Investigating Employees’ Concerns and Wishes Regarding Digital Stress Management Interventions With Value Sensitive Design: Mixed Methods Study

Abstract

Background Work stress places a heavy economic and disease burden on society. Recent technological advances include digital health interventions for helping employees prevent and manage their stress at work effectively. Although such digital solutions come with an array of ethical risks, especially if they involve biomedical big data, the incorporation of employees’ values in their design and deployment has been widely overlooked. Objective To bridge this gap, we used the value sensitive design (VSD) framework to identify relevant values concerning a digital stress management intervention (dSMI) at the workplace, assess how users comprehend these values, and derive specific requirements for an ethics-informed design of dSMIs. VSD is a theoretically grounded framework that front-loads ethics by accounting for values throughout the design process of a technology. Methods We conducted a literature search to identify relevant values of dSMIs at the workplace. To understand how potential users comprehend these values and derive design requirements, we conducted a web-based study that contained closed and open questions with employees of a Swiss company, allowing both quantitative and qualitative analyses. Results The values health and well-being, privacy, autonomy, accountability, and identity were identified through our literature search. Statistical analysis of 170 responses from the web-based study revealed that the intention to use and perceived usefulness of a dSMI were moderate to high. Employees’ moderate to high health and well-being concerns included worries that a dSMI would not be effective or would even amplify their stress levels. Privacy concerns were also rated on the higher end of the score range, whereas concerns regarding autonomy, accountability, and identity were rated lower. Moreover, a personalized dSMI with a monitoring system involving a machine learning-based analysis of data led to significantly higher privacy (P=.009) and accountability concerns (P=.04) than a dSMI without a monitoring system. In addition, integrability, user-friendliness, and digital independence emerged as novel values from the qualitative analysis of 85 text responses. Conclusions Although most surveyed employees were willing to use a dSMI at the workplace, there were considerable health and well-being concerns with regard to effectiveness and problem perpetuation. For a minority of employees who value digital independence, a nondigital offer might be more suitable. In terms of the type of dSMI, privacy and accountability concerns must be particularly well addressed if a machine learning-based monitoring component is included. To help mitigate these concerns, we propose specific requirements to support the VSD of a dSMI at the workplace. The results of this work and our research protocol will inform future research on VSD-based interventions and further advance the integration of ethics in digital health.

Evaluating the Impact of Digital Health Interventions on Workplace Health Outcomes: A Systematic Review

“…In research in Switzerland performed by Kerr et al (2023), 170 employees investigated the adoption of a digital stress-management informing intervention, while Adhyaru and Kemp (2022) performed similar research in the UK and narrowed their lens to 39 NHS clinicians using VR as a wellness tool. Njoku et al (2023) further widened the scope in nine SMEs by interviewing the business perspective on health technology.…”

“…Full interoperability with daily work tools likely supported sustained use with lower attrition, but details were lacking in relation to attrition rates. This value-sensitive design for digital stress-management interventions has been explored by Kerr et al (2023) despite consistently moderate to high reports of intention of use but unreported actual attrition rates.…”

“…A study by Nwaogu et al (2021) examined the subsequent intervention levels for the mental health of Nigerian construction personnel with usage barriers and motivators using mobile and web-based tools. 'HiPPP Portal' digital health interventions targeting preconception, pregnant, and postpartum women were developed by Blewitt et al (2022) using intervention mapping on the one hand, whilst Kerr et al (2023) described the application of value-sensitive design during the development of just-in-time adaptive interventions (JI-TAIs) that are digital stress-management interventions (dSMIs). Adhyaru and Kemp (2022) delved into the use of virtual reality (VR) in improving general mental health well-being for NHS clinicians.…”

“…Similarly, Blewitt et al (2022) were emphatic about the process of developing and using the 'HiPPP Portal' without the involvement of a control group, since the study sought intervention mapping as opposed to comparative efficacy. Similarly, Kerr et al (2023) utilized a value-sensitive design in the study, where users' responses on dSMIs with and without JITAI components were compared as part of a digital stressmanagement intervention. Adhyaru and Kemp (2022) carried out a pilot study to evaluate the effect of VR intervention without having a control group, thereby restricting the interpretation of the effectiveness of a VR session.…”

Digital Nursing Quality Management: A Concept Analysis

“…Third, digital health tools are traditionally developed with little input from end users (Kerr et al, 2023;van Gemert-Pijnen et al, 2011). Therefore, how to narrow the distance between user needs and actual technology, how to integrate humanist overtones of care into each iteration of digital health technology, and how further to deepen human-machine collaboration into a harmonious human-machine symbiosis are all crucial issues to consider at the moment.…”