Interactions - March/April 2013

Empowerment can be operational-ized in terms of a sense of control over one’s life, perceived ability to influence the societal and organizational structures that influence one’s life, and confidence in the community’s collective ability to improve its health [ 2]. A focus on empowerment will illuminate to what extent ICTs can help users confidently pursue wellness within their local communities. For example, the Community Mosaic system began to develop users’ identities as health advocates by helping them feel that it is important for them to advocate healthy eating to others, and also confident that they have the ability to do so.

Going Forward

When we take an activist perspective, we begin looking beyond physiological, attitudinal, and behavioral aspects of health. We encounter a richer, more nuanced, and more complex space that makes technology design even more challenging. Focusing our sights on specific geographic communities can provide a starting point for this work. In addition, ecological models of health behavior theory and interventions from the health sciences (those that explicitly focus on the transactions between people and their sociocultural and physical environments) can help us pinpoint specific phenomena to focus on.

Yet even with this body of lit-
erature as our guide, several chal-
lenges arise when doing this kind
of research. First, as we focus on
the structural forces that work for
and against populations, we must
not design systems that overem-
phasize the barriers that exist. It
will be important to help users
overcome these barriers while not
forcing them to constantly dwell
on the problems. Such an overem-
phasis could have the unintended
consequence of frustrating and
overwhelming users. Instead, we
should design systems that portray
and inspire hope, for example, by
highlighting ways in which the
community is succeeding at over-
coming local barriers or by helping
users feel empowered to take on
the problems.

To treat wellness as a state that is equally achievable for all people is to neglect a vast body of work showing otherwise, and national mandates describing the need for innovations that address health disparities. Examining health at the community level provides a promising way for us to begin tackling these issues.

More broadly, it is also critical for HCI researchers engaged with societal problems beyond health and wellness to similarly address issues of inequality and the underlying structural forces and environmental conditions that create inequities. Designing systems and conducting research at the community level necessarily involves understanding how and why neighborhoods differ from one another. As we examine how ICTs can intervene in diverse contexts such as education and environmental sustainability, our work will be greatly enriched as we design and evaluate how activist tools can directly address issues of power, conflict, and equity.

ENDNOTES:

1. Hafner, K. Redefining medicine with apps and iPads. The New York Times, 2012; http://www. nytimes.com/2012/10/09/science/redefining-medi- cine-with-apps-and-ipads-the-digital-doctor.html 2. Rogers, E.S., Chamberlin, J., Ellison, M.L., and Crean, T. A consumer-constructed scale to measure empowerment among users of mental health services. Psychiatric Services 48, 8 (1997), 1042-1047. 3. World Health Organization. Closing the gap in a generation: Health equity through action on the social determinants of health. 2008.

ABOUT THE AUTHOR Andrea Grimes Parker is an assistant professor at Northeastern University, with joint appointments in the College of Computer and Information Science and the Bouvé College of Health Sciences.