Hi, my name is Camille Nadal, and today
I'm presenting our paper on the
Technology Acceptance toolkit: a new tool and
method to help designers create health
technologies that are accepted by people,
and used in the long-term.
In this research, we are looking at
user acceptance, a concept that has been
explored for over 3 decades
in the field of HCI.
User acceptance is how the user
perceives the technology, and how this
perception leads to its use or non-use.
To give you an example, sometimes
we download an app, use it a few times,
and then never open it again.
So it's important to understand and
address the reasons why users abandon
technology.
In healthcare, digital health
interventions often rely on long-term
use of technology.
If people in need of care refuse to use
technology or abandon it before the end
of their treatment, this can highly
impact on their clinical outcomes.
So, when designing healthcare
technologies, we have to go further than
just clinical effectiveness and need
to consider what would make a person
willing to take on and engage
with the technology.
But how do we do this in
the design process?
Well, there are many theories and models
available in the literature.
However,
this large theoretical landscape limits
our ability to understand what user
acceptance is, and to apply this
knowledge into real design practice.
In order to help designers design for
long-term technology acceptance,
we introduced the TAC toolkit: a novel
design tool to support reflection around
user acceptance, and its evolution across
the user journey.
The TAC toolkit is composed of
16 design cards,
3 personas,
3 temporal multi-choice scenarios,
a virtual think-space,
and a website.
To design the TAC cards, we reviewed
the literature on user acceptance,
and selected validated models.
We then extracted the acceptance factors
from these models, and regrouped them
when there was overlap. This resulted
in a set of 16 acceptance factors that
we have translated into cards.
Each TAC card includes on the front:
an icon, the name of the factor; and on the
back: a question in bold which conveys
the factor's definition, and a series of
questions encouraging designers
reflection on the different aspects
of that definition.
We conceived the TAC cards as
an exploratory design method, for use
at early design stage.
For this reason, we chose to evaluate
their use in the context of design
with personas and scenarios.
So, we developed 3 personas, each anchored
in a particular dimension of healthcare.
For each persona, we created a scenario
in which they interact with
a particular technology.
Because user acceptance evolves over
time, each scenario describes the user
journey from introduction of the
technology, through the user's first
interactions, and up to after
a year of use.
We call these stages
"temporal milestones".
These scenarios are also multi-choice.
For each milestone, designers can choose
between 3 paths, recounting
acceptance issues of either high, medium,
or low degree of challenge.
To enable designers to work
collaboratively with the TAC cards,
we created the TAC think-space,
a virtual board on the Miro platform.
Here, designers could select cards, place
them against the temporal milestones,
and take notes on the side.
Finally, we developed a website so that
designers could interact with the
multi-choice scenarios.
Now let's see how we evaluate
the TAC toolkit.
We recruited 21 digital health designers,
divided them into groups of 3,
and made sure each group included
participants with varied background and
expertise, to reproduce the reality of
interdisciplinary teams.
The study took the form of 7 workshops,
with a facilitator.
During the workshops, participants
interacted with the physical
TAC cards, but also remotely via Zoom
and the think-space.
After the workshop, each participant was
interviewed.
This study was approved by the
university ethics committee.
The workshop proceeded as follow.
First, the group decides which of the 3
participants takes on the role
of the user.
We now have a group with 1 User and
2 Designers.
The user then goes on to the TAC
website, and chooses one of the personas.
They read the person out loud and move
on to the first scenario milestone.
The user then picks among 3 possible
scenario paths, and read it out loud to
the group.
As a group, the 3 participants then use
the TAC cards to discuss what acceptance
factors are at play in that particular
path.
Once they agree on a factor, they go on
to the think-space, and place the digital
card next to the corresponding milestone.
The group then brainstorms,
and writes down actions in design
that could support user acceptance
at this stage.
The participants repeat these steps
until the end of the scenario.
At the end, the facilitator asks
the group to reflect on the process.
The workshops and interviews' transcripts
were analyzed through inductive and
deductive thematic analysis.
I will now present the main findings.
Designers comments and interactions
revealed 3 main improvements brought
by the TAC toolkit.
First, it bridged theory and
design practice.
Then, it helped account for the temporal
dimension of acceptance.
Finally, it facilitated conversations
around user acceptance.
For time today, I will just review the
first aspect.
Designers commented on how the toolkit
challenged preconceptions they had
about acceptance.
It helped them see acceptance as
a dynamic process, closely linked
to the user journey.
P9 described "It really helps to re-focus
the design in a user-centered
perspective all along".
While acceptance can often appear quite
abstract, the toolkit helped make the
concept more concrete and accessible.
P15 explained "Without the moderation of
the cards, I think about user acceptance at
a very abstract level. The toolkit helped
navigate our thinking to one certain
area in depth".
Using the TAC toolkit expanded designers'
perspectives on user acceptance,
and the many factors at play.
P21 commented "I was not familiar with
all these factors... My spectrum and my way
of speaking changed around that topic".
Designers also enjoyed working with the
toolkit. For some participants, it felt
like "playing a board game",
and P11 explained how they were
"holding the cards, but in a way that
the cards were telling the story".
Designers also gained satisfaction from
being able to leverage the complex issue
of user acceptance in such a short
timeframe.
Using the TAC toolkit also helped shape
designers actions to better account for
user acceptance in design.
First, it helped them understand the
impact their design choices have on
user acceptance trajectories.
During the workshop, P20 asked their group:
"We had picked this factor before, and
the persona is still in the same
problematic place... So, what do we need
to think of for the technology?".
Some designers, however, highlighted
the difficulty of envisaging
future user experiences.
Then, participants discussed how the
toolkit will guide their own
design practice.
P6 said they will use the cards during
design, to ensure that their team is
"having the right conversations".
Finally, when working with the TAC cards,
designers naturally discussed the
ethical implications of their design.
To briefly wrap up...
First, the study showed the value of
tools such as the TAC toolkit
for articulating theory, and supporting
design for acceptance of
health technologies.
Design tools for acceptance also need to
account for the temporal dimension of
the concept, and the fact that factors
influencing acceptance evolve over time.
Finally, addressing future acceptance
issues can be challenging for designers.
Therefore it's important to have tools
that help designers visualize future
user experiences.
Thank you very much for listening.