Sean A. Munson

University of Washington | UW · Department of Human Centered Design and Engineering

Human-centered design (HCD) is an approach that aligns innovation development with the needs of the people and the settings where those innovations will be used. HCD is increasingly being applied across a variety of health domains, most often with the goals of translating research into real-world settings and expanding innovation adoption. This rev...

Menopause is often overlooked or medicalized, consequently devaluing individual experiences and failing to support individuals experiencing this life event. Family dynamics, death, and taboo further mean that individuals often miss out on information that could help them contextualize their experiences. We examine participant experiences with menop...

BACKGROUND Although substantial progress has been made in establishing evidence-based psychosocial clinical interventions and implementation strategies (CIs/ISs) for mental health, translating this research into practice—especially in more accessible, community settings—has been slow. We outline our protocol for the renewal of the National Institut...

BACKGROUND Out-of-office blood pressure (BP) measurement is recommended when making a new hypertension diagnosis. In practice, however, hypertension is primarily diagnosed using clinic BP. The study objective was to understand patient attitudes about accuracy and patient-centeredness regarding hypertension diagnostic methods. METHODS Qualitative s...

US college sports teams are increasingly adopting personal data technologies, such as wearable sensors, with a goal of improving individual and team performance as well as individual safety. These tools can also reinforce the power that coaches hold over student-athletes and compromise student-athletes' needs for privacy and agency. To investigate...

Background Undiagnosed hypertension and uncontrolled blood pressure (BP) are common and contribute to excess cardiovascular morbidity and mortality. We examined whether BP control, changes in BP, and patient behaviors and attitudes were associated with a new hypertension diagnosis. Methods We performed a post hoc analysis of 323 participants from...

Background Irritable bowel syndrome (IBS) is a disorder of the gut-brain interaction that is associated with abdominal pain, altered bowel patterns, and reduced quality of life. Up to 50% of patients with IBS also report anxiety or depressive symptoms. Although effective self-management interventions exist for individuals with IBS, few have been ef...

Background Psychological impacts of hypertension diagnostic testing and new hypertension diagnoses are unclear. Methods BP-CHECK was a randomized diagnostic study conducted in 2017-2019 in an integrated healthcare system. Participants with no hypertension diagnosis or medications and elevated blood pressure (BP) were randomized to one of three dia...

The COVID-19 pandemic resulted in fewer clinic-based blood pressure (BP) measurements and worsening hypertension control, but new opportunities for taking hypertension care out of the office and into patients homes using self-measured BP (SMBP). Methods: We performed a mixed methods study of 6489 patients at Kaiser Permanente Washington with hypert...

Background: Out-of-office blood pressure (BP) measurement is recommended when making new hypertension diagnoses. However, in current practice, hypertension is primarily diagnosed using clinic BP measurements. Objective: To understand patient attitudes about the accuracy and patient-centeredness of different BP measurement and hypertension diagnosti...

Opportunities exist to leverage mobile phones to replace or supplement in-person supervision of lay counselors. However, contextual variables, such as network connectivity and provider preferences, must be considered. Using an iterative and mixed methods approach, we co-developed implementation guidelines to support the implementation of mobile pho...

Background: Digital mental health interventions, such as 2-way and asynchronous messaging therapy, are a growing part of the mental health care treatment ecosystem, yet little is known about how users engage with these interventions over the course of their treatment journeys. User engagement, or client behaviors and therapeutic relationships that...

YouTube has many features, such as homepage recommendations, that encourage users to explore its vast library of videos. However, when users visit YouTube with a specific intention, e.g., learning how to program in Python, these features to encourage exploration are often distracting. Prior work has innovated ‘commitment interfaces’ that restrict s...

Background: We compared critical flicker frequency (CFF) thresholds obtained using a novel, portable device "Beacon" with thresholds from the commercially available Lafayette Flicker Fusion System (Lafayette-FFS) in patients with cirrhosis. Methods: 153 participants with chronic liver disease underwent CFF testing using Beacon and Lafayette-FFS...

Background Early identification and control of hypertension is critical to reducing cardiovascular disease events and death. U.S. Preventive Services Task Force guidelines recommend health care professionals screen all adults for hypertension, yet 1 in 4 adults with hypertension are unaware of their condition. This gap between guidelines and clinic...

Background The US Preventive Services Task Force recommends measuring blood pressure (BP) outside of clinic/office settings. While various options are available, including home devices, BP kiosks, and 24-h ambulatory BP monitoring (ABPM), understanding patient acceptability and adherence is a critical factor for implementation.Objective To compare...

Aims To understand the experiences and needs of symptom management among individuals with irritable bowel syndrome and concurrent symptoms of anxiety and/or depression. Design This study used a qualitative descriptive research design. Methods Individuals with a diagnosis of irritable bowel syndrome and concurrent symptoms of anxiety and/or depres...

Goal setting is critical to achieving desired changes in life. Many technologies support defining and tracking progress toward goals, but these are just some parts of the process of setting and achieving goals. People want to set goals that are more complex than the ones supported through technology. Additionally, people use goal-setting technologi...

BACKGROUND Irritable bowel syndrome (IBS) is a disorder of the gut-brain interaction that is associated with abdominal pain, altered bowel patterns, and reduced quality of life. Up to 50% of patients with IBS also report anxiety or depressive symptoms. Although effective self-management interventions exist for individuals with IBS, few have been ef...

BACKGROUND Digital mental health interventions such as two-way, asynchronous messaging therapy are a growing part of the mental healthcare treatment ecosystem, yet little is known about how users engage with these interventions over the course of their treatment journeys. Mapping the user experience in digital therapy may be facilitated by integrat...

BACKGROUND Task-shifting is an effective mode of increasing access to mental health treatment via lay counselors with less specialized training that deliver care under supervision. Mobile phones may present a low-tech opportunity to replace or decrease reliance on in-person supervision in task-shifting, but important technical and contextual limita...

Background: Task shifting is an effective model for increasing access to mental health treatment via lay counselors with less specialized training that deliver care under supervision. Mobile phones may present a low-technology opportunity to replace or decrease reliance on in-person supervision in task shifting, but important technical and context...

Objective: This study explored consumers' perspectives on self-monitoring, a common feature in behavioral interventions that helps inform consumers' progress and answer their questions, to learn what outcome metrics matter to consumers and whether self-selection of these metrics leads to greater engagement (i.e., compliance, satisfaction) in self-...

Background: The US Preventive Services Task Force recommends blood pressure (BP) measurements using 24-h ambulatory monitoring (ABPM) or home BP monitoring before making a new hypertension diagnosis. Objective: Compare clinic-, home-, and kiosk-based BP measurement to ABPM for diagnosing hypertension. Design, setting, and participants: Diagnos...

Introduction: The US Preventive Services Task Force recommends out-of-office blood pressure (BP) measurement before making a new hypertension diagnosis and initiating treatment, using 24-hour ambulatory (ABPM) or home BP monitoring. However, this approach is not common. Methods: e-mail-linked surveys were sent to primary care team members (n = 4...

BACKGROUND People often prefer evidence-based psychosocial interventions (EBPIs) for mental health care, but these interventions often remain unavailable to people in non specialty or integrated settings, such as primary care and schools. Previous research has suggested that usability–a concept from human centered design–could support an understand...

Background: People often prefer evidence-based psychosocial interventions (EBPIs) for mental health care; however, these interventions frequently remain unavailable to people in nonspecialty or integrated settings, such as primary care and schools. Previous research has suggested that usability, a concept from human-centered design, could support...

Adolescent depression is common; however, over 60% of depressed adolescents do not receive mental health care. Digitally-delivered evidence-based psychosocial interventions (EBPIs) may provide an opportunity to improve access and engagement in mental health care. We present a case study that reviews lessons learned from using the Discover - Design...

Background Developers, designers, and researchers use rapid prototyping methods to project the adoption and acceptability of their health intervention technology (HIT) before the technology becomes mature enough to be deployed. Although these methods are useful for gathering feedback that advances the development of HITs, they rarely provide usable...

The COVID-19 pandemic upended the lives of families with young children as school closures and social distancing requirements left caregivers struggling to facilitate educational experiences, maintain social connections, and ensure financial stability. Considering families' increased reliance on technology to survive, this research documents parent...

Though political theorists have emphasized the importance of political discussion in non-political spaces, past study of online political discussion has focused on primarily political websites. Using a random sample from Blogger.com, we find that 25% of all political posts are from blogs that post about politics less than 20% of the time, because t...

People tend to prefer information sources that agree with their viewpoints, as predicted by the selective exposure theory, and to associate with people who are like them, a process known as homophily. Scholars raise fears that the combination of these factors can limit the diversity of viewpoints to which people are exposed, particularly when peopl...

The Internet gives individuals more choice in political news and information sources and more tools to filter out disagreeable information. Citing the preference described by selective exposure theory — people prefer information that supports their beliefs and avoid counter-attitudinal information — observers warn that people may use these tools to...

As self-tracking has evolved from a niche practice to a mass-market phenomenon, it has become possible to track a broad range of activities and vital parameters over years and decades. This creates both new opportunities for long term research and also illustrates some challenges associated with longitudinal research. We establish characteristics o...

Background Implementation strategies have flourished in an effort to increase integration of research evidence into clinical practice. Most strategies are complex, socially mediated processes. Many are complicated, expensive, and ultimately impractical to deliver in real-world settings. The field lacks methods to assess the extent to which strategi...

Background Many teenagers in the United States experience challenges with symptoms of depression, and they lack adequate resources for accessing in-person mental health care. Involving teens and clinicians in designing technologies that use evidence-based practices that reduce barriers to accessing mental health care is crucial. Interventions based...

BACKGROUND Developers, designers, and researchers use rapid prototyping methods to project the adoption and acceptability of their health intervention technology (HIT) before the technology becomes mature enough to be deployed. Although these methods are useful for gathering feedback that advances the development of HITs, they rarely provide usable...

Personal health informatics continues to grow in both research and practice, revealing many challenges of designing applications that address people's needs in their health, everyday lives, and collaborations with clinicians. Research suggests strategies to address such challenges, but has struggled to translate these strategies into design practic...

Human-computer interaction has a long history of working with marginalized people. We sought to understand how HCI researchers navigate work that engages with marginalized people and considerations researchers might work through to expand benefits and mitigate potential harms. In total, 24 HCI researchers, located primarily in the United States, pa...

Goals: The goal of this study was to describe the influence of the COVID-19 pandemic on ability to engage in activities and the influence on psychological distress and gastrointestinal symptoms among individuals with irritable bowel syndrome (IBS) and comorbid anxiety and/or depression. Background: Individuals with IBS and comorbid anxiety and/o...

Background: Usability - the extent to which an intervention can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction - may be a key determinant of implementation success. However, few instruments have been developed to measure the design quality of complex health interventions (i.e., those with sev...

In the attention economy, video apps employ design mechanisms like autoplay that exploit psychological vulnerabilities to maximize watch time. Consequently, many people feel a lack of agency over their app use, which is linked to negative life effects such as loss of sleep. Prior design research has innovated external mechanisms that police multipl...

Background Although research continues to support task-shifting as an effective model of delivering evidence-based practices (EBPs), little scholarship has focused how to scale up and sustain task-shifting in low- and middle-income countries, including how to sustainably supervise lay counselors. Ongoing supervision is critical to ensure EBPs are d...

Background. Implementation strategies have flourished over the last decade in an effort to increase integration of research evidence into clinical practice. Most strategies are complex, socially-mediated processes. Many are complicated, expensive, and ultimately impractical to deliver in real-world settings. The field lacks methods to assess the ex...

Background: Although research continues to support task-shifting as an effective model of delivering evidence-based practices (EBPs), little scholarship has focused how to scale up and sustain task-shifting in low- and middle-income countries, including how to sustainably supervise lay counselors. Ongoing supervision is critical to ensure EBPs are...

Introduction Many patients use mobile devices to track health conditions by recording patient-generated health data. However, patients and clinicians may disagree how to use these data. Objective To systematically review the literature to identify how patient-generated health data and patient-reported outcomes collected outside of clinical setting...

Advancements in evidence-based psychosocial interventions, digital technologies, and implementation strategies (i.e., health services research products) for youth mental health services have yet to yield significant improvement in public health outcomes. Achieving such impact will require that these research products are easy to use, useful, and co...

Context: The US Preventive Services Task Force recommends out-of-office blood pressure (BP) measurement before making a new diagnosis of hypertension, using 24-hour ambulatory (ABPM) or home BP monitoring. However, this approach is not common in routine practice. Objective: To evaluate provider knowledge, beliefs, and practices about BP diagnostic...

BACKGROUND Accounting for how end-users engage with technologies is imperative for designing an efficacious mobile behavioral intervention. OBJECTIVE This mixed-methods analysis examined the translational potential of user-centered design and basic behavioral science to inform the design of a mobile intervention for obesity and binge eating. METH...

Background Accounting for how end users engage with technologies is imperative for designing an efficacious mobile behavioral intervention. Objective This mixed methods analysis examined the translational potential of user-centered design and basic behavioral science to inform the design of a new mobile intervention for obesity and binge eating....

BACKGROUND Many teenagers in the United States experience challenges with symptoms of depression, and they lack adequate resources for accessing in-person mental health care. Involving teens and clinicians in designing technologies that use evidence-based practices that reduce barriers to accessing mental health care is crucial. Interventions based...

Hundreds of popular mobile apps today market their ties to mindfulness. What activities do these apps support and what benefits do they claim? How do mindfulness teachers, as domain experts, view these apps? We first conduct an exploratory review of 370 mindfulness-related apps on Google Play, finding that mindfulness is presented primarily as a to...

Parents and their school-age children can impact one another's sleep. Most sleep-tracking tools, however, are designed for adults and make it difficult for parents and children to track together. To examine how to design a family-centered sleep tracking tool, we designed DreamCatcher. DreamCatcher is an in-home, interactive, shared display that agg...

Mobile mental health interventions have the potential to reduce barriers and increase engagement in psychotherapy. However, most current tools fail to meet evidence-based principles. In this paper, we describe data-driven design implications for translating evidence-based interventions into mobile apps. To develop these design implications, we anal...

Digital psychiatry is a rapidly growing area of research. Mobile assessment, including passive sensing, could improve research into human behavior and may afford opportunities for rapid treatment delivery. However, retention is poor in remote studies of depressed populations in which frequent assessment and passive monitoring are required. To impro...

N-of-1 tools offer the potential to support people in monitoring health and identifying individualized health management strategies. We argue that elicitation of individualized goals and customization of tracking to support those goals are a critical yet under-studied and under-supported aspect of self-tracking. We review examples of self-tracking...

Background Usability – the extent to which an intervention can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction – is a key determinant of implementation success. However, usability is rarely assessed in implementation research and no instruments have been developed to measure the design quality...

Background. Usability – the extent to which an intervention can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction – is a key determinant of implementation success. However, few instruments have been developed to measure the design quality of complex health interventions (i.e., those with several...

Background Usability – the extent to which an intervention can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction – is a key determinant of implementation success. However, usability is rarely assessed in implementation research and no instruments have been developed to measure the design quality...

Background. Usability – the extent to which an intervention can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction – is a key determinant of implementation success. However, few instruments have been developed to measure the design quality of complex health interventions (i.e., those with several...

Background Usability – the extent to which an intervention can be used by specified users to achieve specified goals with effectiveness, efficiency, and satisfaction – is a key determinant of implementation success. However, usability is rarely assessed in implementation research and no instruments have been developed to measure the design quality...

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Background: Innovative approaches are needed to maximize fit between the characteristics of evidence-based practices (EBPs), implementation strategies that support EBP use, and contexts in which EBPs are implemented. Standard approaches to implementation offer few ways to address such issues of fit. We characterized the potential for collaboration...

Background: Wearable devices, mobile health apps, and geolocation technologies place the ability to track, monitor and report data in the individuals' hands - or on their bodies. These innovations create an opportunity for "connected health," where individuals collect data outside of the healthcare encounter and report it to care providers. Collec...

Collaborations increasingly draw on personal data. We examine personal-data-supported collaborations in a high stakes, high-performance environment: collegiate sports. We conducted 22 interviews with people from four common roles within collegiate sports teams: athletes, sport coaches, athletic trainers, and strength and conditioning coaches. Using...

Although self-tracking offers potential for a more complete, accurate, and longer-term understanding of personal health, many people struggle with or fail to achieve their goals for health-related self-tracking. This paper investigates how to address challenges that result from current self-tracking tools leaving a person's goals for their data uns...