1. Harnessing technology seems like a great way to motivate people to engage in healthful behaviors. But how do we encourage elders who find technology intimidating to use these devices? How can we make them as user-friendly as possible?
2. IDEO's paper on adherence presents the idea of an "Adherence Loop" that consists of belief, knowledge and action. It has become unmistakably clear that people need to maintain some level of physical activity as they age to stay healthy. But simply "knowing" the fact that doing x, y or z will make you healthier doesn't make people do those things. (Studies have shown that nutrition and exercise education classes are much less effective than, say, dance classes aimed at fitness). How do we get older people to believe, know and act on exercise? What are some possible stealth interventions?
3. A lot of the older adults we interviewed (as a class) seemed to value flexibility with time --- whether that be how late to sleep in on a given morning, or being able to call their own shots on the schedule for the afternoon. How to we create a mobile technology that is encouraging and persuasive yet not oppressive?
1. We've learned over the past few weeks that in order for health behavior changes to actually occur, they must be publicly acknowledged. Where does this factor fit into the adherence loop - believe, know, act? For example, where can people with the goal of weight loss be held accountable?
2. The idea of a rewards system through surveillance is enticing, but at what point does this become a bribe - gas money, candy, etc.? Is there a way to shift the focus of the reward from something external to something internal -- the self-fulfillment attained by the activity? For example, perhaps if elderly adults use a certain exercise machine that has a surveillance technology, it is somehow reinforced that the reward is better health or more active time to spend with their kids, perhaps in the form of a certificate or a public congratulations at a group exercise meeting?
3. I'm interested to know what exactly it is about "social facilitation" that makes individuals perform better when other are watching them. Chapter 8 from Fogg talks about competition, cooperation and recognition. Which of these three factors is most dominant and how does this vary from person to person? Could health behavior change programs be more effective if they analyzed individual personalities and grouped them with people similar to them in order to maximize results?
Based on the “Medication Adherence: Many Conditions, a Common Problem” article (Klein, Wustrack, Schwartz)
The authors talk about the various demographics of patients being asked to adhere to medicine regimes. How can diverse groups of patients and users be motivated to perform similar behaviors? From what sources should motivating messages be delivered (self-motivated origin, social and familial support, authority, policy, etc.)?
How might the “naturalistic” approach to gathering data differ from surveys, focus-groups, and in-lab interviews in terms of information quality? Are there any shortcomings of this particular method in the case of medicine adherence (i.e. patients changing their behaviors as a result of knowing the issue being researched)?
The researchers claim that “people must believe in the accuracy of the diagnosis, the appropriateness of the therapy, their self-efficacy to perform the therapy, and the therapy’s validity and likelihood to succeed” (Ajzen, 1991; Bandura, 1989). What could be the potential obstacles with relying on this piece of the puzzle as the catalyst for an effective adherence model?
Fogg mentions surveillance as a persuasive tool and assumes that an authority figure is doing the watching. He also spins a scenario where someone's colleagues can track her status. Is "surveillance by peers" more or less effective than surveillance by authorities? What are the ethical issues?
How could persuasive technologies be combined to better persuade? For example, there are insulin pumps that monitor blood sugar (self-monitoring) and inject insulin automatically (reduction).
How do mobile technologies used for health overcome the "annoyance" factor of intrusions and interruptions? Is a viable solution to make them more intrusive (in the cigarette monitoring example, make the cigarette lighter not light unless it's an approved cigarette time)?
Reading the Medication Adherence article, I was struck by how many in-depth interviews they did. How do they "get in the door" to interview all these people? I find it difficult just to strike up a conversation on a bus; how do IDEO people get so many patients to let them in?
Very nice model of the "adherence loop." I think that framework would be "generative" for a number of the projects we're working on.
Captology Ch 3: It was hard to read this and not brainstorm all sorts of solutions in my group's problem space... even though we haven't yet determined our POV! But as I read I also wondered to what extent some of the technologies Fogg describes are less effective for another generation? For example, I know an 87-year-old in Illinois who won't wear a shirt with a logo, even a polo shirt, because that's advertising. He thinks the company should pay _him_ to wear their logo. Do older Americans tend to react differently to issues of privacy or targeting, having not grown up with as much commercialism?
Ch 8: I think mobile technologies hold a lot of promise for allowing seniors more freedom of movement, but I don't see cellphones as being the right platform. I don't know many seniors who like dealing with the tiny buttons (let alone read the screen). The simple pedometer that uploaded to a web site was more convincing.
How many older adults use the Internet? Here in the Bay Area I don't think it's too unusual for an 80-year-old to log on to a computer in a community center, but surely it's still far from all of them? And in less tech-centered parts of the country, what can we realistically expect? Are we designing for today's seniors, or tomorrow's?
One more response to the IDEO adherence article:
I really like the point they make that knowledge needs to be conceptual. I recently heard about a study in the context of teacher training. Literacy specialists who were trained with conceptual versus procedural knowledge were equally able to work with children as long as everything went "by the book." But when they were presented with a case they had not encountered before, those trained with a conceptual understanding of literacy interventions were able to adapt; the others were lost. This also resonates with my own experiences with doctors; when they tell me WHAT to do I sometimes come across as stupidly non-adherent ("Can't you even follow simple directions?"), while if they tell me WHY I'm doing it, I can exercise judgement in order to adapt to changes of circumstance. Having a conceptual model, then, is critical to continuing with a program when the context shifts.
1.) What is the three-phase model of adherence, and how does the adherence-loop model summarize the literature across the four disease conditions regarding the factors indicative of failure and success?
2.) What are some examples in which technology is used as persuasive tools? What factors allowed these products to be successful? What are some ethical concerns that go along with increased technology use?
3.) What is the principle of kairos? The principle of convenience? Mobile simplicity? Mobile loyalty? Mobile marriage? Information quality? Social facilitation? Social comparison? Normative influence? Social learning? Competition? Cooperation? Recognition? How do all these principles contribute to increased persuasion through mobility and connectivity?
Question about tailoring info: Tailoring certain information - even if the user knows about it can be dangerous. If I'm a Democrat and I request only information on the Democratic party, propoganda etc. I'm going to be even more stuck in my ways and less willing to "reach across the aisle." How do you provide users with information without reinforcing beliefs? Is there a point at which you shouldn't tailor information any more?
How can you create a surveillance technology that doesn't feel like "big brother" is watching? Do people rebel when they're no longer being monitored? (I sometimes speed up after those stupid speed signs on the side of the road)...
A lot of BJ's research seems to measure cause and effect - a person sees blank they do blank. But what about how they feel when they're doing it? Simply because I don't go on Facebook at work b/c my computer is being monitored doesn't mean that outcome is good.
Now that research into how people react to given products is being applied to products that people interact with - should we provide warnings about the potentially habit-altering effects of these products? If something can change your behavior much like a drug, shouldn't a warning label be included? i.e. you will spend 20% more of your time playing video games if you have an addictive personality and buy this product...
Where should/do we draw the line between persuasion and coersion/ manipulation?
How would one implement mobile health applications in a population that is not widely thought of as “tech-savvy”?
When making observations, are the observations of a specific population with a problem broadly applicable to other populations with similar challenges?
1.)Fogg, Persuasive Technology, Chapter 3
Fogg writes that when people know they are being watched they will
behave in a certain way but when the observation stops they'll revert
to a different mode of behavior unless they have reason to continue
internally. How can we address this when it comes to exercise by not
just encouraging people to be active when watched but as part of their
everyday life?
2.)Fogg, Persuasive Technology, Chapter 3
Fogg notes that with feedback technology via self-monitoring it is
possible to make a device more fun by giving real-time data about how
good this activity is for you. For older people, is this kind of data
more or less motivating than for, say, a teenager?
3.)Fogg, Persuasive Technology, Chapter 3
Multiple ethical concerns are raised in this chapter regarding the
active role of computers providing information to the "user" in order
to modify their behavior. How do you think the older population would
respond to technology taking such an active role in their daily lives?
Would they get used to it, embrace it, or outright reject it?
these popped in my mind while reading the article on medication adherence.
Why do people feel they need to be perfectly healthy?
Why is it difficult to accept that we are growing old?
if given a choice, do people usually choose high-frequency or low-frequency treatments, and which turn out to be more effective?
why is exercise generally viewed as a 'treatment' rather than fun?