In this paper we present the promise of the Cognitive Work Analysis (CWA) methodology, particularly abstraction hierarchy modeling, in the foster care domain. There is increasing interest in applying machine learning decision aids to foster care decision making, but that interest is accompanied by concerns that those aids may perpetuate systemic bias or be largely context-blind. Modeling the work conducted at different levels of the domain offers unique insights into where bias may enter the system as well as possible design implications for these future decision aids. This project models two major areas of work in the domain, management of individual cases and management of overall programs offered. These work areas are then considered in the first 3 levels of the abstraction hierarchy to display the promise that this model can hold for the domain in future work, particularly when supported with more naturalistic studies.
more »
« less
This content will become publicly available on March 1, 2025
The Context of Care: Abstraction Hierarchy Modeling of Therapeutic Foster Care Programs
Therapeutic foster care agencies provide temporary placements and a range of services to at-risk youth to help ensure their safety, permanency, and wellbeing. The practitioners that plan such care operate under heavy caseloads, limited resources, and high stakes. There is significant interest in supporting these practitioners with various technological interventions, but their work and the context around it is still poorly understood. This study aims to better understand the current assessment and treatment planning work in therapeutic foster care. We used the abstraction hierarchy modeling approach to outline the purposes, values, constraints, processes, and tools that define the workplace ecology encountered by care coordinators and clinicians from therapeutic foster care programs at Hillside, a collaborating human service organization. The resulting abstraction hierarchy was closely examined to identify areas for interventions and design implications.
more » « less- Award ID(s):
- 1939579
- PAR ID:
- 10498095
- Publisher / Repository:
- SAGE
- Date Published:
- Journal Name:
- Journal of Cognitive Engineering and Decision Making
- Volume:
- 18
- Issue:
- 1
- ISSN:
- 1555-3434
- Page Range / eLocation ID:
- 22 to 36
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
More Like this
-
-
In foster care settings, the treatment plan captures goals and interventions for youth in care. The first version of this plan is typically due 30 days after the youth is enrolled in the foster care program, leading to a challenging month of assessing the case and developing the treatment plan. This study utilized Critical Decision Method interviews with care coordinators and clinicians to understand the decision-making involved in balancing assessment tasks, and the barriers to using assessment to inform treatment. The interviews were coded to identify major themes including information sources and constraints. These identified themes and general understanding of the problem space will drive future work developing interventions to improve the workflow process and drive better outcomes for youth in foster care.more » « less
-
more » « less
Abstract We propose and extend a qualitative, complex systems methodology from cognitive engineering, known as the
abstraction hierarchy , to model how potential interventions that could be carried out by social media platforms might impact social equality. Social media platforms have come under considerable ire for their role in perpetuating social inequality. However, there is also significant evidence that platforms can play a role inreducing social inequality, e.g. through the promotion of social movements. Platforms’ role in producing or reducing social inequality is, moreover, not static; platforms can and often do take actions targeted at positive change. How can we develop tools to help us determine whether or not a potential platform change might actually work to increase social equality? Here, we present the abstraction hierarchy as a tool to help answer this question. Our primary contributions are two-fold. First, methodologically, we extend existing research on the abstraction hierarchy in cognitive engineering with principles from Network Science. Second, substantively, we illustrate the utility of this approach by using it to assess the potential effectiveness of a set of interventions, proposed in prior work, for how online dating websites can help mitigate social inequality. -
more » « less
Abstract Drawing from ethnographic research with Latin American migrant mothers seeking prenatal care at a safety net clinic in southern Connecticut, I describe the racial dynamics of a medical hierarchy that situates White providers and nurses above Black and Brown medical assistants and patients, terming this the
prenatal care color line . I characterize three segments of the prenatal care color line: through (1) onerous enrollment in prenatal care support that strips rights from migrant mothers; (2) differences in racialized embodiment that harden essentialist and stereotyped notions surrounding Latinx reproduction, making the experience of pregnancy and birth a process of race‐making; and (3) obstetric racism manifest through both denying or delaying critical medical care to Latinx pregnant patients while also overmedicalizing their uncomplicated births. I argue that the presence of the prenatal care color line—in my study clinic as in other safety net clinics—permits the harsher racialization of Latinx birthers. -
Much research has been conducted that demonstrates a link between racial/ethnic residential segregation and health care outcomes. We suggest that minority segregated neighborhoods may have diminished access to organizations and that this differential access may contribute to differences in health care outcomes across communities. We analyze this specifically using the case of pediatric health care provider choice. To examine this association, we estimate a series of multinomial logistic regression models using restricted data with ZIP code level geoidentifiers from the 2011–2012 National Survey of Children’s Health (NSCH). We find that racial/ethnic residential segregation is related to a greater reliance on non-ideal forms of health care, such as clinics, and hospital outpatient departments, instead of pediatric physician’s offices. This association is at least partially attenuated by the distribution of health care facilities in the local area, physician’s offices, and health care practitioners in particular. Additionally, families express greater dissatisfaction with these other forms of care compared to physician’s offices, demonstrating that the lack of adequate health care provision is meaningful for health care outcomes. This study expands the literature by examining how the siting of health organizations has consequences for individuals residing within these areas.more » « less
