Behavioral intervention technologies are well suited to addressing health behavior such as medication adherence, but only if successfully integrated into a user's daily life. Little is known about how to design such technologies to be adoptable, adaptable, useful, and feasible in everyday life. We report on the design process for TreatYoSelf, a smartphone application designed to improve medication adherence among youth living with HIV through reminders and positive reinforcement. Using participatory design, our aim was to understand factors related to adoption and acceptance of behavioral intervention technology as part of daily life. Two challenges of living with HIV led to an empathy-driven approach in our design process: (1) HIV is a stigmatized condition, which (2) disproportionately affects the marginalized populations of young African American men who have sex with men and transgender women. We discuss five empathy-driven design strategies: positive and nonjudgmental tone; minimal, avatar-based gamification; motivational and corny messages; nondisclosure through neutral signifiers; and social support through camaraderie. Our approach enabled us to identify and work through factors, often related to stigma and marginalization, which would lead to rejection of TreatYoSelf use in daily life. CCS Concepts • Human-centered computing➝HCI design and evaluation methods • Applied computing➝Consumer health.
According to the National Institute of Deafness and other Communication Disorders 2012 report, the number of cochlear implant (CI) users is steadily increasing from 324,000 CI users worldwide. The cochlea, located in the inner ear, is a snail-like structure that exhibits a tonotopic geometry where acoustic waves are filtered spatially according to frequency. Throughout the cochlea, there exist hair cells that transduce sensed acoustic waves into an electrical signal that is carried by the auditory nerve to ultimately reach the auditory cortex of the brain. A cochlear implant bridges the gap if non-functional hair cells are present. Conventional CIs directly inject an electrical current into surrounding tissue via an implanted electrode array and exploit the frequency-to-place mapping of the cochlea. However, the current is dispersed in perilymph, a conductive bodily fluid within the cochlea, causing a spread of excitation. Magnetic fields are more impervious to the effects of the cochlear environment due to the material properties of perilymph and surrounding tissue, demonstrating potential to improve precision. As an alternative to conventional CI electrodes, the development and miniaturization of microcoils intended for micromagnetic stimulation of intracochlear neural elements is described. As a step toward realizing a microcoil array sized for cochlear implantation, human-sized coils were prototyped via aerosol jet printing. The batch reproducible aerosol jet printed microcoils have a diameter of 1800 μm, trace width and trace spacing of 112.5 μm, 12 μm thickness, and inductance values of approximately 15.5 nH. Modelling results indicate that the coils have a combined depolarization–hyperpolarization region that spans 1.5 mm and produce a more restrictive spread of activation when compared with conventional CI.
To stimulate the auditory nerve, cochlear implants directly inject electrical current into surrounding tissue via an implanted electrode array. While many cochlear implant users achieve strong speech perception scores, there remains significant variability. Since cochlear implant electrode arrays are surrounded by a conductive fluid, perilymph, a spread of excitation occurs. The functionality of the cochlea is spatially dependent, and a wider area of excitation negatively affects the hearing of the user. Importantly, magnetic fields are unaffected by the material properties of biological components. To utilize the electromagnetic properties of the human ear, a microcoil array was developed. The microcoils are 4-turn solenoids with a 250-µm turn radius and a 31.75-µm wire radius, coated with Parylene-C. The efficient design was implemented to accelerate testing. The obtained results describe stimulation capabilities. Functionality was validated using a frequency response analyzer to measure how the generated electromagnetic power radiates in space. 99.8% power loss was observed over a 100-µm separation between a pair of identical microcoils. Obtained through finite-element modeling, the microcoils can be driven by a 60 mA, 5 kHz, sinusoidal input for 10 minutes before predicted inflammation. Rattay's activating function was calculated to evaluate the magnetic stimulation effect of external fields on target neurons. Combined with the frequency response analysis, magnitude and spatial effects of the generated potential is established. As a result, each microcoil requires a 400-µmwide area for each independent stimulation channel, which is 84% narrower than a commercial cochlear array channel, thereby suggesting greater spatial selectivity.
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