Helena Lindgren | Umeå University (original) (raw)
Papers by Helena Lindgren
pHealth 2021, 2021
The aim of the work presented in this article was to develop a conceptual model for behavior chan... more The aim of the work presented in this article was to develop a conceptual model for behavior change progress, which could be used for automated assessment of reasons for progress or non-progress. The model was developed based on theories for behavior change, and evaluated by domain experts. The information models of two prototype systems of a digital coach under development for preventing cardio-vascular diseases and stress respectively, were evaluated by comparing the content of the prototypes with concepts in the model. The conceptual model was found useful as instrument to evaluate to what extent the prototypes are based in theories for behavior change, whether some vital information is missing, and to identify mechanisms for short and long time goal setting. Moreover, the connection between the ontology underpinning the prototypes and the conceptual model could be defined. Future work includes the integration of the conceptual model to function as a meta-ontology, which could be...
Studies in health technology and informatics, 2013
It is argued that a development of healthcare systems should emerge within a healthcare providing... more It is argued that a development of healthcare systems should emerge within a healthcare providing organization and as part of daily practice instead of something implemented by a third party, in order to become successful. This sociotechnical view on system development is shared with new methods developed in the end-user development field. However, is it possible to realize this in practice? This paper explores the obstacles and potentials in the realization, leading to a discussion about sociotechnical systems as innovation systems. We describe two examples of sociotechnical innovation systems, and discuss the results from an end user driven innovation process perspective.
Studies in health technology and informatics, 2011
There is a need to provide tools for the medical professional at the point of care in the assessm... more There is a need to provide tools for the medical professional at the point of care in the assessment of a suspected dementia disease. Early diagnosis is important in order to provide appropriate care so that the disease does not cause unnecessary suffering for the patient and relatives. DMSS (Dementia Management and Support System) is a clinical decision-support system that provides support in the diagnosis of a dementia disease, which is in use in controlled clinical evaluation settings in four countries. This paper reports the results of evaluations done in use environments in these places during a period of two years. Data in 218 patient cases were collected by 21 physicians during their use of the system in clinical practice. In 50 of the cases the use of the system were also observed and the physicians were interviewed in 88 cases. The collected data and inferences made by the system were analyzed. To summarize the results, DMSS gave appropriate support considering the patient ...
Proceedings of the European Conference on Cognitive Ergonomics 2017, 2017
The goal of this study is to develop a computer-interpretable model for activity detection and re... more The goal of this study is to develop a computer-interpretable model for activity detection and representation, based on existing informal models of how humans perform activity. Appropriate detection of purposeful human activity is an essential functionality of active assistive technology aiming at providing tailored support to individuals for improving activity performance and completion. The main contribution is the design of a model for detection and representation of human activities based on three categories of instruments, which is implemented as two generic and supplementary terminology models: an event ontology and a core ontology. The core ontology is extended for each new knowledge domain into a domain ontology. The model builds the base for personalization of services generated by the cooperative reasoning performed by a human collaborating with an intelligent and social software agent. Ongoing and future work includes user studies in the different application domains.
Proceedings of the European Conference on Cognitive Ergonomics 2017, 2017
A clinical decision-support system for dementia investigation was used in clinical practice. User... more A clinical decision-support system for dementia investigation was used in clinical practice. User information was collected based on interactions with the application. The aim of this study is to identify features in logged data that can be used for detecting learning and reasoning patterns in the user. A case of a physician who is novice to both the application and the dementia domain was studied and compared to the case of an expert physician using the system. Differences between them were found, and a clear pattern that indicates that learning takes place, both how to use the system and about dementia, was observed in the novice user. Further studies need to be conducted, focusing on whether patterns become stable over time, and with complementary methods that can detect reasons for observed behaviors. Software for automatic detection will be developed based on the results of this study.
This paper is aimed at formalize the interplay among a person to be assisted, an assistive agent-... more This paper is aimed at formalize the interplay among a person to be assisted, an assistive agent-based software, and a caregiver. We propose principles that agents should follow in such interplay, this principles may have impact in different agent-based assistive technology. We propose a mechanism to integrate individual’s information into the final decision-making process of an agent. Moreover, we endow agents with mechanisms for evaluating the distance between independent and supported activity execution, the so called zone of proximal development (ZPD) in four scenarios: I) independent activity execution; II) ZPDH activity performance of a person when is supported by another person (e.g. a therapist); III) the ZPDS representing a potential activities when a person is supported by a software agent; and IV) the ZPDH+S when a person is supported by a caregiver and a software agent. Formal argumentation theory is used as foundation. Our formal models were tested using a prototype usi...
Studies in health technology and informatics, 2012
We investigate a user-driven collaborative knowledge engineering and interaction design process. ... more We investigate a user-driven collaborative knowledge engineering and interaction design process. The outcome is a knowledge-based support application tailored to physicians in the local dementia care community. The activity is organized as a part of a collaborative effort between different organizations to develop their local clinical practice. Six local practitioners used the generic decision-support prototype system DMSS-R developed for the dementia domain during a period and participated in evaluations and re-design. Additional two local domain experts and a domain expert external to the local community modeled the content and design of DMSS-R by using the modeling system ACKTUS. Obstacles and success factors occurring when enabling the end-users to design their own tools are detected and interpreted using a proposed framework for improving care through the use of clinical guidelines. The results are discussed.
Studies in health technology and informatics, 2018
Social isolation and loneliness among older people is a growing problem with negative effects on ... more Social isolation and loneliness among older people is a growing problem with negative effects on physical and mental health. In co-creation with older adults individualized social activities were designed where older adults through computer mediated communication were able to participate in social activities without leaving their homes. Four types of activities were designed; outdoor activity, music event, visiting a friend and leisure activity. A participatory action research design was applied, where end users together with scientists from two research fields developed, tested and evaluated online participation in the activities. Usability and safety of the systems were major concerns among older adults. The evaluation pointed out that level of simplicity, usability and audio-video quality determined the level of satisfaction with the human interaction during the activity, thereby affecting the meaningfulness of the activity. The research presented in this paper constitutes the fi...
Proceedings of the 7th International Conference on Human-Agent Interaction, 2019
A common conversation between an older adult and a nurse about health-related issues includes top... more A common conversation between an older adult and a nurse about health-related issues includes topics such as troubles with sleep, reasons for walking around nighime, pain conditions, etc. Such a dialogue can be regarded as a ”natural” dialogue emerging from the participating agents’ lines of thinking, their roles, needs and motives, while switching between topics as the dialogue unfolds. e purpose of this work is to dene a generic model of purposeful human-agent dialogue activity including dierent types of argumentation dialogues, suitable for health-related topics. is is done based on analyses of scenarios, personas and models of human behavior. e model will be shared between the human and the agent, allowing for adaptation to the human’s reasoning, needs and motives.
The goal to facilitate a continuing medical education can be incorporated in the design of a clin... more The goal to facilitate a continuing medical education can be incorporated in the design of a clinical decision-support system. Developing a method for evaluating knowledge and skill development as part of evaluating the system is the aim for the research presented in this paper. The activity supported by the system was analyzed using Activity theory and structured into a protocol. Four clinicians were studied using the system for the first time, and their activity were assessed using the concept of Zone of Proximal Development. Initial results show how the system was used for clinician with different level of skills, and provide implications for further development of the methodology and the system.
Reasoning conducted in clinical practice is manifested through different and often combined reaso... more Reasoning conducted in clinical practice is manifested through different and often combined reasoning and learning strategies, adjusted to the characteristics of the available information, the medical professional's experience and skills, and the available tools, such as clinical practice guidelines. This research outlines a design model for supporting the commonly used strategies. This design model was implemented into a clinical decision-support system (CDSS), in addition to a method for detecting reasoning strategies applied when using the CDSS. This method was applied in a case study, with preliminary results presented in this paper and will be further implemented in future studies.
The main purposes of clinical decision-support systems (CDSS) are disseminating evidence-based me... more The main purposes of clinical decision-support systems (CDSS) are disseminating evidence-based medical knowledge (EBM), supporting a continued medical education, and improving clinical decision mak ...
A methodology was defined and developed for designing theory-based behaviour change systems for h... more A methodology was defined and developed for designing theory-based behaviour change systems for health promotion that can be tailored to the individual. Theories from two research fields were combined with a participatory action research methodology. Two case studies applying the methodology were conducted. During and between group sessions the participants created material and designs following the behaviour change strategy themes, which were discussed, analysed and transformed into a design of a behaviour change system. Theories in behavioural change and persuasive technology guided the data collection, data analyses, and the design of a behaviour change system. The methodology has strong emphasis on the target group's participation in the design process. The different aspects brought forward related to behaviour change strategies defined in literature on persuasive technology, and the dynamics of these are associated to needs and motivation defined in literature on behaviour ...
Lecture Notes in Computer Science, 2017
The overall aim of this research is to develop an adaptive digital coaching system that gives sen... more The overall aim of this research is to develop an adaptive digital coaching system that gives seniors personalized support for increasing physical activity, and promoting participation in social activity and their own care. The main research question is how can different behavioral and motivational factors of an individual be formally integrated into the knowledge base of a coach agent for generating support tailored to the individual’s needs and preferences in a specific situation?
IEEE Intelligent Systems, 2021
Frontiers in Public Health, 2021
Introduction: The Västerbotten Intervention Programme (VIP) in the Region Västerbotten Sweden is ... more Introduction: The Västerbotten Intervention Programme (VIP) in the Region Västerbotten Sweden is one of the very few cardiovascular disease (CVD) prevention programmes globally that is integrated into routine primary health care. The VIP has been shown as a cost-effective intervention to significantly reduce CVD mortality. However, little is known about the effectiveness of a digital solution to tailor risk communication strategies for supporting behavioral change. STAR-C aims to develop and evaluate a technical platform for personalized digital coaching that will support behavioral change aimed at preventing CVD.Methods: STAR-C employs a mixed-methods design in seven multidisciplinary projects, which runs in two phases during 2019–2024: (i) a formative intervention design and development phase, and (ii) an intervention implementation and evaluation phase. In the 1st phase, STAR-C will model the trajectories of health behaviors and their impact on CVDs (Project 1), evaluate the role...
Lecture Notes in Computer Science, 2019
European Journal of Ageing, 2020
Social participation and digital engagement can contribute to health and well-being among older a... more Social participation and digital engagement can contribute to health and well-being among older adults. Because of older adults’ decline in abilities, coupled with complex technology and its perceived insufficient relevance to daily life, there is a need to create and tailor social opportunities and services that are supported by digital technologies for older adults to continue participating in society. Thus, it becomes relevant to explore older adults’ perceptions about contexts surrounding their social participation in a digital society. This exploration used a qualitative research design with focus group interviews and qualitative content analysis. Eighteen older adults, aged 66–81 years, from rural communities in Northern Sweden, participated in this study. The analysis resulted in three categories: experiencing conditions for social participation in a state of flux, perceiving drawbacks of urbanization on social participation, and welcoming digital technology that facilitates ...
Argument & Computation, 2016
pHealth 2021, 2021
The aim of the work presented in this article was to develop a conceptual model for behavior chan... more The aim of the work presented in this article was to develop a conceptual model for behavior change progress, which could be used for automated assessment of reasons for progress or non-progress. The model was developed based on theories for behavior change, and evaluated by domain experts. The information models of two prototype systems of a digital coach under development for preventing cardio-vascular diseases and stress respectively, were evaluated by comparing the content of the prototypes with concepts in the model. The conceptual model was found useful as instrument to evaluate to what extent the prototypes are based in theories for behavior change, whether some vital information is missing, and to identify mechanisms for short and long time goal setting. Moreover, the connection between the ontology underpinning the prototypes and the conceptual model could be defined. Future work includes the integration of the conceptual model to function as a meta-ontology, which could be...
Studies in health technology and informatics, 2013
It is argued that a development of healthcare systems should emerge within a healthcare providing... more It is argued that a development of healthcare systems should emerge within a healthcare providing organization and as part of daily practice instead of something implemented by a third party, in order to become successful. This sociotechnical view on system development is shared with new methods developed in the end-user development field. However, is it possible to realize this in practice? This paper explores the obstacles and potentials in the realization, leading to a discussion about sociotechnical systems as innovation systems. We describe two examples of sociotechnical innovation systems, and discuss the results from an end user driven innovation process perspective.
Studies in health technology and informatics, 2011
There is a need to provide tools for the medical professional at the point of care in the assessm... more There is a need to provide tools for the medical professional at the point of care in the assessment of a suspected dementia disease. Early diagnosis is important in order to provide appropriate care so that the disease does not cause unnecessary suffering for the patient and relatives. DMSS (Dementia Management and Support System) is a clinical decision-support system that provides support in the diagnosis of a dementia disease, which is in use in controlled clinical evaluation settings in four countries. This paper reports the results of evaluations done in use environments in these places during a period of two years. Data in 218 patient cases were collected by 21 physicians during their use of the system in clinical practice. In 50 of the cases the use of the system were also observed and the physicians were interviewed in 88 cases. The collected data and inferences made by the system were analyzed. To summarize the results, DMSS gave appropriate support considering the patient ...
Proceedings of the European Conference on Cognitive Ergonomics 2017, 2017
The goal of this study is to develop a computer-interpretable model for activity detection and re... more The goal of this study is to develop a computer-interpretable model for activity detection and representation, based on existing informal models of how humans perform activity. Appropriate detection of purposeful human activity is an essential functionality of active assistive technology aiming at providing tailored support to individuals for improving activity performance and completion. The main contribution is the design of a model for detection and representation of human activities based on three categories of instruments, which is implemented as two generic and supplementary terminology models: an event ontology and a core ontology. The core ontology is extended for each new knowledge domain into a domain ontology. The model builds the base for personalization of services generated by the cooperative reasoning performed by a human collaborating with an intelligent and social software agent. Ongoing and future work includes user studies in the different application domains.
Proceedings of the European Conference on Cognitive Ergonomics 2017, 2017
A clinical decision-support system for dementia investigation was used in clinical practice. User... more A clinical decision-support system for dementia investigation was used in clinical practice. User information was collected based on interactions with the application. The aim of this study is to identify features in logged data that can be used for detecting learning and reasoning patterns in the user. A case of a physician who is novice to both the application and the dementia domain was studied and compared to the case of an expert physician using the system. Differences between them were found, and a clear pattern that indicates that learning takes place, both how to use the system and about dementia, was observed in the novice user. Further studies need to be conducted, focusing on whether patterns become stable over time, and with complementary methods that can detect reasons for observed behaviors. Software for automatic detection will be developed based on the results of this study.
This paper is aimed at formalize the interplay among a person to be assisted, an assistive agent-... more This paper is aimed at formalize the interplay among a person to be assisted, an assistive agent-based software, and a caregiver. We propose principles that agents should follow in such interplay, this principles may have impact in different agent-based assistive technology. We propose a mechanism to integrate individual’s information into the final decision-making process of an agent. Moreover, we endow agents with mechanisms for evaluating the distance between independent and supported activity execution, the so called zone of proximal development (ZPD) in four scenarios: I) independent activity execution; II) ZPDH activity performance of a person when is supported by another person (e.g. a therapist); III) the ZPDS representing a potential activities when a person is supported by a software agent; and IV) the ZPDH+S when a person is supported by a caregiver and a software agent. Formal argumentation theory is used as foundation. Our formal models were tested using a prototype usi...
Studies in health technology and informatics, 2012
We investigate a user-driven collaborative knowledge engineering and interaction design process. ... more We investigate a user-driven collaborative knowledge engineering and interaction design process. The outcome is a knowledge-based support application tailored to physicians in the local dementia care community. The activity is organized as a part of a collaborative effort between different organizations to develop their local clinical practice. Six local practitioners used the generic decision-support prototype system DMSS-R developed for the dementia domain during a period and participated in evaluations and re-design. Additional two local domain experts and a domain expert external to the local community modeled the content and design of DMSS-R by using the modeling system ACKTUS. Obstacles and success factors occurring when enabling the end-users to design their own tools are detected and interpreted using a proposed framework for improving care through the use of clinical guidelines. The results are discussed.
Studies in health technology and informatics, 2018
Social isolation and loneliness among older people is a growing problem with negative effects on ... more Social isolation and loneliness among older people is a growing problem with negative effects on physical and mental health. In co-creation with older adults individualized social activities were designed where older adults through computer mediated communication were able to participate in social activities without leaving their homes. Four types of activities were designed; outdoor activity, music event, visiting a friend and leisure activity. A participatory action research design was applied, where end users together with scientists from two research fields developed, tested and evaluated online participation in the activities. Usability and safety of the systems were major concerns among older adults. The evaluation pointed out that level of simplicity, usability and audio-video quality determined the level of satisfaction with the human interaction during the activity, thereby affecting the meaningfulness of the activity. The research presented in this paper constitutes the fi...
Proceedings of the 7th International Conference on Human-Agent Interaction, 2019
A common conversation between an older adult and a nurse about health-related issues includes top... more A common conversation between an older adult and a nurse about health-related issues includes topics such as troubles with sleep, reasons for walking around nighime, pain conditions, etc. Such a dialogue can be regarded as a ”natural” dialogue emerging from the participating agents’ lines of thinking, their roles, needs and motives, while switching between topics as the dialogue unfolds. e purpose of this work is to dene a generic model of purposeful human-agent dialogue activity including dierent types of argumentation dialogues, suitable for health-related topics. is is done based on analyses of scenarios, personas and models of human behavior. e model will be shared between the human and the agent, allowing for adaptation to the human’s reasoning, needs and motives.
The goal to facilitate a continuing medical education can be incorporated in the design of a clin... more The goal to facilitate a continuing medical education can be incorporated in the design of a clinical decision-support system. Developing a method for evaluating knowledge and skill development as part of evaluating the system is the aim for the research presented in this paper. The activity supported by the system was analyzed using Activity theory and structured into a protocol. Four clinicians were studied using the system for the first time, and their activity were assessed using the concept of Zone of Proximal Development. Initial results show how the system was used for clinician with different level of skills, and provide implications for further development of the methodology and the system.
Reasoning conducted in clinical practice is manifested through different and often combined reaso... more Reasoning conducted in clinical practice is manifested through different and often combined reasoning and learning strategies, adjusted to the characteristics of the available information, the medical professional's experience and skills, and the available tools, such as clinical practice guidelines. This research outlines a design model for supporting the commonly used strategies. This design model was implemented into a clinical decision-support system (CDSS), in addition to a method for detecting reasoning strategies applied when using the CDSS. This method was applied in a case study, with preliminary results presented in this paper and will be further implemented in future studies.
The main purposes of clinical decision-support systems (CDSS) are disseminating evidence-based me... more The main purposes of clinical decision-support systems (CDSS) are disseminating evidence-based medical knowledge (EBM), supporting a continued medical education, and improving clinical decision mak ...
A methodology was defined and developed for designing theory-based behaviour change systems for h... more A methodology was defined and developed for designing theory-based behaviour change systems for health promotion that can be tailored to the individual. Theories from two research fields were combined with a participatory action research methodology. Two case studies applying the methodology were conducted. During and between group sessions the participants created material and designs following the behaviour change strategy themes, which were discussed, analysed and transformed into a design of a behaviour change system. Theories in behavioural change and persuasive technology guided the data collection, data analyses, and the design of a behaviour change system. The methodology has strong emphasis on the target group's participation in the design process. The different aspects brought forward related to behaviour change strategies defined in literature on persuasive technology, and the dynamics of these are associated to needs and motivation defined in literature on behaviour ...
Lecture Notes in Computer Science, 2017
The overall aim of this research is to develop an adaptive digital coaching system that gives sen... more The overall aim of this research is to develop an adaptive digital coaching system that gives seniors personalized support for increasing physical activity, and promoting participation in social activity and their own care. The main research question is how can different behavioral and motivational factors of an individual be formally integrated into the knowledge base of a coach agent for generating support tailored to the individual’s needs and preferences in a specific situation?
IEEE Intelligent Systems, 2021
Frontiers in Public Health, 2021
Introduction: The Västerbotten Intervention Programme (VIP) in the Region Västerbotten Sweden is ... more Introduction: The Västerbotten Intervention Programme (VIP) in the Region Västerbotten Sweden is one of the very few cardiovascular disease (CVD) prevention programmes globally that is integrated into routine primary health care. The VIP has been shown as a cost-effective intervention to significantly reduce CVD mortality. However, little is known about the effectiveness of a digital solution to tailor risk communication strategies for supporting behavioral change. STAR-C aims to develop and evaluate a technical platform for personalized digital coaching that will support behavioral change aimed at preventing CVD.Methods: STAR-C employs a mixed-methods design in seven multidisciplinary projects, which runs in two phases during 2019–2024: (i) a formative intervention design and development phase, and (ii) an intervention implementation and evaluation phase. In the 1st phase, STAR-C will model the trajectories of health behaviors and their impact on CVDs (Project 1), evaluate the role...
Lecture Notes in Computer Science, 2019
European Journal of Ageing, 2020
Social participation and digital engagement can contribute to health and well-being among older a... more Social participation and digital engagement can contribute to health and well-being among older adults. Because of older adults’ decline in abilities, coupled with complex technology and its perceived insufficient relevance to daily life, there is a need to create and tailor social opportunities and services that are supported by digital technologies for older adults to continue participating in society. Thus, it becomes relevant to explore older adults’ perceptions about contexts surrounding their social participation in a digital society. This exploration used a qualitative research design with focus group interviews and qualitative content analysis. Eighteen older adults, aged 66–81 years, from rural communities in Northern Sweden, participated in this study. The analysis resulted in three categories: experiencing conditions for social participation in a state of flux, perceiving drawbacks of urbanization on social participation, and welcoming digital technology that facilitates ...
Argument & Computation, 2016