The focus group took place over two sessions, on Monday 7th March 2022 and Monday 21st of March 2022 at 3:00 PM, each lasting approximately 90 minutes. The focus group sessions were mixed cohorts with a total of 19 participants (63% male and 27% female). The sample size was determined by the saturation threshold, i.e., the number of focus groups was stopped when no new codes or themes emerged from the interviewees, rather, the same ones started recurring (21, 22). Furthermore, as suggested by experts in qualitative research methodology focus groups are generally not large, 8-12 people (23).The sample size was determined by the saturation threshold, i.e., the number of focus groups was stopped when no new codes or themes emerged from the interviewees, rather, the same ones started recurring. All participants were members of the UoW as either staff or student and completed a consent form prior to the session, only collecting information on age, gender and email address. The mean age was 28.6 years with a standard deviation of 10.3 years. Ratio of student to staff (SSR) was 3.75:1, which is an abundant ratio given the SSR is much higher at 16:1 as analysed by the University College Union. This means for the demographic of student and staff, there was an adequate and representative selection range used. The following sections report the results organized accordingly to the macro areas mentioned above.
The Concept of and Thoughts of Wellbeing
Fig 2 shows the results of the first question used to establish participants’ concept of wellbeing.
Fig 2. Response to "what words come to mind when you think of wellbeing?" Sum is greater than total number of participants as each participant could provide more than one entry.
Most participants thought of their wellbeing frequently and as an important aspect to focus on as they recognised its effects on their work/studies. Most participants use methods to track their wellbeing and they believed tracking their own would lead to an overall improvement. Fig 3 shows the given answers.
Fig 3 (a-d). Pie Chart Representation of Poll Results of Interview Questions Delivered During the Focus Group in the First Section. Question asked: a) How often do you think about your wellbeing? b) How important How important is it for you to be able to track and improve your wellbeing? c) Do you currently track your wellbeing? d) Do you think that monitoring your wellbeing can allow you to improve it?
Wellbeing tracking; duration, concerns and reasons
The results showed that participants would like to track their wellbeing consistently and long-term (see Fig 4).
Fig 4. Pie Chart Representation of Poll Results of Preferred duration of wellbeing tracking. Question asked: Over how long would you be interested in tracking your wellbeing?
The outcomes of the discussion showed that people monitored their wellbeing to identify trends to help them avoid taking activities that would produce undesirable results and to keep a logbook of their experiences so they could learn from them in the future. The discussion revealed that, although people thought wellbeing was important, improving wellbeing itself should be the focus and not just tracking it. Other insightful remarks included maintaining a sense of self and understanding how it is evolving over time.
In the discussion, they shared the methods they currently use, at same time expressing a lack of awareness on how to consistently use them towards a real wellbeing.
The reported methods to track their wellbeing are the following:
- Specific devices such as a smart watches.
- Software or device applications. Such as the “Better points” app by Warwick.
- Manual or digital note-taking for personal wellbeing tracking to reflect on one's own actions.
- Journaling - writing about actions during or at the end of the day.
The identified advantages and disadvantages to wellbeing tracking provided by the participants are provided in Table 1.
Table 1. Advantages and Disadvantages of wellbeing tracking and support provided by the participants
Advantages
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Disadvantages
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Identifying triggers
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Source of stress
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Positive influence of behaviour towards desired outcome
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Subliminal persuasion
|
|
Distraction
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Nevertheless, participants confirmed that they would like to track their wellbeing and receive support.
Evaluating Wellbeing monitoring and support services
The findings demonstrate that while the majority of participants were at ease with the use of AI to measure wellbeing, certain concerns were voiced. The main issues were the inaccuracy of interpolations when data was scarce, the inability to decide which data and context were appropriate for assessing wellbeing, the uncertainty surrounding the method of incorporating AI into assessing wellbeing, and the lack of "multi-level experience", which participants thought was essential for a thorough wellbeing examination (see Fig 5).
Fig 5. (a-b) Pie Chart Representation of Poll Results of Interview Questions Delivered During the Focus Group in the Third Section. Questions asked; a) How comfortable are you with the use of artificial intelligence to monitor your wellbeing? b) Do you think remote services for monitoring and supporting wellbeing are useful?
Wellbeing tracking: Data collection, methods, frequency, and analysis
Most of the participants identified stress level and heart rate as meaningful wellbeing indicators, as well as sleep quality and weight fluctuation as shown in Fig 6.
Fig 6. Bar chart representing the valences suggested as markers to track wellbeing
All participants preferred the wellbeing tracker to rely on both user-input and automatically measured data (e.g., using sensors), unless they have not to choose one only.
The poll results (Fig 7a) and discussion revealed that most people were comfortable with a variety of methods for data collection and information delivery, with importance placed on ability to provide holistic and accurate information about wellbeing. Clearly, there is an overlap among these methods, and it was agreed that the joint use of such methods linked to the same database for information collection would be preferred for flexibility.
Fig 7. Pie Chart Representation of Poll Results of Interview Questions Delivered During the Focus Group in the Fourth Section. Questions asked: a) How would you like information about your wellbeing to be collected? b) How often would you like the required information to be tracked and collected? c) Would you prefer the wellbeing tracker to rely on user-input or automatically derived (e.g., using sensors)?
Fig 7b shows the results for the frequency of data collection. There was consensus about the fact that user interactions with the app should be lower, but automatical data collection, e.g., physical activity and step numbers, can be continuous. The interviews (Fig 7c) also revealed a majority preference of automatic data gathering vs a manual user-input.
The dialogue showed which markers the participants consider helpful in understanding one's wellbeing (shown in Fig 6), along with recommendations for how the measurements may be taken (shown in Table 2):
Table 2. Summary of the features and forms of measurement to track wellbeing as suggested by participants, listed in order of importance ascribed by the participants (also visually presented in the word cloud in the supplementary material)
Information valence
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Type
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Measurement method
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Heart rate
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Quantitative
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Via a device, either ring or watch
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Skin galvanic response as a secondary measure of stress
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Individual stress scores
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Qualitative/Quantitative
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Individuals score stress levels based on a uniform scale but scoring system individual to each user.
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Habit tracker
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Qualitative/Quantitative
|
|
University and your wellbeing
The results revealed that most participants believed Universities, including the University of Warwick, care about the wellbeing (Fig 8b). This is because Warwick Wellbeing offers services like (Adverts of) Warwick Nightline and other similar, mentioning wellbeing, free counselling services that would otherwise be expensive, drop-in sessions (up to two hours) for in person “relaxing” activities, such as dog walking, university counselling services offered both in person and remotely, online modules to improve wellbeing with worksheets and activities, and the Better Points application (in partnership with University of Warwick) (Better Points 202224). Although most participants knew about and used this service, a substantial number, 24% were unaware of these services in place (shown in Fig 8a).
Fig 8. Pie Chart Representation of Poll Results of Interview Questions Delivered During the Focus Group in the Fifth Section. Question asked: a) Do you think the University cares about your wellbeing? b) Would you be comfortable in the university tracking your wellbeing using remote services?
Data protection is the main reported concern related to a wellbeing tracking by the University, i.e., the anonymity of information collected. The discussion revealed an even split between those who preferred anonymized and personalized tracked information, Table 3 summarises the points raised.
Table 3. Summary of the arguments postulated for and against preserving anonymity of data collected from wellbeing tracker)
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Reason
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Explanation
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Arguments for anonymisation data
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To keep the university in the loop
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To better understand the specific situations and circumstances of students.
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To quicken the university’s response time
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It would be useful if information about wellbeing is shared with the university, it can facilitate allocation of support systems such as auto referral for counselling, or deadline extensions without the need for mitigation forms, etc.
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Arguments against anonymising data
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Fraudulent information.
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For example, used as a way to escape from their own duties (i.e., people using sick days when not actually sick).
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Possible infringement of data rights
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The tracking instruments should follow existing laws and regulations, such as GDPR as it collects personal and private information.
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Targeted scrutiny
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Might be used against single individuals (i.e., to penalize or punish).
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Intrusiveness
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If university can directly track aspects of your wellbeing, this may lead to disclosing certain information with the university that individuals may not be comfortable with.
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Hidden Intentions
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If the intention of the university would be to use the collected information to improve the general wellbeing of the overall campus population, then disclosure of information about individual’s wellbeing wouldn’t be needed.
|
Wearable Devices
The first questions were about the familiarity with and preferences for wearable devices. The results showed that smaller devices with minimal designs were favoured. The most favourable being inconspicuous devices such as rings that “you would be wearing anyway” and do not hinder one’s ability to carry out day to day activities. However, the option of a small under the skin or implantable device was also suggested, such as the contraceptive implants or continuous glucose monitoring devices.
Participants expressed comfortability with a device that can function “without you thinking about it”, but that provided useful results. The same propensity for “the less effort it takes, the better” was also echoed here.
The accuracy of the data collected and, thus, the feedback provided was also a consideration for the type of device chosen, a less accurate but inconspicuous device might be preferred for day-to-day activities, but a more accurate and somewhat “unfashionable” or “bulkier” device might be preferred for within the home, whilst asleep, or at certain times when specific measurement is needed.
There was a resoundingly positive response on the reliance on and acceptability of wearables. Participants also expressed comfortability with the pairing of devices or other applications that tracks wellbeing with those of other users if better results could be obtained. Participants also mentioned that being linked with other peers could give them a sense of reciprocal wellbeing care.
The sixth section of the focus group also included the question on the desired measurable outcome of monitoring and tracking one’s wellbeing. The main measurable outcome people seemed to be looking for was related to increased happiness, reduced stress and anxiety, improved concentration, and physical fitness. As most of these rely on intangibles, the best measurable outcome could be using user inputs based on the individual’s perception of these facets.
Therefore, a suggested method for presenting a measurable outcome to the user could be through reports generated across a time scale, of the user-input scores or AI suggested values, for all or selected modalities.
As most of these rely on intangibles, the best measurable outcome could be using user inputs based on the individual’s perception of these facets (see Fig 9).
Fig 9. Pie Chart Representation of Poll Results of Interview Questions Delivered During the Focus Group in the Sixth Section. Questions asked: a) Are you familiar with wearables such as wristband/watch and chest patch for monitoring wellbeing b)How much do you think you would rely on wearables to track your wellbeing?(Likert scale) c) Would you like the device application to connect with other applications or devices? d) Would you like the device to be able to select people e.g. friends or family?