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People are increasingly turning to online communities for entertainment, information, and social support, among other uses and gratifications. Online communities include traditional online social networks (OSNs) such as Facebook but also specialized online health communities (OHCs) where people go specifically to seek social support for various health conditions. OHCs have obvious health ramifications but the use of OSNs can also influence people's mental health and health behaviors. The use of online communities has been widely studied but in the health context their exploration has been more limited. Not only are online communities being extensively used for health purposes, but there is also increasing concern that the use of online communities can itself affect health. Therefore, there is a need to better understand how such technologies influence people's health and health behaviors. The research in this dissertation centers on examining how online community use influences health and health behaviors. There are three studies in this dissertation. The first study develops a conceptual model to explain the process whereby the characteristics of a request from an OHC user for social support is answered by a wounded healer, who is a person leveraging their own experiences with health challenges to help others. The second study investigates how algorithmic fairness, accountability, and transparency of an OSN newsfeed algorithm influence the users' attitudes and beliefs about childhood vaccines and ultimately their vaccine hesitancy. The third study examines how OSN social overload, through OSN use, can lead to psychological distress and received social support. The research contributes theoretical and practical insights to the literature on the use of online communities in the health context. / Doctor of Philosophy / People use online communities to socialize and to seek out information and help. Online social networks (OSNs) such as Facebook are large communities on which people segregate into smaller groups to discuss joint interests. Some online communities cater to specific needs, such as online health communities (OHCs), which provide platforms for people to talk about the health challenges they or their loved ones are facing. Online communities do not intentionally seek controversy, but because they welcome all perspectives, they have contributed to phenomena such as vaccine hesitancy. Moreover, social overload from the use of OSNs can have both positive and negative psychological effects on users. This dissertation examines the intersection of online communities and health. The first study explains how the interaction of the characteristics of a request for social support made by an OHC user and the characteristics of the wounded healer drive the provision of social support. The model that is developed shows the paths through which the empathy of the wounded healer and the characteristics of the request lead to motivation to provide help to those in need on an OHC. In the second study, the role of characteristics of a newsfeed algorithm, specifically fairness, accountability, and transparency (FAT), in the development of childhood vaccine hesitancy is examined. The findings show that people's perceptions of the newsfeed algorithm's FAT increase their negative attitudes toward vaccination and their perceived behavioral control over vaccination. The third study examines how different uses of OSNs can influence the relationships between social overload and psychological distress and received social support. The findings show how OSN use can be tailored to decrease negative and increase positive psychological consequences without discontinuing use.

This research has examined how Information and Communication Technologies (ICTs) can promote healthy eating habits amongst African Americans in low-income neighborhoods, a population that faces disproportionately high rates of diet-related health problems. In this dissertation, I describe the formative research I conducted to obtain system design guidelines and how I used those guidelines to develop two applications: EatWell and Community Mosaic. I also describe the results of the in-depth field studies I conducted to evaluate each application. Both EatWell and Community Mosaic incorporate the cultural construct of collectivism, a social orientation in which interdependence and communal responsibility are valued over individual goals and independence. As researchers have generally characterized the African American culture as collectivistic and argued for the value of designing collectivistic health interventions for this population, I examined the implications of taking such an approach to designing health promotion technologies. EatWell and Community Mosaic are collectivistic because they empower users to care for the health of their local community by helping others learn practical, locally-relevant healthy eating strategies. I discuss the results of my formative fieldwork and system evaluations, which characterize the value, challenge and nuances of developing community-based health information sharing systems for specific cultural contexts. By focusing on health disparities issues and the community social unit, I extend previous health technology research within Human-Computer Interaction (HCI). In particular, my results describe 1) a set of characteristics that help make shared material useful and engaging, 2) how accessing this information affects how people view the feasibility of eating well in their local context, 3) the way in which sharing information actually benefits the contributor by catalyzing personal behavior reflection, analysis and modification and 4) how sharing information and seeing that information's impact on others can help to build individuals' capacity to be a community health advocate. In addition, my work shows how examining cultural generalizations such as collectivism is not a straightforward process but one that requires careful investigation and appreciation for the way in which such generalizations are (or are not) manifested in the lives of individual people. I further contribute to HCI by presenting a set of important considerations that researchers should make when designing and evaluating community-based health systems. I conclude this dissertation by outlining directions for future HCI research that incorporates an understanding of the relationship between culture and health and that attempts to address health disparities in the developed world.

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Submitted by FABIANA SOUZA (souza.m.fabiana@gmail.com) on 2017-03-20T13:17:46Z No. of bitstreams: 1 Thesis_final version_20.03.2017 pdf with ficha catalográfica.pdf: 1522104 bytes, checksum: ae5f88ba601637a307b8ea2ea7ec9c03 (MD5) / Rejected by Pamela Beltran Tonsa (pamela.tonsa@fgv.br), reason: Bom dia Fabiana, Já recebi sua submissão, mas será necessário alguns ajustes. *Título do seu trabalho deve estar em letra maiúscula. *Apenas seus título e seu nome em negrito nas páginas. *Após o agradecimento em inglês é necessário colocar o agradecimento em português. Com a conclusão destes ajustes tudo está certinho. Fazer novamente a postagem e aguardar a URL para assim fazer a submissão no aluno online. Qualquer dúvida estamos à disposição. Att, Pâmela Tonsa on 2017-03-20T13:36:23Z (GMT) / Submitted by FABIANA SOUZA (souza.m.fabiana@gmail.com) on 2017-03-20T14:57:55Z No. of bitstreams: 1 Thesis_final version_20.03.2017_final 14h55.pdf: 1527728 bytes, checksum: 54003154e3eecd0b2ea7326a1f8312dc (MD5) / Approved for entry into archive by Pamela Beltran Tonsa (pamela.tonsa@fgv.br) on 2017-03-20T15:37:32Z (GMT) No. of bitstreams: 1 Thesis_final version_20.03.2017_final 14h55.pdf: 1527728 bytes, checksum: 54003154e3eecd0b2ea7326a1f8312dc (MD5) / Made available in DSpace on 2017-03-20T15:39:19Z (GMT). No. of bitstreams: 1 Thesis_final version_20.03.2017_final 14h55.pdf: 1527728 bytes, checksum: 54003154e3eecd0b2ea7326a1f8312dc (MD5) Previous issue date: 2017-02-15 / This thesis is a set of three studies concentrated on the antecedents and effects of users trust in online health groups on Facebook. People in Brazil are increasingly using these groups as a way to find health information and support from people who experience the same health challenges. There are several types of online groups addressing various topics of interest gathering together hundreds and thousands of individuals who can easily participate and interact with others. Their goal is to be able to improve their knowledge about their topic of interest, to manage their health condition better. Also many seek advice to better deal with the disease and alleviate its symptoms. Others are seeking support for behavior change to be healthier. The participation of people in such groups has the potential to address many health issues and positively influences health systems. So it is important to better understand about aspects that can contribute to the online group's sustainability and longevity, such as the activity of members, its inner workings and the relationship between members. These online groups are constituted by people who do not know each other personally. Thus, trust is an aspect that materializes from the interactions experienced and relationships constituted within the community. These experiences, result of the interaction of the individual with the other participants and the knowledge available, has the potential to increase or decrease their trust in the online groups. Which in turn impacts the way people engage in the community and contribute their knowledge as well as the adoption of knowledge available in the online group. The first study discusses aspects of the activity of members and the online group inner workings. These aspects imply the vitality of online communities, a crucial element for its success and development. Based on previous literature, we identified that there is no measure to assess the vitality of the community, although its dimensions have already been conceptualized. The main contribution of this paper is the development and validation of the Online Community Vitality scale, which can be measured by 20 items composed of five sub-dimensions: content quantity, content quality, interactivity, responsiveness, and atmosphere. The second study seeks to address the literature gap by exploring the determinants of individuals trust in online health groups. The main contribution of the second paper is the extension of the literature of trust in the context of social medias by testing and validating new variables as antecedents of trust: online community vitality, community support and perceived information credibility. The last study proposes that the participant's trust in online health groups have the potential to increase their engagement, knowledge adoption and contribution. Also, proposes that engagement positively influences the adoption of knowledge and knowledge contribution. The results support all prepositions. The findings contribute to the expand the literature about trust and engagement, considering the context of online health groups on Facebook. / Esta tese é um conjunto de três estudos sobre os fatores que impactam a confiança do indivíduo em grupos online de saúde no Facebook, bem como os efeitos da confiança nestes grupos. No Brasil as pessoas estão cada vez mais utilizando tais grupos como forma de acesso as informações de saúde e também para obter apoio de pessoas que enfrentam os mesmos desafios de saúde. Existem vários tipos de grupos online que tratam de temas diversos e reúnem centenas e milhares de pessoas, que facilmente participam e interagem com semelhantes. Estas pessoas buscam melhorar o seu conhecimento sobre o tópico de seu interesse, a fim de melhor administrar sua condição de saúde. Além disso, muitos procuram aconselhamento para melhor lidar com a doença e aliviar seus sintomas. Outros buscam suporte para que mudem seu próprio comportamento de modo a se tornarem mais saudáveis. A participação de pessoas em tais grupos tem potencial para ajudar na solução de muitos problemas de saúde e também influenciar positivamente os sistemas de saúde. Desta forma, é relevante a compreensão dos aspectos que podem contribuir para a sustentabilidade e longevidade do grupo online, tais como: as atividades dos membros, o funcionamento interno da comunidade e a relacionamento entre os membros. Os grupos on-line são constituídos por pessoas que geralmente não se conhecem pessoalmente, sendo assim, a confiança é um aspecto que se materializa a partir das interações vivenciadas e das relações constituídas dentro da comunidade. Essas experiências, resultado da interação do indivíduo com os outros participantes e do conhecimento disponível no grupo, têm potencial para aumentar ou diminuir sua confiança nos grupos on-line. O que por sua vez afeta a forma como as pessoas se engajam e contribuem com seus conhecimentos, bem como a adoção do conhecimento disponível no grupo on-line. O primeiro estudo discute aspectos relativos a atividade dos membros e o funcionamento do grupo online. Esses aspectos implicam a vitalidade da comunidade on-line, crucial para seu sucesso e desenvolvimento. Com base na literatura anterior, foi identificado que não há instrumento de medida para avaliar a vitalidade da comunidade, embora suas dimensões já tenham sido previamente conceituadas. A principal contribuição deste trabalho é o desenvolvimento e validação da escala de Vitalidade na Comunidade, que pode ser medida através de 20 itens distribuídos em cinco subdimensões: quantidade de conteúdo, qualidade do conteúdo, interatividade, capacidade de resposta e atmosfera. O segundo estudo trata de uma lacuna da literatura e explora os fatores determinantes da confiança dos indivíduos em grupos de saúde on-line. A principal contribuição do segundo artigo é a ampliação do arcabouço teórico de confiança no contexto das mídias sociais, por meio do teste e validação de novas variáveis como antecedentes de confiança, são elas: vitalidade da comunidade, suporte da comunidade e percepção de credibilidade da informação. O último estudo propõe que a confiança dos participantes em grupos on-line de saúde tem o potencial de aumentar seu engajamento, adoção e contribuição de conhecimento. Também propõe que o engajamento influencia positivamente a adoção de e contribuição de conhecimento. Os resultados suportam todas as proposições. Os achados contribuem para ampliar a literatura sobre confiança e engajamento, considerando o contexto dos grupos de saúde on-line no Facebook.

Digital transformation is evolving, and it is driving at the helm of the digital evolution. The amount of information accessible to us has revolutionized the way we gather information. Mobile technology and the immediate and ubiquitous access to information has changed how we engage with services including healthcare. Digital technology and digital transformation have afforded people the ability to self-manage in different ways than face-to-face and paper-based methods through different technologies. This study focuses on exploring the use of the most commonly used digital health technologies in the healthcare sector and how it affects physicians’ daily routine practice. The study presents findings from a qualitative methodology involving semi-structured, personal interviews with physicians from Sweden and a physician from Spain. The interviews capture what physicians feel towards digital transformation, digital health technologies and how it affects their work. In a field where a lack of information regarding how physicians work is affected by digital health technologies, this study reveals a general aspect of how reality looks for physicians. A new way of conducting medicine and the changed role of the physician is presented along with the societal implications for physicians and the healthcare sector. The findings demonstrate that physicians’ role, work and the digital transformation in healthcare on a societal level are important in shaping the future for the healthcare industry and the role of the physician in this future. / Den digitala transformationen växer och den drivs vid rodret för den digitala utvecklingen. Mängden information som är tillgänglig för oss har revolutionerat hur vi samlar in information. Mobila tekniker och den omedelbara och allmänt förekommande tillgången till information har förändrat hur vi tillhandahåller oss tjänster inklusive inom vården. Digital teknik och digital transformation har gett människor möjlighet att kontrollera sig själv och sin egen hälsa på olika sätt än ansikte mot ansikte och pappersbaserade metoder genom olika tekniker. Denna studie fokuserar på att utforska användningen av de vanligaste digitala hälsoteknologierna inom hälso- och sjukvårdssektorn och hur det påverkar läkarnas dagliga rutin. Studien presenterar resultat från en kvalitativ metod som involverar semistrukturerade, personliga intervjuer med läkare från Sverige och en läkare från Spanien. Intervjuerna fångar vad läkare tycker om digital transformation, digital hälsoteknik och hur det påverkar deras arbete. I ett fält där brist på information om hur läkare arbetar påverkas av digital hälsoteknik avslöjar denna studie en allmän aspekt av hur verkligheten ser ut för läkare. Ett nytt sätt att bedriva medicin och läkarens förändrade roll presenteras tillsammans med de samhälleliga konsekvenserna för läkare och vårdsektorn. Resultaten visar att läkarnas roll, arbete och den digitala transformationen inom hälso- och sjukvården på samhällsnivå är viktiga för att utforma framtiden för vårdindustrin och läkarens roll i framtiden.

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Le domaine aéronautique connait de nos jours un engouement sans précédent autour de l’avion plus électrique. L’importance du nombre d’équipements électriques est à un tel point que l’amélioration de leur fiabilité devient incontournable. Actuellement, les composants passifs occupent 75 % des éléments électroniques utilisés en avionique dont la moitié correspond à des condensateurs. Ces derniers doivent donc répondre aux exigences environnementales avioniques assez contraignantes. C’est dans ce contexte que nous nous sommes intéressés particulièrement à l’étude des condensateurs à technologie film utilisant le polypropylène ou le polyester comme diélectrique. Afin de mieux comprendre le comportement fréquentiel de cette technologie, deux modèles fins de condensateurs films ont été développés, permettant ainsi de suivre les évolutions de leurs grandeurs électriques dans des conditions cohérentes avec l’application. Dans un deuxième temps, l’effet des contraintes en tension et en température constantes a été étudié sous la forme de facteurs d’accélération du vieillissement. Cela a été établi par l’intermédiaire de plusieurs essais, permettant d’établir les lois d’évolutions temporelles des paramètres électriques des condensateurs. Comme ces contraintes constantes ne sont pas toujours représentatives des conditions réelles d’utilisation, les cinétiques de dégradation ont été comparées à celles où les condensateurs sont sollicités par de fortes ondulations de courant, seules ou associées à une tension continue. Enfin, la dernière partie de notre travail expose l’utilisation des données expérimentales issues des essais de vieillissement dans un objectif de diagnostic en ligne. Les techniques utilisées assurent l'analyse de la dégradation de ces composants, étape essentielle dans la prédiction de l’état de santé des condensateurs en ligne / Nowadays, aeronautic research field is moving towards a more electric aircraft. Although this evolutionary path offers many advantages from a financial and ecological point of view, the increased power source usage sets additional constraints on the different electrical systems used onboard. Currently, passive components occupy 75% of the overall electronic equipments used in avionics, whose 50% corresponds to capacitors. Consequently, these latter must be able to withstand the harsh avionic operating conditions. In this thesis we were particularly interested in the study of metallized film capacitors technology using polyester or polypropylene as dielectric. A first approach consisted on the modeling of these components as function of frequency in order to study the evolution of their electrical parameters under consistent avionic stresses. These models were also developed on the purpose of tracking the degradation of the capacitors parameters over time. This operation was done by the means of accelerated floating ageing tests, where capacitors were subjected to different constant voltages and temperatures. Original capacitance ageing laws were thus proposed based on the identification of voltage and temperature degradation kinetics. However, since traditional floating ageing tests, do not reflects the normal ageing of the component, degradation kinetics of metallized films capacitors under high ripple currents, alone or combined with a DC voltage across the devices terminals where also studied, and the associated failure mechanisms were identified. A final step consisted on the health monitoring of metallized film capacitors online based on the experimental ageing data

Il 40 per cento degli intervistati afferma che non ha trovato informazioni esaustive sui rischi e benefici dei farmaci trovati, mentre il 52 per cento afferma che le informazioni trovate hanno aiutato a seguire le indicazioni e i consigli del medico. Tra i rispondenti che si sono sottoposti a visita medica e che hanno discusso le informazioni trovate online con il proprio medico di fiducia, l'84 per cento ha ricevuto la prescrizione di farmaci. Di questi, solo il 17 per cento riporta che il farmaco prescritto era lo stesso trovato online, il 74 per cento è stato inviato da uno specialista e l'80 per cento ha ricevuto una prescrizione per test diagnostici. Più della metà dei rispondenti ha anche riportato azioni intraprese dal medico diverse dalla prescrizione del farmaco trovato online. Il 20 per cento degli intervistati afferma che le informazioni trovate sul farmaco da prescrizione in Internet hanno ridotto il suo / la sua fiducia nel medico, mentre il 41 per cento afferma che lo ha aiutato ad avere una comunicazione migliore con il proprio medico di fiducia. Nonostante le preoccupazioni sulle conseguenze negative della comunicazione di salute online, non abbiamo riscontrato differenze in termini di effetti sulla salute tra i pazienti che hanno assunto i farmaci “menzionati” online e coloro che hanno preso altri farmaci da prescrizione. / We conducted a national online survey about health care experiences associated with digital communication of prescription drugs. 46 percent of the sample (265 adults) found information about prescription drugs during their online search in the last 12 months. 40 percent of respondents agreed they didn’t find exhaustive information about risks and benefits while 52 percent agreed it helped in following their physician’s indications and advise. Among the respondents who had a physician visit during which health information found online was discussed, 84 percent received a drug prescription with only 17 percent being the same drug found on internet, 74 percent was sent to a specialist and 80 percent received a diagnostic test prescription. More than half also reported actions taken by their physician other than prescribing the drug brand found online. 20 percent respondents states that info found on the prescription drug in Internet reduced his/her trust in the physician while 41 percent states it helped in his/her communication with physician. Despite concerns about online health communication’s negative consequences, we found no differences in health effects between patients who took “advocated”/”mentioned” drugs and those who took other prescription drugs.