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Every day patients access and generate online health content through a variety of online channels, creating an ever-expanding sea of data in the form of digital communications. At the same time, proponents of public health have recently called for timely, granular, and actionable data to address a range of public health issues, stressing the need for social listening platforms that can identify and compile this valuable data. Yet previous attempts at social listening in healthcare have yielded mixed results, largely because they have failed to incorporate sufficient context to understand the communications they seek to analyze. Guided by Activity Theory to design HealthSense, we propose a platform for efficiently sensing and gathering data across the web for real time analysis to support public health outcomes. HealthSense couples theory-guided content analysis and graph propagation with graph neural networks (GNNs) to assess the relevance and credibility of information, as well as intelligently navigate the complex online channel landscape, leading to significant improvements over existing social listening tools. We demonstrate the value of our artifact in gathering information to support two important exemplar public health tasks: 1) performing post market drug surveillance for adverse reactions and 2) addressing the opioid crisis by monitoring for potent synthetic opioids released into communities. Our results across data, user, and event experiments show that effective design artifacts can enable better outcomes across both automated and human decision-making contexts, making social listening for public health possible, practical, and valuable. Through our design process, we extend Activity Theory to address the complexities of modern online communication platforms, where information resides not only within the collection of individual communication activities, but in the complex network of interactions between them. 

Digital experiments are routinely used to test the value of a treatment relative to a status quo control setting — for instance, a new search relevance algorithm for a website or a new results layout for a mobile app. As digital experiments have become increasingly pervasive in organizations and a wide variety of research areas, their growth has prompted a new set of challenges for experimentation platforms. One challenge is that experiments often focus on the average treatment effect (ATE) without explicitly considering differences across major sub-groups — heterogeneous treatment effect (HTE). This is especially problematic because ATEs have decreased in many organizations as the more obvious benefits have already been realized. However, questions abound regarding the pervasiveness of user HTEs and how best to detect them. We propose a framework for detecting and analyzing user HTEs in digital experiments. Our framework combines an array of user characteristics with double machine learning. Analysis of 27 real-world experiments spanning 1.76 billion sessions and simulated data demonstrates the effectiveness of our detection method relative to existing techniques. We also find that transaction, demographic, engagement, satisfaction, and lifecycle characteristics exhibit statistically significant HTEs in 10% to 20% of our real-world experiments, underscoring the importance of considering user heterogeneity when analyzing experiment results, otherwise personalized features and experiences cannot happen, thus reducing effectiveness. In terms of the number of experiments and user sessions, we are not aware of any study that has examined user HTEs at this scale. Our findings have important implications for information retrieval, user modeling, platforms, and digital experience contexts, in which online experiments are often used to evaluate the effectiveness of design artifacts.