Chapter

proposal for Research and Design Innovations for Mobile User Experience

Mobile Health: Collaborative participation in personalized health through mobile diaries

Author: Pelin Arslan, Ph.D. in Multimedia Communication and Industrial Design Politecnico di Milano, INDACO Department; Massachusetts Institute of Technology, Comparative Media Studies, Mobile Experience Lab

Towards a healthier lifestyle through mobile interventions

Healthcare is in transition towards wellbeing in daily life of an individual. The concept of healthier lifestyle requires a long-term relation with your everyday health, and co-producer with a good health status. With the improvement of mobile and social media technologies, we are looking for more participative, user friendly and centered, socially connected and economically sustainable health solutions. Mobile technologies can help to manage and promote everyday health and social health connections enabling systems that can monitor, track, and respond to changing health status; and digital spaces tailored to physical, cognitive and social needs of individuals. Today the health experience expands their border in a systematic way where individual monitor, suggest and gives feedback on their activities, choices and behaviors in their everyday life. It is an important issue to provide motivation, and consider privacy and trust issues in the mobile user experiences.

Diaries as self-documentation tools for a healthier lifestyle

As a method for data collection, diaries are used for gathering user experiences and understanding everyday human behavior. Diaries like self-documentation, including digital technologies, enrich classical participatory methods and account for users capacities, skills, and motivation. Self-reporting in situ has been explored by Larson and Csikszentmihalyi (1983) electronic sampling methods, Carter and Mankoff (2005), Gaver et al. (1999) as cultural probes are different types of diary methods. The diary study method usually occurs in one of two ways: participants answer predefined questions about events (feedback studies) or participants capture media that are then used as prompts for discussion in interviews (elicitation studies). To combine self-diary studies with a group participation proposes a social component of self-documentation and inclusion of others in the process of self-reporting reflects a sense of control and ownership by participants over the process. The chapter proposes the methodology of participatory design approach through diaries and social media tools. It aims to explain how to engage individuals in their own health management self-reflecting their habits and behaviors through mobile diaries and a sharing those personal diaries in a social platform to propose a solution to a health prevention of a chronic disease: obesity.

An empirical study on obesity prevention with adolescents through mobile diaries

Obesity is a complex health problem with many interrelated factors involved in energy regulation and body weight. It is not only a medical problem but it has its impact rooted to a sociopsychological environment of an individual. To manage and prevent a chronic disease as obesity, there are various levels of intervention as individual, family, medical, schools, community, environment and policy. Mobile interventions will have the role of creating co-relations, transitions, and participative factors through these levels to increase efficiency in prevention. By co-relating various actors in the system will promote a systematic solution, which confronts the complexity of obesity problem from a multifactorial aspects and bring mobile technology to revive with social aspects of a human being. The empirical study Health Diary uses participatory narrative technique as mobile diaries and location based platform to record user environment and everyday health routines. The project aims to provide a helpful tool for obese teens taking advantage of the Locast platform developed at MIT. The primary aim is to help teens developing awareness of their daily habits and as a consequence, encourage them to change their behaviors towards a healthier life since the process of self-reporting allows people to self-reflect and share aspects of their daily life. As discussed by Grinter and Eldridge (2001) this process can also trigger participants to question their choices and everyday behaviors. The secondary aim is to provide an effective instrument to experts. Psychologists Csikszentmihalyi and Larson (1987) state in their study that they have recognized the need to monitor patients in situ versus asking a participant to recall an event a week or more after the fact. Also the study of asthma conducted by Rich (2000) shows that medical information gathering might be augmented by video diaries created by patients to show clinicians the realities of managing chronic disease in the context of their lives.

A tool to collect socio-psychological data through mobile diaries

Health Diary Project aims to provide a helpful set of tools for teens risk at obesity to record their socio-psychological environment and everyday health routines. It is a personal diary for group participation through a location-based platform. This civic media tool enhances individuals awareness of their everyday experiences while they are performing these activities and social dynamics- taking place around them. The system aims to understand obese teens perception versus reality providing them tools to reflect on their problems and creating a network community that they could develop awareness by social interactions. Video diaries, created by a mobile application, are used as a personal data collection system allows them to record their eating habits, physical exercises and social activities during the day. The diaries are visualized & shared in real-time on a location-based platform using mobile GPS receiver and location sensing technologies all recorded media (videos, notes, etc.) The exchange of diary information affects health decision-making and creates a long-term behavioural change towards a healthier lifestyle. This web based platform supports social networks where teens can share experiences within the community. Diaries are structured in templates where each template refers to a question. Each question is a specific area of intervention for obesity prevention outlined by medical experts. The system allows teens control over what and how data is collected. The templates offers flexibility to frame the camera vision, shooting video narratives in their own style , how to tell their content, what to show in their environment. A supportive environment composed of social network and geo-located video diaries can monitor everyday activities (habits, physical and emotional) of obese teen. Locast as a platform could address obesity problem through using three components: Video diaries, Social network and Location based map.

The system framework consists of three main functionalities. 1) Video diaries are important for recording and reflecting teens habits, choices and behaviors at the exact time of the activity performed. According to previous studies of Csikszentmihalyi and Larson [1987] show that factors can and does affect the memory of participants recalling past experiences. Recall can be caused by (i) the current emotional state of the participant, (ii) the length of time the participant is asked to recall, (iii) the participant sitting in a foreign environment. The video diary, which is a visual storytelling tool, could be useful to provide more direct understanding of participants experiences. This visual narrative tool would not only help them to reflect on what they do in actual day but also give further information about their everyday life, for future collaborative decisions with a medical expert, a youth counselor or a health coach. The primary purpose is to use multimedia diaries to push teens to develop awareness of their everyday eating and activity habits, as a consequence encourage them to change their behaviors towards a healthier lifestyle. In addition, the second purpose is to provide an effective instrument to nutritionists and educational experts. Location based technology allows understanding the co-relation between place, which is individuals environment, and activity type. Individuals environment is correlated with the activity location is an important issue that needs to be considered in patients chronic disease prevention. Activity location visualized on a location based map help to map out the type of activity and services located in the neighborhood. Individuals change of location depending on the activity during a time frame allows giving assumptions about individuals being active or passive during the day. All these properties of location based diaries; aim to give additional information both for the type of the activity and the individual choices. Social Network is a place where social interaction and support occurs. One of the hypotheses in healthcare is to keep mental health positive, not something from negative to positive but making something positive to a more positive state to keep the psychological state of individual positive. There is a correlative relation between social support and physical health of an individual. According to Clark [2011] social support is one of most important factors in predicting the physical health and well-being of everyone, ranging from childhood through older adults. The absence of social support shows some disadvantage among the impacted individuals. In most cases, it can predict the deterioration of physical and mental health among the victims. The initial social support given is also a determining factor in successfully overcoming life stress. Social network motivates individuals socially being active and a part of a community. Being a part of a community make them feel stronger and socially motivated to cope with their problems and also learn from others. However in chronic diseases, individuals take very personal their healthcare, therefore privacy and trust is an important issue to be considered due to sharing on a social platform. It depends on the personality, psychological factors and ethical- cultural background of the individual where they might not want to show their personal life or some particular context of their life to other people even if they are their friends or families.

2)

3)

A supportive shared environment to self-reflect your habits and behaviours.

It is crucial to rethink educational and proactive environments for individuals to create a newgeneration of co-producers of health. It is not far to imagine the use of mobile diaries and civic media creation as a tool to understand correlation of behaviors and encourage active participation in individuals own health. Inviting participants to take the role of author and contributor prior to the development or specification of any particular mobile intervention and social platform creates the potential for a greater personal connection between innovative, participative and socially enriched mobile experiences towards a healthier lifestyle.