Discussions

Designing to Influence Healthful Behaviors: An Opportunity for the Interaction Design Community

Session Title

Designing to Influence Healthful Behaviors: An Opportunity for the Interaction Design Community

Presenter

Woodrow Winchester, III, Virginia Tech

Session Type: Discussion

Rooted in cognitive psychology, revived in application by behavioral economist, and recently kick started in the design & technology arena by research at the Stanford University’s Persuasive Technology Laboratory and the Cleaner Electronics Research Group, Brunel University, Middlesex, the notion of leveraging design’s influence on human behavior is gaining significant traction. Within recent months, much has been explored and discussed within the public forum around this concept. For example, A June 8, 2009 National Public Radio (NPR) piece, “Using Psychology to Save You From Yourself” illustrates this notion in the context of policy design through the selective implementation of defaults. From a healthcare perspective, this idea was demonstrated in a recent June 15, 2009 Time Magazine article detailing a study of the ALIVE! Intervention (A Lifestyle Intervention via Email Intervention), which examined how simple e-mail reminders can positively impact recipients’ eating and/or exercise behaviors. Moreover, Nudge: Improving Decisions about Health, Wealth, and Happiness, a current New York Times bestseller by Richard Tahler and Cass Sunsten, devotes an entire chapter to Choice Architecture — a concept that leverages much of Don Norman’s work in offering design guidelines to support influencing one’s choices (behaviors).

As this evolving notion of designing to influence behavior advances; so has a new lingua franca framing this perspective. In addition to Choice Architecture, terms, or more so, concepts such as Design with Intent (Lockton, 2008), “strategic design that’s intended to influence or result in certain user behavior”, Persuasive Technology (Fogg, 2003), “any interactive computing system designed to change people’s attitudes or behaviors”, and Captology (Fogg, 2003), “the design, research, and analysis of interactive computing products created for the purpose of changing people’s attitudes or behaviors” are defining this discourse.

In the healthcare domain of which this notion is receiving growing attention, Behavioral Informatics (both a term and special interest group (SIG) of the Society of Behavioral Medicine), represents “the study of the use of technologies by patients and health care providers as well as the design, implementation, and evaluation of behavioral change interventions delivered through advanced technologies”. In a somewhat similar vein, the International Medical Informatics Association (IMIA) uses the term Healthcare or Biomedical Informatics, “the knowledge, skills and tools which enable information to be collected, managed, used and shared to support the delivery of healthcare and promote health” and in 2006 established a specific working group on human factors engineering in health informatics with a goal to “make the computer a welcome partner with both the clinician and the patient in the empowered longitudinal care of the individual” (IMIA). Other healthcare concepts that have permeated the popular vernacular that on some level explore these thoughts of technology-enabled behavioral influence/change include eHealth, Health 2.0, and mHealth (mobile technology focus).

While the opportunities in leveraging design’s influence on behavior are great and span a variety of application domains (e.g. Lockton and his colleagues have focused on influencing sustainable (green) behaviors), healthcare, in particular, offers significant possibilities. Delaware Physicians Care, Inc (DPCI), leveraging successes from an initial pilot program that explored using SMS (text messaging) to remind patients with diabetes of their regular blood tests, is now piloting a SMS system for pregnant patients. The health promotion community is also embracing the potential of design’s influence on behavior. With upticks in domestic (US) HIV infection rates recently reported especially in younger demographic groups, public health practitioners are aggressively investigating means in which technology and design can support HIV prevention efforts. For example, work by Judith Cornelius and her interdisciplinary team at the University of North Carolina at Charlotte is providing an understanding of the feasibility of a SMS augmented behavioral intervention in modifying sexual risk behaviors amongst African-American adolescents, an especially HIV vulnerable group.

Further, in regards to the mobile phone as a medium that could foster healthful behaviors, a cottage industry of sorts is being birthed as numerous mobile applications are being developed to support health-related behavioral change. The Apple iTunes mobile applications store now features a dedicated healthcare and fitness page. Many of the offered applications (apps) are designed to engender and/or promote healthful behaviors.

As the healthcare reform debate rages in the United States, the call to do more with less is omnipresnet. This call is lending itself to exploring the design of technologies and systems that not only facilitate but promote and influence healthy behaviors. The potential exists; however, there remains significant developmental challenges; suggesting the role for more active involvement from the interaction design community.

Through just a cursory review of the literature, human factors considerations such as trust, privacy, social stigma, and ethics exist and are not fully understood within this evolving design context. In addition, human-computer interaction (HCI) and socio technical (STS) & cultural implications are present and could challenge research and development efforts. Negative unintended consequences of a design’s intent and barriers to acceptance could reduce a design’s efficacy, unless those factors that impact use and acceptance are discerned and addressed.

The purpose of this discussion is to engage the interaction design community in uncovering opportunities and challenges in advancing this notion of leveraging design’s influence on healthful behaviors. The discussion will be framed within the context of exploring the potential of interactive technologies in engendering healthful behaviors. It is the facilitator’s conjecture that the role for involvement by the interaction design community in this discourse is elucidating and actionable especially in the context of meeting the mounting challenges facing healthcare both domestically and globally.

Biography

Woodrow W. Winchester, III is an Assistant Professor of Industrial and Systems Engineering at Virginia Tech, Blacksburg, VA. A faculty affiliate of Virginia Tech’s Center for Human-Computer Interaction (CHCI), Woodrow directs the Laboratory for User-Centric Innovation in Design (LUCID) and is the co-founder and a program coordinator of Building Interfaces for Tomorrow’s Technology: The Virginia Tech Research Experience for Undergraduates (REU) in Human-Computer Interaction, sponsored by the National Science Foundation (NSF). Woodrow received his BS, MS, and Ph.D. in Industrial and Systems Engineering from North Carolina A&T State University, Greensboro, NC and is an alumnus of the 5th Convivio International Interaction Design Summer School, Napier University, Edinburgh, United Kingdom.