacks. The documentation can then be used to find a possible cause of the attacks. This is also called a migraine journal. Migraine journals can be prescribed by the health services, where you get a template with less words and with simple instructions of the tasks on them. There are also digital solutions, like mobile applications, that supports more detailed documentation. A digital solution provides more opportunities for more detailed information about the person's illness, but mobile apps often lacks adaption for the patient's specific needs and problems. Persons who suffers from a migraine attack, can experience difficulties when documenting a large amount of information on applications. The interaction with digital screens may worsen the symptom. This is one of the findings of this study. The purpose of this study was to examine how a user interface for a mobile health application, could be designed with focus of empowerment and a good user experience. To find out, 7 semi structured interviews were conducted. The informants were asked to tell about their experiences, their knowledge about their illness and some technical aspects of how they want to interact with mobile applications while they are suffering from an attack. The data that was obtained from the interviews were then analyzed using qualitative coding that resulted in four different themes. The study showed that the potential users wish to interact as little as possible with the screen. Documentation of migraine attacks can be done with the help of speech and sound. The interface itself should be easy with simple icons which are easy to identify. It should be possible to manually or automatically adjust the light on the screen. The result of the study contributed to suggestions for how to design a suitable interface for migraine patients. The interface is visualised in this report in the form of mockups. For future research , it is recommended to perform user tests with extended prototypes to investigate whether the design principles and design suggestions developed in this study are perceived as a good user experience and contribute to empowerment.