Mental health disparities for racial-ethnic minorities are a significant concern due to barriers to access, cost, and adequate mental health care. Digital mental health technology holds promise for alleviating these barriers; however, these solutions often lack the cultural responsiveness that is necessary to meet the specific needs of these communities. This dissertation examines the presence of cultural responsiveness in digital mental health solutions for three different racial-ethnic minority groups. Through four research studies, I explore the ways in which social determinants of health impact how racial-ethnic minorities engage and seek digital mental health support, provide evidence of how community-based research is beneficial for ideating and designing for cultural responsiveness, and emphasize the ways researchers can design accessible, scalable, and inclusive digital mental health solutions. To highlight the various levels of influence contributing to mental health disparities and how they impact the design of digital mental health technology, I analyze each study using the National Institute on Minority Health and Health Disparities research framework and discuss how to use this framework to implement culturally responsive design for mental health technologies. Drawing from these findings, I discuss the overarching themes: 1) health-seeking behaviors of racial-ethnic minorities; 2) means of mental healthcare access through technology; 3) research to implementation practices, and 4) implications for design to argue why culturally responsive design is necessary for mental health technologies. Overall, these studies show that designing culturally responsive mental health solutions should be implemented to help reduce mental health disparities for racial-ethnic minority populations and the possible ways it can be accomplished. The findings highlight the importance of designing solutions that consider the unique needs and challenges of diverse communities to ensure increased access and appropriate support.

Natural and artificial acoustics of the built world provide spatial awareness, environmental context, and communicative abilities to people with visual impairments. When the acoustic soundscape is insufficient, assistive technologies -- devices and computational systems designed to augment the visual modality -- can be used to translate visual information to other modalities. In the field of Human-Computer Interaction (HCI), nonvisual assistive technologies seek to bridge the human to computer relationship through speech and non-speech sounds, touch, and by facilitating interactions through sighted support structures. Current research exploring technological approaches to solving nonvisual challenges in a sight-first world, often emphasize the transfer of visual information to a single modality. In this dissertation, I examine how individual modalities can be unified through novel computational interactions to alleviate sensory overload, and support a broad set of activities. I ask the questions: 1) How can tangible and mixed ability computational systems be designed to reduce audio and interactions for blind and low vision people in everyday activities, and 2) Do assistive technologies that are less reliant on auditory input improve blind and low vision user interactions? Through field studies of blind and low vision computers users, I designed and evaluated a platform for augmenting auditory computer interactions with a tangible interface. An experimental evaluation of the combined auditory and tangible control found a thirty-nine percent increase compared to traditional audio-only tools in web navigation tasks. Through a multi-year ethnographic study of a blind and low vision outrigger canoeing community, I examined the intersection of sensory modalities and mixed-ability relationships during canoeing activities. Applying a public-facing co-design participatory methodology, I worked alongside blind and sighted outrigger canoe enthusiasts to design, evaluate, and deploy a shared assistive technology to support blind paddling. Analysis of my work reveals how physicality in the world influences the auditory and tangible interactions of assistive technologies. In addition to my empirical findings, through this work I demonstrate how attending to context and the physicality of sound and touch reveal critical insights to guide the design of assistive technology.

Social communication is one of the key components of successful interaction. People with autism can have significant challenges with social communication, resulting in some of the highest rates of depression and anxiety. In fact, young adults with autism have suicide rates that are 28 times higher than the general population. Thus, supporting social skills of people with autism could have a positive impact on both the social and mental wellbeing of individuals with autism. Although much research has focused on supporting social skills broadly, little attention has been paid to developing effective nonverbal behaviors, which are necessary to initiate, maintain, and gracefully terminate a social interaction.

The aim of the dissertation work is to design and evaluate the effect of realtime visualizations of prosody and proximity. To this end, the research questions are: 1. Does visualizing nonverbal behavior increase the percent of intervals users demonstrate normative proximity and prosody during neurodiverse interactions, and 2. What factors surrounding technological social skills intervention impact its efficacy and acceptance? These research questions are answered through three lab-based experiments that include measuring prosody and proximity in controlled and experimental conditions, as well as interviewing the participants and family members about their experience with these novel technologies.

By using sensory perceptual strength associated with an autistic profile, (i.e., superior visual perception regarding details), I have designed and evaluated three technological systems to assist people with autism to engage in socially expected behavior during a brief conversation in a laboratory setting. The single-case experiments show that visualizations of real time feedback improve nonverbal communication during social interactions for close to half of the participants (i.e., young adults and children with autism). The results from the interviews with participants and parents about their experiences highlight issues of usability, learnability, and comfortability of the systems. Deeper analysis of these combined findings culminates in an assistive technology design concept-Sensory Accommodation Framework-which provides four strategies for supporting sensory perception differences through computation. The contributions to this work are: the empirical findings from the three evaluation studies, the design guidelines from the design activities, and the conceptual framework.

While obesity in America reaches epidemic proportions, at-home cooking rates and cooking skills have been on the decline. Cooking at home improves nutrition and increases weight loss, even in people not attempting to lose weight. Previous explorations in the cooking space have tended to focus on supporting cooking practices. Few, however, have looked at the challenges and decisions that occur during cooking, particularly for novice cooks. My interviews with novice cooks indicate that among other challenges, novices struggle with identifying and tracking cooking phases—the stages that food transitions through as it is being cooked—which results in badly cooked meals, as well as stress and anxiety about cooking. In a complementary study, I explored the capabilities of using gas sensors to provide cooking insight, and found that patterns in the signals can reveal the cooking phases that cause so many challenges for novice cooks. Building on these two studies, I developed and evaluated an interactive sensing system focused on teaching novice cooks to detect and act on the cooking phases. Participants who used the gas sensor visualizations achieved better cooking outcomes than those who did not, regardless of whether the lack of use of sensors was due participant choice or the lack of sensors as an option. These studies open up new trajectories for exploring the insights that gas sensor data provide and how to use such data to support novice cooks.

Autism Spectrum Disorder (ASD) is often characterized by a challenge in social skills, including the ability to interview successfully for jobs, a key hurdle in transitioning towards independent living. Employment interviews require mastery of a variety of skills that can be challenging for transition age youth with ASD. Building on previous work that suggests video modeling as a viable approach to teaching vocational skills, I evaluate the efficacy of peer and self-modeling for employment interviews across a variety of industries. I also study the impact of persuasive design on motivation and technology use. In this thesis, I present results from an iterative study of the feasibility and use of VidCoach, a prototype video modeling application. Results of the efficacy study indicate that use of video modeling can produce some improvement in interview performance. The use study produced deep understanding of use as needed in the specific context of mobile technologies for transition age youth with ASD. Persuasive design showed promise in motivating and positively impacting use of the VidCoach system for job interview preparation. Both studies exhibited the potential of a video modeling system to promote behavior change, but additional work should be undertaken to determine the actual impact and present evidence to that effect.

The playground is a space where play is encouraged and happens most freely. Online communities can be imagined as playgrounds. In addition to face-to-face playgrounds, these “online playgrounds” mediate the embodied experience, but in a different way. In the field of Human-Computer Interaction (HCI), to better understand play, I shift the focus from using technology to assist children with disabilities engage in normative play, to using technology that supports children’s play—whether normative or not. Work in other fields upholds normative, face-to-face interactions as the goal in any social interaction. Current research often holds offline and online as two distinct experiences with many caregivers, teachers, parents, and researchers privileging the experiences that happen in the physical, face-to-face realm—the physical-world playground. In HCI, studying technology for play is often acknowledged only to accomplish specific goals (such as education, skill mastery, or improving health). When stakeholders use technology for play simply for the sake of play, normative interactions are the focal point, such as with able-bodied children. In technology research, children with disabilities are not ignored altogether, but rather when technology for play is studied for disabled children the technology becomes an aid—a support to allow the children more normative interactions. Being disabled inherently means not fitting into and not adhering to the normative embodied interactions. When we assume a normative way of engaging as the best or only way to interact, there will be people who are excluded. In a digital ethnography conducted in Autcraft, an online community centered around a Minecraft world for children with autism, we can see how online communities can become “online playgrounds” and used as an alternative place to play. This dissertation aims to re-center technology design to support topos-mediated ludic sociality—the various ways sociality as an embodied experience is mediated by playful place—rather than focusing on how technology can be used to normalize social interactions.

What happens to our accounts, data, and digital identities after we die? Over 550,000 US Facebook users will die in 2015, but their deaths will not necessarily result in the elimination of their accounts or their place inside a network of friends. This leaves friends and families with both the opportunity and challenge of incorporating digital identities into their practices of grief and mourning. Meanwhile, post-mortem digital identities require designers and administrators to address the ongoing use and maintenance of post-mortem data. In this dissertation, I present findings from mixed-methods research on digital afterlives. I identify how people interact with profiles after the account holder’s death, describe “post-mortem social networking" practices, articulate the multiple and conflicting needs of survivors, and present design research addressing the management of post-mortem digital identities. Framed within the larger scholarship on digital identity, I argue that digital identities are the byproduct of social performances that have been delegated into a technical system such that the system can re-present these performances. Through the study of post-mortem digital identities, I demonstrate ways that digital identities stand in as the deceased in both the social practices of friends and family and the technical functionality of social network sites.

Major life transitions often require people to make complicated decisions about how to disclose information about that change to the people in their lives. Social media, and people’s online self-presentations and social networks, add complexity to decisions about how to manage information disclosure and changing identities. This dissertation focuses on how people present and disclose changing identities on social media during life transitions, and how these changes impact emotional wellbeing. I use gender transition as a case study to understand the relationships between identity disclosure, emotional wellbeing, and social support in online contexts, and how people experience liminality on social media. I examined transgender people’s transition experiences using data from transition blogs on Tumblr, a social media blogging site on which people document their gender transitions. I analyzed text data from these blogs using methods including sentiment analysis and statistical inference, followed by qualitative analysis of in-depth interviews with transgender bloggers. I contribute an empirical examination of how people’s emotional wellbeing changes over time through the gender transition process. Transgender identity disclosures to family members are associated with decreased emotional wellbeing in the short term, followed by increased emotional wellbeing in the long term. Facebook disclosures, an efficient means of mass disclosure, are associated with increased emotional wellbeing for those whose Facebook networks were supportive. However, over a longer time period post-transition, people’s emotional wellbeing is impacted by other life events that take precedence, intersecting identity facets, and the ups and downs of life more broadly. To conceptualize these results, I apply ethnographer van Gennep’s liminality framework to a social media context and contribute a new understanding of liminality by arguing that reconstructing one’s online identity during life transitions is a rite of passage. During life transitions, people present multiple identities and do transition work simultaneously on different social media sites that together act as what I call social transition machinery. Social transition machinery describes the ways that, for people facing life transitions, multiple social media sites often remain separate, yet work together to facilitate life transitions.

Pedestrians, especially those with disabilities, rely on mobile map applications to plan their daily trips and navigate unfamiliar spaces. Yet, many of these applications do not provide crucial real-time information for pedestrians, including foot traffic, semipermanent and permanent obstacles, sidewalk accidents, and other barriers common to pedestrian spaces. Over the past decade, researchers and engineers in academia and industry have explored accessible navigation in a variety of mobile applications. Despite significant effort, accessible navigation features can only provide limited real-time information to select major metropolitan areas. One substantial obstacle preventing real-time accessible navigation from being more informative and deployed to more places is the expensive and manual process of regularly collecting and updating pedestrian walkway data. This thesis presents an initial feasibility study with eight student volunteers who commuted with scooters regularly at the University of California, Irvine. Data collected through custom GPS modules and the follow-up survey revealed insights about the plausibility of extracting real-time pedestrian walkway accessibility information from scooter riders’ travel patterns. My work calls for future researchers working on accessible maps to delve deeper into travel patterns of different human-controlled or autonomous wheeled devices, not just wheelchairs, on pedestrian walkways. Only when pedestrian walkway data collection becomes less manual and costly can updates happen often and more areas be covered.