Effective personal health information management (PHIM), including symptom monitoring, medication management and clinical care coordination, facilitates self-care, ensures appropriate use of health services, and improves health outcomes. Computer tools can assist with PHIM, but these solutions are often created with little attention to where they will be used. The visibility of a calendar for reminding one of a weekly blood test or the proximity of a Bluetooth-enabled glucometer to the computer that stores the readings can enable or interfere with PHIM. Designers must understand where PHIM occurs to make optimally effective solutions. Yet bringing designers and engineers into the private, personal spaces and allowing repeated, systematic study of home contexts is not only burdensome to the home dweller, but also infeasible due to the ever-changing nature of homes. The purpose of this project is to systematically determine how household context shapes personal health information management. Using Venkatesh's (1996) model of the five environments of health to explicate the environmental context in the SEIPS work system model, we will (1) undertake an extensive study of 20 households addressing the social, physical, psychological, technical and health services context of PHIM, including creating detailed photographic, video, and 3D reconstructions of these households in a virtual reality CAVE; (2) through recursive immersive exploration in the CAVE, enumerate the features of these households that shape PHIM; (3) enlist 20 people self-identified with diabetes in a requirements validation activity in the CAVE; (4) engage 60 people with diabetes in an experimental evaluation of these indicators and (5) use all of these results to develop and evaluate, in a field assessment of 200 households, an Assessment of the Context of Home Environments inventory. The reference set of 20 virtual homes will be distributed through Creative Commons for repeated studies by designers. We will also make available the Assessment of the Context of Home Environments (ACHE) protocol for rapid assessments of the home context. This interdisciplinary project brings together nurses, engineers, computer scientists, and health services researchers to explicate how the home context shapes health information needs and can be used to guide the design of consumer health information management solutions. As health care migrates from the institution to the home, and engagement of everyone in healthy practices is necessary to avoid disease or mitigate its consequences, systematic understanding of how homes will foster the integration of technologies into the every-day lives of people that ensure that homes not only become spaces for health but tools that draw people towards optimal well-being.

Public Health Relevance

to Public Health More and more of health care occurs in the home, and a growing number of computer tools are becoming available to help people manage personal health concerns and health information. This project will figure out how features of the home interior, such as the adequacy and privacy of space available for health, and common household objects like calendars and file cabinets, help or hinder people as they manage health information.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Research Project (R01)
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Health Care Technology and Decision Science (HTDS)
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Kim, Bryan
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University of Wisconsin Madison
Schools of Nursing
United States
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