Thesis Summary

Page 1


An exploration into the design process of a multilingual pregnancy application and the formation of meaning across a user interface: a case study Aim and Motivation

The aim of this research was to explore the design process of a pregnancy health web-application by evaluating how the metacommunication between designers and users (de Souza, 2015) occurred.

This study sort to address two research questions centring on the treatment of culture and whether the Semiotic Engineering (Salgado et al., 2013) concepts of designer-to-user metacommunication would help explore and explain the process of designing We-HELP, within the context of this study’s multicultural and inter-disciplinary setting: 1.

How do the designers’ professional and individual cultural contexts impact upon the design outcomes?


How does the co-construction of meaning occur across the user interface between the designers and the users?

To facilitate the qualitative evaluation of users and designers, the study was divided into two parts: Part 1: a field study into the design process (see Appendix 1, Rich Picture) Part 2: evaluating the designer-to-user-metacommunication Key Issues Part 1

Lack of unified user requirements

Limited understanding of user requirements due to a lack of unified perspectives and perceived needs within the designer group and the medical practitioners user group. The application is required to support a number of ambiguous contexts

There was much debate into how We-HELP would be effectively designed, managed and applied into the future to support the multilingual content and the cultural contexts of an expansive range of users. Linguistically complex editorial environment

During the design conceptualisation phase and the building of the low-fidelity prototype, there were a number of issues working with the Vietnamese script. This hasn’t been accounted for in the planning of project timelines and resource allocation into the future, especially in regards to non-Roman languages such as Burmese.

Limited access to Vietnamese-speaking patients

There was a lack access to needs assessments regarding the users’ requirements, which was particularly important given the non-English language background. This initial hurdle revealed a challenging relationship between the hospital and their Vietnamese patients.

Key Issues Part 2

Interpretation of the prototype’s features, differs depending on the participants cultural background

How each participant interpreted the design and communication features of We-HELP corresponded to the needs of their professional culture, with patterns in preferences and affordances of specific features observed within the participant groups. Empowerment is an unspoken success factor

The practitioners and linguists all emphasised that We-HELP must enable both patients and practitioners to feel empowered by having accessible multilingual information. For the practitioners this centred on feeling reassured that their patients have the access to information, in a language they understand. Deep cultural insights aren’t available to the designers, resulting in ambiguous decision-making

When considering literacy issues and the ambiguous and unknown abilities of future users, there were varying levels of assumptions and generalisations being made by the designers and users, revealing a lack of deep insights into the context of use and the user’s needs.

There is a communication gap between the patients and practitioners

The communication channels between the patients and practitioners are hindered by a lack of access to language translations and interpreters, leading to an individual cultural and linguistic misalignment between the patients and practitioners. Alignment of Key Issues and Themes from Part 1 and 2

This tables aligns the keys issues from both parts one and two with the thematic analysis of the axial coding (see Appendix 2). Cultural Sensitivity was found to be the dominant theme and issue throughout both parts of the study. Key Issues Part 1

Part 2



Lack of unified user

Deep cultural insights aren’t


Cultural Sensitivity


available to the designers,


resulting in ambiguous


decision-making (P2.KI.3).


The application is required

Empowerment is an


to support a number of

unspoken success factor

ambiguous contexts



Coordination Cultural Sensitivity

Empowerment Cultural Sensitivity




Literacy Accessibility

Linguistically complex

Interpretation of the


Cultural Sensitivity

editorial environment

prototype’s features, differs


depending on the

Literacy Programmer

participants cultural

Coordination Literacy

background (P2.KI.1) Limited access to

There is a communication



gap between the patients


patients (P1.KI.4 ).

and practitioners (P2.KI.4).


Cultural Sensitivity

Cultural Sensitivity Accessibility

Conclusions and Recommendations


Develop a unified design concept that will be supported by all designers and the medical practitioner users;


Conduct detailed user-based evaluations with the pregnant women and their families. During these evaluations it is critical that the functionality of the application be evaluated, especially focusing on the signification of icons across cultures;


Evaluate how the future iterations of the application will be supported: What will happen post-implementation? Will there be support for the future editorial and content managers? Are there budget and resources allocated to support the future improvements of the application once released?


Gather a wider range of cultural insights into the current and future users groups. For example there seems to be little available information regarding the Burmese demographics.


Further assess the dual language display functions, this is an area that has little academic and industry support. Particularly, the dual display should be assessed for its feasibility to aid in translation and understanding of the medical content and secondly how non-linear and nonRoman languages will be supported with this functionality.


Assign and clarify the roles of all designers and the medical practitioners. Currently medical practitioners and staff of Western health are viewed as users, however their investment and engagement with the development of the prototype has evolved into a ‘hybrid role’ between user and designers.


© Ellen Louise Leather 2016




de Souza, C.S. (2005). Semiotic Engineering designers and user together at interaction time. Interacting with Computers 17. (pp.317-341). Elsevier. doi:10.1016. Salgado, L.C.C., LeitĂŁo, C.F., de Souza, C. (2013). Semiotic Engineering and Culture. A Journey Through Culture: Metaphors for Guiding the Design of CrossCultural Interactive Systems (pp.19-42). Springer Verlag Berlin Heidelberg. doi: 10.1007/978-1-4471-4114-3_2.

Appendix 1 Part 1: Rich Picture of the design context

Appendix 2 Part 2: Axial Coding of Interview Data

User Experience



The app design is not

The numbering system may not be

The use of horizontal text

obviously related to


alignment may reduce the ability


pregnancy, particularly the home screen.

for users to effectively translate The numbering system could result


information overload making Consideration into the user

navigating through actual content

journey and information

difficult. However there was

architecture needs to be

conflicting feedback with this system


with some participants preferring it and others not.

The numbering system must be

The lack of access to interpreters

Inability to work together in a face-

relevant to the user group needs

means this application must be the

to-face setting has blown out some

and the designers, greater

new form of patient information

of the timeframes.

consideration into the feasibility

access and a centralisation of

of how this will work needs to be

practitioner resources.



There is a risk that, there is no time allocated to test and evaluate

Clear decisions need to be made

the usability and overall user

regarding how the content


management will function, particularly how frequently content

There is need to have editor and

will be edited.

proof-readers for the Vietnamese content.

How future user-feedback will be prioritised, categorised and acted


upon needs to be specified. The users must be able to easily

Being able to carry this information

Understanding the user

and efficiently find the

in their pocket and look it up

requirements hasn’t always been

information they require.

whenever they need should enable.


Referring patients onto

There are a wide range of education

Accessing users, especially the

information into the application

backgrounds between all users and

patients have been complex and

will enable the patient’s to


time consuming.

access this contact information instantly.

There are potential technical and presentation issues when

This application will be

considering the future use of Arabic

especially helpful to women who

and Burmese script.

are breastfeeding, as they can open it up whenever the need it.

We-HELP should enable the patients to feel secure in their knowledge by reducing their reliance on interpreters and family members needing to guide them through the medical process. Multimedia and multimodality must be considered due to varying levels of literacy and comprehension.



The patients will have the ability to carry this information in their pocket (with a smartphone) gives them access previously not possible to their pregnancy information, enabling them to have personal and private interactions with the medical content.

Cultural Sensitivity

The current numbering system may be too much, a ‘information overload’ when considering nonEnglish speakers or poorly educated users. There may be problems in recitation and intercomprehension of the numerical system. The globe icon was not universally understood by all interviewees. How users select a language was not clear and both designers and users found this difficult. Intuitive design was quoted as necessary, however what this is was not defined.

We want the women to feel empowered by having access to this information. As practitioners we need to be confident that this is a trusted source of information that we are giving to our patients.

There are wide ranges of educational backgrounds of English speakers and non-English speakers, this means the content and way the app functions must be simplistic and easy to understand. Most Vietnamese patients should be able to read the content, the issue lies in making sure the content is in lay-mans terms. Colours and layout styles need to be evaluated and assessed for their cultural connotations. The reading of the content in a horizontally may make it harder to translate the material, as opposed to a vertical, side-by-side layout. The iconography will play a crucial role in communicating the functions and interaction capabilities of the UI.

The valuable contribution of each member makes this project unique and offers a range of interdisciplinary insights. The interdisciplinary nature of the project has brought to light issues that may have been missed.

There is a lack of deep insights into current literacy levels of pregnant women and their families. There was conflicting information regarding the usergroups requirements from the designer’s team and the medical practitioners perspective

The project has assumed much of the cultural applicability of this application. How the patient user groups have been recruited hasn’t always been successful, especially when considering the Vietnamese women, there is some disconnect between what the designers have recommended and what the Western Health practice.