Wellbeing Design Research: Four Part Framework, starting with Inbodied5

@mcphoo© m.c. schraefel, 2013

how design for wellbeing?

and why doing sois

so important

pbodycology

presentation by: m.c. schraefel, u of southampton, UK, based on work by m.c. with Natasa Millic-Frayling, Microsoft Research, Cambridge UK and Richard Gomer, USouthampton and stats magic and cogitation with Matt Kay, UWashington

Friday, 29 November 13


how design for wellbeing?

and why doing sois

so important

pbodycology

The focus of the work is to figure out in HCI what is the territory, what are the dimensions for understanding research/design opportunities for HCI around wellbeing



@mcphoo

m.c. schraefel

CONTEXT: Connect with me on twitter @mcphoo about this and related work

pronounced “em cee fu”



@mcphoo

m.c. schraefel

Just to make translating these slides easier, you might want to think of the small font notes in this reddish colour as the voice over of the talk that goes with these slides.

pronounced “em cee fu”



Current work in HCI/Wellbeing: What is the territory?How explore and chart the territory?

Building maps is iteractive - note how California has changed connexion to the USA over time? - the presented work is an effort at being an early cartographer of wellbeing















Reason for a map, model, theory

Consistent Language, Measures, awareness in principled way of where we’ve been; where we may need to go















starting assumptions:what is wellbeing?

what is the problem around wellbeing?



what is wellbeing?Being Excellent in a bodywhere the Brain is part of the Bodythe body is a complex systemwe perform BETTER when optimizing

i n b o d i e d

how can interactive tech help us get to the SKILLS we need to UNDERSTAND what we need to perform our best as PHYSICAL beings?



challenge?



value

as a sedentary culture we have progressively moved to privilege brain based activities.



value

not

we have dichotomized the brain away from the body



current position

our technology acts as if the body does not exist other than as a transport mechanism for the brain from one seated position to another



our technology is designed to support this framing of the brain so that engaging with the body can be de-emphasized against brain engaged activities from work to entertainment



40% GDP - knowledge work - UK/US

brain based - that is sedentary, screen oriented work, is growing



But the state of the body effects the brain in critical ways



Let’s consider just sugar, sedentarism and screen reading



Type 3 diabetes - insulin resistance of the brain, aka: Alzheimer’s Disease

de la Monte, 2012

sedentary = stupidityWhitehall II

J.

increase in myopiaLeo/Young 2013



Type 3 diabetes - insulin resistance of the brain, aka: Alzheimer’s Disease

de la Monte, 2012

one example:remember: this is your brain? this is your brain on drugs?

comparable harm may be:this is your brainthis is your brain on sugar

sugar is in just about every processed food (food product in a box and with a label is usually processed)

As such increasing evidence to suggest we’re out of balance on sugar. new work is showing how harmful this overload is for the brain, too.



Work by de le Monte where Rats with normal diets are placed in a water maze and comparied with rats that have brains that have been treated to reflect “insulin resistance” an effect that builds up from so much glucose that it can no longer be managed properly.This case is a great example of how interaction with food affects cognition, and cognition we’ll see shortly in discussion of the Nun Study correlates with effect of physical state of the brain, too. These are key interactions for TUNING awareness/evaluation



here’s a sequence with normal food / insulin response rat to find the target island in 5.2 secs in a standard rat water maze



“after a day they don’t remember their learning” de le Monte

now here’s the rat with an insulin resistant brain

the rat swims passed the island several times; it literally has to bump into it to find it.



Goal of Wellbeing Design



Put this

back in



Role of computation/automation in this Wellbeing

challenge?

All computers can do is automate processes. So in wellbeing, we’re asking the question, what processes can be automated? Part of the work of HCI is to understand WHERE the opportunities may be before getting at WHAT to do. Most of us are very keen to get at WHAT can be done - the work here is to say first we need to understand better WHERE we might have an effect



Things that can count Things(or doing what’s easy

for computers to do)

state of the current commercial art in what might be considered wellbeing design: things that count. anything we can automate by a sensor, from fitbits, to wifi scales, to calorie loggers.













make a bug a feature:“self-monitoring of behaviour change”

What’s missing?

What is the territory?

in the literature this is refered to as self-monitoring around persuasion for behaviour change.ok. that’s maybe fine.but (a) is self-monitoring all there is? is there more to the territory than this?(b) what is the scope of a fitbit for instance? is there an exit strategy?



what is the territory of wellbeing?what is needed?

Where are these on the map?

WHEN are these on the map?

so what we’re looking for iw where do these technologies fit into a wellbeing map? what’s going on in other parts of the map? what ARE the other parts of the map? where do we begin?



Tools for Exploration to chart:

what is the wellbeing design space?

where are points for intervention?



4 part model to begin to map the territory for design



Part 1: in-bodied-ness

start with the body




distinct from embodied

In HCI in particular, the BODY has been introduced to consideration as “embodied”see Dourish 99 Where the Action Is for an example of this kind of framing.

Embodied assumes that there are persons who interact in physical/social environments. That’s super. embodiment however treats the body itself as a black box.

For wellbeing, we need to be able to lift the lid of the black box to understand the interactions of the complex system that is the body if we are going to design to support it.

makes sense right?


@mcphoo


One way to understand in-bodiedness: 11 systems

But how are we going to understand the body? This slide shows reps of 8 of 11 systems of the body from the nervous system to the digestive system to skin and bone etc. Few HCI designers today will delve into this level of detail. As per einstein can we get to a place as simple as possible, but not simpler? what is sufficient?



in-bodied wellbeingmoveeatengagesleepcogitate

Each linked by long research to mortality

I’m proposing “the inbodied5” that offers a functional model of the body: that reflects 5 key operations of the body that are (1) strongly correlated to our mortality and (2) that we therefore already perform - most at least daily if not more frequently - whether we want to or not. Consider, for instance, we will fall asleep at some point. If we undersleep, there are known functional effects. eg, it becomes difficult to lose weight; memory is affected and stress levels can increase. So someone trying to lose weight, we can through this model not just look at food, but at sleep. Someone wanting to socialize better - we can look at movement - more paths, strongly supported in research. (refs on request if not in chi14!)

the inbodied5





This point bears repeating: while these five components are life critical, the goal is NOT to treat them in isolation (as do current apps, either eating or moving or sleeping - even tools that support monitoring of each of these like jawbone’s UP - do NOT show how these factors inter-relate). A key approach for more holistic consideration, and i argue based on coaching, much more effective, is to treat the person as an holistic being. Each of these attributes affects and is affected by the others. Complex systems. Paraphrasing einstein, as simple as possible but not simpler. Eating alone, movement alone - too simple. we need the interaction.

the inbodied5





Holt-Lunstad, J., Smith, T.B., and Layton, J.B. Social relationships and mortality risk: a meta-analytic review. PLoS medicine 7, 7 (2010), e1000316

WHile eat & move & to a lesser extent sleep are already keen (isolated) focii of wellbeing apps, engage and cogitate are less so - but they are it seems just as critical. See Holt-Lundstad’s meta-review of effects of relationships on mortality. Strongly correlated.

We need SKILLS to be able to perform well in social engagement with others IN THE REAL (not the digital) - we are wired to deal with particular components of PHYSICAL (or embodied in this case) interaction



in-bodied wellbeing moveeatengagesleepcogitate


Holt-Lunstad, J., Smith, T.B., and Layton, J.B. Social relationships and mortality risk: a meta-analytic review. PLoS medicine 7, 7 (2010), e1000316

I too am very keen to examine whether such digital environments offer similar benefits. If so, there is great poten>al for increasing sociability and interven>ons. If not, the fact that it is so prevalent would suggest that individuals (and society) will be at increased risk.

This quote is from my question to H-L as to whether her review showed benefits of digitally mediated social interaction. The answer was no - the long studies wind up in 2002, predating face book. As she notes, it’s not clear that switching to digital for social mediation translates to similar benefits. Ask someone if they’re more comfy online or off dealing with people. If the preference is for online, it may be because we’re missing skills that are just as crucial there as knowing how to feed ourselves effectively.



in-bodied wellbeing

moveeatengagesleepcogitate

Cognitive Engagement: Idea Density

Likewise the nun study shows that nuns who demonstrated in their writing high idea density did not manifest symptoms of Alzheimer’s, though their brains looked like they should have had AD. Hence, rich cognitive engagement creates neuro-physical defenses/resources in the body.




Tune rather than “change”

Much language of wellbeing is around “behaviour CHANGE” - change sounds so radical. If we are focusing on functions we carry out everyday, why not think about TUNE’ing that practice rather than “changing” it.In my experience as a coach, helping someone work with what they’re already doing, tuning it, making it more effective, has often been a far more effective path for evolving better, more effective practices to optimise wellbeing.How can our app designs help discover current practice and help tune that practice?



OFFLOADOUTSOURCEDIY

ValuesBeliefsKnowledgeAccessSupport

rational decision theorytheory of planned action (self-efficacy)affective modeling evolutionary processmany many coaching sessions

part 2: descriptive decision: design ops

Opportunities for Intervention:

2nd part of design research model: what does engagement with a tuning practice look like? We explored decision models to be able to map points where support has an opportunity to act. The goal being if we can understand specific points where intervention is possible we can evaluate strategies/interactions at these points for efficacy, vs at other points. We can also ask, critically, HOW do we get into ANY of these points?

a key concern here has been Natasa Millic-Frayling’s insight that we Offload/Outsource our requirements at these points - whether it’s to offload meal care to a restaurant or to a ready meal for example; or movement to a trainer.Can design interventions fit into these offloading moments?



“Wow, you’ve put on weight, eh?”

To see where opportunities for intervention are, lets walk through this wellbeing decision process to assess a new or tuning practice.

it starts with a trigger, like in this case someone saying “you’ve put on weight”

a doctor, a friend, a nasty colleague may all be sources for such a trigger. Here it was a colleague

Example walk through of cylce:



Wow, you’ve put on weight

Wrong Measures?

a. The next step is to assess if this assertion is true: there is a measure of STATE (am i fat? - check put on skinny jeans haven’t worn in 10 years). There is a measure of process (how did i get here? - i haven’t been very active, gone to the gym)

b. But what if these are the wrong measures for best tuning? It’s well established now that the best path to weight reduction is food. As a colleague sums up the research “you can’t outrun a donut”How can design help connect with the RIGHT measure



Wrong Identification?

The next step is to identify options - again - what is informing the choice?There is then cost/benefit analysis: what informs this selection? picking something like the treadmill because it’s at work may actually be less appropriate than another practice that may be more sustainable - assuming it’s an effective thing to do for a particular purpose







“i’m broken” Reassess

How many times is the practice repeated before it is remeasured? what helps with this part of the process?



“Exercise sucks...i quit”

i’m doomed Where reflection may lead to wrong understanding, and thus decisions that are inappropriate, and reassessment that can lead to faulty conclusions, then the person can create new beliefs about a practice that can lead to suboptimal practices

Where can computational processes intervene in this cycle?



OFFLOADINGOUTSOURCING

DIY

Opportunities for new technonew culture

beliefs values knowledge

how get to right sources




DIY

Opportunities for new technonew culture


how get to right sources

We see these four key moments as points where we tend to offload our practices to another party or we try to DIY something based on beliefs, like the last example.Offloading might be buying boxed meals at the store rather than buying whole food and cooking it, or going ot a restaurant.Outsourcing might be trusting a trainer.These are intervention opportunities



Decision Cycle: Action

drilling in: interviewsNot considered experts; like to “hack” Scared of Experts: bad experiences; bad resultsExpertise gained through reading; self-directed

In our surveys we saw that apps were not used for advice. And that mainly only experts consulted other experts. Most used books or friends as information sources for practice. How leverage these paths for interaction intervention?



drilling in: interviewswho says these are the right measures?

how get to right measures?

A current health app UI treats all food components equally. Is being low on fiber really as critical for attention as being low on protein? (there are only two essential nutrients: essential amino acids and essential fatty acids; there are no essential starches(including fiber)/sugars) This lack of discrimination lead one participant to focus on fiber to the detriment of protein.




DIY


EXAMPLE

“no time”

Right Practice?

What we have found is that someone saying i have “no time” for something like cooking usually means 1) i haven’t really done it before2) i also don’t know how or what to do3) i feel some shame and fear and guilt about this because i think i probably should

how can design catch and interact with “no time” and create safe interaction?



part 3: translation to routine practice (with a bit of habit)

Next part of our model is moving from evaluating a new or tuned practice to getting it to be routine - we need to talk about what we mean by routine, practice and habit.



forget habits (well, good luck); think skillscreate robust practices

Routine = Reps = Learning = a Practice how get reps

for skills?

habits are defined to include efficient repeatability that is cued by context, reflexively, unconsciously. What happens when the context isn’t there? Like someone who can’t action their good eating habit from home when they’re on the road or out for dinner. I’d suggest that instead of “habits” associated with “behaviour change” we challenge ourselves to design for robust PRACTICES that are skills based and can survive context changes.The example here is of Bear Grylis who’s famous for surviving any environment - he has some basic heuristics he follows - find protein and water - and has skills that can be applied to a variety of environments. As Natasa asked this summer, how do we create that kind of Bear Gryllis survivor for the grocery store or more challenging - a fresh produce market? How do we create both the SKILLS and OPPORTUNITIES for REPS?



forget habits (well, good luck); think skillscreate robust practices

Routine = Reps = Learning = a Practice how get reps

for skills?

Here’s a potentially huge op for HCI wellbeing design: learning skills takes reps. If we only eat a few times a day, we only get in a few reps, not hundreds in a day, less than two dozen in a week. Computers are great at simulations.Are there opportunities for wellbeing simulations to provide opportunities for skills development towards context neutral practice? Are these also complex skills: eg, learning to ask a server at a restaurant to prepare something off menu is both knowledge that this is possible and an inbodied5 ENGAGEment skill. How support developing reps for both these skills?



PLAYTypes of play

(flow)

One way to encourage REPS in a safe way is to look at PLAY.Cunnane in Survival of the Fattestargues PLAY - not the fight or flight of desperate food search - is where our tool building happened - exploring options happens in a safe place; not a life or death stress moment.

Stuart Brown in PLAY talks about various types of play from games for friendly challenge/competition, to jokes, stories and tinkering among others. Outdoor play with others in particular is fabulous for engaging the body, developing a demand for food, having to engage the brain both to strategise and engage with others, and providing a driver for recovery as well as to blow off the fight or flight stress hormones. Play is also where we can learn and practice skills in an error free environment.How harness play for robust practice, er, practice?

Types of playjokes

storiesgames

tinkering...



Zombies, Run!

PLAYTypes of play

moveengagecogitate

jokesstoriesgames

tinkering...

A very intriguing example of engagement with a practice, of translating it into something with fun and creativity is the gamification of a practice. Zombies, Run, uses the story of zombies chasing players/runners: runners listen to the story as they run and they get updates on their mileage and how far to a next target. They are running to DO something as opposed to run itself. Narrative is a keen type of play, and being able to make a routine practice PLAY is a well known great way to help develop skills.

How help make the social element of ZR more real than virtual??

(thanks to Elizabeth Churchill for pointing me to Zombies, Run...)


Translation to RoutineTechnology enhances EXISTING practicewith adding Values:- sharing//comparing/real time feedback

One’s own practice may also be game-ified in terms of competition.the Strava app combined with a bike computer enables one to record, compare and share ride information and it encourages one to see how they’re doing against others. Of course one can compete against oneself: the computer is used for real time monitoring of performance on multiple attributes from speed to heart rate to power during an activity as well as for reflection. A fitbit on steroids


Translation to RoutineIncrease inbodied5 Ratio,

higher traction.

moveengagecogitate

What’s not entirely clear is the degree to which one’s practice is “changed” by these tools rather than, as we argue, TUNED by these tools. We did not get reports of *much* more cycling because of the tools, but that the quality of the engagement already planned seemed to benefit. Yes there were reports of oh i have to work harder to catch my friend, but that again is quality within an activity rather than MORE or CHANGE or NEW.


mirroring || Validating

(but is it right?)

What we also saw is that where technology was being used as part of a practice - like a fitbit - was to mirror and validate existing practices. A participant who took a lot of stairs during the day was delighted to see stair climbing reflected in the fitbit.

NOTE: It did not increase practice or change it; it validated an existing practice. Do mirrored practices need reinforcement, thought? Is mirroring a potential way to nudge an existing practice?

For a number of participants, the social connection that fitbit facilitated became almost more important than the step monitoring.

Routine, Practice And Technologydrilling in: interviews

Use of Technologywhere part of (existing)

routine



interactive technology becomes “the practice”

Design Caveat

or assists “a practice” to develop?integration or exit strategy?

We also see practices change: cycling now means cycling with the computer; running now means zombies run. We may wish to consider if we want to deliberately design a revised practice rather than consider skills building and an exit strategy for a monitoring device. It may be fine to have running = running plus heart rate montior - but what does that particular tech dependence mean? are we designing for that deliberately or accidentily



Overview: forging robust practice

Routine = Reps Learning a Practice

Routine - structure for dynamic skills

The biggie takeaway about developing a robust practice is that it takes reps, and it’s very challenging for most of us to get PRACTICE at our practice -what is practice shopping? what is practice cooking? or socializing? or recovery/sleeping?

how can interactive tech help here?



technology produces culture

what culture are we creating?


Another caveat: technology creates culture.as we saw earlier we have reified a sedentary culture with all sorts of systems to privilege seated, screen based interactions, where the rest of the body is treated often with the equivalent of a feed lot or factory farm life.

These (infra)structures are cultural. 1) we are potentially designing against the cultural grain - how do we do that successfully?2) should our design targets be higher up the chain towards industry and govn’t interaction rather than individual? new infrastructure design?

4th element of model: technology creates culturetechnology of culture of wellbeing?



designing against cultural norms/beliefs

(Design) Tensions

ValuesBeliefs

Knowledge

An example of change: processed foods were used as a way for women to get out of the kitchen (faster). Does the call to whole food/home cooking away from processed food, for instance, for wellbeing, risk re-introducing gender roles/limitations? How bring these factors into our design work consciously?



culture = communication of

values

egstatus (quo)educationprivilege (or not)social engagementrules



Film Wall-e as embodiment of where the current practice of bodiless screen-ness is going

By being aware that EACH OF OUR DESIGNS contributes to a re-inforcement of or challenge to current culture, we may ask ourselves more deliberately - what are the cultural assumptions at play in my design? is this what i wish to reinforce?



There are alternative culturesAlternative values, beliefs and practices.

How does design help us get there?What is appropriate individual focus?

What industrial, 3rd sec, govn’t? burn the chair


@mcphoo @begin2dig

who are your research innovators/leaders?their inbodied5?

Reality CheckWhen i think about the folks who currently lead fields of interest, they embody the inbodied5.



offloadingoutsourcing

Access

decisions vs routines

guidance

option discovery

accelerating REPSaccelerating Experience

Test/reassess

Play

This talk has been an effort at a sketch of a model, a set of tools like the inbodied5, decision cycle, reps for robust practices, tuning rather than change, and deliberate culture creation as a means to begin to sketch a map for more deliberate design intervention




Access


guidance

option discovery


Test/reassess

Play





Access


guidance

option discovery


Test/reassess

Play





The hope is that in this talk we have begun to have a better sense of the scope of the domain where we might intervene for design (get California at least connected for the time being to the USA)



Routine = Reps = Learning = Practice


valuesknowledge

beliefsTechnology /

Culture

4 part in-bodied well being model

The model is multi-dimensional: a way to think about the inter-relations of the body as a complex system opening up more design paths for TUNING (sleep affects body comp; movement affects cognition etc...); the descision cylce’s outsourcing are targetted moments for intervention; developing REPS to build skills/practice and the act of designing wellbeing as culture - that current cultural assumptions affect our designs: how become conscious of designing with or against that grain



4 part in-bodied well being model

Routine = Reps = Learning = Practice


valuesknowledge

beliefs

Technology /Culture

Questions/Thoughts Welcome

@mcphoo

Keep in touch - let me know what you thinktwitter @mcphoohttp://ecs.soton.ac.uk/~mc


http://ecs.soton.ac.uk/~mcchain

http://ecs.soton.ac.uk/~mcchain


why coffee w double cream vs

pizza

if you do dairy...whipping cream, unlike pizza (crust esp)is all fat and protein - no carbs; mostly fat with healthy fat like CLA strongly associated with promoting fat loss.

Fat doesn’t disrupt RER - respiratory exertion rate - so doesn’t trigger (much of) an insulin response. That means triggering the storage of glucose as it enters the blood stream. Thus staying in more of a fat burning mode.

Double cream - being closer to a whole food as well - has higher satiety cues than processed foods.Caffeine also has some interesting properties for mental acuity - if taken early enough in the day not to disrupt sleep.

Some have also argued that starchy carbs tend to turn on the Grim Reaper genes rather than the Sweet Sixteen (google it, eh?)

So, if i’m trying to maintain fat burning, and i haven’t just done some big exercise bout depleting glucose from muscles, and if i’m extending an overnight fast to get a little more fating benefit, this is a not bad way to go to get to dinner time.

bonus slide:


@mcphoo© m.c. schraefel, 2013Friday, 29 November 13

Wellbeing Design Research: Four Part Framework, starting with Inbodied5

Health & Medicine

theory consistent language

current commercial art

deliberate culture creation

considered wellbeing design

bodied wellbeing move

insulin resistance

complex system

good luck