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Trust, Reciprocity, and the Role of Timebanks as Intermediaries: Design Implications for Addressing Healthcare Transportation BarriersMillions of Americans forego medical care due to a lack of non-emergency transportation, particularly minorities, older adults, and those who have disabilities or chronic conditions. Our study investigates the potential for using timebanks—community-based voluntary services that encourage exchanges of services for “time dollars” rather than money—in interventions to address healthcare transportation barriers to seed design implications for a future affordable ridesharing platform. In partnership with a timebank and a federally qualified healthcare center (FQHC), 30 participants completed activity packets and 29 of them attended online workshop sessions. Our findings suggest that promoting trust between drivers and riders requires systems that prioritize safety and reliability; yet, there were discrepancies in the ability of the timebank and FQHC to moderate trust. We also found that timebank supports reciprocity, but healthcare transportation requires additional support to ensure balanced reciprocity. We explain these findings drawing from network closure and trust literature. Finally, we contribute design implications for systems that promote trust and facilitate relational over transactional interactions, which help to promote reciprocity and reflect participants’ values.
The rise of ridesharing platforms has transformed traditional transportation, making it more accessible for getting to work and accessing grocery stores and healthcare providers, which are essential to physical and mental well-being. However, such technologies are not available everywhere. Additionally, there is a scarcity of HCI work that investigates how vulnerable populations such as rural-dwelling people with HIV face and overcome transportation barriers. To extend past research, we conducted 31 surveys and 18 interviews with people living with HIV (22 surveys, 14 interviews) and their case coordinators (9 surveys, 4 interviews) in rural areas. Contrary to past research, we found that the use of alternative vehicles, extensive support networks, and nonprofit health organizations facilitated transportation. However, distance, the lack of trust and infrastructure, stigma, and other cultural underpinnings made popular forms of urban transportation unappealing. We contextualize our findings with prior research and contribute implications for future research and design.
Not Another Medication Adherence App: Critical Reflections on Addressing Public HIV-related Stigma Through DesignPeople living with HIV experience a high level of stigma in our society. Public HIV-related stigma often leads to anxiety and depression and hinders access to social support and proper medical care. Technologies for HIV, however, have been mainly designed for treatment management and medication adherence rather than for helping people cope with public HIV-related stigma specifically. Drawing on empirical data obtained from semi-structured interviews and design activities with eight social workers and 29 people living with HIV, we unpack the ways in which needs for privacy and trust, intimacy, and social support create tensions around key coping strategies. Reflecting on these tensions, we present design implications and opportunities to empower people living with HIV to cope with public HIV-related stigma at the individual level.
Transportation has evolved throughout the past several years through developments in HCI and sociotechnical systems. However, there has been a lack of studies examining transportation in rural areas for vulnerable populations. Our study focuses on the transportation facilitators and barriers faced by people living with HIV in rural areas. We were informed through 31 surveys and 18 interviews with people living with HIV in rural areas and their case coordinators. We highlight the importance of utilizing a patchwork of transportation methods and having social networks to support transportation needs. Emerging, popular forms of urban transportation do not translate well due to differences in trust, infrastructure, rural culture, and stigma.
Conducting HCI research with people living with HIV in face-to-face settings can be challenging in terms of recruitment and data collection due to HIV-related stigma. In this case study, we share our experiences from conducting research remotely in two studies using the Asynchronous Remote Communities method with participants recruited from in-person and online support groups, respectively. Our findings and discussion around challenges, best practices, and lessons learned during the phases of recruitment and data collection expand and further support the suitability of the method to conduct research remotely with a highly stigmatized population.