Department of Family and Emergency Medicine, Laval University, Quebec City, QC, Canada.
Vaccine Evaluation Center, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada.
J Med Internet Res. 2020 Oct 30;22(10):e20113. doi: 10.2196/20113.
Herd immunity or community immunity refers to the reduced risk of infection among susceptible individuals in a population through the presence and proximity of immune individuals. Recent studies suggest that improving the understanding of community immunity may increase intentions to get vaccinated.
This study aims to design a web application about community immunity and optimize it based on users' cognitive and emotional responses.
Our multidisciplinary team developed a web application about community immunity to communicate epidemiological evidence in a personalized way. In our application, people build their own community by creating an avatar representing themselves and 8 other avatars representing people around them, for example, their family or coworkers. The application integrates these avatars in a 2-min visualization showing how different parameters (eg, vaccine coverage, and contact within communities) influence community immunity. We predefined communication goals, created prototype visualizations, and tested four iterative versions of our visualization in a university-based human-computer interaction laboratory and community-based settings (a cafeteria, two shopping malls, and a public library). Data included psychophysiological measures (eye tracking, galvanic skin response, facial emotion recognition, and electroencephalogram) to assess participants' cognitive and affective responses to the visualization and verbal feedback to assess their interpretations of the visualization's content and messaging.
Among 110 participants across all four cycles, 68 (61.8%) were women and 38 (34.5%) were men (4/110, 3.6%; not reported), with a mean age of 38 (SD 17) years. More than half (65/110, 59.0%) of participants reported having a university-level education. Iterative changes across the cycles included adding the ability for users to create their own avatars, specific signals about who was represented by the different avatars, using color and movement to indicate protection or lack of protection from infectious disease, and changes to terminology to ensure clarity for people with varying educational backgrounds. Overall, we observed 3 generalizable findings. First, visualization does indeed appear to be a promising medium for conveying what community immunity is and how it works. Second, by involving multiple users in an iterative design process, it is possible to create a short and simple visualization that clearly conveys a complex topic. Finally, evaluating users' emotional responses during the design process, in addition to their cognitive responses, offers insights that help inform the final design of an intervention.
Visualization with personalized avatars may help people understand their individual roles in population health. Our app showed promise as a method of communicating the relationship between individual behavior and community health. The next steps will include assessing the effects of the application on risk perception, knowledge, and vaccination intentions in a randomized controlled trial. This study offers a potential road map for designing health communication materials for complex topics such as community immunity.
群体免疫或社区免疫是指通过具有免疫能力的个体的存在和接近，降低人群中易感个体的感染风险。最近的研究表明，提高对社区免疫的理解可能会增加接种疫苗的意愿。
本研究旨在设计一个关于社区免疫的网络应用程序，并根据用户的认知和情感反应对其进行优化。
我们的多学科团队开发了一个关于社区免疫的网络应用程序，以个性化的方式传达流行病学证据。在我们的应用程序中，人们通过创建一个代表自己的头像和 8 个代表自己周围人的头像来构建自己的社区，例如他们的家人或同事。该应用程序将这些头像集成到一个 2 分钟的可视化中，展示不同参数（例如疫苗接种覆盖率和社区内的接触）如何影响社区免疫。我们预先定义了沟通目标，创建了原型可视化，并在大学人机交互实验室和社区环境（自助餐厅、两个购物中心和公共图书馆）中对我们的可视化进行了四个迭代版本的测试。数据包括心理生理测量（眼动追踪、皮肤电反应、面部情绪识别和脑电图），以评估参与者对可视化的认知和情感反应，以及口头反馈，以评估他们对可视化内容和信息传递的解释。
在四个周期的 110 名参与者中，68 名（61.8%）为女性，38 名（34.5%）为男性（4/110，3.6%；未报告），平均年龄为 38 岁（标准差 17）岁。超过一半（65/110，59.0%）的参与者报告具有大学学历。整个周期的迭代变化包括增加用户创建自己头像的功能、特定的信号来表示不同头像所代表的人、使用颜色和运动来表示对传染病的保护或缺乏保护，以及改变术语，以确保具有不同教育背景的人能够理解。总的来说，我们观察到了 3 个普遍适用的发现。首先，可视化确实似乎是一种很有前途的媒介，可以传达什么是社区免疫以及它是如何运作的。其次，通过让多个用户参与迭代设计过程，可以创建一个简短而简单的可视化，清晰地传达一个复杂的主题。最后，在设计过程中评估用户的情感反应，除了评估他们的认知反应外，还可以提供帮助确定干预措施最终设计的见解。
带有个性化头像的可视化可能有助于人们了解他们在人群健康中的个人角色。我们的应用程序在沟通个人行为与社区健康之间的关系方面表现出了前景。下一步将包括在随机对照试验中评估该应用程序对风险感知、知识和疫苗接种意愿的影响。这项研究为设计复杂主题（如社区免疫）的健康传播材料提供了潜在的路线图。
