Hello everyone, I’m Fernando Maestre and I’m excited to present our work. Trust,
Reciprocity, and the Role of Timebanks as Intermediaries:
Design Implications for Addressing Healthcare Transportation Barriers.
Lack of adequate transportation services is an important barrier to proper healthcare access for
vulnerable and marginalized populations such as individuals with low income, from ethnic
or racial minorities, older adults, people living with disabilities or multiple chronic conditions.
HCI research has already investigated the use of ridesharing services such as Uber or Lyft to help
such populations get rides to their healthcare appointments as well as get access to nutritional
food. Yet, this research has identified several challenges that keep members of these communities
from using traditional ridesharing services as their main mode of transportation to healthcare.
Discrimination, lack technological literacy or access to sufficient credit or money to
use these technologies are a few examples of these barriers. Trust and reciprocity between riders and
drivers has made it difficult for people to use and adopt ridesharing technologies as well. Thus,
overcoming transportation barriers to healthcare in their communities remains an open challenge.
There has also been some work that has looked at timebanks for transportation needs in communities.
Yet, more work is needed to determine if such intermediaries like timebanks or
Federaly Qualified Health Centers would be a feasible way to help
overcome issues with trust and reciprocity encountered in prior related research.
Federally Qualified Health Centers are community-based health care providers
that receive funds from the Health Resources and Services Administration Health Center Program
to provide primary care services in low-resourced areas.
Timebanks are Community-based non-specific voluntary services
that encourage exchange of services for “time dollars” rather than money
As you can see in the diagram, Gloria joins a timebank and lists the skills she has and
the things she needs. Gloria helps Ron with his grocery shopping and earns 2 hour credits. Gloria
spends her Hour credits having Jasmine drive her to a job interview. And the cycle continues...
Because timebanks are community-based, they might eliminate driver reluctance
to serve poorer areas and safety issues raised in past transportation research
While they do require some level of digital literacy, the non-profit organization
as an intermediary could potentially mitigate these concerns by members exchanging computer
instruction as a service. Because timebanks do not rely on monetary currency, they might also
alleviate issues related to limited money and credit access among lower-resourced populations.
we asked the two research questions:
1. How can shared mobility systems in the context of a timebank be designed to promote trust and
reciprocity between drivers and ride recipients in minoritized and lower-resourced communities?
2. What are the potential roles of intermediaries for supporting trust and reciprocity?
We held a series of online workshop sessions from November 2020 – May 2021 with Detroiters who were
recruited by either : 1) the local timebank or 2) a federally qualified healthcare center.
Participation included: completion of activity packets before taking
part in a virtual two-hour Zoom workshop sessions;
We designed the activity packets and virtual workshops to complement one another.
We constructed two activity packets for participants: one aimed at potential riders
and the other aimed at potential drivers. Packet goals were to begin to stimulate participant
reflection on issues related to trust and reciprocity. For example, in terms of reciprocity,
we asked what three things besides money might you give Ronnie to compensate for the ride?
Or, what services might you be able to provide in exchange for a ride?
For trust, what concerns might he have getting a ride from a stranger?
Facilitators walked through each question,
asking participants to expand on their activity packet responses.
Our data included packet responses, session transcriptions, and demographic surveys
Our data analyses focused primarily on (a) descriptive analysis of demographic data; (b)
content analysis of participant packet responses and (c) thematic analysis of transcribed sessions.
We found that promoting trust between drivers and riders requires that
shared mobility systems address safety and reliability concerns.
As you can see on this slide, safety and reliability concerns were the most salient:
In terms of safety, there were crime risks, driver safety and skill, and with COVID-19, health risks
In terms of reliability-related concerns,
there were risks of missing or being late for appointments and risks of vehicle malfunction
We also saw through timebank members that trust was made possible by
the formation of dense social networks that lasted over time.
Participants expressed strong commitments to designing a shared mobility service that
expressed relational values over transactional ones.
Transactional exchanges are typically short-term and are described by monetary exchanges
for an easily measured commodity. These exchanges can be adversarial because
stakeholders must grapple with what’s needed to achieve the best position economically.
By contrast, relational exchanges are longer-term and value relationships and are characterized by
factors including cooperation, interdependence, commitment, trust, and shared values.
Reciprocity-related tensions could be reduced by interpersonal relationship development
and expressing appreciation.
In response to a query about how the gas money or vehicle upkeep
should be handled, a timebank driver emphasized values of building community over the specifics
of reimbursement for those expenses. (W2-P9) says in the quote“...they also want to feel...that
they appreciate the ride, and I think that plays into giving some token of appreciation too...I
don’t know if it has to be transactional as much as it’s like fellowship and just, friendship,
and developing that relationship with people.”
We learned from our sessions how simple thank you’s, virtual hugs,
or even fist bumps might be appreciated as an alternative form of payment…
Our findings suggest methods to balance reciprocity. On the one hand, all timebank
hours are equal and some participants felt firm in these principles. On the other hand, rides
used gas and led to wear and tear on vehicles that can’t be fully accounted with time dollars.
We believe that technology could be used to book equipment and identify drivers whose
level of transportation service provision warrants compensation beyond time dollars.
In addition, systems could build on opportunities for reciprocal
exchange beyond monetary transactions such as what we see here. Teaching, mentorship,
and skill exchange; home services and repair, and other services like volunteering space
or lending money were services mentioned by our participants as things they could offer.
To answer our last research question, we found that intermediaries must facilitate safety,
reliability, reciprocity, and potential issues related to digital access and proficiency.
As we saw earlier, trust between riders and drivers was supported by building dense
networks that persisted over time, which we saw in timebank members. Timebanking allows for a
history of service exchanges which was needed for people to feel comfortable sharing rides.
Our findings therefore uncover discrepancies
between the two intermediaries' abilities to moderate these trust-related factors.
However, both types of intermediaries were seen to hold potential for further
supporting trust based on certifications.
Our participants indicated that certifications could come from different types of intermediaries:
Mechanics, insurance companies, or the state government.
Here are some proposed designs from our work that we plan to get feedback on going forward.
The key takeaways from our study are:
Intermediaries play a key role in addressing transportation challenges found in our work,
and that Timebanks could serve as a starting point
for promoting relational over transactional interactions.
Our next steps include holding participatory design sessions with both to build out our
recommendations and pilot our proposed designs.
Thank you.