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AI-driven tools are increasingly deployed to support low-skilled community health workers (CHWs) in hard-to-reach communities in the Global South. This paper examines how CHWs in rural India engage with and perceive AI explanations and how we might design explainable AI (XAI) interfaces that are more understandable to them. We conducted semi-structured interviews with CHWs who interacted with a design probe to predict neonatal jaundice in which AI recommendations are accompanied by explanations. We (1) identify how CHWs interpreted AI predictions and the associated explanations, (2) unpack the benefits and pitfalls they perceived of the explanations, and (3) detail how different design elements of the explanations impacted their AI understanding. Our findings demonstrate that while CHWs struggled to understand the AI explanations, they nevertheless expressed a strong preference for the explanations to be integrated into AI-driven tools and perceived several benefits of the explanations, such as helping CHWs learn new skills and improved patient trust in AI tools and in CHWs. We conclude by discussing what elements of AI need to be made explainable to novice AI users like CHWs and outline concrete design recommendations to improve the utility of XAI for novice AI users in non-Western contexts.more » « lessFree, publicly-accessible full text available April 17, 2025
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Home care workers (HCWs) provide essential care in patients' homes but are often underappreciated and work in stressful and isolated environments with diverse and intersecting support needs. This paper describes a computer-mediated peer support program that centers around sharing circles: spaces for personal, narrative storytelling to encourage HCWs to collaboratively reflect on their home care experiences and build rapport and shared identity with their peers. We describe the design of this program and a 12-week deployment that we conducted to evaluate the program with 42 HCWs in New York City. Our findings show that participants engaged in multiple types of peer support including emotional validation, learning how to navigate the workplace and patient care, defining and enabling good home care praxis, and building understanding around purpose and identity as HCWs. We discuss how these findings inform the design of technology and use of holistic pedagogies, such as storytelling, to enable this support in computer-mediated peer support programs. Such programs can help researchers and practitioners interested in addressing diverse needs that occur in intersectional contexts, such as that of HCWs and other marginalized populations.more » « less
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Home health aides are paid professionals who provide long-term care to an expanding population of adults who need it. However, aides' work is often unrecognized by the broader caregiving team despite being in demand and crucial to care---an invisibility reinforced by ill-suited technological tools. In order to understand the invisible work aides perform and its relationship to technology design, we interviewed 13 aides employed by home care agencies in New York City. These aides shared examples that demonstrated the intertwined nature of both types of invisible work (i.e., emotions- and systems-based) and expanded the sociological mechanisms of invisibility (i.e., sociocultural, sociolegal, sociospatial) to include the sociotechnical. Through these findings, we investigate the opportunities, tensions, and challenges that could inform the design of tools created for these important, but often overlooked, frontline caregivers.more » « less
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This study examines the unique challenges facing rural home care workers. Semi-structured interviews were undertaken between July 2021 and February 2022 with 23 participants that have experience in rural home care delivery. The major challenge confronting rural home care workers involved distance and transportation. This challenge emerged due to long distance between clients, unreliable vehicles, inadequate reimbursement, and inclement weather. In turn, this challenge exacerbated three other types of challenges facing rural home care workers: workforce challenges that consisted of a persistent labor shortage and shorter visits that forced workers to rush through tasks, client isolation due to the social and physical seclusion of households, and the poor working conditions of home care work more broadly. Without policy interventions that respond to these particular challenges, the care gap in rural areas can be expected to grow.more » « less