Human-Centered Design to Enhance Implementation and Impact in Health.

Human-centered design (HCD) is an approach that aligns innovation development with the needs of the people and the settings where those innovations will be used. HCD is increasingly being applied across a variety of health domains, most often with the goals of translating research into real-world settings and expanding innovation adoption. This review introduces key HCD concepts, reviews the growth of HCD in public health and its alignment with the complementary field of implementation science, and details four prominent proximal outcomes of design processes: () usability, () user burden, () contextual appropriateness, and () engagement.

Unforeseen plant phenotypic diversity in a dry and grazed world.

Earth harbours an extraordinary plant phenotypic diversity that is at risk from ongoing global changes. However, it remains unknown how increasing aridity and livestock grazing pressure-two major drivers of global change-shape the trait covariation that underlies plant phenotypic diversity. Here we assessed how covariation among 20 chemical and morphological traits responds to aridity and grazing pressure within global drylands.

Patient Experiences With Blood Pressure Measurement Methods for Hypertension Diagnosis: Qualitative Findings From the BP-CHECK Study.

Background: Out-of-office blood pressure (BP) measurement is recommended when making a new hypertension diagnosis. In practice, however, hypertension is primarily diagnosed using clinic BP. The study objective was to understand patient attitudes about accuracy and patient-centeredness regarding hypertension diagnostic methods.

Conducting Research at the Intersection of HCI and Health: Building and Supporting Teams with Diverse Expertise to Increase Public Health Impact.

Research at the intersection of human-computer interaction (HCI) and health is increasingly done by collaborative cross-disciplinary teams. The need for cross-disciplinary teams arises from the interdisciplinary nature of the work itself-with the need for expertise in a health discipline, experimental design, statistics, and computer science, in addition to HCI. This work can also increase innovation, transfer of knowledge across fields, and have a higher impact on communities.

HCI Contributions in Mental Health: A Modular Framework to Guide Psychosocial Intervention Design.

Many people prefer psychosocial interventions for mental health care or other concerns, but these interventions are often complex and unavailable in settings where people seek care. Intervention designers use technology to improve user experience or reach of interventions, and HCI researchers have made many contributions toward this goal. Both HCI and mental health researchers must navigate tensions between innovating on and adhering to the theories of change that guide intervention design.

MigraineTracker: Examining Patient Experiences with Goal-Directed Self-Tracking for a Chronic Health Condition.

Self-tracking and personal informatics offer important potential in chronic condition management, but such potential is often undermined by difficulty in aligning self-tracking tools to an individual's goals. Informed by prior proposals of goal-directed tracking, we designed and developed MigraineTracker, a prototype app that emphasizes explicit expression of goals for migraine-related self-tracking. We then examined migraine patient experiences in a deployment study for an average of 12+ months, including a total of 50 interview sessions with 10 patients working with 3 different clinicians.

Dryland soil recovery after disturbance across soil and climate gradients of the Colorado Plateau.

Drylands impacted by energy development often require costly reclamation activities to reconstruct damaged soils and vegetation, yet little is known about the effectiveness of reclamation practices in promoting recovery of soil quality due to a lack of long-term and cross-site studies. Here, we examined paired on-pad and adjacent undisturbed off-pad soil properties over a 22-year chronosequence of 91 reclaimed oil or gas well pads across soil and climate gradients of the Colorado Plateau in the southwestern United States. Our goals were to estimate the time required for soil properties to reach undisturbed conditions, examine the multivariate nature of soil quality following reclamation, and identify environmental factors that affect reclamation outcomes.

Hotspots of biogeochemical activity linked to aridity and plant traits across global drylands.

Perennial plants create productive and biodiverse hotspots, known as fertile islands, beneath their canopies. These hotspots largely determine the structure and functioning of drylands worldwide. Despite their ubiquity, the factors controlling fertile islands under conditions of contrasting grazing by livestock, the most prevalent land use in drylands, remain virtually unknown.

Bridging HCI and Implementation Science for Innovation Adoption and Public Health Impact.

Human computer interaction (HCI) and implementation science (IS) each have been applied to improve the adoption and delivery of innovative health interventions, and the two fields have complementary goals, foci, and methods. While the IS community increasingly draws on methods from HCI, there are many unrealized opportunities for HCI to draw from IS and to catalyze bidirectional collaborations. This workshop will explore similarities and differences between fields, with a goal of articulating a research agenda at their intersection.

Climate-induced tree-mortality pulses are obscured by broad-scale and long-term greening.

Vegetation greening has been suggested to be a dominant trend over recent decades, but severe pulses of tree mortality in forests after droughts and heatwaves have also been extensively reported. These observations raise the question of to what extent the observed severe pulses of tree mortality induced by climate could affect overall vegetation greenness across spatial grains and temporal extents. To address this issue, here we analyse three satellite-based datasets of detrended growing-season normalized difference vegetation index (NDVI) with spatial resolutions ranging from 30 m to 8 km for 1,303 field-documented sites experiencing severe drought- or heat-induced tree-mortality events around the globe.

Relationship of Blood Pressure, Health Behaviors, and New Diagnosis and Control of Hypertension in the BP-CHECK Study.

Background: Undiagnosed hypertension and uncontrolled blood pressure (BP) are common and contribute to excess cardiovascular morbidity and mortality. We examined whether BP control, changes in BP, and patient behaviors and attitudes were associated with a new hypertension diagnosis.

Methods: We performed a post hoc analysis of 323 participants from BP-CHECK (Blood Pressure Checks for Diagnosing Hypertension), a randomized diagnostic study of BP measuring methods in adults without diagnosed hypertension with elevated BP recruited from 12 primary care clinics of an integrated health care system in Washington State during 2017 to 2019.

Obstetric and neonatal outcomes in South Africa.

Background: Background epidemiologic population data from low- and middle-income countries (LMIC), on maternal, foetal and neonatal adverse outcomes are limited. We aimed to estimate the incidence of maternal, foetal and neonatal adverse outcomes at South African maternal vaccine trial sites as reported directly in the clinical notes as well as using the 'Global Alignment of Immunization Safety Assessment in Pregnancy' case definitions (GAIA-CDs). GAIA-CDs were utilized as a tool to standardise data collection and outcome assessment, and the applicability and utility of the GAIA-CDs was evaluated in a LMIC observational study.

Formative Evaluation of a Comprehensive Self-Management Intervention for Irritable Bowel Syndrome, Comorbid Anxiety, and Depression: Mixed Methods Study.

Background: Irritable bowel syndrome (IBS) is a disorder of the gut-brain interaction that is associated with abdominal pain, altered bowel patterns, and reduced quality of life. Up to 50% of patients with IBS also report anxiety or depressive symptoms. Although effective self-management interventions exist for individuals with IBS, few have been effectively implemented, and most do not consider the unique needs of patients with comorbid IBS and anxiety or depression.

The OSA patient journey: pathways for diagnosis and treatment among commercially insured individuals in the United States.

Study Objectives: The aims of this study were to characterize obstructive sleep apnea (OSA) care pathways among commercially insured individuals in the United States and to investigate between-groups differences in population, care delivery, and economic aspects.

Methods: We identified adults with OSA using a large, national administrative claims database (January 1, 2016-February 28, 2020). Inclusion criteria included a diagnostic sleep test on or within ≤ 12 months of OSA diagnosis (index date) and 12 months of continuous enrollment before and after the index date.

Co-developed implementation guidelines to maximize acceptability, feasibility, and usability of mobile phone supervision in Kenya.

Opportunities exist to leverage mobile phones to replace or supplement in-person supervision of lay counselors. However, contextual variables, such as network connectivity and provider preferences, must be considered. Using an iterative and mixed methods approach, we co-developed implementation guidelines to support the implementation of mobile phone supervision with lay counselors and supervisors delivering a culturally adapted trauma-focused cognitive behavioral therapy in Western Kenya.

Testing the hierarchy of predictability in grassland restoration across a gradient of environmental severity.

Ecological restoration is critical for recovering degraded ecosystems but is challenged by variable success and low predictability. Understanding which outcomes are more predictable and less variable following restoration can improve restoration effectiveness. Recent theory asserts that the predictability of outcomes would follow an order from most to least predictable from coarse to fine community properties (physical structure > taxonomic diversity > functional composition > taxonomic composition) and that predictability would increase with more severe environmental conditions constraining species establishment.

Is Hypertension Diagnostic Testing and Diagnosis Associated With Psychological Distress?

Background: Psychological impacts of hypertension diagnostic testing and new hypertension diagnoses are unclear.

Methods: BP-CHECK was a randomized diagnostic study conducted in 2017-2019 in an integrated healthcare system. Participants with no hypertension diagnosis or medications and elevated blood pressure (BP) were randomized to one of three diagnostic regimens: (i) Clinic, (ii) Home, or (iii) Kiosk.

Potential for Maternally Administered Vaccine for Infant Group B Streptococcus.

Background: Natural history studies have correlated serotype-specific anti-capsular polysaccharide (CPS) IgG in newborns with a reduced risk of group B streptococcal disease. A hexavalent CPS-cross-reactive material 197 glycoconjugate vaccine (GBS6) is being developed as a maternal vaccine to prevent invasive group B streptococcus in young infants.

Methods: In an ongoing phase 2, placebo-controlled trial involving pregnant women, we assessed the safety and immunogenicity of a single dose of various GBS6 formulations and analyzed maternally transferred anti-CPS antibodies.

Synergistic soil, land use, and climate influences on wind erosion on the Colorado Plateau: Implications for management.

Two decades of drought in the southwestern USA are spurring concerns about increases in wind erosion, dust emissions, and associated impacts on ecosystems, agriculture, human health, and water supply. Different avenues of investigation into primary drivers of wind erosion and dust have yielded mixed results depending on the spatial and temporal sensitivity of the evidence. We monitored passive aeolian sediment traps from 2017 to 2020 across eighty-one sites near Moab, Utah to understand patterns of sediment flux.

An Integrative Engagement Model of Digital Psychotherapy: Exploratory Focus Group Findings.

Background: Digital mental health interventions, such as 2-way and asynchronous messaging therapy, are a growing part of the mental health care treatment ecosystem, yet little is known about how users engage with these interventions over the course of their treatment journeys. User engagement, or client behaviors and therapeutic relationships that facilitate positive treatment outcomes, is a necessary condition for the effectiveness of any digital treatment. Developing a better understanding of the factors that impact user engagement can impact the overall effectiveness of digital psychotherapy.

Soil surface treatments and precipitation timing determine seedling development across southwestern US restoration sites.

Restoration in dryland ecosystems often has poor success due to low and variable water availability, degraded soil conditions, and slow plant community recovery rates. Restoration treatments can mitigate these constraints but, because treatments and subsequent monitoring are typically limited in space and time, our understanding of their applicability across broader environmental gradients remains limited. To address this limitation, we implemented and monitored a standardized set of seeding and soil surface treatments (pits, mulch, and ConMod artificial nurse plants) designed to enhance soil moisture and seedling establishment across RestoreNet, a growing network of 21 diverse dryland restoration sites in the southwestern USA over 3 years.

Evaluating a Novel, Portable, Self-Administrable Device ("Beacon") That Measures Critical Flicker Frequency as a Test for Hepatic Encephalopathy.

Introduction: We compared critical flicker frequency (CFF) thresholds obtained using a novel portable device "Beacon" with thresholds from the commercially available Lafayette Flicker Fusion System (Lafayette-FFS) in patients with cirrhosis.

Methods: One hundred fifty-three participants with chronic liver disease underwent CFF testing using Beacon and Lafayette-FFS with a method-of-limits and/or forced-choice protocol.

Results: Beacon demonstrated excellent test-retest reliability (intraclass correlation 0.