As an Automation fellow with SWCTN, I have been using workshops, group discussion, remote activities and interviews to explore how personal technologies can benefit wellbeing, the potential for wellbeing wearables to cater for an expanded definition of wellbeing and how people might create small, automated processes that help them to achieve their individual wellbeing goals.
Co-design – designing collaboratively with the people who will use the product or service – is essential to understanding how things could be different to a mass-market, one-size fits all approach. I believe in combining honest assessment of the status quo with stimulating the imagination. Joining the two provides valuable insights that enable new possibilities to be considered in product and service development, leading to something that meets the needs and desires of people. More than this, making the design process more distributed helps to prevent bias that would otherwise limit benefit to certain privileged groups or individuals. Co-design can be used to ensure that technology is working in service of humanity, a reversal of which is detrimental to our wellbeing.
Initially, the co-design of personalisable and customisable wellbeing wearables was my primary interest for this fellowship; eventually, however, I decided to narrow my focus and settled upon exploring the role of technology in changing or creating habitual behaviours. I became interested in how and whether it was possible to automate wellbeing via small changes in behaviour or mindset.
In tandem with collaborative activity with other people, I was inspired by wellbeing wearables designer, Peta Bush, to combine the triple role of researcher, designer and research participant. Being both research participant and researcher was a new practice for me – allowing me to expand my understanding from a consumer, critical and creative perspective. I selected the area of motivation and behaviour change due to their resonance with my own mental health and wellbeing, and because I felt that the adoption or rejection of habits is something that a large proportion of people could relate to, meaning more people might be interested in engaging with my research activities.
I am interested in what motivates human behaviour; the ways in which we can make life easier and harder for ourselves. Even self-sabotaging behaviour has a pay-off – it keeps us somewhere familiar and safe when change feels threatening. Equally, we can do certain activities to ‘trick’ our brains so that we do not experience resistance to something we have been avoiding. I am interested in how we can encourage the adoption of desirable habits and minimise or remove non-desirable habits with the minimum of resistance. The notion that certain behaviours and thought patterns are automatic intrigues me, as does the possibility that these are patterns that can be reset and do not need to be inevitable or binding.
We are probably all familiar with how fitness trackers use gamification to motivate people to move more. If the goal is to walk 10,000 steps, then people will invent reasons to move if they have so far fallen below the daily target through their ordinary activities. If someone doesn’t hit the daily target, they are likely to lose motivation, and for some, 10,000 steps a day will never be achievable. Beyond movement, which indisputably does benefit our mental and physical health, there are many types of goals we might have.
Current personal wellbeing technologies such as fitness watches and apps allow people to work on specific areas of their wellbeing. The starting point for my research, however, is that there needs to be more flexibility to allow products and services to be more personalised, and to afford the user or wearer greater control to customise their experience. Looking for examples of best practice, I found one such in the Exeter-based company, Brain in Hand.
Brain in Hand has developed a service for people with mental health difficulties to help them to achieve their personal goals, helping them to remember or decide things when they encounter unexpected or personally challenging situations. App users are provided in-person support to customise the app’s content to their exact needs, mapping out scenarios and solutions in a safe environment meaning they can become more self-reliant in future. The human support does not end with the set-up of the app; telephone-based support will be given within 30 minutes if needed. The app has been co-designed with its users and user-testing is ongoing. The company’s commitment to providing the best possible user-experience is evident.
Weight Watchers is another company that helps people address aspects of their wellbeing through a variety of motivational structures. Both in person and digitally, Weight Watchers provides a variety of methods to help its members stay engaged and motivated. They create a community where people have a shared goal, are accountable, can celebrate reaching milestones, where progress can be visualised, tracked, reviewed and rewarded, and where resources and advice can be shared both formally and informally. Attentional focus and repeated connection with the goal help to reinforce desirable behaviours and the adoption of new patterns. These are all important factors in staying committed to an ongoing goal.
I was interested to explore how I could take some of these principles and create something that would be individual to my own needs.
Rather than try to create the hardware, I used existing hardware in the form of my mobile phone to very simply prototype some ideas using phone reminders and video recordings.
With the video recordings, I was curious to see whether hearing my own voice would decrease resistance to the content of the video message. Most of us will resist well-intentioned advice from others, even when we know it might be good for us, and likewise, many of us battle internally between what we feel like doing versus what we know we should be doing. I recorded videos when I was feeling motivated and positive, hoping externalising the voice of my ‘better self’ might help me to stop an unhealthy habit and build a healthy one. I set alarms so that I would watch the videos at times I expected I would need some support. This was somewhat helpful, but also being able to access the videos at any time of day created a connection to what I wanted and why, which felt like I had my own support system throughout the day.
If we are modest or self-critical, it can be hard to create positive, believable words about ourselves. With the text-based reminders, I was curious to see whether someone else’s kind, encouraging words, repeated daily, could have a positive effect on a negative mindset. I chose an excerpt of a greetings card from my sister-in-law as the content of my daily reminder messages. I trialled this so that I either received messages based on my location – for example, when entering the supermarket that I visit when I feel like comfort eating, to see if it might shift my behaviour – as well as at specific times of day, when my resolve or energy might be flagging, and a little encouragement might make me feel more positive.
There is no doubt I did get a little lift from reading the words but after a while, repeated notifications, just like those from a smart watch, were easy to dismiss. Perhaps a more varied delivery time would have been better, or perhaps the message needed to change. These areas could be explored further, but maybe the most useful element of the prototyping exercise was consciously identifying the areas of my behaviour or mindset that I wanted to work on and doing something on a regular basis that reinforced this.
My fellowship has included me attending the Digital Wellness Festival in London and the wearable technology conference, Wear It Innovation Summit, in Berlin, holding interviews with app and wearables companies, designers, researchers and psychologists, and hosting workshops and group discussions in Plymouth, Exeter and Bristol with health professionals, patient-experts, creative technologists, and researchers working in health, prosthetics and technology. I have a new-found respect for the work that goes into the design of wearable technology, chatbots and personalised health apps, and the challenges that currently limit their wider adoption, as well as the destructive impact that apps, social media and mobile-based technologies can have on our attention, wellbeing and relationships.
Through the fellowship, I have had the opportunity to explore and expand my co-design methodologies in a new context, while continuing to explore my lifelong engagement with mental and emotional wellbeing. Working alongside research fellows B Aga and Ellie Foreman, I have grappled with the ethics of automation, and deepened my understanding of the in-built bias present in artificial intelligence systems. To me, this justifies the need for a human-centred-design approach to be at the heart of the development of new and existing technologies if we want to create accessible, helpful and responsible products and services. Companies like Brain in Hand commit to the ongoing inclusion of people in their service design and delivery, which is what makes them succeed. To me they point a way for how we should be building our businesses: a wholly technological or fully automated solution cannot provide everything needed for human wellbeing.
To learn more about Rosie’s co-design approach, why not come along to an event she is running in Spring 2020 at Kaleider Studios, Exeter? Meanwhile, feel free to be in touch by email firstname.lastname@example.org or on Twitter @braveresearch