All of the selected articles provided different perspectives for the determinants of health in Canada. These perspectives represent the different variables examined in each article. For example, the article titled “Cause-Specific Mortality by Education in Canada”
provided many perspectives, including the mortality rates for different educational levels, age groups, and gender. Therefore, I have created several visualizations for each article. However, when I started publishing the articles on the tool website, I reduced the number of visualizations per article to reduce the effort and time required by my research
participants to explore the tool. I also provided visualizations for some of the determinants only to reduce the time required to examine the tool by research participants. However, I believe that I have provided enough visualizations to demonstrate the tool and collect sufficient data.
In my tool, I wanted to test the utility of visualizing frameworks, which is my main research question. I also wanted to evaluate different visualization constructs, including different interaction techniques, visualization techniques, and data encoding techniques to develop the next version of the tool. Interaction techniques that I have provided in my tool included zooming, hand scrolling, filtering, hovering and tooltips, and sorting. I have created several kinds of representation techniques, such as scatter plots, heat maps, bar charts, and choropleth maps. I have used two visual encoding marks: color and shape. These marks have different attributes, including color saturation, and shape size. Developing the visualizations started at the beginning of September 2015 and ended by the end of December 2015. The development stage resulted in three versions of the visualizations. The third version was the one used in the final tool. Except for a few minor changes in some visualizations, research participants saw and explored the same version of visualizations.
Chapter 5
5
Results
The purpose of my thesis is to explore the use of information visualization to represent the social determinants of health and health equity indicators, and to understand the benefits of such use in knowledge translation and health policymaking. While the focus of my thesis is to examine the perceived utility of visualizing a conceptual framework for the social determinants of health, my thesis reveals many aspects of health policymaking and knowledge translation.
In this chapter, I present my research findings. In my presentation I use the following terms to represent specific meanings:
1. The tool or the visualization tool: These terms refer to the tool (www.healthvisualization.ca) that I have developed for my thesis.
2. The framework or the visualized framework: These terms always refer to CSDH framework, which was developed by the World Health Organization’s Commission on the social determinant of health.
3. Visualizations: Although the word visualization is a non-count noun, a plural form of it has been used in information technology literature to refer to a group of visualized charts, and I have used it here for the same purpose.
4. The expert: This term is defined in Chapter 2 (the literature review), and it refers to expert policy actor, who has the technical expertise or policy area expertise that enable him/her to analyze policy problems and suggest solutions. Experts might be professionals working in healthcare or public health organizations in Canada, including epidemiologists, data analysts, or researchers in research centers. The experts could also be researchers in academia who participate directly in decision support activities either in hospitals or in not for profit organizations. Expert policy actors are knowledge producers, who produce the knowledge required for health policymaking.
Quotations from my participants’ talk were put in quotation marks. In some quotations, I have put my words in square brackets. Whenever put, my words always refer to a
meaning that was explicitly or implicitly mentioned in the conversation. For example, if I had asked a participant a question about a specific concept, then this participant might have used the pronoun “it” to refer to that concept, and I might find it more useful to clarify certain sentences, without changing the overall meaning that the participant wanted to convey. I have also underlined some sentences for emphasis.
The themes presented represent the stories told by my participants, and I have tried to explicate these stories by objectively interpreting the content of the interviews that I conducted with my research participants. I have also tried to use a relevant coding system to analyze my data and to facilitate an objective interpretation of it. However, given the semi-structured nature of the interview guide, some themes could be the direct result of specific questions. For example, themes related to the usability of the tool were expected to appear because I have asked about it, albeit using open-ended questions. On the other hand, some themes reflect my participants’ priorities and concerns and were not
prompted directly by interview questions. For example, the misinterpretation of information by laypeople theme, and the complexity of health policymaking were brought up by some participants.
The following themes emerged from my analysis: 1. Expert's Perceived Usefulness of the Framework.
a. The Framework as a knowledge construct. b. The Framework as a visualization construct. 2. Expert's Perceived Usefulness of the Tool.
3. Expert's Perceived Complexity of Knowledge Communication. 4. Expert's Need for Quality Information.
6. Expert's Perceived Complexity of Policymaking, and Policymakers' Needs. 7. Expert's Evaluation of the Features of the Tool
a. Ease of Use.
b. Representation Techniques and Encoding Marks.