Yvonne O' Connor
email: y.oconnor@ucc.ie

Treasy Stephen

O ' Donoghue
email: j.odonoghue@ucc.ie

Examining Contextual Factors and Individual Value Dimensions of Healthcare Providers Intention to Adopt Electronic Health Technologies in Developing Countries

Keywords: Contextual Factors, Individual Value System, Developing Countries, Theoretical Model

Despite substantial research on electronic health (e-Health) adoption, there still exist vast differences between resource-rich and resource-poor populations regarding Information Technology adoption. To help bridge the technological gulf between developed and developing countries, this research-in-progress paper examines healthcare providers' intention to adopt e-health technologies from two perspectives 1) contextual factors (i.e. specific to developing world settings) and 2) individual value dimensions (i.e. cultural, utilitarian, social and personal). The primary output of this paper is a theoretical model merging both the contextual factors and value dimensions; this forms a strong baseline to examine and help ensure the successful adoption of e-Health technologies within developing countries. Future research will be performed to validate the model developed in this paper, with a specific focus on mobile Health in Malawi, Africa.

Introduction

A vast array of research exists which examines the adoption of Information Technology (IT) at various levels of analysis in both developed and developing regions, with the former dominating extant Information Systems (IS) research. In recent years, academics have focused their research attentions on the implementation 1 Corresponding Author: Yvonne O' Connor, Health Information Systems Research Centre, Business Information Systems, University College Cork, Cork, Ireland; E-mail: y.oconnor@ucc.ie of IT in developing regions, i.e. countries operating within Information and Communication Technology (ICT) resource-constrained conditions and where the population has limited knowledge in utilising ICT solutions [START_REF] Ssekakubo | Issues Of Adoption: Have E-Learning Management Systems Fulfilled Their Potential In Developing Countries[END_REF]. Adoption levels of IT in resource-poor regions continue to lag behind their richer region counterparts [START_REF] Dasgupta | Impact of Organizational Culture on Technology Use in a Developing Country[END_REF][START_REF] Greenhalgh | The Organising Vision For Telehealth And Telecare: Discourse Analysis[END_REF], particularly in the health care domain [START_REF] Li | Mhealth For Influenza Pandemic Surveillance In Developing Countries[END_REF]. The need for reforming the delivery of healthcare services to accommodate the needs of modern societies is driven by unprecedented health inequities between the poor and wealthy economies.

A significant amount of literature focuses on intentions to adopt technology in the e-health domain. Despite the contributions of such studies, there still remains a high failure rate of e-health technologies in developing regions [START_REF] Heeks | Information Systems And Developing Countries: Failure, Success, And Local Improvisations[END_REF], due to the lack of adoption [START_REF] Wouters | Supporting Home Based Health Care In South African Rural Communities Using USSD Technology[END_REF]. Understanding why people accept or reject information technology is the first step toward finding a solution to the problem [START_REF] Al-Gahtani | Computer Technology Adoption In Saudi Arabia: Correlates Of Perceived Innovation Attributes[END_REF]. Such failure rates imply that more effort is required to fully understand this research domain and that additional factors exist which were previously undocumented in extant literature. However, more attention is required to examine the human, as opposed to technical, aspects associated with e-health implementation initiatives [START_REF] Cocosila | Adoption of Mobile ICT for Health Promotion: An Empirical Investigation[END_REF].

Extant research shows that factors which effect the adoption of IT in western societies may not have the same influential impact on IT adoption in developing regions [START_REF] Al Sukkar | Toward A Model For The Acceptance Of Internet Banking In Developing Countries[END_REF][START_REF] Vatanasakdakul | Introducing Cultural Fit Factors to Investigate the Appropriateness Of B2b Technology Adoption To Thailand. 21st Bled Econference Ecollaboration: Overcoming Boundaries Through Multi-Channel Interaction[END_REF]. The rationale is that the contextual landscape and individual values differ across both populations [START_REF] Ahern | What Is Ehealth (6): Perspectives On The Evolution Of Ehealth Research[END_REF][START_REF] Fischer | Uptake of Electronic Prescribing In Community-Based Practices[END_REF]. First, the very concept of value has been defined as "the worth, desirability or utility of a thing" [START_REF] Cronk | Understanding "IS Business Value": Derivation Of Dimensions[END_REF] and it has been measured and explored at various levels of analysis. However few authors would contend that the search for value has reached a point where both theoreticians and practitioners are satisfied with its outcomes [START_REF] Davern | Discovering Potential and Realizing Value from Information Technology Investments[END_REF], as the worth/desirability/utility to a targeted user depends on many factors [START_REF] Cronk | Understanding "IS Business Value": Derivation Of Dimensions[END_REF], for example transparency and ease of access. A review of extant literature also shows a wide array of opinions as to what value actually entails, with no unanimously accepted definition. As a result, authors often seek to interchange the term with other concepts such as impact [START_REF] Gable | Re-Conceptualizing Information System Success: The IS-Impact Measurement Model[END_REF], influence [START_REF] Mason | Measuring Information Output: A Communication Systems Approach[END_REF], quality [START_REF] Day | Value Assessment: The Antecedent Of Customer Satisfaction[END_REF], success [START_REF] Delone | Information Systems Success: The Quest For The Dependent Variable[END_REF], and effectiveness [START_REF] Iivari | User Information Satisfaction: IS Implementability And Effectiveness[END_REF]. It should not be surprising therefore that investigating value creation from emerging ICTs is a complex phenomenon, involving the simultaneous presence and interaction of various exogenous and endogenous factors.

Developing from the various disagreements between authors surrounding their approach of theorising value, there is a consensus that value creation starts with identifying the perceived value that is being offered to the end user by the project in question [START_REF] Davern | Discovering Potential and Realizing Value from Information Technology Investments[END_REF]. Hu et al. [START_REF] Hu | A Study of the Relationship Between The Value Perception And Loyalty Intention Toward An E-Retailer Website[END_REF] define perceived value as the intended user's "perception of the net benefits gained in exchange for the costs incurred in obtaining the desired benefits" (p.4). Despite various definitions of perceived value, there exists general acceptance that it: a) is linked through the use of some product, service or object; b) is subjectively perceived by users, rather than objectively determined; and c) involves a trade-off between what the user receives and gives to acquire and use the product or service [START_REF] Woodruff | Customer Value: The Next Source For Competitive Advantage[END_REF]. From this synopsis, the locus of potential value in e-health technologies can be identified where there exists the opportunity for the users involved to obtain desired results. Multiple loci (cultural, utilitarian, social and personal) have been therefore identified for the successful adoption of e-health technologies in developing countries.

Second, when examining an end users' rationale for adopting e-health technologies in developing countries it is important that the contextual landscape along with the perceived value is taken into account. For example, existing researchers [START_REF] Meijers | Assessing The Relationships Between Contextual Factors And Research Utilization In Nursing: Systematic Literature Review[END_REF] argue for the significance of examining context but rarely portray its importance. Exploring the contextual landscape is imperative as it reflects external elements that comprise the environment or conditions for decision making tasks [START_REF] Fjerrnestad | Experimental Studies Of Group Decision Support Systems: An Assessment Of Variables Studied And Methodology[END_REF], which may be outside of the researchers' control. Yet, a dearth of research exists which examines the impact contextual landscape and individual values have on behavioural intentions to adopt e-health technologies in developing countries. The authors argue that it is imperative to examine this unexplored area in extant literature to obtain richer insights into the intentions to adoption e-health technologies in resource poor countries.

The objective of this study is to develop a theoretical model which explores the drivers of e-health technology adoption from a contextual and value dimensions perspective. The authors observe that exploring contextual factors in association with an individual's value system may help enhance current knowledge on health care providers' intentions to adopt e-health technologies in developing countries.

This paper is structured as follows: In an effort to bridge the research gap highlighted previously, a theoretical model and three propositions are presented in Section 2. This theoretical model, which draws upon and extends extant literature, is proposed for future research. Section 3 outlines the proposed research methodology which will empirically examine the newly established theoretical model and associated propositions. Section 4 concludes by presenting the key implications of this study for theory and practice.

Theoretical Model Development and Propositions

This paper seeks to provide richer insights into healthcare providers' (referred to as Health Surveillance Assistants in rural Malawi, Africa) intentions to adopt e-health technologies. A theoretical model (see Figure 1) is presented which will be used to explore this phenomenon. This model, developed by adopting and extending extant literature will be explained in the following section, beginning with the rationale underpinning each construct and proceeding to the development of three propositions.

Contextual Factors

Contextual factors have been found to influence the intentions to adopt an innovation at various levels of analysis (i.e. individual, firm/organisational, and national). Contextual factors influence one's decision making behaviour [START_REF] Fjerrnestad | Experimental Studies Of Group Decision Support Systems: An Assessment Of Variables Studied And Methodology[END_REF] which can vary across populations and industries.

According to extant literature [START_REF] Rigby | Taking Health Telematics Into The 21st Century[END_REF], important differences exist between healthcare and other industries (e.g. manufacturing, financial, aerospace). First, Chiasson et al. [START_REF] Chiasson | Pushing The Contextual Envelope: Developing And Diffusing IS Theory For Health Information Systems Research[END_REF] argue that healthcare represents a markedly different social and technical context compared with many of the industries where IS research is conducted. Second, it is argued that the special characteristics of healthcare functions, processes and organisations are another difference which distinguishes it from any other service sectors or industries, with healthcare being a highly customised, complex relationship (person-to person), contrary to banking or insurance industries [START_REF] Rigby | Taking Health Telematics Into The 21st Century[END_REF].

The healthcare context in resource-poor regions is more complex than developed countries due to uncertainty surrounding lack of resources (financial, technical and human). Therefore, the contextual factors for e-health technology adoption in developing countries differentiate this research from previous studies examined in developed countries. Several authors have concluded that value conceptualisations may vary depending on a study's context [START_REF] Chiu | Usability, Quality, Value and E-Learning Continuance Decisions[END_REF]. As a result, it is proposed that: P1: Contextual factors in developing countries impact Healthcare Surveillance Assistants' value system. P2: Contextual factors impact Healthcare Surveillance Assistants' to adopt ehealth technologies in developing countries.

Individual Value System

Defined as "an organized set of preferential standards that are used in making selections of objects and actions, resolving conflicts, invoking social sanctions, and coping with needs or claims for social and psychological defenses of choices made or proposed" [START_REF] Williams | Change And Stability In Values And Value Systems: A Sociological Perspective[END_REF], an individuals' 'value system' comprises of a cluster of combined values which influences individual behavior [START_REF] Fritzsche | Personal Values' Influence on the Ethical Dimension of Decision Making[END_REF]. For this paper, an individual value system comprises of cultural, utilitarian, social and personal values (each dimension is described in Table 1). An 'individual' in the context of this paper refers to Health Surveillance Assistants (HSA), whose role in society is described in Section 2.

Table 1. Value Dimensions Definition

Value Dimension

Definition used for the purpose of this study

Relevance to Behavioural Intentions to Adopt e-Health technologies

Cultural Value A set of beliefs and norms that are both consciously and subconsciously held by HSA in the given society (adapted from [START_REF] Adler | International Dimensions of Organizational Behavior[END_REF]).

It is unlikely that cultural values can be easily changed or adjusted to conform to any changes introduced by new technology. This conformity, therefore, may have an impact on individual users' intentions to adopt e-health technologies [START_REF] Al Sukkar | Toward A Model For The Acceptance Of Internet Banking In Developing Countries[END_REF].

Utilitarian Value

The degree to which a HSAs believe that using e-health technologies will assist in accomplishing his/her goals (i.e. delivering healthcare services to patients) in terms of effectiveness and efficiency (adapted from [START_REF] Holbrook | The Nature of Customer Value: An Axiology Of Services In The Consumption Experience[END_REF], 35]).

The utilitarian view is concerned with the effectiveness and efficiency that result from the potential use of an IT application [START_REF] Holbrook | The Nature of Customer Value: An Axiology Of Services In The Consumption Experience[END_REF].

HSAs perceive utilitarian value from e-health technologies when such technological tools facilitate healthcare providers to deliver healthcare services to patients without impacting their daily routines.

Social Value

The degree to which HSAs perceive social utility acquired from the potential adoption of e-health technologies (adapted from [START_REF] Chou | Exploring the Collective Actions of Public Servants in E-Government Development[END_REF]).

It is argued [START_REF] Chou | Exploring the Collective Actions of Public Servants in E-Government Development[END_REF] that social value represents "the preference for certain outcome distributions between the self and the interdependent other." As a result, social value is often established from the use of a product or service which is shared with other people [START_REF] Sheth | Consumption Values And Market Choices: Theory And Applications[END_REF], [START_REF] Sweeney | Consumer Perceived Value: The Development Of A Multiple Item Scale[END_REF]. This perspective may have an impact on HSAs' intentions to adopt ehealth technologies.

Personal Value

Conscious valuing of a behavioural goal such that the action is accepted or owned as personally important to HSAs (based on [START_REF] Kay | Healthcare Marketing: What Is Salient?[END_REF]).

Individual perception that the values associated with an IT project are similar with his/her personal goals and identity, thus viewing the action as personally important [START_REF] Ke | The Effects of Extrinsic Motivations and Satisfaction in Open Source Software Development[END_REF], thus increasing likelihood of e-health technology adoption by HSAs.

Culture diversity between developing and developed countries can be observed based on "Individualism versus Collectivism", "Power distance", and "Masculinity versus Femininity" [START_REF] Hofstede | Culture's Consequences: International Differences In Work-Related Values[END_REF]. For instance, resource-rich environments (such as Europe and U.S.A) are driven by individualist approaches whereas developing countries are concerned with collectivist strategies [START_REF] Hofstede | The Cultural Relativity of Organizational Practices and Theories[END_REF].

Utilitarian values reflect functional values which are relevant for task-specific use and are characterised as instrumental and extrinsic [START_REF] Babin | Work And/Or Fun: Measuring Hedonic and Utilitarian Shopping Value[END_REF]. E-health technologies offer an array of services which can assist HSAs in their tasks. For instance, electronic health records provide a digital collection of clinical accounts and diagnostic reports pertaining to an individual patient [START_REF] Safran | Electronic Patient Records and the Impact of the Internet[END_REF] which can assist HSAs when assessing and diagnosing patients. When individual users' perceive that the technological tool could facilitate them when accomplishing tasks, their behavioural intentions towards adopting the IT increases [START_REF] Miller | Clinical Decision Support and Electronic Prescribing Systems[END_REF].

Social value, as defined in the context of this study, is closely linked to the [37] motivational construct; namely, introjected motivation. This type of motivation identifies the social needs of individuals to obtain social approval from other individuals in society to improve/maintain feelings of worth. Individuals often adopt IT solutions in pursuit of recognition among other individuals and/or based on the influence of 'others', for instance, the social influence of peers, superiors, and family members has been found to directly affect individuals' decision to adopt IT [START_REF] Venkatesh | Consumer Acceptance And Use Of Information Technology: Extending the Unified Theory of Acceptance and Use of Technology[END_REF], [START_REF] Venkatesh | User Acceptance Of Information Technology: Toward A Unified View[END_REF], [START_REF] Venkatesh | Why Don't Men Ever Stop To Ask For Directions? Gender, Social Influence, and Their Role in Technology Acceptance and Usage Behavior[END_REF].

Personal values are conceptualised as deeply-embedded motivational sources and often defined as goals that vary in their importance and serve as guiding principles in people's lives [START_REF] Schwartz | Universals In The Content And Structure Of Values: Theoretical Advances And Empirical Tests In 20 Countries[END_REF]. Personal values therefore are similar to the concept of identified motivation [START_REF] Ryan | Self-Determination Theory and the Facilitation of Intrinsic Motivation, Social Development, and Well-Being[END_REF]. With an identified motivation, an individual consciously values the collective goal of the IT project and perceives it as his or her own [START_REF] Ryan | Self-Determination Theory and the Facilitation of Intrinsic Motivation, Social Development, and Well-Being[END_REF], [START_REF] Ke | The Effects of Extrinsic Motivations and Satisfaction in Open Source Software Development[END_REF], which ultimately can influence e-health technology adoption.

It is evident from the previous sections and Table 1 that healthcare providers' intentions towards e-health technologies can be attributed to various value dimensions which form an individual's value system. As a result, it is proposed that:

P3: Healthcare Surveillance Assistants' Value System impacts their intentions to adopt e-health technologies in developing countries.

Based on this review of extant literature a theoretical model is developed, consisting of three propositions (Figure 1).

Contextual Factors

Individual's Value System

Intentions to Adopt e-Health Technologies

Proposed Methodology

Future work will empirically examine the theoretical model (Figure 1) by obtaining quantitative data from HSAs (sometimes referred to as Community Healthcare Workers) in Malawi, Africa. HSAs are deployed in rural settings with an assigned catchment area, responsible for preventive health in children. Presently, HSAs utilise a paper-based set of guidelines known as the Case Community Management (CCM), which is a stepwise and structured approach towards assessing and managing children. Attempts are currently underway to digitise this paper-based approach.

To obtain the necessary quantitative data, a paper-based survey is the data collection technique which will be implemented. The survey will be designed adhering to existing guidelines in the IS literature. Measures for each construct highlighted in Figure 1 are reflective in nature and will be obtained from extant literature. The Partial Least Square [PLS] (Structural Equation Modelling [SEM]) approach will be employed to analyse the data. All statistical analysis of the quantitative results will be conducted using SmartPLS (Version 2.0.M3). All reliability and validity test will be performed meeting the integral criteria and their associated threshold levels documented in the IS literature.

Discussion and Conclusions

The technological gulf between resource-rich and resource-poor populations still exists. To assist in overcoming this real-world problem, developing countries need to leverage their existing ICT resources. To help ensure that a successful adoption of ICT is achieved, greater attention is required to assess contextual factors and individual value dimensions of a healthcare provider's intention to adopt e-health technologies. Therefore the objective of this study is to develop a theoretical model which explores the drivers of e-health technology adoption intentions from both a contextual and value perspective.

Values can be difficult to interpret, considering the complexity, significance and meaning that differs from one context to another. There is a real need to examine individual values under a clear set of contextual factors. The primary contribution of this paper is the construction of a theoretical model which will enable multiple individual values to be assessed under different contexts. From this baseline, researchers will be able to assess more accurately a user's intentions to adopt e-health technologies under a variety of contextual factors. The framework is supported by three propositions which are supported based on existing research:

• P1: Contextual factors in developing countries impact Healthcare Surveillance Assistants' value system. • P2: Contextual factors impact Healthcare Surveillance Assistants' intention to adopt e-health technologies in developing countries. • P3: Healthcare Surveillance Assistants' Value System impacts their intentions to adopt e-health technologies in developing countries. While the proposed model has been rigorously developed based on extant literature, its principal limitation is that it has not been empirically examined against a developing world context. Moreover it solely focuses on human/environmental as opposed to technological dimensions, which have been reported to impact intentions to adopt IT in extant literature. Once the data is collected and assessed the proposed theoretical model may be refined to reflect the real-world impact (a) contextual factors in the developing world and (b) associated values have on the intentions to adopt e-health technologies. This research will serve as a basis for future adoption based research within developing countries.

Figure 1 .

 1 Figure 1. Theoretical Model.


Peter Bednar
email: peter.bednar@port.ac.uk

Peter Imrie
email: pch.imrie@gmail.com

Christine Welch
email: christine.welch@port.ac.uk

Personalized Support with 'Little' Data

Keywords: Personalized support, End-user owned, Knowledge worker, Little data, chat-bot, Emotional engagement, Contextual dependency, Natural Language Processing

de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

Introduction

How could we help to support the creation of value for all through IT? We reflect on the use of Virtual Personal Assistant (VPA) as an example of future technology with a potential to create value by transferring and diffusing new functionality, features and capability. The VPA we are looking at as an example (Kari) is not just an intelligent program with natural language processing capabilities. This software has potential value through its AI and natural language processing combined with emulation and imitation of emotional engagement [START_REF] Studios | Advanced Virtual Girl with Artificial Intelligence[END_REF]. This is contextualized and private in the form of an end user controlled VPA. As a contrast to large scale AI based personalized DSS which draw upon centralized systems [START_REF]The DeepQA Project[END_REF] and / or cloud computing [START_REF]Siri. Your wish is its command[END_REF]. Kari (used as an example in this paper) is completely independent from central systems and costs the equivalent of a typical computer game. Kari could run on handheld computers (e.g. smartphones) without needing any additional processing or database.

It can also interact with other devices (internet-of-things) on behalf of its user (local owner).

"We are witnessing a shift in human attention, from physical to dynamic instances in which digital and physical blends emerge" [START_REF] Croon Fors | The beauty of the beast: the matter of meaning in digitalization[END_REF].

Kari is not a front end to a larger centralized system so avoids focusing on Big Data. The system is not a top down managed systems due to the human enhancement being provided to and from the true user, where the true user is the expert involved in the situational problem space. All metadata analysis and pattern analysis etc. is consequently developed locally and not shared with other devices or databases. It is a bottom up approach and appropriately described as 'Little Data'.

The personality and capabilities of Kari is developing through interaction with its unique user via natural language processing. It expands its database and constantly evolves its behaviour and interaction model through pattern recognition and metadata analysis, both on heuristics and behavioural analysis of user interaction (not just content analysis). This makes it adapting to increasingly complex, uncertain and differentiated contexts, as it develops a unique behavioural personality as a consequence of its evolving analysis and meta-analysis of end user interactions [START_REF] Imrie | Virtual Personal Assistant[END_REF]. Kari is capable of analysing similar data and creates different outputs which may be inconsistent with each other. This para-consistent logic [START_REF] Bednar | Knowledge Creation and Sharing -Complex Methods of Inquiry and Inconsistent Theory[END_REF] allows for the expert to reflect upon their own perspective and personal 'bias' [START_REF] Bednar | Bias, Misinformation and the Paradox of Neutrality[END_REF].

Discussion

In an era of 'Big Data', it could be said that professionals are supported by organizational systems that will capture all aspects of working life and can be interrogated and used to perform analysis. However, we suggest that this is to ignore the need for 'Little Data' that is both immediate and context specific (even if incomplete) [START_REF] Berger | Contagious: Why Things Catch On, reported at[END_REF]. As deZeeuw [START_REF] Zeeuw | Knowledge Acquisition in changing realities[END_REF] puts it: "An alternative is to invite the user to become a proper user, one who uses results in a way which makes them useful. An example is the development of professional organizations." [13,p837] This is relevant in the context of knowledge organizations and society.

When engaging complex problem spaces we want to support a move from uncertainty to ambiguity. One example of usefulness is when support for reflection is necessary but alternative interpretations and viewpoints are not imagined. To have more than one alternative description opens the potential to reflect and contrast alternatives with each other. In other words when choices are available decisions can be reflected upon.

"In the case of ambiguity, people engage in sense making because they are confused by too many interpretations, whereas in the case of uncertainty they do so because they are ignorant of any interpretations" [12, p91].

Croon-Fors [START_REF] Croon Fors | The Ontology of the Subject in Digitalization[END_REF] highlights two aspects of life with which individuals seek help. First, people perceive that the use of universal theories misses most of their experience of 'reality'. Secondly, there is a necessity for human beings to take responsibility for social relations of science and technology. We benefit from embracing the skillful task of reconstructing the boundaries of daily life, in partial connection with others, in communication with all our parts including technologies. A VPA (such as Kari) in the form of a metaphorical human avatar could contribute to enhance our understanding of, and reflection over, our situated problem experiences. It also makes it possible to criticize the idea of a person as a coherent subject individual, and so helps us as users with our self-exploration. As such, a VPA emulates "moodiness" and multiple emotional behaviour patterns. It expresses a variety and incompleteness of control mechanism as part of its natural language processing and interaction.

With the VPA we can engage with the three principal responses as mentioned by Croon-Fors, i.e. disclosure, performativity and 'the real'. Disclosure is related to the provocation ability of the VPA, its demands on personal attention and affectionate interaction. Performativity is related to the ability to simulate emotional behaviour, such as 'being' moody, bitchy, humorous etc., and its ability to explore alternative and even inconsistent avenues and subjects for conversation. The reality aspect of the VPA is related to the intimate and physical interaction between a unique real user and the software imitation of a metaphorical human (avatar).

As Croon-Fors [7,p55] states, "… we acknowledge the existence of various interrelationships between self and otherness, interrelationships that are constantly changing in various sense-making and interpretative processes. Such view also suggests the real to be constituted by an indefinite number of on-going sense-making processes."

A user-owned service running a VPA (as opposed to an interface to 'Big Data') changes the focus of the supporting system to the contextual sphere of the user [START_REF] Bednar | learning Objects and their implications on Learning: a case of developing the foundation for a new Knowledge Infrastructure[END_REF]. E.g. Kari can function as a virtual 'girlfriend' [START_REF] Studios | Advanced Virtual Girl with Artificial Intelligence[END_REF] because it communicates with the user using similar methods of natural language processing and also tries to provoke social conversation with the user. This purpose of social interaction is closely related to the one developed by Kiribo.

"Earth's first talking robot to go off world, is en route to the International Space Station -and its prime directive is to tackle loneliness." [START_REF] Parnell | World's FIRST TALKING SPACE ROBO-CHUM BLASTS OFF to the ISS: Domo arigato[END_REF].

Conclusions

Kari is social, intimately private and personal to the user. The software aims to give personal companionship, and to replicate human interaction as nearly as possible with the assistance of algorithms designed to enable the program to learn from its inputs. As Kari develops new libraries and metadata based on conversation with the user, the patterns of use and subject content developed are uniquely personal and in a way contextually relevant. This reflects on how today's new trends are creating value for all through development of new technology, focusing on innovation of human enhancement through a personal, user owned decision support systems. This category of VPA has a potential as a sophisticated self-service support system. Its great benefit is that it constantly develops as a self-user generated service. Software such as Kari is versatile, running on hand-held devices and costing no more than a typical gaming package. Adaptable for many differing purposes, and therefore providing new opportunities in professional life, everyday activities or leisure applica-tions. It could create value for all, potentially supporting the evolution of a democratizing society.


Anna Sigridur Islind
email: anna-sigridur.islind@hv.se

The "PantryApp": Design Experiences from a User-Focused Innovation Project about Mobile Services for Senior Citizens

Keywords: Design Experiences, Senior Citizens, Mobile Application and Services, Mobile Payments

This experience report aims to reflect on a design initiative conducted as a user-focused innovation. It is based on a research and development project about mobile commerce. Herein, I include various forms of mobile services that accumulate the core function of mobile payments. The target group of the design was senior citizens who need to have their grocery shopping done in a more safe and convenient way. In this report I will particularly focus on the design process and the design product.

Introduction

This experience report aims to reflect on a design initiative conducted as a userfocused innovation. It is based on an action design research project about mobile services and mobile payments [START_REF] Sein | Action Design Research[END_REF]. The target group of the design is senior citizens and other caretakers that need their grocery shopping done in a more safe, sufficient and convenient way. The focus in this report lies on the design process and the design product.

The Problem

People need food and grocery shopping is a part of everyday life. For people with disabilities, diseases, impaired vision, high age or other problems that render them unable to take care of themselves completely, going grocery shopping is out of the picture. These citizens belong to the home care system and receive help from caregivers that tend to their needs and see to that they get fresh groceries. The actual situation in the case of the studied municipality, the caregivers collect handwritten shopping lists and money and then shop for five caretakers at a time. This quite often results in mistakes and the caregivers have a tendency to bring home the wrong groceries. Problems have also occurred during the payment process. To hand money or a payment card over to a caregiver, which a caretaker might be meeting for the first time, is precarious since time to establish important trust is not always available. Furthermore, the caregivers do not consider it optimal to handle money and having the forced responsibility of bringing the right change back to the five caretakers. Some caretakers have portrayed mistrust towards the caregivers and have occasionally made allegations against the caregivers, accusing them of stealing. These kinds of incidents usually have a logical explanation and are resolved in a good manner but put unnecessary stress on all parties involved. Additionally, the caregivers have educated themselves in care or nursing and should not be forced to go grocery shopping.

Consequently, this is a process with a lot of human factors that can easily go wrong. Nevertheless, after almost one and a half year of working with this project and this problematic process, it is obvious that as long as the money factor is involved in this process, there will be mistrust.

2

The Design of the PantryApp

The design of the PantryApp was reflected by the steps: investigation, exploration, composition and evaluation [START_REF] Nelson | The design way: intentional change in an unpredictable world[END_REF].

Investigation

The investigation has included extensive empirical research, in terms of interviews in focus groups in addition to individual interviews. As this is a project with user focus, the key-persons in the interview phase were the senior citizens (caretakers), a group of retired citizens that do not yet belong to the Swedish home care system as well as the caregivers. The caregivers have tacit knowledge so they were able to, through interviews, distinguish how they perceived their daily work tasks into the tiniest detail. The owners and employees in the store that delivers the groceries have also been interviewed regularly. The caretakers have shed light on their specific needs and wants. Their lack of technology knowledge implied that they all in fact belonged to digital divide as presented by [START_REF] Selwyn | Older adults' use of information and communications technology in everyday life[END_REF]. These user groups have had the biggest influence, both in the interface design and in the usability design. Leaders from all levels in the municipality in addition to politicians have been involved as well through giving feedback on the applications impact on the organizational structure. They helped crystalize how the organization works on a higher level.

Exploration

From being a software developer for six years to becoming a more user-focused designer has been a learning journey for me. My role as a project leader in this complex project has been the greatest experience yet. I have developed real passion for helping the caretakers and caregivers as I felt compelled to use my education for some greater good: to help those in need, and these wonderful senior citizens are certainly in dire need. This helped develop a sense of possibilities and led to the realization of what can be, rather than putting emphasis on what is [START_REF] Nelson | The design way: intentional change in an unpredictable world[END_REF]. At a certain point there was a shift in focus to how things could be done in the perfect world, full of possibilities. The first draft of this "perfect world" did not correspond to what the application later evolved into, since aiming for the perfect scenario is neither relevant nor realistic. This was merely a learning process for all parties and led to an even closer collaboration. This close cooperation with the end-users resulted in a functional co-produced prototype, which has been redesigned for the next phase, a full-scale artifact. It answers the needs of today, but it requires nurture as well as careful and continuous cooperation to answer the needs of the future users. What we have today might not look or feel anything like what the future will hold but is certainly a start of something. This start of something has already, according to the caregivers themselves, shown improvement possibilities in their daily work. Consequently, their role should evolve into a more meaningful care taking and nurturing one and resulting in them having more pride in their profession.

With the implementation of the PantryApp, both in its prototype stage and in the full-scale version, the handwritten shopping lists from the seniors are history. They now pick their products out in the PantryApp, which presents all products with pictures and sit in the comfort of their home alongside their caregiver that help them choose and order selected products.

The implementation has generated further needs and wants such as a guidance role for the caregivers that have been asked to provide nutrition advice. The caretakers have progressed as well. They have expressed curiosity towards what others buy, so a function that presents the most popular choices amongst all buyers has been implemented. The prototype version was only an android application but the full-scale PantryApp is platform independent at the request of both user groups. Taking this user-focused perspective has generated these new innovative user ideas continuously and thus made the application richer.

Composition

The application was designed and programmed in harmony with the organizational changes. This organizational development included designing a new schedule for the caregivers to go between the caretakers' homes in a more efficient manner to grocery shop via the PantryApp. The grocery store involved picks and packs the groceries and sent out an invoice directly to the senior citizens during the pilot phase. In the fullscale PantryApp, the caretakers pay directly within the application using mobile payments. The groceries are then picked up and delivered to the seniors' homes, by another party.

Evaluation

The users have expressed satisfaction towards the project as a whole and shown fulfillment regarding the new design of the full-scale application. Their gratitude gets me excited and enthusiastic to get to the next stage in the project. The anticipation is that a large group of caretakers alongside caregivers will find the artifact facilitating and useful and that the application will be implemented in numerous municipalities. The money factor, already eliminated in the prototype phase, has influenced trustcreation between the caretaker and the caregivers to a great deal. The implementation of mobile payments in the full-scale application is expected to result in an even greater impact on the trust factor.

The application allows the caretakers to gain control over their own economy and spending decisions again, that most of them lost years ago. The PantryApp even allows the caretakers to make the final decision about their grocery selection. Being in need of care, should not mean loss of control.

3

Conclusions and Lessons Learned L1. End user involvement: The concrete and direct involvement of senior citizens in the design process was essential. During that process it became clear that the senior citizens especially had difficulties seeing how things are possible without having an artifact right in front of their eyes. This may be due to the digital divide. L2. Mediating artifact: Before, there was a lack of caring communication between the caretakers and the caregivers. At present, the application is considered as a conversation starter as the caretakers now sit closer to their caregivers and they seem more relaxed with each other than they did before. There is no pressure to know each other beforehand or get to know each other on a personal level. The artifact actually links these two groups together in a community-of-practice kind of way.

L3. Professional values: Daily problems in the professionals' practices regarding trust factor and handling money are accommodated through the artifact. The focus is now shifting from the role of a personal assistant towards the professional role of nursing and caring.