Elizabeth L. Murnane

Background: Major depressive disorder (MDD) is a prevalent and impairing mental health condition characterized by persistent low mood and diminished energy. Self-report instruments, such as the Patient Health Questionnaire-8 (PHQ-8), are frequently used in clinical and research settings for depression assessment. Objective: We developed, redesigned, and tested 2 alternative versions of the PHQ-8 that incorporate visual elements and reframed statements aimed at improving acceptability and comprehension. Methods: In a mixed methods study, 20 participants with high subclinical to moderately severe depressive symptoms provided feedback after completing 3 versions: the standard PHQ-8 form, our version augmented with visual aids, and our version that combined visual aids with rephrased item statements for greater clarity and engagement. Results: Eighty percent (16/20) of participants preferred one of the augmented PHQ-8 versions over the standard questionnaire Conclusions: Participants reported that the augmented versions improved their understanding of survey items, reduced response burden, and increased engagement, suggesting that visual and linguistic design modifications may enhance the patient experience in depression screening.

Self-tracking tools can support health awareness and behavior change, though sustaining engagement remains difficult. Prior work has explored qualitative visualization, customization, and collaborative features to promote engagement; but little is known about how these strategies interact when combined. We present Sprout, a mobile application that integrates qualitative, customizable, and collaborative health tracking using a garden metaphor. Sprout allows users to choose what they track, customize how data is visually encoded, and participate in anonymous communities where collective progress unlocks shared features. In a 2-week field study with N=22 participants, users reported that qualitative displays worked best as a complement to quantitative tools, customization mostly happened during app setup, social features were the most engaging though collaboration produced both motivation and frustration, and anonymity protected privacy but limited social connection. Our findings show how multiple design strategies coexist in one system, sometimes competing and sometimes aligning in supporting users’ tracking needs.

This longitudinal study, conducted during the COVID‐19 pandemic, investigates how indoor and outdoor nature exposure relate to wellbeing and environmental behavior among remote workers. We recruited 460 US participants at baseline and tracked them over four surveys (2020–2023), examining impacts of indoor features (plants, natural materials, biophilic décor, and natural light/views) and outdoor time on stress, creativity, and workplace/residential environmental behavior. Linear mixed‐effects models showed natural materials reduced stress and enhanced creativity, whereas indoor plants and natural light/views promoted environmental behaviors in workplace and residence. Aggregated indoor natural elements were associated with workplace environmental behavior and creativity. Outdoor nature time mainly influenced residential environmental behavior. These effects were moderated by environmental attitudes: Those with higher self‐inclusion in nature benefited more from indoor nature, whereas those with stronger ecological worldviews exhibited greater behavioral responsiveness. Findings highlight complementary roles of indoor and outdoor nature, informing design strategies for healthier, more sustainable environments.

Long-term dementia care is often shaped by fragmented documentation practices that fail to capture the relational and evolving nature of caregiving. We present CareInsights, an AI-enabled infrastructure that supports caregivers by passively capturing interaction data, enriching it with contextual and clinical signals, and generating narrative-based feedback to support day-to-day person-centered care. Our system was developed through a two-year collaboration with seven long-term care facilities and integrated into existing electronic health record systems and memory therapy platforms to minimize disruption and streamline uptake. We evaluated CareInsights through a combination of system performance analysis, content assessments, caregiver surveys, and interviews. Our model demonstrated expert-level performance, and caregivers reported outcomes consistent with more effective person-centered dementia care. Adoption was supported by integration into existing staff workflows and design choices that mirrored caregiver reasoning. We conclude with design implications for “narrative AI infrastructure,” offering guidance for scaling person-centered, AI-enabled support in real-world care environments.

Person-centered care provides a critical framework for dementia support in long-term care facilities, emphasizing attention to each resident's evolving needs, personal history, preferences, and values. Achieving this level of personalized attention depends on coordination among staff and active family involvement to record and share this essential context. However, fragmented communication, caregiver burnout, limited resources, and regulatory complexity frequently disrupt the flow of information, creating conditions in which person-centered care becomes difficult to sustain in practice. To address these challenges, we introduce Family In The Loop (FITL), an AI-enabled web platform that enhances continuity and collaboration for person-centered dementia care. FITL automatically synthesizes diverse care data-including video, notes, and records-into contextually relevant, emotionally resonant updates tailored for staff and family members. It offers four interlinked views: ''Reels'' provides families with concise, meaningful video updates; ''Essentials'' supplies caregivers with resident-specific summaries for immediate use; ''Explanations'' presents narrative insights into care decisions; and ''Archives'' maintains a searchable, longitudinal record of care activities. Together, these views enable flexible yet coordinated information sharing, respecting the fluid nature of family involvement and supporting continuity across caregiver roles and shifts. Through an iterative co-creation process spanning two years and seven resource-constrained facilities, we designed, developed, and deployed FITL in real-world dementia care contexts. Findings indicate that FITL improved staff access to critical resident information and facilitated sustained family engagement without increasing caregiver burdens. By surfacing timely, personalized, and meaningful information, FITL strengthened trust between families and staff, reduced misunderstandings, and bridged communication gaps. Our work highlights the potential of AI tools to stitch fragmented care interactions into cohesive, person-centered caregiving ecosystems. We conclude the paper by discussing inherent tensions around automation, oversight, and privacy, and we propose design principles for adaptive, collaborative, and person-centered care technologies.

Physical Therapy (PT) is crucial for recovery from acute injuries and plays a vital role in promoting functional ability. However, at-home PT is often associated with boredom, lack of engagement, and difficulties in receiving immediate feedback about exercise performance, all of which contribute to poorer PT outcomes. This paper introduces an approach that leverages the engaging, therapeutic power of music to provide intuitive, real-time feedback and adaptive guidance during PT. Developed through a user-centered, research-through-design process, our "MusicalPT" system tracks and sonifies limb movements using computer vision and music generation techniques. We present a low-cost, lightweight, and robust tracking setup that can be used at home with a webcam and a computing device. Our lab-based evaluation shows that this musical guidance helps people perform exercises correctly and remain engaged, while promoting enjoyment and other dimensions of positive user experience. Based on these findings, we discuss broader design directions for interactive musical technologies in the context of health management.

UNSTRUCTURED Major Depressive Disorder (MDD) is a prevalent and impairing mental health condition characterized by persistent low mood, diminished energy, and disrupted sleep. Self-report instruments, such as the PHQ-8, are frequently used in clinical and research settings for depression assessment. However, repeated administration of these tools may lead to survey fatigue, diminished patient engagement, and misunderstanding of survey-item content, undermining patient satisfaction and compromising the validity of the responses. To address these limitations, we developed, redesigned, and tested two new versions of the PHQ-8, incorporating visualizations and reframed statements aimed at improving acceptability and comprehension. In a mixed-methods study, 20 participants with high subclinical to moderately severe depressive symptoms provided feedback after completing three versions: the standard PHQ-8 form, our version augmented with visual aids, and our version that combined visual aids with rephrased item statements for greater clarity and engagement. Results showed that 80% of participants expressed a preference for the augmented PHQ-8 over the traditional PHQ-8 that was statistically significant, where p was equal to 0.006. Participants cited their preference for the augmented PHQ-8 was related to improved understanding, ease of use, and engagement.

On-demand mental health services-including counseling, crisis hotlines, and peer support programs-are vital to the healthcare system, providing acute and ongoing support through telephone, online chats, and text messaging. Although such services have proven effective at reducing hopelessness, psychological pain, and suicidality, they put the providers of these services at high risk of burnout, secondary traumatic stress, and compassion fatigue. Our interviews with professionals from four mental health organizations revealed that while these workers have a strong motivation to help clients with mental health care needs, they face various challenges themselves, particularly regarding heavy caseloads, difficult crisis clients, and coping with repeated exposure to abuse and harassment. To overcome challenges, participants identify the need to be self-reliant and engage in self-care practices ranging from socializing with coworkers to yoga and meditation. Although organizations spend significant time training workers prior to their involvement with clients, the training typically lacks components on self-compassion and self-care. Designers might see technology as an opportunity to promote such practices; however, while technology is an integral part of their work routine, participants, irrespective of age, had misapprehensions regarding technology use in the mental health care space, including for managing their psychological well-being. We recommend design guidelines for HCI researchers, including developing contextualized just-in-time adaptive interventions to promote self-compassion and educating workers regarding the use of various technologies to manage their well-being.