Cristina Bosco

After the overturn of Roe v. Wade, access to abortion care in the United States has been highly restricted, with some states imposing complete bans on abortion. In this newly emerging restrictive social context, people rely on methods outside of formal healthcare settings to manage their reproductive health, one of which is self-managed pill-based abortion. Digital tools present a novel opportunity to help people navigate the complex task of seeking self-managed abortions. However, deliberately designing digital tools to support this need remains an underexplored topic. This research aims to explore the design needs and requirements for aiding people living in the U.S. to seek a self-managed abortion by conducting a two-phased study: first, investigating the needs of U.S. abortion seekers, and then using these needs to design a platform that serves as a design probe. Our findings reveal core design tensions, concerns, and opportunities when conceptualizing technologies for abortion care. This study contributes meaningfully to the discussion on how digital technologies can be deliberately designed to foster bodily autonomy and reproductive rights.

BACKGROUND Mobile health applications have the potential to empower community-dwelling African Americans (AAs) by increasing access to health education, improving health literacy, and encouraging engagement in research. Despite the potential, few digital interventions provide culturally responsive, evidence-based education on Alzheimer’s disease and related dementia (ADRD) and brain health. Thus, the Lola mobile app was developed with the goals of increasing ADRD literacy and participation in clinical brain health research among AAs. OBJECTIVE This was a single-group pretest–posttest design to field-test the Lola mobile app, a newly developed and culturally responsive mobile application. AAs aged 45 years and older were recruited and asked to use this app for a one-month period. The app automatically recorded engagement and categorized users into four groups: infrequent, casual, core, and power users. METHODS This study used pre- and post-statistical analyses of participants’ responses to different knowledge-score questionnaires. RESULTS Of 303 AAs screened, 135 were eligible and consented; 105 AAs with a mean age of 63.4 years completed both pre- and post-surveys, yielding a completion rate of 77.8%. Half of the participants were classified as core or power users. Knowledge scores in ADRD and brain health significantly improved following one month of using the Lola mobile app. Higher engagement with the app did not lead to higher intention to participate in ADRD-related research. Power users reported being less likely to participate in genetic testing. CONCLUSIONS The Lola mobile app is a feasible and highly usable mobile platform for AAs. However, increased engagement with the app did not translate into consistently greater knowledge gains, nor did it meaningfully increase participants’ intentions to engage in ADRD-related research activities. These results suggest that while the app effectively enhances knowledge and information accessibility, additional strategies may be necessary to influence research participation behaviors.

Low levels of health literacy concerning Alzheimer’s Disease and related dementias (ADRD) impact African American/Black communities access to appropriate ADRD care. Additionally, a legacy of mistrust in medical research due to systemic racism has resulted in insufficient participation in ADRD clinical trials among African American/Black adults. This study explores the potential of generative AI to improve ADRD literacy and encourage participation in clinical trials among African American/Black older adults. We designed a mobile health intervention featuring AI-driven conversational agents—a chatbot and a voice assistant—specifically developed for this population. We tested the quality of the intervention using heuristics methodology adapted to the target population along with inputs from African American/Black medical professionals and UX designers. Key findings highlight the unique needs of the African American/Black communities for culturally relevant content that is accessible to users with varying language levels and tailored to users’ geographical location. Concerning the interaction, high levels of personalization and control over the interaction can promote the use of the tool, by minimizing complexity and maximizing accessibility. These findings show the novel contribution offered by our study in the domain of designing health technology with generative AI, particularly LLMS, for African American/Black communities.

The overturn of Roe v. Wade radically changed abortion access within the United States leaving women to navigate new financial, legal, and logistical challenges in managing their reproductive health needs. Reporting on findings from co-design workshops with participants from Indiana (a state with an abortion ban) and New York (where abortion is accessible), we investigate how women envision care in response to ongoing legal and medical uncertainty. Drawing together techno-feminist scholarship on care and reproductive health, in this paper we highlight several "entangled" design stories of anxiety and fear in navigating diminished healthcare services, as well as resistance and hope. Our findings prompt critical reflections for HCI on the role of health technology amid a world in which reproductive health, and medicine at large, is often a site of political contestation and conflict. Care-in-Retrograde re-orients a techno-utopian and future-oriented view of health technology to consider design work amid healthcare trajectories of disruption and reversal.

Background: As restrictive abortion laws continue to emerge in various states of the United States, pregnant individuals are turning to alternative channels to seek abortion medication, one of which is engaging in self-managed medication abortion, purchasing the medication from online websites without any medical prescriptions. Objective: This study explores the phenomenon of self-managed abortion medication sought by using online tools, by focusing mainly on the motivational factors and concerns behind such a decision, and the abortion seekers’ journey throughout this process. Methods: We conducted 20 semistructured interviews with individuals who have sought an abortion in the United States by buying medication online. The interviews occurred online, and participants were compensated for their participation. Participants were recruited from Reddit communities centered around abortion access. The interviews were audio-recorded and transcribed. The data were analyzed using a grounded theory approach. Results: The results showed that participants expressed the need for anonymity, digital and physical, when seeking an abortion and considered self-managed abortion to be more economically and time-convenient. They also discussed how much self-managed abortion can lead to isolation and anxiety because of the lack of medical support and the sole reliance on information found online. The risks, such as counterfeit medication, possible fraud, and issues of timing, associated with seeking a self-managed abortion were extensively discussed by participants. Conclusions: Our research uncovered the motivational factors behind relying on online tools to purchase abortion medication and engaging in self-managed abortion. Moreover, our research provides evidence of the importance of digital services to offer pregnant individuals a way to find abortion medication detached from their physical communities, circumventing the stigma associated with seeking an abortion and the sociocultural consequences of it. This promised anonymity is the core motivational factor that encourages pregnant individuals to prefer these systems compared to legal options. However, behind this promised anonymity, privacy and security concerns might be hidden.