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COVID-19 Risk Negotation

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During the COVID-19 pandemic, risk negotiation became an important precursor to in-person contact. For young adults, social planning generally occurs through computer-mediated communication. Given the importance of social connectedness for mental health and academic engagement, we sought to understand how young adults plan in-person meetups over computer-mediated communication in the context of the pandemic. We present a qualitative study that explores young adults’ risk negotiation during the COVID-19 pandemic, a period of conflicting public health guidance. Inspired by cultural probe studies, we invited participants to express their preferred precautions for one week as they planned in-person meetups. We interviewed and surveyed participants about their experiences. Through qualitative analysis, we identify strategies for risk negotiation, social complexities that impede risk negotiation, and emotional consequences of risk negotiation. Our findings have implications for AI-mediated support for risk negotiation and assertive communication more generally. We explore tensions between risks and potential benefits of such systems.

Margaret E. Morris, Jennifer Brown, Paula S. Nurius, Savanna Yee, Jennifer Mankoff, Sunny Consolvo:
“I Just Wanted to Triple Check… They were all Vaccinated”: Supporting Risk Negotiation in the Context of COVID-19.ACM Trans. Comput. Hum. Interact. 30(4): 60:1-60:31 (2023)

Physical Therapy Accessibility for People with Disabilities and/or Chronic Conditions

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Many individuals with disabilities and/or chronic conditions experience symptoms that may require intermittent or on-going medical care. However, healthcare is often overlooked as an area where accessibility needs to be addressed to improve physical and digital interactions between patients and healthcare providers. We discuss the challenges faced by individuals with disabilities and chronic conditions in accessing physical therapy and how technology can help improve access. We interviewed 15 people and found both social (e.g. financial constraints, lack of accessible transportation) and physiological (e.g. chronic pain) barriers to accessing physical therapy. Our study suggests that technology interventions that are adaptable, support movement tracking, and community building may support access to physical therapy.  Rethinking access to physical therapy for people with disabilities or chronic conditions from a lens that includes social and physiological barriers presents opportunities to integrate accessibility and adaptability into physical therapy technology.

“I’m Just Overwhelmed”: Investigating Physical Therapy Accessibility and Technology Interventions for People with Disabilities and/or Chronic Conditions. Momona Yamagami, Kelly Mack, Jennifer Mankoff, and Katherine M. Steele. ACM Transactions on Accessible Computing 15, no. 4 (2022): 1-22.

Cross-Dataset Generalization for Human Behavior Modeling

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Overview; Data; Code

Overview of The Contributions of This Work. We systematically evaluate cross-dataset generalizability of 19 algorithms: 9 prior behavior modeling algorithm for depression detection, 8 recent domain generalization algorithms, and 2 two new algorithms proposed in this paper. Our open-source platform GLOBEM consolidates these 19 algorithms and support using, developing, evaluating various algorithms.

There is a growing body of research revealing that longitudinal passive sensing data from smartphones and wearable devices can capture daily behavior signals for human behavior modeling, such as depression detection. Most prior studies build and evaluate machine learning models using data collected from a single population. However, to ensure that a behavior model can work for a larger group of users, its generalizability needs to be verified on multiple datasets from different populations. We present the first work evaluating cross-dataset generalizability of longitudinal behavior models, using depression detection as an application. We collect multiple longitudinal passive mobile sensing datasets with over 500 users from two institutes over a two-year span, leading to four institute-year datasets. Using the datasets, we closely re-implement and evaluated nine prior depression detection algorithms. Our experiment reveals the lack of model generalizability of these methods. We also implement eight recently popular domain generalization algorithms from the machine learning community. Our results indicate that these methods also do not generalize well on our datasets, with barely any advantage over the naive baseline of guessing the majority. We then present two new algorithms with better generalizability. Our new algorithm, Reorder, significantly and consistently outperforms existing methods on most cross-dataset generalization setups. However, the overall advantage is incremental and still has great room for improvement. Our analysis reveals that the individual differences (both within and between populations) may play the most important role in the cross-dataset generalization challenge. Finally, we provide an open-source benchmark platform GLOBEM – short for Generalization of LOngitudinal BEhavior Modeling – to consolidate all 19 algorithms. GLOBEM can support researchers in using, developing, and evaluating different longitudinal behavior modeling methods. We call for researchers’ attention to model generalizability evaluation for future longitudinal human behavior modeling studies.

Xuhai Xu, Xin Liu, Han Zhang, Weichen Wang, Subigya Nepal, Yasaman S. Sefidgar, Woosuk Seo, Kevin S. Kuehn, Jeremy F. Huckins, Margaret E. Morris, Paula S. Nurius, Eve A. Riskin, Shwetak N. Patel, Tim Althoff, Andrew Campbell, Anind K. Dey, and Jennifer Mankoff. GlOBEM: Cross-Dataset Generalization of Longitudinal Human Behavior Modeling. Proc. ACM Interact. Mob. Wearable Ubiquitous Technol. 6(4): 190:1-190:34 (2022).

Xuhai Xu, Han Zhang, Yasaman S. Sefidgar, Yiyi Ren, Xin Liu, Woosuk Seo, Jennifer Brown, Kevin S. Kuehn, Mike A. Merrill, Paula S. Nurius, Shwetak N. Patel, Tim Althoff, Margaret Morris, Eve A. Riskin, Jennifer Mankoff, Anind K. Dey:
GLOBEM Dataset: Multi-Year Datasets for Longitudinal Human Behavior Modeling Generalization. NeurIPS 2022

Rapid Convergence: The Outcomes of Making PPE during a Healthcare Crisis

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Kelly Avery Mack, Megan Hofmann, Udaya Lakshmi, Jerry Cao, Nayha Auradkar, Rosa I. Arriaga, Scott E. Hudson, Jennifer Mankoff. Rapid Convergence: The Outcomes of Making PPE During a Healthcare Crisis. [Link to the paper]

The U.S. National Institute of Health (NIH) 3D Print Exchange is a public, open-source repository for 3D printable medical device designs with contributions from clinicians, expert-amateur makers, and people from industry and academia. In response to the COVID-19 pandemic, the NIH formed a collection to foster submissions of low-cost, locally-manufacturable personal protective equipment (PPE). We evaluated the 623 submissions in this collection to understand: what makers contributed, how they were made, who made them, and key characteristics of their designs. We found an immediate design convergence to manufacturing-focused remixes of a few initial designs affiliated with NIH partners and major for-profit groups. The NIH worked to review safe, effective designs but was overloaded by manufacturing-focused design adaptations. Our work contributes insights into: the outcomes of distributed, community-based medical making; the features that the community accepted as “safe” making; and how platforms can support regulated maker activities in high-risk domains.

Distress and resilience among marginalized undergraduates

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Nurius, P. S., Sefidgar, Y. S., Kuehn, K. S, Jake, X, Zhang, H., Browning, A., Riskin, E., Dey, A. K., & Mankoff, J.  Distress among undergraduates: Marginality, stressors and resilience supports. Journal of American College Health, 1-9.

Stress and related mental health struggles are of growing concern at colleges and universities across the country and internationally, with some evidence of levels higher than general population peers. The university experience can pose considerable strain on students, in some cases adding to early and current life stressors, and, if not mitigated, can lead to impaired well-being and academic success/retention.

This study provides a 2019 data snapshot of multiple stressor effects on early-stage students, resilience resources (or the lack thereof) that can mitigate these effects, and sociodemographic characteristics reflecting minoritized identities. Participants were 253 first- and second-year undergraduate students (age =18.76; 49.80% male, 69% students of color) enrolled at the University of Washington.

Multivariate analysis demonstrated significant associations between greater stress exposures and lower levels of resilience resources with each of three mental health indicators—perceived stress (intensity of experienced stress), depression, and anxiety. Stressors such as poor physical health, discrimination exposure, experiencing one or more marginalizing status (e.g., first generation student, having disabilities, sexual minority), and using maladaptive coping strategies (e.g, denial, self-blame) significantly accounted for each of the mental health indicators. Prior stressors such as adverse childhood experiences and other life and academic adversities were also significantly correlated with the mental health variables.

Race/ethnicity was less clearly patterned, although students of Asian descent reported significantly greater depression and anxiety, and females reported higher levels on all distress forms. In terms of resilience supports, those reporting greater social support and perception of oneself as a “bounce back” kind of person reported lesser psychological distress and these variables reduced the effects of stressors. Assessment of student well-being from this same project during the 2020 COVID-19 context indicated that students entering the pandemic with mental health vulnerabilities experienced significantly greater psychological distress and academic strain as the university pivoted toward remote instruction, signaling highly consequential differences (Morris et al., 2021)

These results support the value of “poly-strengths” –multiple forms of resilience- fostering resources–for mitigating the effects of stressors on psychological distress. College leaders are noting increases in the severity of students’ mental health concerns and demand for services, changing the roles of campus counseling centers, and requiring new institutional responses. Better understanding cumulative stress/resilience resource profiles, particularly among marginalized students and those experiencing discrimination, can help universities in prioritizing institutional support responses toward prevention, strengthening resilience, and mitigating psychological distress.

TypeOut: Just-in-Time Self-Affirmation for Reducing Phone Use

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Smartphone overuse is related to a variety of issues such as lack of sleep and anxiety. We explore the application of Self-Affirmation Theory on smartphone overuse intervention in a just-in-time manner. We present TypeOut, a just-in-time intervention technique that integrates two components: an in-situ typing-based unlock process to improve user engagement, and self-affirmation-based typing content to enhance effectiveness. We hypothesize that the integration of typing and self-affirmation content can better reduce smartphone overuse. We conducted a 10-week within-subject field experiment (N=54) and compared TypeOut against two baselines: one only showing the self-affirmation content (a common notification-based intervention), and one only requiring typing non-semantic content (a state-of-the-art method). TypeOut reduces app usage by over 50%, and both app opening frequency and usage duration by over 25%, all significantly outperforming baselines. TypeOut can potentially be used in other domains where an intervention may benefit from integrating self-affirmation exercises with an engaging just-in-time mechanism.

Typeout: Leveraging just-in-time self-affirmation for smartphone overuse reduction. Xuhai Xu, Tianyuan Zou, Xiao Han, Yanzhang Li, Ruolin Wang, Tianyi Yuan, Yuntao Wang, Yuanchun Shi, Jennifer Mankoff,and Anind K. Dey. 2022. In Proceedings of the 2022 CHI Conference on Human Factors in Computing Systems (CHI ’22). ACM, New York, NY, USA.

Practices and Needs of Mobile Sensing Researchers

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Passive mobile sensing for the purpose of human state modeling is a fast-growing area. It has been applied to solve a wide range of behavior-related problems, including physical and mental health monitoring, affective computing, activity recognition, routine modeling, etc. However, in spite of the emerging literature that has investigated a wide range of application scenarios, there is little work focusing on the lessons learned by researchers, and on guidance for researchers to this approach. How do researchers conduct these types of research studies? Is there any established common practice when applying mobile sensing across different application areas? What are the pain points and needs that they frequently encounter? Answering these questions is an important step in the maturing of this growing sub-field of ubiquitous computing, and can benefit a wide range of audiences. It can serve to educate researchers who have growing interests in this area but have little to no previous experience. Intermediate researchers may also find the results interesting and helpful for reference to improve their skills. Moreover, it can further shed light on the design guidelines for a future toolkit that could facilitate research processes being used. In this paper, we fill this gap and answer these questions by conducting semi-structured interviews with ten experienced researchers from four countries to understand their practices and pain points when conducting their research. Our results reveal a common pipeline that researchers have adopted, and identify major challenges that do not appear in published work but that researchers often encounter. Based on the results of our interviews, we discuss practical suggestions for novice researchers and high-level design principles for a toolkit that can accelerate passive mobile sensing research.

Understanding practices and needs of researchers in human state modeling by passive mobile sensing. Xu, Xuhai, Jennifer Mankoff, and Anind K. Dey. CCF Transactions on Pervasive Computing and Interaction (2021): 1-23.

College during COVID

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Mental health of UW students during Spring 2020 varied tremendously: the challenges of online learning during the pandemic were entwined with social isolation, family demands and socioeconomic pressures. In this context, individual differences in coping mechanisms had a big impact. The findings of this paper underline the need for interventions oriented towards problem-focused coping and suggest opportunities for peer role modeling.

College from home during COVID-19: A mixed-methods study of heterogeneous experiences. Morris ME, Kuehn KS, Brown J, Nurius PS, Zhang H, Sefidgar YS, Xuhai X, Riskin EA, Dey A, Consolvo S, Mankoff JC. (2021) PLoS ONE 16(6): e0251580. (reported in UW News and the Hechtinger Report)

A lineplot showing anxiousness (Y axis, varying from 0 to 4) over time (X axis). Each student in the study is plotted as a different line over each day of the quarter. The plot overall looks very messy, but two things are clear; Every student has a very different trajectory from every other, with all of them going up and down multiple times. And the average, overall, shown is a fit line, is fairly low and slightly increasing (from about .75 to just under 1).
Heterogeneity in individuals’ levels of anxiety (reported in ESM). Individual trajectories of anxiety are shown in different line types and colors (dotted versus solid lines represent different participants). Although the mean level of anxiety is 1 on a scale of 0–4, the significant variation in responses invites examination of individuals and subgroups.

This mixed-method study examined the experiences of college students during the COVID-19 pandemic through surveys, experience sampling data collected over two academic quarters (Spring 2019 n1 = 253; Spring 2020 n2 = 147), and semi-structured interviews with 27 undergraduate students. 

There were no marked changes in mean levels of depressive symptoms, anxiety, stress, or loneliness between 2019 and 2020, or over the course of the Spring 2020 term. Students in both the 2019 and 2020 cohort who indicated psychosocial vulnerability at the initial assessment showed worse psychosocial functioning throughout the entire Spring term relative to other students. However, rates of distress increased faster in 2020 than in 2019 for these individuals. Across individuals, homogeneity of variance tests and multi-level models revealed significant heterogeneity, suggesting the need to examine not just means but the variations in individuals’ experiences. 

Thematic analysis of interviews characterizes these varied experiences, describing the contexts for students’ challenges and strategies. This analysis highlights the interweaving of psychosocial and academic distress: Challenges such as isolation from peers, lack of interactivity with instructors, and difficulty adjusting to family needs had both an emotional and academic toll. Strategies for adjusting to this new context included initiating remote study and hangout sessions with peers, as well as self-learning. In these and other strategies, students used technologies in different ways and for different purposes than they had previously. Supporting qualitative insight about adaptive responses were quantitative findings that students who used more problem-focused forms of coping reported fewer mental health symptoms over the course of the pandemic, even though they perceived their stress as more severe. 

Example quotes:

“I like to build things and stuff like that. I like to see it in person and feel it. So the fact that everything was online…. I’m just basically reading all the time. I just couldn’t learn that way”

Insomnia has been pretty hard for me . . .  I would spend a lot of time lying in bed not doing anything when I had a lot of homework to do the next day. So then I would become stressed about whether I’ll be able to finish that homework or not.”

“It was challenging … being independent and then being pushed back home. It’s a huge change because now you have more rules again”

“For a few of my classes I feel like actually [I] was self-learning because sometimes it’s hard to sit through hours of lectures and watch it.”

“I would initiate… we have a study group chat and every day I would be like ‘Hey I’m going to be on at this time starting at this time.’ So then I gave them time to all have the room open for Zoom and stuff. Okay and then any time after that they can join and then said I [would] wait like maybe 30 minutes or even an hour…. And then people join and then we work maybe … till midnight, a little bit past midnight”

Medical Making During COVID

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The onset of COVID-19 led many makers to dive deeply into the potential applications of their work to help with the pandemic. Our group’s efforts on this front, all of which were collaborations with a variety of people from multiple universities, led me to this reflective talk about the additional work that is needed for us to take the next step towards democratizing fabrication.

This talk is based on a series of papers studying and working with people who make, including the following recent COVID-related papers:

Navigating Illness, Finding Place

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Sylvia Janicki, Matt Ziegler, Jennifer Mankoff:
Navigating Illness, Finding Place: Enhancing the Experience of Place for People Living with Chronic Illness. COMPASS 2021: 173-187

When chronic illness, such as Lyme disease, is viewed through a disability lens, equitable access to public spaces becomes an important area for consideration. Yet chronic illness is often viewed solely through an individualistic, medical model lens. We contribute to this field of study in four consecutive steps using Lyme disease as a case study: (1) we highlight urban design and planning literature to make the case for its relevance to chronic illness; (2) we explore the place-related impacts of living with chronic illness through an analysis of interviews with fourteen individuals living with Lyme disease; (3) we derive a set of design guidelines from our literature review and interviews that serve to support populations living with chronic illness; and (4) we present an interactive mapping prototype that applies our design guidelines to support individuals living with chronic illness in experiencing and navigating public and outdoor spaces.

(Left) Users can select accessibility qualities to filter the places shown on the map. (Right) Clicking on a place opens a popup window to see all of that place's coded accessibility qualities, pictures, reviews, and additional textual descriptions.