Enid Montague

Northwestern University, General Internal Medicine, Faculty Member

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I am an Assistant Professor at Northwestern University in General Internal Medicine and Geriatrics. I am interested in how trust is formed by multiple users in technological systems, the system effects of trusting or distrusting attitudes, and designing for trust. My current research looks at trust in health and wellness technologies.

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Cultural critical incidents in hazardous occupations: A preliminary exploration

Abstract. Cultural critical incidents (CCIs;), defined as any events involving an ethnically hete... more Abstract. Cultural critical incidents (CCIs;), defined as any events involving an ethnically heterogeneous dyad or group, can be used to identify contributors to disparities in hazard exposures. CCIs characterize the nature of cultural misunderstandings (Smith-Jackson & Essuman-Johnson, 2002), assumptions, stereotypes, or other barriers that contribute to the higher incidence of accidents, injuries, and fatalities among ethnic minority groups in both the USA and abroad.

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Physician interactions with electronic health records in primary care

Objective: It is essential to design technologies and systems that promote appropriate interactio... more Objective: It is essential to design technologies and systems that promote appropriate interactions between physicians and patients. This study explored how physicians interact with Electronic Health Records (EHRs) to understand the qualities of the interaction between the physician and the EHR that may contribute to positive physician–patient interactions. Study Design: Video-taped observations of 100 medical consultations were used to evaluate interaction patterns between physicians and EHRs.

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International Journal of Cyber Society and Education, Vol 5, No 2 (2012)

Abstract The purpose of this study was to better understand user trust in web sites designed for ... more Abstract The purpose of this study was to better understand user trust in web sites designed for different contexts; commerce, health and news. This research evaluated changes in trust ratings as users interacted with website elements. Differences in user trust ratings were observed between websites, which suggests that these changes in trust ratings are likely related to the website context.

Design Challenges and Guidelines for PersuasiveTechnologies that Facilitate Healthy Lifestyles

Abstract: Many diseases and health risks are the result of unhealthy lifestyles and technology co... more Abstract: Many diseases and health risks are the result of unhealthy lifestyles and technology could be used as an intervention. However, designing healthy lifestyle technologies is challenging, as the technology should be able to influence user behavior. In this case study, the design and evaluation process of a persuasive healthy lifestyle assistance technology was investigated.

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Health and Wellness Technology Use by Historically Underserved Health Consumers: Systematic Review

Background: The implementation of health technology is a national priority in the United States a... more Background: The implementation of health technology is a national priority in the United States and widely discussed in the literature. However, literature about the use of this technology by historically underserved populations is limited. Information on culturally informed health and wellness technology and the use of these technologies to reduce health disparities facing historically underserved populations in the United States is sparse in the literature.

Crowd reactions to sublethal weapons: Universal triggers for crowd violence

Abstract Since the end of the cold war, military forces have increasingly been required to manage... more Abstract Since the end of the cold war, military forces have increasingly been required to manage crowds of people, some of which may quickly turn violent. Frequently, crowd researchers identify “flashpoint” variables: environmental or social triggers that cause a crowd to become hostile. The goal of this research was to identify potential flashpoints, to assist the simulation and training communities in crowd representation.

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Modeling Eye Gaze Patterns in Clinician–Patient Interaction With Lag Sequential Analysis

Objective: The aim of this study was to examine whether lag sequential analysis could be used to ... more Objective: The aim of this study was to examine whether lag sequential analysis could be used to describe eye gaze orientation between clinicians and patients in the medical encounter. This topic is particularly important as new technologies are implemented into multiuser health care settings in which trust is critical and nonverbal cues are integral to achieving trust. This analysis method could lead to design guidelines for technologies and more effective assessments of interventions.

Improving Consumer Health IT Application Development: Lessons From Other Industries Findings from Key Informant Interviews

This project was funded by the Agency for Healthcare Research and Quality (AHRQ), US Department o... more

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Understanding active and passive users: The effects of an active user using normal, hard and unreliable technologies on user assessment of trust in technology and co-user

The aim of this study was to understand how passive users perceive the trustworthiness of active ... more The aim of this study was to understand how passive users perceive the trustworthiness of active users and technologies under varying technological conditions. An experimental study was designed to vary the functioning of technologies that active users interacted with, while passive users observed these interactions. Active and passive user ratings of technology and partner were collected.

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Patients User Experiences with Technologies in Health Service Industry

Abstract The purpose of this exploratory study was to identify usability problems encountered by ... more Abstract The purpose of this exploratory study was to identify usability problems encountered by patients, as passive users, during the interpretation of technologies that are used during patient care by clinicians and nurses. Participants were asked to interpret key artifacts in the health information technology display and determine potential outcomes.

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Trust in Medical Technology by Patients and Health Care Providers in Obstetric Work Systems

Multiple types of users (i.e. patients and care providers) have experiences with the same technol... more Multiple types of users (i.e. patients and care providers) have experiences with the same technologies in health care environments and may have different processes for developing trust in those technologies. The objective of this study was to assess how patients and care providers make decisions about the trustworthiness of mutually used medical technology in an obstetric work system. Using a grounded theory methodology, we conducted semi-structured interviews with 25 patients who had recently given birth and 12 obstetric health care providers to examine the decision-making process for developing trust in technologies used in an obstetric work system. We expected the two user groups to have similar criteria for developing trust in the technologies, though we found patients and physicians differed in processes for developing trust. Trust in care providers, the technologies' characteristics and how care providers used technology were all related to trust in medical technology for the patient participant group. Trustworthiness of the system and trust in self were related to trust in medical technology for the physician participant group. Our findings show that users with different perspectives of the system have different criteria for developing trust in medical technologies.

Validation of a trust in medical technology instrument

A patient's trusting attitude towards technology used in their medical care may be a predictor of... more A patient's trusting attitude towards technology used in their medical care may be a predictor of acceptance or rejection of the technology and, by extension, the physician. The aim of this study was to rigorously determine the validity of an instrument for measuring patients' trust in medical technology. Instrument validity was established based on a framework, which included test and data evidence for validity assessment. The framework for validity assessment evaluates the instrument on content, substantive, structural, generalizability, external and consequential aspects of validity. The results of the current study show that the instrument is reliable and valid for assessing a patient's trust in obstetric medical technology.

Empirically understanding trust in medical technology

Researchers across disciplines have developed measures of interpersonal trust, system trust, and ... more Researchers across disciplines have developed measures of interpersonal trust, system trust, and trust in technology and sought to determine if measures of trust in technology should use the same trust factors as interpersonal trust measures. Studies have found evidence to support the notion that trust and distrust are considered opposites, negating the need for two separate measures to be developed and that participants rate concepts of generalized trust, interpersonal trust, system trust, and trust in technology similarly. It is not apparent if trust in medical technology is the same as trust in general technology; if the two constructs are different, existing trust in technology models may not be useful in discussions about medical technology. The studies involved in the development of a framework of trust in medical technology provide evidence to determine that trust in medical technology is empirically different from trust in technology. The methods described in the studies are based on research methods used to empirically define the constructs trust and comfort and were chosen to extend previous trust in technology models and to offer comparison and validation of findings and methods used in previous studies.

Using variance analysis to detect mismatches in role expectations in patient physician interactions in obstetric work systems

A socio-technical systems role analysis was conducted with patients and care providers at a midsi... more A socio-technical systems role analysis was conducted with patients and care providers at a midsize hospital in the United States. Participants in each group were asked how they viewed their role in the care proving process and how they viewed the role of the other group. Results indicate variances between how patients and providers see the role of the provider and how patients and providers see the role of the patient. Implications relative to work system improvement are discussed.

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TRUST IN SOCIOTECHNICAL SYSTEMS

Human Factors and …, Jan 1, 2010

Abstract The purpose of this panel is to provide a general overview and discussion of trust relat... more Abstract The purpose of this panel is to provide a general overview and discussion of trust relationships in sociotechnical systems. The panel will be composed of five well-known experts in complex systems research and will offer differing views on the concept of trust in these systems. The panel will consist of a brief introduction sociotechnical and macroergonomic theory followed by a comprehensive overview of conceptualizing trust as a sociotechnical construct. The range of concepts discussed in this panel include: trust in ...

Trust in health websites: a review of an emerging field

… of the 1st ACM International Health …, Jan 1, 2010

Abstract As people increasingly turn to health websites for the purposes of self-diagnosis and he... more Abstract As people increasingly turn to health websites for the purposes of self-diagnosis and healthier living, we have an obligation to evaluate the factors that might affect a given user&amp;#x27;s assessment and their willingness to use such sites. Constructs such as quality, trust, and credibility need to be defined within this space in order for us to truly understand how and why people use health websites. In an effort to better understand these constructs we conducted a comprehensive analysis of all peer-reviewed empirical studies on trust in ...

Patient source of learning about health technologies and ratings of trust in technologies used in their care

Ergonomics, Jan 1, 2010

In order to design effective health technologies and systems, it is important to understand how p... more In order to design effective health technologies and systems, it is important to understand how patients learn and make decisions about health technologies used in their care. The objective of this study was to examine patients&amp;amp;#39; source of learning about technologies used in their care and how the source related to their trust in the technology was used. Individual face-to-face and telephone interviews were conducted with 24 patients. Altogether, 13 unique sources of information about technology were identified and three major themes emerged: outside of the work system vs. inside the work system; when the health information was provided; the medium used. Patients used multiple sources outside of the healthcare work system to learn about technologies that will be used in their care. Results showed a relationship between learning about technologies from web sources and trust in technologies but no relationship between learning about technologies from healthcare providers and trust in technologies. STATEMENT OF RELEVANCE: The value of considering human attitudes about elements in health systems has been illustrated. This research shows a relationship between patient attitudes about medical technologies used in their care and healthcare work system design. Results show that patient attitudes are formed about technologies used in their care by sources within and outside of the sociotechnical work system.

A Case Study of the Design and Evaluation of a Persuasive Healthy Lifestyle Assistance Technology: Challenges and Design Guidelines

Universal Access in Human …, Jan 1, 2011

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Understanding Trust in Medical Technology: Using the Example of Obstetrics

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Designing a Better Morning: A Study on Large Scale Touch Interface Design

Human-Computer Interaction …, Jan 1, 2011

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Enid Montague

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