As global rates of anxiety and depression increase, we observe millions of downloads of mobile apps addressing mental health that adopt 'freemium' charging models offering complex combinations of free and paid features. We explore potentially negative outcomes of deploying such freemium designs to vulnerable MH populations. We assess outcomes for 41 frequently downloaded mental health apps, by combining thematic analysis of 41K user reviews with audits to validate app descriptions and reviews. We propose a new analytic framework identifying three types of negative outcomes for freemium deployments: first vulnerable users currently experiencing crises may feel pressure to download unhelpful or costly apps. Second unintuitive descriptions of complex apps can lead to inappropriate treatments and expensive subscriptions. Third, limited duration offers may result in incomplete treatments or unexpected charges. We discuss ethical considerations and broader HCI consequences. We describe implications for mental health app design, including the need for greater transparency around free versus paid features, and propose new approaches to provide vulnerable users with validated information about these commonly downloaded apps.

"Money Doesn't Buy You Happiness": Negative Consequences of Using the Freemium Model for Mental Health Apps

Contemporary connected things entail ongoing relations between producers, end users, and other actors characterized by ongoing updates and production of data about and through use. These relations are currently governed by Terms of Service (ToS) and related policy documents, which are known to be mostly ignored beyond the required interaction of ticking a box to indicate consent. This seems to be a symptom of failure to design for effectively mediating ongoing relations among multiple stakeholders involving multiple forms of value generation. In this paper, we use ToS as an entrance point to explore design practices for democratic data governance. Drawing on posthuman perspectives, we make three posthuman design moves exploring entanglements, decentering, and co-performance in relation to Terms of Service. Through these explorations we begin to sketch a space for design to engage with democratic data governance through a practice of what we call revealing design that is aimed at meaningfully making visible these complex networked relations in actionable ways. This approach is meant to open alternative possible trajectories that could be explored for design to enable genuine democratic data governance. 

Terms of entanglement: a posthumanist reading of Terms of Service

An empirical analysis of consumer-unfriendly E-commerce terms of service agreements: Implications for customer satisfaction and business survival

Rethinking 'Terms of Service' through programmatic time travel

Body doubling has emerged as a community-driven phenomenon primarily employed by neurodivergent individuals. In this work, we survey 220 people to investigate how, when, and why they engage in body doubling and their own definitions for it. The community roughly defines it as using the presence of others to start, stay focused on or accomplish a task. Tasks can be productivity or leisure-related. A body double can be collocated or remote, recorded or live, known or a stranger. This phenomenon remains nameless to many neurodivergent individuals; however, once presented with the term and concept, many recognize it as a strategy they have engaged in for years. We present the variety of ways people engage in body doubling (e.g., at a café, with YouTube videos), the diverse range of tasks people utilize it for (e.g., studying and working, doing dishes, cleaning, exercising, etc.), and their motivations for doing so (e.g., generating momentum, staying on task). Lastly, we present implications for future work based upon a two-part model of body doubling as a continuum of space/time and mutuality.

“It was something I naturally found worked and heard about later”: An Investigation of Body Doubling with Neurodivergent Participants

Terms of Service (ToS) agreements are typically written to satisfy corporate legal requirements rather than user understanding. Users are often deeply dissatisfied with online ToS agreements, which they typically find incomprehensible. Nevertheless, users frequently agree to the ToS, potentially surrendering their data and rights. We therefore designed alternative ways of presenting existing ToS documents using crowdsourced sentiment highlighting, to make documents more readable. This highlighting visualizes different sections of the agreement as positive or negative. We evaluated the visualization, finding that participants recognized highlighted information better, and most participants praised the visualization. We discuss design implications and the next steps for more interactive ToS.

https://dl.acm.org/doi/pdf/10.1145/3334480.3382787

Beyond Avoidance and Passivity: Novel UIs to Make Terms of Service Comprehensible

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Beyond Avoidance and Passivity: Novel UIs to Make Terms of Service Comprehensible