Approaches to HCI

  FeedFinder: A Location-Mapping Mobile Application for Breastfeeding Women

1st Author Name – Affiliation – Address – e-mail address

2nd Author Name – Affiliation – Address – e-mail address

3rd Author Name – Affiliation – Address – e-mail address

ABSTRACT

Breastfeeding is positively encouraged across many countries as a public health endeavour. The World Health Organisation recommends breastfeeding exclusively for the first six months of an infant’s life. However, women can struggle to breastfeed, and to persist with breastfeeding, for a number of reasons from technique to social acceptance. This paper reports on four phases of a design and research project, from sensitizing user-engagement and user-centred design, to the development and in-the-wild deployment of a mobile phone application called FeedFinder.

Comment 1

FeedFinder has been developed with breastfeeding women to support them in finding, reviewing and sharing public breastfeeding places with other breastfeeding women.

Comment 2

We discuss how mobile technologies can be designed to support public health endeavours, and suggest that public health technologies are better aimed at communities and societiesrather than individual.

Comment 3

Author Keywords breastfeeding, mobile, user-centred design, public health.

ACM Classification Keywords H.5.m. Information interfaces and presentation (e.g., HCI):

Miscellaneous.

INTRODUCTION

Breastfeeding is viewed as a positive health behaviour that has lasting health benefits for the breastfeeding mother and her child. In the UK women are recommended to breastfeedfor the first six months exclusively and to supplement additional food for at least a year [15]. Research has suggested that infants who are not breastfed are more likely to contract short-term infections (including respiratory and ear) and in particular infections that require a period of hospitalization. Longer-term implications can include a greater likelihood to become obese in later life, to develop type 2 diabetes, as well as slightly higher levels of blood-pressure and blood cholesterol. For breastfeeding women, evidence suggests that benefits include a reduction in the risk of breast and ovarian cancer [20]. According to the 2010 Infant Feeding Study [15] 81% of women in the UK initiate breastfeeding within the first 48 hours, with 69% of women continuing to breastfeed their infant at 1 week. By the six to eight week medical check-up 55% of women are continuing to breastfeed their infant. By six months just over a third of women (34%) are continuing to breastfeed their infant, well below the target of exclusive breastfeeding up to six months. Those women that are most likely to breastfeed are older, with 87% of women aged over 30 choosing to breastfeed their infant, compared to 58% of women aged under 20 choosing to breastfeed. In addition, women who undertook managerial and professional occupations were more likely to breastfeed (90%), than women who have never worked (71%).

There is much perceived pressure among women to breastfeed [21], from midwifery care through to public health messaging, where the choice to breastfeed is framed in moralistic terms. Choosing to breastfeed therefore becomes strongly linked with being a “good mother”, while choosing not to breastfeed is viewed as morally and socially deviant [18]. And, while breastfeeding is often described as the natural and trouble-free feeding method [38], many women experience practical difficulties and concerns in breastfeeding during the first few weeks of a baby’s life.

Breastfeeding requires learning on behalf of both the mother and baby, which requires support from local health services, practice, perseverance and persistence [5]. Less than optimal techniques can result in an extremely painful breastfeeding experience. And as the quantity of breast milk a baby consumes through breastfeeding not known, women can have concerns about insufficient milk supply and milk consumption, which undermine confidence in their ability to breastfeed and their bodies ability to ensure their baby thrives [4]. Finally, social, cultural and public values, familial history, class and regional influences all play a partin a woman’s choice to breastfeed or not [29].

The Public Construction of Breastfeeding

Women’s feeding choices are influenced not only by their own opinions, but by the socio-cultural context in which those decisions take place. A woman’s family, partner and the community in which she lives and works all play a part in the decision she makes as to whether she will breastfeed and continue to breastfeed up to and past six months [28, 29]. Previous research has identified that support forbreastfeeding outside of the home is limited within the UK  [29]. The act of breastfeeding is considered intimate and personal and therefore not appropriate for public consumption [6]. This lack of perceived public, practical and moral support for breastfeeding can be extremely problematic for breastfeeding women, as this sense of disapproval is viewed as a negative judgment of them as a person [28]. In response women arrange their day such that they remain close to home or to designated lactation rooms, in order that they never have to feed in public [6]. The work of keeping breastfeeding invisible clearly increases the labour associated with breastfeeding [37]. This paucity of day-to-day contact with breastfeeding is also evident in media production and consumption. For example, content analysis of British TV showed that bottlefeeding was shown often in televised programmes, but breastfeeding only appeared once [17]. Photos of women breastfeeding have, until very recently, been banned from social networking sites [27]. In addition, news stories in print media regularly report on instances where women have been asked not to breastfeed in a public place. This contrives to achieve a context where it is rare to see a woman breastfeeding an infant in public [6], and, where public breastfeeding is a necessity, there is a social expectation it will be discrete [32]. As less women are seen breastfeeding in public, breastfeeding is seen as a less available infant feeding option, especially for those from socio-economic groups where breastfeeding is less common [24, 35].

Lactivism and Community Support

It has been suggested that the transition to motherhood can be a motivational force for women to engage in political activism [34]. And, since breastfeeding in public is not a neutral activity [29], but rather a political performance where the caring practice associated with, in particular, very young babies is made visible to the public [6, 36], there has been an increasing amount of activism in relation to breastfeeding in public in recent years. Nurse-ins are perhaps the pinnacle of this kind of ‘lactivisim’, where breastfeeding women congregate to breastfeed en-mass, typically in restaurants, cafes and shops where a women haspreviously been told that they can’t breastfeed. Breastfeeding picnics similarly focus on bringing women together en-mass to breastfeed, but usually take place in family friendly places such as parks. Boyer et al [6] make the distinction between these two forms of lactivisim, stating that nurse-ins focus on breastfeeding mothers rights as consumers (to breastfeed in cafes, airplanes, etc.), whereas breastfeeding picnics focus on breastfeeding mothers rights as citizens (to breastfeed in parks, on benches). However, she also highlights how these forms of lactivism can further alienate some women who simply see themselves as trying their best to cater to their infant’s needs when breastfeeding publically.

HCI and the New Mother / Parent

HCI has turned to new mother- and parent-hood as a transitional time in life which digital technologies may be well placed to support [3]. There exists a diverse range of design studies and devices from pregnancy suits to enable the non-pregnant partner to better empathise with the experiences of the pregnant women [19] through to devices to support pregnant women manage and share their healthcare records [13]. Research has investigated how new mothers use social networking technologies to find confidence in their new role, as well as maintain their identity beyond that of ‘mother’ [14]. Recently a small body of work within HCI has responded to needs around breastfeeding specifically, with for example the development of a relational agent that is able to engage in an empathetic dialogue with a mother to deliver information about breastfeeding antenatally [12]. Other projects have explored how a mobile application can aid people in correctly pasteurising breastmilk donated to human milk banks in developing countries [7]. Contributing to this work, this paper provides a case study of a user-centred design process undertaken with new mothers in the design, development and evaluation of a mobile application which enables women to find, review and share public places for breastfeeding.

Comment 4

We report on methods used for engaging new mothers in a design process, and reflect on the role that mobile technologies can take in delivering public health that focuses on change in the community, rather than change in the individual.

Comment 5

BREASTFEEDING IN THE NORTH EAST UK

The North East UK has low rates of breastfeeding initiation and continuation when compared with the national average. Around 54.5% of new mothers initiate breastfeeding within the first 48 hours, below the national average of 72.5%. While breastfeeding initiation in the area has improved slightly since 2006, continuation of breastfeeding beyond the first six to eight weeks is the lowest in the country, with only 31.9% of infants receiving some breast milk at six to eight weeks. Recent research notes that despite good maternity units and innovative interventions to support breastfeeding, breastfeeding is rarely seen in public [29], with participants stating that adequate and comfortable places were rarely provided.

DESIGNING FEEDFINDER

We followed an iterative user-centred design cycle in the design of FeedFinder, initially seeking to develop a sensitising account of women’s experiences of breastfeeding locally.

Comment 6

Generative design ideation around these accounts led to the concept of a breastfeeding mapping application to allow women to find, review and share places for breastfeeding. Further inquiry took the form of a series of design workshops that explored what values contribute to good and bad breastfeeding experiences. Finally, a medium fidelity prototype was evaluated using cooperative evaluation to identify any usability issues.

Comment 7

Sensitising Interviews with Breastfeeding Mothers

At the outset of the project we conducted four one-to-one 30-minute sensitising interviews with new mothers in a local café, 12 to 16 weeks after the birth of their first baby. Each mother had reported prior to giving birth that it was their intention to breastfeed their baby. At the point of interview three women were breastfeeding their babies exclusively and one woman was formula feeding her baby exclusively. These interviews focused primarily on initial experiences of breastfeeding, but also touched on wider experiences of early motherhood. Each interview was audio recorded, transcribed and analysed using an inductive thematic analysis. We report on two reoccurring themes related to breastfeeding pressures and the act of public breastfeeding.

Pressures on Unfamiliar Ground

For each of the women the choice to breastfeed had initially been entangled with social, professional and familial identities and relationships. Two women had chosen to breastfeed as a result of their professions (a nutritionist and a support worker at a charity supporting early years education and health). “I felt pretty pressured [to breastfeed] in the first place cause I work for Sure Start, so there we encourage Mums to breastfeed and it’s best thing obviously, I know it is anyway” (Sandra). Cara on the other hand stated that she had never really questioned whether she would breastfeed. As a nutritionist she considered it to be the best start for her child and “… was determined to try and try and try even if it doesn’t work.” Sarah similarly reported the sense that breastfeeding was the best thing for her baby and although she “… wasn’t overly enthusiastic about it” she felt that breastfeeding was a familiar option since her mother had breastfed her and her siblings. Although Sarah felt that breastfeeding was what she wanted to do, she was acutely aware that both her mother-in-law and her own mother wanted her to breastfeed. “Yeah, like my family encouraged me to breastfeed as well so ya know, both my Mum and my Husband’s Mum were like quite keen for me to do it.” While each woman might have made the decision to at least try breastfeeding for their own reasons, their choices was made antenatally. And for each of the women the experience is something quite different from their original perception. Cara explained: “I knew it would be tiring – but I didn’t realize how tiring it was going to be.I’ve got a couple of friends who have already given up because they found it too tiring. Some days you have more time between feeds, but most of the time it’s sort of every hour, hour and a half.” And, while Cara was able to overcome some of the uncertainty associated with breastfeeding a baby (for example, knowing when to feed and knowing whether the baby has had enough), Sandra found herself unable to: “I’m not breastfeeding anymore. I started mix feeding. It’s just too, too hard, too tiring. She was too greedy, but she’s in a lot better routine now, I wish I hadn’t given up, but… I didn’t realise how difficult it was going to be … I had no idea when she was going to need feeding.” The choice to continue or not with breastfeeding has to be both the best choice for the baby and the mother. So while Sandra might wish she hadn’t given up breastfeeding, she is now better able to sleep as she can share the care of her baby with her partner more fully, and feels “much happier now I have stopped.” In making this choice Sandra wasn’t just choosing what was best for her and her partner, but also her baby “she [the baby] took the bottle so well I thought it was the best thing for her, but I do wish I’d tried for longer.” However, once making this choice Sandra had to fight to legitimise it. She considers that she continued to breastfeed “more for other people than for me, like the midwives and things. They ask you if you are still breastfeeding and if you have any concerns they push you to do a couple more days… I was terrified about telling my midwife I didn’t want to breastfeed anymore so I avoided her.”

Exposing a New Self

In the early weeks of motherhood the women we interviewed attempted to confine breastfeeding to the home. Cara would “try and time feeds so I could feed him at home, get out and then be back at home for the next one or somewhere where I could hide away”. But the attempt to provide this care for their babies in private hindered the extent to which they could continue managing other aspects of their lives.

Sandra tells us how ‘I couldn’t even nip to the shops’, ‘I didn’t come into town in case she did wanted to be fed’. Yet, for most breastfeeding women there comes a time when one must breastfeed in public. In doing so, they are confronted with the public perception of breastfeeding. For instance, Sarah was aware “from my antenatal classes is that breastfeeding is really low in the north east”. As a result when the women made the finally decision to breastfeed in a public place they seemed to anticipate that it would be perceived by others as a controversial activity. Sarah told us with surprise “I haven’t had any problems – no one has said anything to me or anything like that.”, while Sandra armed herself with legal knowledge when breastfeeding outside of the home: “because of the job I do I would know I was well within my rights to be doing it.”

Having “jumped in at the deep end” and fed in public, Cara seemed to positively embrace a sense of freedom: “I don’t care where I do it. I fed him on the Quayside market sitting on a step the other day! I’ve turned into one of those mothers who will just get their boobs out everywhere. I just don’t care anymore.” While Sarah is also “not that bothered about breastfeeding in public”, she took a much more deliberated approach to breastfeeding in a public place: “…I’ve spoken to a few people at church just to like gage what other people’s opinion [of breastfeeding in public] is, like am I too confident, should I be more like reserved? But I don’t think I have been. Like, I only do it when I’m sitting out of the way or in a café I’d sort of sit in a corner, like I try and sit somewhere more discrete…” This concern with whether there is a proper way to feed in public is felt by Cara not through her own concerns, but through the concerns of others she is close to: “My friends who don’t have babies, they would be like, this woman just got her boob out in McDonalds, and I would tell them well I hope you know I’m going to be doing that don’t you. And they were like well you will have to be discrete won’t you and I was like well I’ll try.”

And, while both Sarah and Cara use a feeding scarf in order to be discrete in public if and when necessary, Sarah attempts to be discrete also through planning and choosing where she can breastfeed when out and about: “I think it’s useful in bigger department stores knowing there’s somewhere you can go which I hadn’t known existed beforehand… but I’m quite happy to sit in a coffee shop if I need to.” Similarly although Cara will breastfeed anywhere she has at times sought to find places where breastfeeding is welcome, but has found online resources to be lacking: “…the resources are old, they aren’t kept up to date. Like it said there was a good one [breastfeeding room] in Boots and I went in and they don’t have one anymore. It didn’t matter in my case but that could panic people who don’t like to feed in public at all.”

While drawing attention to a range of issues related to early experiences of motherhood, the interview data highlights some challenges experienced by new mothers who choose to breastfeed. In particular, we see how breastfeeding a young baby can be unpredictable, such that women do not feel confident to leave the house in case they have to breastfeed outside of their home. We see that breastfeeding outside of the home is considered a challenge not only because of the fact that intimate parts of one’s body may be exposed, bodily fluids might be leaked, but also because women are unsure how their breastfeeding might be perceived by the public, and how they might cope with public hostility.

Comment 8

Design Workshops

Following analysis and ideation our design response took the form of a mobile phone application that allows women to find, review and share places for public breastfeeding. The application could serve the very practical benefit of allowing women to know where other women have had positive experiences of breastfeeding in public places, while also potentially highlighting the variety and breadth of places where women do have positive experiences of breastfeeding in public. To explore the design as well as understand the specificities of how such an application we conducted a series of design workshops.

Within the UK context local community breastfeeding support groups are available to offer informal places for women (often with new babies) to gather and breastfeed. On the whole, these groups offer a much needed space for women to meet other women who have recently become mums, as well as a place where women can come to solicit support and advice on breastfeeding. We were invited to run our design sessions within four of these community support groups around the city and its suburbs, and through this engaged with a further 21 mothers.

Our design sessions were structured around two lightweight and flexible activities, the first focused on mapping women’s experiences of breastfeeding locally (mapping past experiences) and the second focused on drawing out the experiential qualities that make a place good for breastfeeding (prioritizing location qualities). Each activity was designed to be relatively quick to complete, require minimum hands-on activity from the women (since they could be breastfeeding) and could be conducted either with individual women, or with groups of women. Each workshop was audio recorded, transcribed and analysed using an deductive thematic analysis.

Mapping Past Experiences

Using an annotated map of the area surrounding each breastfeeding community group we asked the women to map places where they had breastfeed publically and to describe some of their (positive and negative) experiences of breastfeeding locally. The data further suggested that women experience anxiety in relation to breastfeeding in public. And while this anxiety and feeling of embarrassment fades over time and with experience (“I don’t find it embarrassing because I think you get over that really quickly, within the first of weeks…”) it was considered to exacerbate stress relating to early breastfeeding experiences (“What am I going to do, where am I going to go and that’s another anxiety you’ve got to get over and not only have you got to make sure they latch on properly and you’re doing all the other things, you’re trying to go through a mental checklist and the problem of finding somewhere and then thinking are they going to let me, is it going to be alright?”)

In discussing public breastfeeding with our participants we heard a handful of negative stories. Nancy told us of her experience breastfeeding in a high-end pizza chain: “… They were absolutely awful in there… When they saw me getting [my baby] ready to feed they were like ‘oh don’t come and sit over here. Oh no no, go and sit over here in this corner…’ I’m like no what’s wrong with me sitting here because I was quite near the window and they were like ‘oh no, we’d rather you go and sit there’ and then I had people walking out of there because I was feeding…” However, overall the women’s experiences were positive when they did breastfeed in public, with one participant reporting that a stranger in cafe had congratulated her for breastfeeding.

In our group discussions women often shared with one another good places to breastfeed around the city, as well as discussing certain problems that had to be overcome when looking for somewhere to breastfeed. The pragmatics of navigating a busy café with a buggy (“…there’s nothing worse than banging into every table and chair going…”), to knowing that a member of staff would carry a hot drink to the table (“because you can’t manage a buggy, a baby, a toddler if you’ve got one and whatever drink”), or that free drinking water was available. Common strategies for juggling these practical concerns was to only visit places which had baby changing facilities as the women considered that this indicated some level of baby friendliness.

Prioritizing Place Qualities

The second activity aimed to understand what qualities of a place were important to a positive public breastfeeding experience. We explored this through a card sorting activity. 14 cards were designed, each representing a feature or quality used to describe a place: clean, open, bustling, stylish, convenient, baby facilities, friendly, comfy, familiar, privacy, spacious, affordable, entertaining, calm. To complete the activity an individual or group of women were asked to provide a description of the quality in question and then place it on a target; the nearer the centre the more important, the nearer the perimeter the less important (see Figure 1). Blank cards were also available for women to include additional qualities of places that they considered important to a positive breastfeeding experience.

Through this activity we discovered that the qualities central to a positive experience of public breastfeeding were in part changeable dependent upon the age of the women’s baby and thereby their experience in breastfeeding. For example, for those new to breastfeeding, women tended to prefer to feed their babies somewhere private so as to concentrate on getting the baby to latch on properly. Alternatively, women with older babies tended to prefer somewhere quiet so as to reduce possible distractions (“Especially now as he’s got older I need somewhere quiet rather than somewhere that there’s loads going on because literally he’ll be on and off and on and off to see what’s going on.”). Similarly, while women got used to breastfeeding and in particular different ways of holding and supporting their baby while feeding, they tended to seek out places to breastfeed with supportive soft seating.  However, as women became more experienced and in tandem their baby developed better head control and strength, women found they could feed on hard seats, or the ground if necessary.

Figure 1: A Completed Prioritisation of Place Qualities

Co-operative Evaluation

The final element of our user-centred design cycle saw the cooperative evaluation [26] of a wireframe, medium fidelity prototype of FeedFinder. We brought the wireframe, which illustrated interactions required to find a review, add a review and add a place, to one of the breastfeeding community groups who had participated in the original design workshops. We asked six women to walkthrough the wireframe, completing three activities: finding and viewing the reviews for a place, adding a review for a place, and adding a new breastfeeding place to the map. As the women completed each task, we asked the women to ‘think-aloud’ their actions and discuss with any problems that they were encountering. Notes were made throughout each evaluation and any usability issues and potential remedies were discussed with the user.

Comment 9

WHAT IS FEEDFINDER?

FeedFinder is a mobile application, available for free on both iOS and Android that enables women (and other interested parties, such as breastfeeding community workers, midwives, partners, business owners) to explore and contribute to a map which describes how supportive the local community and services are toward women who breastfeed. Women can use FeedFinder to search for and view places on the map where other women have previously breastfed, along with those women’s reviews and ratings along five categories: Comfy(ness), Clean(liness), Privacy, Baby Facilities and Average Spend.

Women can also add new places to the map where they have breastfed and leave reviews for that place. We added a brief survey to FeedFinder to collect an overview of women’s experiences of using the application. The short survey asks users to rate how happy they are with the application, whether they would recommend the application to a friend and whether the application has helped them to find a place to breastfeed in the last week. The survey has an open text box for any additional comments. The survey is made available to women four weeks after the application was first downloaded.

RELEASING FEEDFINDER

The release of FeedFinder was planned to coincide with the birth of Prince George (July 2013) in order to maximise on possible interest within both regional and national press. The project was featured in television, radio and print media, including Sky News, BBC News as well as local press venues such as ‘the Journal’, the Metro radio and LBC radio.

We wanted the women who downloaded the application when it was first released to feel there was content there for them to interact with before hopefully moving onto adding reviews and new places to breastfeed based on their own  experiences. As such, we invited a number of local breastfeeding women (recruited primarily through the university and informal networks) to use an early version of the application to add reviews for places where they had experience of breastfeeding. In addition, we added reviews to the map within the local area based on data collected in our design workshops, and particularly in relation to the ‘Mapping Past Experiences’.

EVALUATING FEEDFINDER

FeedFinder has now been running for over 12 months and has seen an uptake of just under 3,000 members. FeedFinder has been used primarily in the UK however a smaller, but growing, number of venues and reviews have been added in the USA, Western Europe and Australia. At present, FeedFinder has 2888 women who have used or currently use FeedFinder, 1800 places where women have breastfed added, and a total of 1686 reviews.

Members on average used FeedFinder on 2.6 separate occasions over a period of 25 days. However those that interacted with the application on more than a single day, around 48% (1366 users), used the application almost twice that, with an average of 4.16 sessions over an average period of 53 days. The average session use time was 164.14 seconds (~3 minutes). During each session members performed on average 7.37 actions, viewing 1.45 venues and performed 5.2 map searches, with members searching 1.17 miles from their starting location. In addition, we found that 16% (475) of FeedFinder members have added at least one venue. A similar figure 14% (399) of members have contributed at least one review.

Members used the application throughout the day, but there were peaks in use three points during the day: 9am, 4pm and then 9pm. The application usage in the morning may reflect women searching to find places to breastfeed for later in the day. The 4pm peak in map searching may correspond with members attempting to find places to breastfeed while out and about. At 9pm the majority of reviews are submitted and places added suggesting that members find it easier to contribute to FeedFinder when in  the evening, perhaps once the baby is in bed.

Figure 2 shows the FeedFinder map centred on the UK.

As FeedFinder made use of the Foursquare API it was possible to categorise places added to FeedFinder. The four place types added most commonly were Coffee Shops (108), Cafés (95), Pubs (82) and Department Stores (74). The most reviewed venue categories were Department Stores (119), Coffee Shops (95), Cafés (87) and Pubs (60).

Survey Data, Feedback and Member Correspondance

So far, a total of 109 unique comments have been received in the “additional comments” section of the survey. These comments provided insight on the need for more places (49), specific faults (43), potential new features (15),  motivations for use (33), and miscellaneous items (1).

Not Many Local Places Yet!

Most prominent was the identified need for more places, which was linked to the need for more users (15), for pre-populated data (6), and for more promotion and advertising (5). In some cases, despite its usefulness, members recognised the need for further content: “Easy to use app and has helped me to locate breastfeeding friendly locations. Would benefit from further reviews and more locations however I understand this requires user feedback.”

Figure 2: The FeedFinder map centred on the UK as of 09/14

Members were also keen to either be directly involved in this member feedback, or in recruiting or promoting feedback from others. One member wanted to integrated FeedFinder with Facebook to promote other members to provide reviews. “great concept. will improve with more recommendations. anyway of linking it to check ins with eg Facebook to remind people to add venues?”

Yet, feedback also pointed to a need to prepopulate the app with ‘obvious’ locations, and contradicts the above suggestions of member feedback. As one comment suggests: “I love the idea but there’s no places listed! Would have been much better if you’d done some research and pre-populated it with a few of the obvious places in advance. Mothercares, mamas and papas, John Lewis etc. You shouldn’t just rely on user submissions as people won’t use an app with no content. Hopefully it’ll have more content soon though.” These comments point to a conflict in the expectations for authoritative data and the design of FeedFinder to promote community generated data.

Consumers and Citizens

Motivation for use appears to come from both its current usefulness (9) and expected usefulness for expecting mothers (7). Four commenters were active promoters of the application, while eight others identified their use as ‘helping others’, often despite their own comfort in public breastfeeding and reduced need for the app (4). Promoters of the app were particularly interested in demonstrating the ease of public breastfeeding to nervous mothers. This was both for professional support workers: “As a breastfeeding worker, I use this app to show new mums how easy it is to find a decent place to feed, especially if they are worried about public feeding. It’s a great local app!” And for mothers: “I am happy to bf [breastfeed] my 22 month anywhere but will review places to aid new bf mothers or mothers that are more nervous to feed in public.”

The use of FeedFinder as a tool to promote breastfeeding more formally was also confirmed in email correspondence with three NHS trusts and two local councils. In all five cases FeedFinder is abeing used as part of campaigns to support and increase breastfeeding.

There was also a change in how these members approached FeedFinder as they grew in confidence. “I used the app more when my baby was new born, now my baby is 4-5 month I am more confident and feed where ever I want! I think it’s great for more nervous mothers so will still review places for them.” One of these commenters disagreed with the notion of only certain places being breastfeeding friendly: “If someone was nervous about feeding in public and found confidence in others feeding at a location without issue then that’s where this would be handy. For this reason only I’ve added some locations. But I hate the idea of acceptable places to feed, if your baby wants feeding then it’s fine to feed them, wherever, whenever.

“Focus on baby and be proud of what you’re doing.” This perspective was also evident in e-mail correspondence received by the authors, where, following the UK’s Equality Act, all locations across the country should be ‘relatively breastfeeding friendly’. Although FeedFinder aims to expand on the ‘relative’ element to this, some users (and non-users) reject this for an absolute model of breastfeeding friendly places.

Beyond using the application to support other breastfeeding mothers in finding places to breastfeed, we know some women used FeedFinder to attempt to influence local service provision. In email correspondence with a FeedFinder member and local lactivist, Violet, discusses how she used FeedFinder to show the customer service manager of a large department store how reviews for his store compared with a local competitor, and where his store might improve its facilities to improve women’s breastfeeding experience.

DISCUSSION

Feeling comfortable breastfeeding in public is as suggested by much of our interview and design data a time sensitive issue. For many, it is a case of doing it once or twice before feeling at ease with the act. FeedFinder appears to have been helpful in giving women the confidence to go out and breastfeed, with a large number of women (and breastfeeding supporters) downloading and using the application over a short period of time.

Figure 1: FeedFinder on iOS, the home screen, a mapped breastfeeding place, a review for a place, and the add a review screen

Some women then go onto to continue adding places and reviews to support a community of women after them is entering into public breastfeeding. Other women simply leave the community, their needs hopefully fulfilled. Here we frame FeedFinder as a supportive health technology and discuss the ecosystem of members that are necessary to make supportive public health technologies such as FeedFinder successful.

Changing the Individual, Changing the Environment

Much work within the HCI community has focused on how digital technologies might persuade or motivate individuals to engage in positive health behaviour [for example 1, 2, 10, 23]. Strategies used have ranged from those inspired by theories of individual behaviour change, and lived experiences of motivation [2, 11], through to ambient adaptations of public space that aim to make healthy choices more available [1, 33]. Within the domain of public and preventative health there is similarly an increasing interest on how web 2.0 technologies can and have changed the landscape of health communication [8].

In such discussion, there is an acceptance that the public at large is moving away from simply consuming information to being engaged in the production of information for themselves and others. And examples exist of public health web interactions that enable individuals to share healthcare experiences [16] or supporting the personalization of healthcare messages to specific communities.

Key to public health messaging and many persuasive health interventions is the notion of a “right” health behaviour regardless of culture and context. Accordingly, the core tenant of criticism in relation to public health approaches therefore is that these channels allow for patients to share their own healthcare advice and views, which will not necessarily agree with official, and rigorously evaluated (i.e. “right”) advice, and in fact may even be classified by experts as bad advice.

When a critical lens from within the field of HCI is applied to technologies which seek persuade or motivate healthy behaviour [9, 22, 30, 31], concerns are raised such that technologies have the potential to produce a context where healthy behaviour is forced and where negative comparisons with others are rife (in turn leading to neurosis).

The choice over whether to breastfeed or not is often constructed as a moral one, where breastfeeding is a value and cornerstone of “good” mothering [18, 21]. We cannot argue that FeedFinder is an example of a valueless technology, since its core focus is providing support to mothers who have chosen to breastfeed, and not those who haven’t. But, FeedFinder was not designed to persuade mothers to breastfeed. Instead, FeedFinder was designed from the position of offering a supportive health technology for women who have chosen to breastfeed, or for women who might chose to breastfeed should the socio-cultural context prove accepting. As such, we consider that FeedFinder contributes to a vision for public health services where the focus is not on whether particular (healthy) choices are actually made in practice, but instead on whether individuals within a society have the opportunities to make a particular (healthy) choice where it suits them [18].

FeedFinder has the potential to help women find out for themselves (from the comfort of their own home) how their local community and services respond to breastfeeding women, provide feedback to their local services about how they might improve their services in relation to breastfeeding women, as well as with time increase the number of women seen breastfeeding in public. All of which can help to contribute to providing breastfeeding as infant feeding option for those women who want to try.

So, rather than attempting to change the individual [2, 11], or design a new environment [1, 33], FeedFinder attempts to provide women with the tools to understand and affect change in their own environment for themselves.

Comment 10

Consumers, Communities and Citizens

It is clear from the data describing FeedFinder’s use that women used it in different ways at different times: sometimes acting as consumers (using FeedFinder as an information resource), at other times as citizens (leaving reviews and places for other breastfeeding women) and finally as a community (where FeedFinder was used by members to affect change in their own local contexts). This ecosystem of different types of members and users is essential to the success of applications like FeedFinder, with a large pool of (happy) consumers central to the emergence of communities and citizens [25].

The majority of our members used FeedFinder to search for and find places within their local area where other women had had positive breastfeeding experiences. We configure these women as consumers of FeedFinder, orientating in this moment of use to the application as an information resource. This is reflected in comments made within the survey, where members told us that the application needed more reviews and venues to be useful and that in part, we should be responsible for adding these to the application before its release. In actuality, we did work with women around the Newcastle area to seed the application with venues and reviews before its release, but had been unable to accomplish this nationwide, let alone worldwide.

Unsurprisingly though, the application isn’t viewed positively by women when they need to consume information about how their local community and services respond to women breastfeeding in public, and that information isn’t there. This suggests the importance of devising strategies through which the cold start problem can be overcome on a national and global level. Our approach has mostly been a social one, working with individuals and groups in the local area to promote and initially populate the map. But, we recognise also that this isn’t scalable. In response, HCI must develop design and engagement methods that work at the population level.

Comment 11

A small proportion of FeedFinder’s members, who initially consume information, eventually turn their focus to producing content for the community of breastfeeding women in their local area. In some cases these women are knowingly try to give back to the community that once was key in supporting them in public breastfeeding. Encouraging this kind of use of FeedFinder by its members is essential for maintaining an up-to-date record of breastfeeding experiences, as well as ensuring the FeedFinder map is well populated for consumers.

Supporting consumers into contributing to the community is an area ripe for further design research. Current opportunities include the exploration of reminders which prompt women to add a review after recently viewing a review or place on FeedFinder. Alternatively, it may be fruitful to explore how FeedFinder can support an experience of social cohesion among the community, for example providing ambient awareness of other women who are using FeedFinder during the small hours of the night (presumably during a nightfeed). Equally interesting, would be a feature that enabled women to see days and times of days where local places for breastfeeding are popular among the community, thereby supporting serendipitous opportunities for meeting other breastfeeding women.

Finally, we see a few of examples of individuals and services are using FeedFinder to affect change in their community. We frame these members as using FeedFinder to support their citizenship, since they are actively fighting or the rights of women in their local community to receive good breastfeeding support. For example, Violet used FeedFinder to show a local business how it could improve its breastfeeding provision. We recognise that those that use FeedFinder to fight for improved services are likely to be in a minority. Nevertheless, mechanisms such as greater connectivity between the FeedFinder dataset and local services may serve to better support FeedFinder citizens, for example through providing quick interactions whereby reviews can be sent to individual breastfeeding places to alert those places of their reviews and thereby areas of improvement, as well as potentially the financial case for doing so.

Designing with Mothers with Babies

The involvement of breastfeeding women within our iterative user centred-design process was essential in identifying and confirming the design space, as well as understanding how breastfeeding experiences might be rated and reviewed. When working with women with young children we quickly learned that design tasks needed to be incredibly flexible, quick and undemanding. Young babies crave to be held, even when they’re not being fed, which means that individuals participating in a design tasks will likely only ever have one hand free, ruling out many creative tasks. In addition, because the needs of a young baby can be particularly demanding and unpredictable it is important to develop design methods that can be easily paused and re-started, as well as not requiring a large amount of time to complete (we found ten minutes to be about right).

Finally, since a participant’s attention will be split consider developing methods that are easy to respond  to. We found tasks which were already part completed, or required ordering were sufficient for supporting useful design dialogue while being respectful of the amount and time and energy a women would have for participating in the project.

CONCLUSION

Breastfeeding in public causes many women anxiety and can make the early weeks of motherhood a lonely and isolating time. In response we have designed, developed and deployed a mobile application which supports women in finding, reviewing and sharing places for public breastfeeding. Through so doing, we have identified one vision for the design of technologies to support public health, which moves the focus away from the individual and instead holds a lens to communities and societies and asks whether these contexts provide opportunities within which healthy choices can be made.

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Interacting with the Computer: a Framework

J. Morton, P. Barnard, N. Hammond* and J.B. Long

M.R.C. Applied Psychology Unit, Cambridge, England *also IBM Scientific Centre, Peterlee, England

Recent technological advances in the development of information processing systems will inevitably lead to a change in the nature of human-computer interaction.

Direct interactions with systems will no longer be the sole province of the sophisticated data processing professional or the skilled terminal user. In consequence, assumptions underlying human-system communication will have to be re-evaluated for a broad range of applications and users. The central issue of the present paper concerns the way in which this re-evaluation should occur.

First of all, then, we will present a characterisation of the effective model which the computer industry has of the interactive process. The shortcoming of the model is that it fails to take proper account of the nature of the user and as such can not integrate, interpret, anticipate or palliate the kinds of errors which the new user will resent making. For remember that the new user will avoid error by adopting other means of gaining his ends, which can lead either to non-use or to monstrously inefficient use. We will document some user problems in support of this contention and indicate the kinds of alternative models which we are developing in an attempt to meet this need.

The Industry’s Model (IM)

The problem we see with the industry’s model of the human-computer interaction is that it is computer-centric. In some cases, as we shall see, it will have designer-centric aspects as well.To start off with, consider a system designed to operate in a particular domain of activity. In the archetypal I.M. the database is neutralised in much the same kind of way that a statistician will ritually neutralise the data on which he operates, stripping his manipulation of any meaning other than the purely numerical one his equations impose upon the underlying reality. This arises because the only version of the domain which exists at the interface is that one which is expressed in the computer. This version, perhaps created by an expert systems analyst on the best logical grounds and the most efficient, perhaps, for the computations which have to be performed, becomes the one to which the user must conform. This singular and logical version of the domain will, at best, be neutral from the point of view of the user. More often it will be an alien creature, isolating the user and mocking him with its image of the world and its resources to which he must haplessly conform.

Florid language? But listen to the user talking.

“We come into contact with computer people, a great many of whom talk a very alien language, and you have constant difficulty in trying to sort out this kind of mid-Atlantic jargon.”

“We were slung towards what in my opinion is a pretty inadequate manual and told to get on with it”

“We found we were getting messages back through the terminal saying there’s not sufficient space on the machine. Now how in Hell’s name are we supposed to know whether there’s sufficient space on the machine?” .

In addition the industry’s model does not really include the learning process; nor does it always take adequate note of individual’s abilities and experience:

“Documentation alone is not sufficient; there needs to be the personal touch as well . ”

“Social work being much more of an art than a science then we are talking about people who are basically not very numerate beginning to use a machine which seems to be essentially numerate.”

Even if training is included in the final package it is never in the design model. Is there anyone here, who, faced with a design choice asked the questions “Which option will be the easiest to describe to the naive user? Which option will be easiest to understand? Which option will be easiest to learn and remember?”
Let us note again the discrepancy between the I.M. view of error and ours . For us errors are an indication of something wrong with the system or an indication of the way in which training should proceed. In the I.M. errors are an integral part of the interaction. For the onlooker the most impressive part of a D.P. interaction is not that it is error free but that the error recovery procedures are so well practised that it is difficult to recognise them for what they are. We would not want it thought that we felt the industry was totally arbitrary . There are a number of natural guiding principles which most designers would adhere to.
We do not anticipate meeting a system in which the command DESTROY has the effect of preserving the information currently displayed while PRESERVE had the effect of erasing the operating system. However , the principles employed are intuitive and non-systematic. Above all they make the error of embodying the belief that just as there can only be one appropriate representation of the domain, so there is only one kind of human mind.

A nice example of a partial use of language constraints is provided by a statistical package called GENSTAT. This package permits users to have permanent userfiles and also temporary storage in a workfile. The set of commands associated with these facilities are :

PUT – copies from core to workfile

GET – copies from workfile to core

FILE – defines a userfile

SAVE – copies from workfile to userfile

FETCH – copies from userfile to workfile

The commands certainly have the merit that they have the expected directionality with respect to the user. However to what extent do, for example, FETCH and GET relate naturally to the functions they have been assigned? No doubt the designers have strong intuitions about these assignments. So do users and they do not concur. We asked 40 people here at the A. P.U. which way round they thought the assignments should go: nineteen of these agreed with the system designers, 21 went the 0ther way . The confidence levels of rationalisations were very convincing on both sides!

The problem then, is not just that systems tend to be designer-centric but that the designers have the wrong model either of the learning process or of the non-D.P. users’ attitude toward error. A part-time user is going to be susceptible to memory failure and, in particular, to interference from outside the computer system. du Boulay and O’ Shea [I] note that naive users can use THEN in the sense of ‘next’ rather then as ‘implies’. This is inconceivable to the IM for THEN is almost certainly a full homonym for most D.P. and the appropriate meaning the appropriate meaning thoroughly context-determined .
An Alternative to the Industry Model

The central assumption for the system of the future will be ‘systems match people’ rather than ‘people match systems’. Not entirely so, as we shall elaborate, for in principle, the capacity and perspectives of the user with respect to a task domain could well change through interaction with a computer system. But the capacity to change is more limited than the variety available in the system . Our task, then, is to characterise the mismatch between man and computer in such a way that permits us to direct the designer’s effort.

Comment 1 In doing this we are developing two kinds of tool, conceptual and empirical. These interrelate within an overall scheme for researching human-computer interaction as shown in Figure 1.

Comment 2

 

Relating Conceptual and Empirical Tools

The conceptual tools involve the development of a set of analytic frameworks appropriate to human computer interaction. The empirical tools involve the development of valid test procedures both for the introduction of new systems and the proving of the analytic tools. The two kinds of tool are viewed as fulfilling functions comparable to the role of analytic and empirical tools in the development of technology. They may be compared with the analytic role of physics, metallurgy and aerodynamics in the development of aircraft on the one hand and the empirical role of a wind tunnel in simulating flight on the other hand.

Comment 3

Empirical Tools

The first class of empirical tool we have employed is the observational field study, with which we aim to identify some of the variables underlying both the occasional user’s perceptions of the problems he encounters in the use of a computer system, and the behaviour of the user at the terminal itself.

The opinions cited above were obtained in a study of occasional users discussing the introduction and use of a system in a local government centre [2]. The discussions were collected using a technique which is particularly free from observer influence [3 ].

In a second field study we obtained performance protocols by monitoring users while they solved a predefined set of problems using a data base manipulation language [4 ]. We recorded both terminal performance and a running commentary which we asked the user to make, and wedded these to the state of the machine to give a total picture of the interaction. The protocols have proved to be a rich source of classes of user problem from which hypotheses concerning the causes of particular types of mismatch can be generated.

There is thus a close interplay between these field studies, the generation of working hypotheses and the development of the conceptual frameworks.

Comment 4

We give some extracts from this study in a later section.
A third type of empirical tool is used to test specific predictions of the working hypothesis. The tool is a multi-level interactive system which enables the experimenter to simulate a variety of user interfaces, and is capable of modeling and testing a wide range of variables [5]. It is based on a code-breaking task in which users perform a variety of string-manipulation and editing functions on coded messages.

It allows the systematic evaluation of notational, semantic and syntactic variables. Among the results to be extensively reported elsewhere is that if there is a common argument in a set of commands, each of which takes two arguments, then the common argument must come first for greatest ease of use. Consistency of argument order is not enough: when the common argument consistently comes second no advantage is obtained relative to inconsistent ordering of arguments [6].
Conceptual Tools

Since we conceive the problem as a cognitive one, the tools are from the cognitive sciences.

Comment 5

Also we define the problem as one with those users who would be considered intellectually and motivationally qualified by any normal standards. Thus we do not admit as a potential solution that of finding “better” personnel, or simply paying them more, even if such a solution were practicable.

The cognitive incompatibility we describe is qualitative not quantitative and the mismatch we are looking for is one between the user’s concept of the system structure and the real structure: between the way the data base is organised in the machine and the way it is organised in the head of the user: the way in which system details are usually encountered by the user and his preferred mode of learning.

The interaction of human and computer in a problem-solving environment is a complex matter and we cannot find sufficient theory in the psychological literature to support our intuitive needs.

Comment 6

He have found it necessary to produce our own theories, drawing mainly on the spirit rather than the substance of established work.

Comment 7 Further than this, it is apparent that the problem is too complex for us to be able to use a single theoretical representation.
The model should not only be appropriate for design, it should also give a means of characterising errors – so as to understand their origins and enable corrective measures to be taken.
Take the following protocol.

The user is asked to find the average age of entries in the block called PEOPLE.

“I’ll have a go and see what happens” types: *T <-AVG(AGE,PEOPlE)

machine response: AGE – UNSET BLOCK

“Yes, wrong, we have an unset block. So it’s reading AGE as a block, so if we try AGE and PEOPLE the other way round maybe that’ll work.”

This is very easy to diagnose and correct. The natural language way of talking about the target of the operation is mapped straight into the argument order. The cure would be to reverse the argument order for the function AVG to make it compatible.

The next protocol is more obscure. The task is the same as in the preceding one.

“We can ask it (the computer) to bring to the terminal the average value of this attribute.”

types: *T -AVG( AGE)

machine response: AVG(AGE) – ILLEGAL NAME

“Ar.d it’s still illegal. .. ( … ) I’ve got to specify the block as well as the attribute name.”

Well of course you have to specify the block. How else is the machine going to know what you’re talking about? A very natural I.M. response. How can we be responsible for feeble memories like this.

However, a more careful diagnosis reveals that the block PEOPLE is the topic of the ‘conversation’ in any case.

The block has just been used and the natural language conventions are quite clear on the point.

We have similar evidence for the importance of human-machine discourse structures from the experiment using the code-breaking task described above. Command strings seem to be more ‘cognitively compatible’ when the subject of discourse (the common argument) is placed before the variable argument. This is perhaps analogous to the predisposition in sentence expression for stating information which is known or assumed before information which is new [7]. We are currently investigating this influence of natural language on command string compatibility in more detail.

Comment 8

The Block Interaction Model

Systematic evidence from empirical studies, together with experience of our own, has led us to develop a conceptual analysis of the information in the head of the user (see figure 2). Our aim with one form of analysis is to identify as many separable kinds of knowledge as possible and chart their actual or potential interactions with one another. Our convention here is to use a block diagram with arrows indicating potential forms of interference. This diagram enables us to classify and thus group examples of interference so that they could be counteracted in a coordinated fashion rather than piecemeal. It also enables us to establish a framework within which to recognise the origin of problems which we haven’t seen before. Figure 2 is a simplified form of this model. The blocks with double boundaries, connected by double lines, indicate the blocks of information used by the ideal user. The other lines indicate prime classes of interference. The terminology we have used is fairly straightforward: Domain – the range of the specific application of a system. This could be a hospital, a city’s buildings, a set of knowledge such as jobs in ~n employment agency. Objects – the elements in the particular data base. They could be a relational table, patients’ records. I Representation of domain I Representa ti on of work-base version of domain domain Representation of problem Operations – the computer routines which manipulates the objects. Labels – the letter sequences which activate operators which, together with arguments and syntax, constitute the commands. Work base – in general, people using computer systems for problem solving have had experience of working in a non-computerised work environment either preceding the computerisation or at least in parallel with the computer system. The representation of this experience we call the work-base version. There will be overlap between this and the users representation of the computer’s version of the domain; but there will be differences as well, and these differences we would count as potential sources of interference. There may be differences in ·the underlying structure of the data in the two cases, for example, and will certainly be differences in the objects used. Thus a user found to be indulging in complex checking procedures after using the command FILE turned out to be perplexed that the material filed was still present on the screen. With pieces of paper, things which are filed actually go there rather than being copied. Here are some examples of interference from one of our empirical studies [4]:

Interference on the syntax from other languages. Subject inserts necessary blanks to keep the strings a fixed length.

“Now that’s Matthewson, that’s 4,7, 10 letters, so I want 4 blanks”

types: A+<:S:NAME = ‘MATTHEWSON ‘:>PEOPLE

Generalised interference

“Having learned how reasonably well to manipulate one system, I was presented with a totally different thing which takes months to learn again.”

Interference of other machine characteristics on machine view

“I’m thinking that the bottom line is the line I’m actually going to input. So I couldn’t understand why it wasn’t lit up at the bottom there, because when you’re doing it on (another system) it’s always the bottom line.”

The B.I.M. can be used in two ways. We have illustrated its utility in pinpointing the kinds of interference which can occur from inappropriate kinds of information. We could look at the interactions in just the opposite way and seek ways of maximising the benefits of overlap. This is, of course, the essence of ‘cognitive compatibility’ which we have already mentioned. Trivially, the closer the computer version of the domain maps onto the user’s own version of the domain the better. What is less obvious is that any deviations should be systematic where possible.

In the same way, it is pointless to design half the commands so that they are compatible with the natural language equivalents and use this as a training point if the other half, for no clear reason, deviate from the principle. If there are deviations then they should form a natural sub-class or the compatibility of the other commands will be wasted.

Information Structures

In the block interaction model we leave the blocks ill-defined as far as their content is concerned. Note that we have used individual examples for user protocols as well as general principles in justifying and expanding upon the distinctions we find necessary. What we fail to do in the B. I .M. is to characterise the sum of knowledge which an individual user carries around with him or brings to bear upon the interaction. We have a clear idea of cognitive compatibility at the level of an individual. If this idea is to pay then these structures must be more detailed.

There is no single way of talking about information structures. At one extreme there is the picture of the user’s knowledge as it apparently reveals itself in the interaction; the view, as it were, that the terminal has of its interlocutor. From this point of view the motivation for any key press is irrelevant. This is clearly a gross oversimplification.

The next stage can be achieved by means of a protocol. In it we would wish to separate out those actions which spring from the users concept of the machine and those actions which were a result of him being forced to do something to keep the interaction going. This we call ‘heuristic behaviour’. This can take the form of guessing that the piece of information which is missing will be consistent with some other system or machine. “If in doubt, assume that it is Fortran” would be a good example of this. The user can also attempt to generalise from aspects of the current system he knows about. One example from our study was where the machine apparently failed to provide what the user expected. In fact it had but the information was not what he had expected. The system was ready for another command but the user thought it was in some kind of a pending state, waiting with the information he wanted. In certain other stages – in particular where a command has produced a result which fills up the screen – he had to press the ENTER key – in this case to clear the screen. The user then over-generalised from this to the new situation and pressed the ENTER key again, remarking

“Try pressing ENTER again and see what happens.”

We would not want to count the user’s behaviour in this sequence as representing his knowledge of the system – either correct knowledge or incorrect knowledge. He had to do something and couldn’t think of anything else. When the heuristic behaviour is eliminated we are left with a set of information relevant to the interaction. With respect to the full, ideal set of such information, this will be deficient with respect to the points, at which the user had to trust to heuristic behaviour.

Note that it will also contain incorrect information as well as correct information; all of it would be categorised by the user as what he knew, if not all with complete confidence, certainly with more confidence than his heuristic behaviour. The thing which is missing from B.I.M. and I.S. is any notion of the dynamics of the interaction. We find we need three additional notations at the moment to do this. One of these describes the planning activity of the user, one charts the changes in state of user and machine and one looks at the general cognitive processes which are mobilised.

Goal Structure Model

The user does some preparatory work before he presses a key. He must formulate some kind of plan, however rudimentary. This plan can be represented, at least partially, as a hierarchical organisation. At the top might be goals such as “Solve problem p” and at the bottom “Get the computer to display Table T”. The Goal Structure model will show the relationships among the goals. This can be compared with the way of structuring the task imposed by the computer. For example, a user’s concept of editing might lead to the goal structure: Two problems would arise here. Firstly the new file has to be opened at an ‘unnatural’ place. Secondly the acceptance of the edited text changes from being a part of the editing process to being a part of the filing process.

The goal structure model, then, gives us a way of describing such structural aspects of the user’s performance and the machines requirements. Note that such goals might be created in advance or at the time a node is evaluated. Thus the relationship of the GSM to real time is not simple. The technique for determining the goal structure may be as simple as asking the user “What are you trying to do right now and why?” This,may be sufficient to reveal procedures which are inappropriate for the program being used.
State Transition Model

In the course of an interaction with a system a number of changes take place in the state of the machine. At the same time the user’s perception of the machine state is changing. It will happen that the user misjudges the effect of one command and thereafter’ enters others which from an outside point of view seem almost random. Our point is, as before, that the interaction can only be understood from the point of view of the user.

This brings us to the third of the dynamic aspects of the interaction: the progress of the user as he learns about the system.

Let us explore some ways of representing such changes. Take first of all the state of the computer. This change is a result of user actions and can thus be represented as a sequence of Machine States (M.S.) consequent on user action.

If the interaction is error free, changes in the representations would follow changes in the machine states in a homologous manner. Errors will occur if the actual machine state does not match its representation.

We will now look at errors made by a user of an interactive data enquiry system. We will see errors which reveal both the inadequate knowledge of the particular machine state or inadequate knowledge of the actions governing transitions between states. The relevant components of the machine are the information on the terminal display and the state of a flag shown at the bottom right hand corner of the display which ‘informs the user of some aspects of the machine state (ENTER … or OUTPUT … ). In addition there is a prompt, “?”, which indicates that the keyboard is free to be used, there is a key labelled ENTER. In the particular example the user wishes to list the blocks of data he has in his workspace. The required sequence of machine states and actions is:

The machine echoes the command and waits with OUTPUT flag showing.

User: “Nothing happening. We’ve got an OUTPUT there in the corner I don’ t know what that means.

The user had no knowledge of MS2: we can hypothesise his representation of the transition to be:

This is the result of an overgeneralisation. Commands are obeyed immediately if the result is short, unless the result is block data of any size. The point of this is that the data may otherwise wipe everything from the screen. With block data the controlling program has no lookahead to check the size and must itself simply demand the block, putting itself in the hands of some other controlling program. We see here then a case where the user needs to have some fairly detailed and otherwise irrelevant information about the workings of the system in order to make sense of (as opposed to learn by rote) a particular restriction.

The user was told how to proceed, types ENTER, and the list of blocks is displayed together with the next prompt. However, further difficulties arise because the list of blocks includes only one name and the user was expecting a longer listing. Consequently he misconstrues the state of the machine. (continuing from previous example)

User types ENTER

Machine replies with block list and prompt.

Flag set to ENTER …

“Ah, good, so we must have got it right then.

A question mark: (the prompt). It doesn’t give me a listing. Try pressing ENTER again and see what happens.”

User types ENTER

“No? Ah, I see. Is that one absolute block, is that the only blocks there are in the workspace?”

This interaction indicates that the user has derived a general rule for the interaction:

“If in doubt press ENTER”

After this the user realises that there was only one name in the list. Unfortunately his second press of the ENTER key has put the machine into Edit mode and the user thinks he is in command mode. As would be expected the results are strange.

At this stage we can show the machine state transitions and the user’s representation together in a single diagram, figure 3.

This might not be elegant but it captures a lot of features of the interaction which might otherwise be missed.

The final model we use calls upon models currently available in cognitive psychology which deal with the dynamics of word recognition and production, language analysis and information storage and retrieval. The use of this model is too complex for us to attempt a summary here.

Comment 9 Conclusion

We have stressed the shortcomings of what we have called the Industrial Model and have indicated that the new user will deviate considerably from this model. In its place we have suggested an alternative approach involving both empirical evaluations of system use and the systematic development of conceptual analyses appropriate to the domain of person-system interaction. There are, of course, aspects of the I.M. which we have no reason to disagree with, for example, the idea that the computer can beneficially transform the users view of the problems with which he is occupied. However, we would appreciate it if someone would take the trouble to support this point with clear documentation. So far as we can see it is simply asserted.
Finally we would like to stress that nothing we have said is meant to be a solution – other than the methods. We do not take sides for example, on the debate as to whether or not interactions should be in natural language – for we think the question itself is a gross oversimplification. What we do know is that natural language interferes with the interaction and that we need to understand the nature of this interference and to discover principled ways of avoiding it.

Comment 10 And what we know above all is that the new user is most emphatically not made in the image of the designer.

References

[1 ] du Boulay, B. and O’Shea, T. Seeing the works: a strategy of teaching interactive programming. Paper presented at Workshop on ‘Computing Skills and Adaptive Systems’, Liverpool, March 1978.
[2] Hammond, N.V., Long, J.B. and Clark, l.A. Introducing the interactive computer at work: the users’ views. Paper presented at Workshop on ‘Computing Skills and Adaptive Systems’, Liverpool, March 1978.
[3] Wilson. T. Choosing social factors which should determine telecommunications hardware design and implementation. Paper presented at Eighth International Symposium on Human Factors in Telecommunications, Cambridge, September 1977.
[4] Documenting Human-computer Mismatch with the occasional interactive user. APU/IBM project report no. 3, MRC Applied Psychology Unit. Cambridge, September 1978.
[5] Hammond, N.V. and Barnard, P.J. An interactive test vehicle for the investigation of man-computer interaction. Paper presented at BPS Mathematical and Statistical Section Meeting on ‘Laboratory Work Achievable only by Using a Computer’, London, September 1978.
[6] An interactive test vehicle for the study of man-computer interaction. APU/IBM project report no. 1,MRC Applied Psychology Unit, Cambridge, September 1978.
[7] Halliday, M.A.K. Notes on transitivity and theme in English. Part 1. Journal of Linguistics, 1967, 3, 199-244.

FIGURE 3: STATE TRANSITION EXAMPLE