During the early phases of our research collaboration with the Bridge Project, our needs assessment revealed a number key design considerations as we moved towards implementing technology-based interventions to improve health in the community we were working. One of the insights was related to the preferred technological platform for building the intervention. We found that people in the community had a strong preference for a mobile phone-based application and that smartphones and feature phones were ubiquitous compared to other technologies. We explored other possible platforms, including desktop and laptop computers, tablets, wearables, and television and set-top boxes, but mobile phones were greatly preferred.
Although our formative research provided broad design insights and helped narrow the focus of our work, we needed to conduct further research to more directly inform the design of a mobile application. What would the application look and feel like? How would users’ interact with it? What kinds of information would users interact with and how would it be represented? These were some of the specific questions that still needed to be answered in our effort towards designing a socio-technical intervention to help improve health in the Bridge community.
As a first step towards designing a mobile application, we conducted prototyping activities with members of the community to envision mobile interfaces for interacting with their personal health information. Our early work suggested that “family” was extremely important to the people we were working with. Family members directly influenced each others behaviors and each person modeled different behaviors, which had significant impact on the behaviors of others in the family.
This discovery led us to conduct prototyping activities, and all research activities throughout the project, with both parents and their children. This was so important because the needs of the two groups were very different and we needed to engage all members of the family to be successful in changing behaviors in the community.
It is often challenging for users to verbally explicate the ideas inside their head. It can be easier for them to visually express their ideas when given tools to do so. Prototyping with participants allowed them to visually express their ideas and provide us tangible, actionable design ideas. We used tablet devices as the canvas for participants to illustrate their ideas because it gave them freedom in how they could represent their ideas.
In total, we had 8 people (4 parents and 4 children) participate in this participatory prototyping study. From this prototyping study and our earlier exploratory work, we began to see common patterns emerge in how participants envisioned interacting with health information in a mobile application. A few highlights of these findings included:
- Both parents and children were interested in seeing visual representations of the health and behaviors of others in their family, in addition to seeing it for themselves.
- Tabular and graphical representations of personal health information were common in the prototypes. Participants were particularly interested in being able to visualize their behaviors along the dimension of time (i.e., view information about their behaviors over time)
- Participants focused on food and eating more than other health behaviors. Snacking was a specific behavior that participants described as being problematic and something they wanted to improve.
- Participants had a strong desire to improve their behaviors, but didn’t know where to start. They described feeling overwhelmed with the idea of figuring out how to eat healthier. They also identified that they had hard times making the big changes that their doctors or others had suggested for them.
The initial participant developed prototypes, and the findings of our earlier formative studies, informed the development of four high fidelity prototypes, which we evaluated with members of the community. These four prototypes were functional in that participants could interact with different interface elements, though the interactions were predetermined. Two prototypes focused on gameplay elements that aimed at motivating the families through play. The other two prototypes focused more on providing visibility of family members’ eating behaviors and educating participants about specific things they could do to improve their eating behaviors.
We met with 26 people living in the Bridge community, including both parents and children, and asked them to complete a series of tasks with each interface. Our goal was to expose them to the main user interactions in the application and get their feedback on the different designs. We used a think-aloud protocol where we urged them to verbalize their thoughts while interacting with the prototypes. After the task-based activity, we conducted a semi-structured interview where we discussed their experiences with the application and asked them to complete a survey about their preferences.
With the youth participants, we used subjects in tandem, where we paired two youth participants together. We decided to use this approach because we found earlier in our research that the youth participants were often quiet and appeared less comfortable sharing their thoughts with our research team. By pairing youth participants together, we created a space where they worked with someone they felt comfortable with. Furthermore, they bounced ideas off each other, which helped them generate conversation and feedback.
Through this study, we developed a number of design insights that directly informed the next stage of our research and the design of Family Snack Buddy. Here are a few highlights:
- The parents and the children had very different preferences in the prototypes. The children greatly preferred the game-based prototypes (C and D in the diagram above), while the parents preferred the non-game prototypes (A and B above).
- Counter to our earlier research, participants reacted negatively to having price information included in the design. The common sentiment was that price information was distract from the focus on healthy choices and potentially discourage people from making healthy changes in their lives, as one participant summarized: “They might see it and be like this one is, the healthy one is more expensive than what I am eating now so I can’t afford so I won’t.” Earlier in our research participants highlighted price as a major factor in driving their behaviors. However, using a prototyping approach, which allowed users to see and interact with the manifestation of those ideas, helped us to better understand the design implications.
- The family aspect of the application was lauded by both parents and children. Parents were excited to get better insights into how their children were eating and using the information to inform their decisions about food purchasing and cooking. Children enjoyed the competitive element of seeing how they were doing compared to others in their family and highlighted how it helped them feel connected as a family.