Richard Anderson’s research while affiliated with United States University and other places

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Publications (147)


Speculating with Care: Worker-centered Perspectives on Scale in a Chat-based Health Information Service
  • Article

October 2023

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19 Reads

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6 Citations

Proceedings of the ACM on Human-Computer Interaction

Naveena Karusala

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Shirley Yan

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Nupoor Rajkumar

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[...]

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Richard Anderson

Seeking to address barriers to in-person care, governments and non-governmental organizations (NGOs) globally have been pushing for scaling chat- or phone-based information services that rely on care workers to engage with users. Despite theoretical tensions between care and scale and the essential role of care workers, workers' perspective on scale and its impact on care provision is rarely centered early on in decisions to scale. In this paper, we examine care and scale from the perspective of medical support executives (MSEs) who support a chat-based health information service for maternal and child health deployed across multiple states in India. We draw on observations of MSEs' work, interviews with MSEs, NGO staff who implement the service, and families who use the service, and speculative design sessions conducted with MSEs. We find that by centering MSEs' perspectives, we can differentiate between growth of the relationships and heterogeneity that enable social impact, versus scale-thinking that promotes the decontextualization of care. We leverage our findings to discuss implications for scale and automation in chat-based health information services, including the importance of human connection, place, and support for care workers.



Figure 2: Figure showing the new workflow among stakeholders involving generation of a scrubbing token and the usage of scrubbing services. The solid red lines indicate the scrubbing service workflow. The scrubbing operations can be performed through any registered blockchain participant providing the scrubbing services. The solid blue lines indicate the post-scrubbing workflow which is modified from the workflow presented in Figure 1 for final message delivery.
Figure 3: Blockchain participant node architecture indicating the web based application layer which includes an authenticated service proxying the requests made by the application users as a blockchain client. The database layer includes event driven approaches to replicate the global state of the blockchain, especially used by scrubbers for high performance tasks, layered over Hyperledger Fabric infrastructure. The blue arrows indicate the sequence of events in the blockchain.
Telechain: Bridging Telecom Policy and Blockchain Practice
  • Preprint
  • File available

May 2022

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119 Reads

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3 Citations

The use of blockchain in regulatory ecosystems is a promising approach to address challenges of compliance among mutually untrusted entities. In this work, we consider applications of blockchain technologies in telecom regulations. In particular, we address growing concerns around Unsolicited Commercial Communication (UCC aka. spam) sent through text messages (SMS) and phone calls in India. Despite several regulatory measures taken to curb the menace of spam it continues to be a nuisance to subscribers while posing challenges to telecom operators and regulators alike. In this paper, we present a consortium blockchain based architecture to address the problem of UCC in India. Our solution improves subscriber experiences, improves the efficiency of regulatory processes while also positively impacting all stakeholders in the telecom ecosystem. Unlike previous approaches to the problem of UCC, which are all ex-post, our approach to adherence to the regulations is ex-ante. The proposal described in this paper is a primary contributor to the revision of regulations concerning UCC and spam by the Telecom Regulatory Authority of India (TRAI). The new regulations published in July 2018 were first of a kind in the world and amended the 2010 Telecom Commercial Communication Customer Preference Regulation (TCCCPR), through mandating the use of a blockchain/distributed ledgers in addressing the UCC problem. In this paper, we provide a holistic account of of the projects' evolution from (1) its design and strategy, to (2) regulatory and policy action, (3) country wide implementation and deployment, and (4) evaluation and impact of the work.

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Figure 1 ALRITE sample screenshots. (A) Menu screen. (B) Respiratory rate counter. (C) Example of diagnosis and treatment recommendations. (D) Educational toolkit pop-up on bronchodilator administration. (E) Educational toolkit pop-up on stridor. on July 21, 2021 by guest. Protected by copyright.
Figure 2 Frontline health workers' perspectives of determinants of ALRITE implementation.
Health workers’ perspectives of a mobile health tool to improve diagnosis and management of paediatric acute respiratory illnesses in Uganda: a qualitative study

July 2021

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84 Reads

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15 Citations

BMJ Open

Objectives Mobile health tools have potential to improve the diagnosis and management of acute lower respiratory illnesses (ALRI), a leading cause of paediatric mortality worldwide. The objectives were to evaluate health workers’ perceptions of acceptability, usability and feasibility of Acute Lower Respiratory Illness Treatment and Evaluation (ALRITE), a novel mobile health tool to help frontline health workers diagnose, treat and provide education about ALRI in children <5 years. Design A qualitative study including semistructured interviews with health facility administrators and focus groups with primary care health workers. Setting Two federally funded Ugandan primary care health facilities, one peri-urban and one rural. Participants We enrolled 3 health administrators and 28 health workers (clinical officers and nurses). Intervention The ALRITE smartphone application was developed to help frontline health workers adhere to ALRI guidelines and differentiate wheezing illnesses from pneumonia in children under 5 years of age. ALRITE contains a simple decision tree, a partially automated respiratory rate counter, educational videos and an adapted respiratory assessment score to determine bronchodilator responsiveness. We performed a demonstration of ALRITE for participants at the beginning of interviews and focus groups. No participant had used ALRITE prior. Results Themes impacting the potential implementation of ALRITE were organised using individual-level, clinic-level and health-system level determinants. Individual-level determinants were acceptability and perceived benefit, usability, provider needs and provider–patient relationship. Clinic-level determinants were limited resources and integration within the health centre. Systems-level determinants included medication shortages and stakeholder engagement. Conclusions Incorporation of these themes will ready ALRITE for field testing. Early engagement of end users provides insights critical to the development of tailored mHealth decision support tools.






Citations (81)


... Scholars in Human-Computer Interaction (HCI) have emphasized the importance of considering worker perspectives in contexts prone to technological changes [41,61]. As GAI increasingly defines, manages, or even replaces what workers do, it changes not only the nature of work processes and individual tasks. ...

Reference:

Generative AI in the Software Engineering Domain: Tensions of Occupational Identity and Patterns of Identity Protection
Speculating with Care: Worker-centered Perspectives on Scale in a Chat-based Health Information Service
  • Citing Article
  • October 2023

Proceedings of the ACM on Human-Computer Interaction

... Another context that researchers explored is health inequities. For instance, Karusala et al. illustrated that the inequitable access to healthcare systems in the Global South motivated the researchers to develop a patient education program focused on maternal and child health [71]. Amugongo et al. emphasized the importance of developing ethical guidelines and principles for healthcare AI systems to address ethnic minorities' needs. ...

Unsettling Care Infrastructures: From the Individual to the Structural in a Digital Maternal and Child Health Intervention
  • Citing Conference Paper
  • April 2023

... To construct the posts for the two test groups, three researchers with interdisciplinary expertise in HCI and healthcare collected authentic user contributions from communities dedicated to ADHD on Reddit 1 , Twitter 2 , and Facebook 3 . We selected these platforms because they are widely recognized within the HCI community as popular, open social media spaces for accessing and sharing health-related information [35]. To query for posts related to adult ADHD and its subtopics, we used specific keywords including: adult attention deficit hyperactivity disorder, adult ADHD, adult ADHD diagnosis, adult ADHD medication, inattention disorder, hyperactivity disorder, oppositional defiant behavior, etc. ...

Towards Conviviality in NavigatingHealth Information on Social Media
  • Citing Conference Paper
  • April 2022

... This research may provide additional insights for designing crowd work tools, such as "prioritizing workers' personal experiences over strict categorization" or "being aware of structural factors impacting their well-being" [57]. Decolonized tools for crowdworkers can be designed to reduce power imbalances and empower workers to control their well-being [35]. ...

The Future of Care Work: Towards a Radical Politics of Care in CSCW Research and Practice
  • Citing Conference Paper
  • October 2021

... For example, Carcharodon carcharias (GWS, great white shark)-tagging activities have received extensive media attention, especially on "Shark week". The primary goal for tagging GWS is to obtain shark migration data [10]. Migration data add essential information to the knowledge of GWS ecology. ...

“How’s Shelby the Turtle today?” Strengths and Weaknesses of Interactive Animal-Tracking Maps for Environmental Communication
  • Citing Conference Paper
  • June 2021

... While e-health had the potential to positively impact health-seeking behaviour, the benefits could be hampered by problems with training. Adequate training for both patients [35,36,43,57,58,64] and HCPs [36,37,48,71] emerged as a key factor to enable technology access and the implementation of e-health interventions [58]. Familiarity with technology, rather than age, was thought to be a key positive determinant of e-health adoption, suggesting that future generations of elderly individuals might be better equipped to utilize e-health solutions [48,53]: ...

Health workers’ perspectives of a mobile health tool to improve diagnosis and management of paediatric acute respiratory illnesses in Uganda: a qualitative study

BMJ Open

... In Kenya, the "ELIMIKA" web-based peer support platform includes blog posts by project coordinators, a Q&A section for health providers, and private messaging for confidential communication (Ivanova et al., 2019). Another Kenyan program overcomes the need for smartphones by using USSD (Unstructured Supplementary Service Data), enabling interactive SRH programming via regular cell phones (Karusala et al., 2021). ...

“That courage to encourage”: Participation and Aspirations in Chat-based Peer Support for Youth Living with HIV
  • Citing Conference Paper
  • May 2021

... In this study we focus on the technical choices made at the national level to secure the hosting of government domains and routing that underlies the digital interaction between governments and citizens. Other relevant, comparable studies have focused on the use of HTTPS as a way of securing government domains (Singanamalla et al. (2020); Hsiao et al., 2019) and, more closely related to this study, some that investigated 'Schengen Routing'. These latter studies, many in the wake of the 2013 Snowden leaks, analyzed the concept of routing not crossing the borders of the Schengen area with the goal of regaining and retaining digital sovereignty in the Schengen area (Dönni, Machado, Tsiaras, & Stiller, 2015;Pohlmann, Sparenberg, Siromaschenko, & Kilden, 2014). ...

Accept the Risk and Continue: Measuring the Long Tail of Government https Adoption
  • Citing Conference Paper
  • October 2020

... There are efforts to make social networks more accessible for BVIP and lessliterate populations, with interactive voice-based social media platforms [21,35] TTS narrations for emojis [34], and software to add emotional markup tags into children's stories to enable story-telling software for BVIP children [23]. Traditional TTS practices suffer from an unnatural, monotone and "robotic" quality of speech, meaning that the experience of social networks is hampered for them, since it is the "speaker's voice that transmits the meaning and the affective dimension" [31]. ...

Social Media Platforms for Low-Income Blind People in India
  • Citing Conference Paper
  • October 2015