Hello everyone. My name is Teresa O'Leary. I'm a Personal Health Informatics PhD
student from Northeastern University. Today, I am presenting our paper,
Investigating Opportunities for Crowdsourcing in Church-Based Health
Interventions: a participatory design study. This work is part of a four-year
community-based participatory research project. The goal of the project is to
design, develop, and evaluate an mHealth intervention to address health
disparities faced by predominantly Black church communities. In our first year of
the project, we worked directly with church members to identify the needs and
strengths of their communities and to engage church members in the
participatory design of the mHealth application. Black churches in the u.s.
have a strong tradition of social action and community outreach. This is aimed at
addressing inequities, including health inequities, faced by their congregation
and their surrounding communities. They are often the most visible and respected
organizations in the African American community. These church communities
represent an important source of social support for the congregants with
affordances such as existing health ministry initiatives, community-based
resources, and frequent and regular opportunities for members to interact.
However limited work has explored how technology developed in a religious or
spiritual context can promote health and wellness. While there are distinct
benefits to embedding and health technology intervention into a church
community there are also unique challenges the practices, needs, and
priorities of churches vary significantly even among churches of the
same religious denomination. Meaning that intervention content developed by one
church community may feel inauthentic or worse inappropriate in another. Further,
designing an intervention for a community with long term membership
poses challenges to engagement. Such interventions require a large quantity
of content that is not only culturally relevant but also continuously updates
and evolves with the community. In community-based participatory research
or CBPR, researchers work in partnership with community
members through each phase of the project. Community members are viewed as
experts of their local context and play an active role in identifying important
problems and developing solutions. Therefore we partnered with an
organization that provides resources to over a hundred faith organizations
serving predominantly Black churches. This organization identified two churches
to support the first year of the project. Church members joined us for a number of
participatory design activities over the course of the year. Each activity
building upon what we had learned in the previous. Beyond using CBPR for the
initial designs of the application, we explored how crowdsourcing could further
tailor an mHealth intervention. Crowdsourcing is an efficient means of
collecting and enhancing user-generated contributions allowing networked
communities to provide information, resources, and creatively author content
to solve problems like other types of community engagement research
involving community members ultimately can enhance public health interventions
and programming to reflect the underlying principles, values, and beliefs
of the priority community. While crowdsourcing has been applied in many
public health domains crowdsourcing techniques have yet to be designed to
create tailored behavior change content for unique spiritual communities.
Specifically we investigate how crowdsourcing can be used to harness the
collective power of church communities to create socially relevant and
meaningful content tailored to user specific cultural needs. We report on
participatory design sessions in which church members created mHealth
interventions that leveraged a range of crowdsourcing techniques in their church
communities. Our work explores the types of resources and support church members
seek through a faith-based mHealth application and how the context and
culture of the Church impacts access to these resources. Today we present a
subset of our findings as they relate to church members' motivation to participate
in crowdsourcing within their faith communities. To answer our research
questions, we developed a novel modular storyboard method we can roughly think
of it as an academic 'choose your own adventure'
book where the protagonist uses a church app to address a health concern. Similar
to a static storyboard, each storyboard has the same overarching storyline. This
allowed for both researchers and participants to readily compare between
storyboards. However given that we the researchers are not members of the
priority communities it was important for participants to truly drive the use
cases and design decisions in the storyboards. Therefore participants were
encouraged to customize their boards by choosing between storylines, adding new
parts to the story, and completing fill in the blanks and even writing all over
the storyboards. Participants completed storyboards individually. In the
following session, participants worked in groups on shared boards to help reach
consensus around crowdsourcing tasks. Interviews and focus groups were audio
recorded and transcribed. We conducted a thematic analysis of focus group content
guided by our research questions with the aim of identifying design insights.
We invite you to check out the full paper for an analysis of crowdsourcing
techniques that draws upon the public health crowdsourcing topology. Nine
church members participated in the focus group sessions. All church members
self-identified as Black. Six were female and three were male. Participant ages
ranged from 33 to 73. Data was collected in a total of four focus groups and
eight interviews. For the sake of time, I will discuss our findings as they relate
to crowdsourcing tasks and motivations. I invite you to check out our full paper
for additional findings as they relate to types of support church members would
like to receive and barriers to accessing this support. During our
storyboard sessions and interviews, participants discussed three main
motivations to contribute to the application. 1. supporting the missions
of the church; 2. extending one's faith practices and 3. strengthening
connections to the church community. These motivations were illustrated in
the types of crowdsourcing tasks participants endorsed from
the storyboards and the crowdsourcing tasks participants themselves created. The
simplest form of reinforcing community using a place-based mHealth
application is through awareness of events by keeping a community-wide
calendar up to date. A church calendar was not mentioned in the storyboard and
yet multiple participants saw the benefit of a calendar in the storyboards.
A calendar of events not only encourages in-person attendance but also allows for
passive awareness of the goings-on of the community. One participant who had
moved states away from her home church describes how she uses the calendar. "You
can like download stuff and you can figure out they're having like a kid's
camp and they're doing a food drive even out of state," Even though she is unable
to attend the events in person awareness of these events helps her feel even more
connected to her community. Another participant suggested that by supporting
these church events through a simple solution like an up-to-date church
calendar not only impacts current members abilities to participate and
increase fellowship opportunities for interaction, it promotes the growth of
church membership. An up-to-date calendar supports both the mission of the Church
and participant motivation to connect with peers in their community. However,
both churches in this formative work have defunct online calendars. While a
digital calendar may not pose a technical challenge or innovation,
understanding how these existing technologies can be leveraged for
community level health behavior change provides insight into sustainable
mHealth interventions. Participants were also motivated to engage in
crowdsourcing tasks that support or strengthen their spiritual practices.
This motivation became clear with participant reactions to two scenarios.
In the storyboards that depicted similar crowdsourcing tasks using a rating or
nominating technique. In both scenarios the protagonist is asked to rate a
message as being helpful or unhelpful in a particular health context. In the first
scenario, the protagonist is asked to rate messages with health content.
Participants generally found the reading of health messages to be beneficial
given that it would result in health messages that felt useful to
their community. However, they also thought that the activity would be
time-consuming and therefore they might not even engage with the task.
A rating activity was also applied to scriptural content. In a second scenario, the
characters asked to rate or nominate scripture as most helpful when in need
of comfort or encouragement. While some participants chose this storyline as a
way for the character to contribute to the application. All participants stated
that using the term 'rating' scripture was inappropriate and that earlier
language contained in the storyboard of nominating scripture was a much more
sensitive description of the activity. One participant explained why script
scriptural messages required a more nuanced approach to crowdsourcing. They state, but
"but what's reading a scripture? Like what Scripture may be good for me on this day
may not even be good for that person. That scripture may not be something that
resonates with me. But on this particular day that scripture could uplift the next person"
Therefore, participants suggested that a more interesting and
meaningful activity would be to nominate and relate scripture to contextual
circumstances. Participants felt the context, such as how that scripture has
helped them in the past and under what health circumstances, was critical for
nominating socially relevant messages. Further by leveraging the church
community and the approach these messages could reflect a congregations
preferences for the scripture use and Bible translation. Members of one
ministry within one of the churches already thematically tag and compile
scripture in its paper-based monthly prayer calendar. However, this activity is
limited to this smaller group of ministry members. Our findings show that
participants were motivated to engage in crowdsourcing with scripture. Nominating
and tagging Scripture within the application both supports existing faith
practices by promoting reflection on Scripture and increases access to this
activity beyond a particular ministry. Our findings illuminated participant
desires to connect with their peers and build stronger connections with the
church community through an mHealth application. They further stated
preferences towards crowdsourcing tasks and conceptualized how such tools could
benefit their community. We invite you to check out the
full paper for a discussion of the reciprocal benefits of mHealth
interventions when anchored in these church communities and how crowdsourcing
tasks can be leveraged to support longitudinal community engagement. I will
now talk about value based crowdsourcing.
Participant reactions to authoring and rating health messages differed from
their reaction to writing and nominating messages with scripture. While our work
focused on exploring design requirements for an mHealth application, designing
for values beyond health enhances engagement. Prior research demonstrates
that Black members of Protestant faith communities feel a strong affiliation
between their faith and health. Promoting scripture for health topics and concerns
was proposed as a low burden crowdsourcing activity to create
tailored mHealth intervention content that reflects values important to church
members: spirituality and faith. However, unlike reading health messages
as helpful or unhelpful, nominating the most helpful scripture was rejected by
participants. Rating or nominating was perceived as trivializing scriptural
content. In contrast participants expressed enthusiasm for contextualizing
the scripture to create more meaningful health communication messages. This
activity both increased community access to faith-based support and served as an
opportunity for the individual to practice their faith through reflection
on scripture. Designing crowdsourcing tasks that reflect multiple values of
this population can simultaneously nurture application engagement and
strengthen spiritual practice and further participant correction of the
rating scripture activity demonstrates the strengths of the long-term
relationships researchers have with community members when conducting CBPR.
Through rapport building over the course of the project our participants were
empowered as experts of their faith communities and thus felt comfortable
correcting our terminology and generating their own description of and
design for working with scriptural content in the app. Through our
participatory design study, we investigated motivations and preferences
for engaging with an mHealth app among church members of predominantly Black
churches. Our findings shed light on how crowdsourcing tasks can be leveraged to
increase access to church-situated social supports. We further discussed the
importance of aligning crowdsourcing tasks with participant values of
fellowship and faith. The needs, priorities, and strengths of social organizations are
ever-changing. Therefore future HCI work in mHealth intervention delivery
should focus on how implementing
crowdsourcing approaches may positively
complement this evolution. Currently we are building upon what we've learned
through our formative work. Through an iterative design process, community
members continue to provide insight and feedback to ensure the values we
identified are represented in the application. Practically, this has meant
identifying opportunities for leveraging core values such as fellowship and
spirituality to enhance tech-enabled health promotion activities anchored in
a church community. We invite you to check out our full paper and if you have
any questions or feedback, we of course would love to hear from you. Thanks.