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Reflection-through-performance: personal implications of documenting health behaviors for the collective

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Abstract

Previous work has examined how technology can support health behavior monitoring in social contexts. These tools incentivize behavior documentation through the promise of virtual rewards, rich visualizations, and improved co-management of disease. Social influence is leveraged to motivate improved behaviors through friendly competition and the sharing of emotional and informational support. Prior work has described how by documenting and sharing behaviors in these tools, people engage in performances of the self. This performance happens as users selectively determine what information to share and hide, crafting a particular portrayal of their identity. Much of the prior work in this area has examined the implications of systems that encourage people to share their behaviors with friends, family, and geographically distributed strangers. In this paper, we report upon the performative nature of behavior sharing in a system created for a different social group: the local neighborhood. We designed Community Mosaic (CM), a system with a collectivistic focus: this tool asks users to document their behaviors using photographs and text, but not for their own benefit—for the benefit of others in their community. Through a 6-week deployment of CM, we evaluated the nature of behavior sharing in this system, including participants’ motivations for sharing, the way in which this sharing happened, and the reflexive impact of sharing. Our findings highlight the performative aspects of photograph staging and textual narration and how sharing this content led participants to become more aware and evaluative of their behaviors, and led them to try to eat more healthfully. We conclude with recommendations for behavior monitoring tools, specifically examining the implications of users’ perceived audience and automated behavioral tracking on opportunities for reflection-through-performance.

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Notes

  1. In this paper, I use the term reflection to refer to the process of considering one’s present, past, or planned health-related behaviors, attitudes, and experiences. This cognitive processing may take the form of reflection-in-action (during the unfolding of an event), or reflection-on-action (after the completion of an event) [62, 67].

  2. www.fitbit.com, http://nikeplus.nike.com/plus/.

Abbreviations

CM:

Community Mosaic

HCI:

Human–computer interaction

ICTs:

Information and communication technologies

References

  1. Agrawal T, Hoffman JA, Ahl M, Bhaumik U, Healey C, Carter S, Dickerson D, Nethersole S, Griffin D, Castaneda-Sceppa C (2012) Collaborating for impact: a multilevel early childhood obesity prevention initiative. Family Community Health 35:192–202

    Article  Google Scholar 

  2. Amft O, Tröster G (2008) Recognition of dietary activity events using on-body sensors. Artif Intell Med 42(2):121–136

    Article  Google Scholar 

  3. Anderson I, Maitland J, Sherwood S, Barkhuus L, Chalmers M, Hall M, Brown B, Muller H (2007) Shakra: tracking and sharing daily activity levels with unaugmented mobile phones. Mob Netw Appl 12(2–3):185–199

    Article  Google Scholar 

  4. Baumer EP, Katz SJ, Freeman JE, Adams P, Gonzales AL, Pollak J, Retelny D, Niederdeppe J, Olson CM, Gay GK (2012) Prescriptive persuasion and open-ended social awareness: expanding the design space of mobile health. In: CSCW’12. ACM, pp 475–484

  5. Boerdam J, Martinius WO (1980) Family photographs: a sociological approach. Neth J Sociol 16(2):95–119

    Google Scholar 

  6. Braithwaite DO, Waldron VR, Finn J (1999) Communication of social support in computer-mediated groups for people with disabilities. Health Commun 11(2):123–151

    Article  Google Scholar 

  7. Chi P, Chen J, Chu H, Chen B-Y (2007) Enabling nutrition-aware cooking in a smart kitchen. In: CHI ‘07 extended abstracts. ACM Press, pp 2333–2338

  8. Chiu M-C, Chang S-P, Chang Y-C, Chu H-H, Chen CC-H, Hsiao F-H, Ko J-C (2009) Playful bottle: a mobile social persuasion system to motivate healthy water intake. In: Ubicomp’09, pp 185–194

  9. Cohen S (2004) Social relationships and health. Am Psychol 59(8):676

    Article  Google Scholar 

  10. Connelly KH, Faber AM, Rogers Y, Siek KA, Toscos T (2006) Mobile applications that empower people to monitor their personal health. E & I Elektrotech Informationstech 123(4):124–128

    Article  Google Scholar 

  11. Consolvo S, Everitt K, Landay JA (2006) Design requirements for technologies that encourage physical activity. In: CHI’06. ACM, pp 457–466

  12. Consolvo S, Klasnja P, McDonald DW, Avrahami D, Froehlich J, LeGrand L, Libby R, Mosher K, Landay JA (2008) Flowers or a robot army? Encouraging awareness and activity with personal, mobile displays. In: Ubicomp’08, pp 54–63

  13. Consolvo S, McDonald DW, Toscos T, Chen MY, Froehlich J, Harrison B, Klasnja P, LaMarca A, LeGrand L, Libby R, Smith I, Landay JA (2008) Activity sensing in the wild: a field trial of UbiFit garden. In: CHI’08, pp 1797–1806

  14. Consolvo S, Roessler P, Shelton BE, LaMarca A, Schilit B, Bly S (2004) Technology for care networks of elders. Pervasive Comput 3(2):22–29

    Article  Google Scholar 

  15. Curmi F, Ferrario MA, Southern J, Whittle J (2013) HeartLink: open broadcast of live biometric data to social networks. In: Proceedings of the 2013 ACM annual conference on human factors in computing systems. ACM, pp 1749–1758

  16. DiMicco JM, Millen DR (2007) Identity management: multiple presentations of self in Facebook. In: Proceedings of the 2007 international ACM conference on supporting group work. ACM, pp 383–386

  17. Dishman E (2004) Inventing wellness systems for aging in place. Computer 37(5):34–41

  18. Economos CD, Irish-Hauser SA (2007) Community interventions: a brief overview and their application to the obesity epidemic. J Law Med Ethics 35(1):131–137

    Article  Google Scholar 

  19. Feathers JT, Kieffer EC, Palmisano G, Anderson M, Sinco B, Janz N, Heisler M, Spencer M, Guzman R, Thompson J, Wisdom K, James SA (2005) Racial and ethnic approaches to community health (REACH) detroit partnership: improving diabetes-related outcomes among African American and Latino adults. Am J Public Health 95(9):1552–1560

    Article  Google Scholar 

  20. Freedman DS (2011) CDC Health Disparities and Inequalities Report, USA

  21. Frey LR (2003) Group communication in context: studies in bona fide groups. Lawrence Erlbaum Associates, London

    Google Scholar 

  22. Frost J, Smith BK (2003) Visualizing health: imagery in diabetes education. In: DUX’03. ACM, pp 1–14

  23. Frost JH, Massagli MP (2008) Social uses of personal health information within PatientsLikeMe, an online patient community: what can happen when patients have access to one another’s data. J Med Internet Res 10:3

    Article  Google Scholar 

  24. Glanz K, Rimer BK, Viswanath K (eds) (2008) Health behavior and health education. Jossey-Bass, San Francisco, CA

    Google Scholar 

  25. Goffman E (1959) The presentation of self in everyday life. Anchor, New York

    Google Scholar 

  26. Grimes A, Bednar M, Bolter JD, Grinter RE (2008) EatWell: sharing nutrition-related memories in a low-income community. In: Proceedings of CSCW’08. ACM, pp 87–96

  27. Horowitz CR, Colson KA, Hebert PL, Lancaster K (2004) Barriers to buying healthy foods for people with diabetes: evidence of environmental disparities. Am J Public Health 94(9):1549–1554

    Article  Google Scholar 

  28. Johnson GJ, Ambrose PJ (2006) Neo-tribes: the power and potential of online communities in health care. Commun ACM 49(1):107–113

    Article  Google Scholar 

  29. Kamal N, Fels S, McGrenere J, Nance K (2013) Helping me helping you: designing to influence health behaviour through social connections. In: Kotzé P, Marsden G, Lindgaard G, Wesson J, Winckler M (eds) Human–computer interaction—INTERACT 2013. Springer, Berlin, pp 708–725

    Chapter  Google Scholar 

  30. Kim S, Kientz JA, Patel SN, Abowd GD (2008) Are you sleeping? Sharing portrayed sleeping status within a social network. In: Proceedings of the 2008 ACM conference on Computer supported cooperative work. ACM, pp 619–628

  31. Kim S, Schap T, Bosch M, Maciejewski R, Delp EJ, Ebert DS, Boushey CJ (2010) Development of a mobile user interface for image-based dietary assessment. In: Proceedings of the 9th international conference on mobile and ubiquitous multimedia. ACM, Limassol, Cyprus

  32. Kimani S, Berkovsky S, Smith G, Freyne J, Baghaei N, Bhandari D (2010) Activity awareness in family-based healthy living online social networks. In: IUI’2010. ACM, pp 337–340

  33. King AC, Ahn DK, Oliveira BM, Atienza AA, Castro CM, Gardner CD (2008) Promoting physical activity through hand-held computer technology. Am J Prev Med 34(2):138–142

    Article  Google Scholar 

  34. Klasnja P, Pratt W (2012) Healthcare in the pocket: mapping the space of mobile-phone health interventions. J Biomed Inform 45(1):184–198

    Article  Google Scholar 

  35. Komarraju M, Cokley KO (2008) Horizontal and vertical dimensions of individualism–collectivism: a comparison of African Americans and European Americans. Cultur Divers Ethnic Minor Psychol 14(4):336–343

    Article  Google Scholar 

  36. Kreuter MW, Haughton LT (2006) Integrating culture into health information for African American women. Am Behav Sci 49(6):794–811

    Article  Google Scholar 

  37. Kreuter MW, McClure SM (2004) The role of culture in health communication. Annu Rev Public Health 25:439–455

    Article  Google Scholar 

  38. Krippendorff K (2004) Content analysis: an introduction to its methodology. Sage, Thousand Oaks

    Google Scholar 

  39. Kristal AR, Glanz K, Curry SJ, Patterson RE (1999) How can stages of change be best used in dietary interventions? J Am Diet Assoc 99(6):679–684

    Article  Google Scholar 

  40. Kummervold PE, Gammon D, Bergvik S, Johnsen JA, Hasvold T, Rosenvinge JH (2002) Social support in a wired world: use of online mental health forums in Norway. Nord J Psychiatry 56(1):59–65

    Article  Google Scholar 

  41. Leimeister JM, Krcmar H (2005) Evaluation of a systematic design for a virtual patient community. J Comput Mediat Commun 10:4

    Article  Google Scholar 

  42. Lin JJ, Mamykina L, Lindtner S, Delajoux G, Strub HB (2006) Fish’n’Steps: encouraging physical activity with an interactive computer game. In: Ubicomp’06, pp 261–278

  43. Lisovicz N, Johnson RE, Higginbotham J, Downey JA, Hardy CM, Fouad MN, Hinton AW, Partridge EE (2006) The Deep South network for cancer control. Cancer 107(S8):1971–1979

    Article  Google Scholar 

  44. Maitland J, Chalmers M (2011) Designing for peer involvement in weight management. In: Proceedings of the 2011 annual conference on Human factors in computing systems. ACM, pp 315–324

  45. Maitland J, Sherwood S, Barkhuus L, Anderson I, Hall M, Brown B, Chalmers M, Muller H (2006) Increasing the awareness of daily activity levels with pervasive computing. In: Pervasive Health’06. IEEE, pp 1–9

  46. Maloney-Krichmar D, Preece J (2005) A multilevel analysis of sociability, usability, and community dynamics in an online health community. ACM Trans Comput Hum Interact 12(2):201–232

    Article  Google Scholar 

  47. Mamykina L, Miller AD, Grevet C, Medynskiy Y, Terry MA, Mynatt ED, Davidson PR (2011) Examining the impact of collaborative tagging on sensemaking in nutrition management. In: Proceedings of the 2011 annual conference on Human factors in computing systems. ACM, Vancouver, BC, Canada, pp 657–666

  48. Mamykina L, Mynatt E, Davidson P, Greenblatt D (2008) MAHI: investigation of social scaffolding for reflective thinking in diabetes management. In: CHI’08. ACM, pp 477–486

  49. Mankoff J, Kuksenok K, Kiesler S, Rode JA, Waldman K (2011) Competing online viewpoints and models of chronic illness. In: Proceedings of the SIGCHI conference on human factors in computing systems. ACM, pp 589–598

  50. Marwick AE (2011) I tweet honestly, I tweet passionately: twitter users, context collapse, and the imagined audience. New Media Soc 13(1):114–133

    Article  Google Scholar 

  51. Mendelson AP, Papacharissi Z (2010) Look at us: collective narcissism in college student Facebook photo galleries. The networked self. In: Papacharissi Z (ed) The networked self: identity, community and culture on social network sites. Routledge, London

    Google Scholar 

  52. Minkler M, Wallerstein N (2008) Community-based participatory research for health: from process to outcomes. Wiley, San Francisco

    Google Scholar 

  53. Morland K, Wing S, Diez Roux A, Poole C (2002) Neighborhood characteristics associated with the location of food stores and food service places. Am J Prev Med 22(1):23–29

    Article  Google Scholar 

  54. Mynatt ED, Rowan J, Jacobs A, Craighill S (2001) Digital family portraits: supporting peace of mind for extended family members, pp 333–340

  55. Naaman M, Boase J, Lai C-H (2010) Is it really about me? Message content in social awareness streams. In: Proceedings of the 2010 ACM conference on computer supported cooperative work. ACM, pp 189–192

  56. Newman MW, Lauterbach D, Munson SA, Resnick P, Morris ME (2011) It’s not that i don’t have problems, I’m just not putting them on Facebook: challenges and opportunities in using online social networks for health. In: CSCW’11. ACM, pp 341–350

  57. Noronha J, Hysen E, Zhang H, Gajos KZ (2011) Platemate: crowdsourcing nutritional analysis from food photographs. In: UIST’11. ACM, Santa Barbara, CA, USA pp 1–12

  58. Papacharissi Z (2012) Without you, I’m nothing: performances of the Self on Twitter. Int J Commun 6:18

    Google Scholar 

  59. Parker AG, Grinter RE (2014) Collectivistic health promotion tools: accounting for the relationship between culture, food and nutrition. Int J Hum Comput Stud 72(2):185–206

    Article  Google Scholar 

  60. Parker AG, Kantroo V, Lee H, Osornio M, Sharma M, Grinter RE (2012) Health promotion as activism: building community capacity to affect social change. In: Proceedings of CHI’12, pp 99–108

  61. Plescia M, Groblewski M, Chavis L (2008) A lay health advisor program to promote community capacity and change among change agents. Health Promot Pract 9(4):434–439

    Article  Google Scholar 

  62. Ploderer B, Reitberger W, Oinas-Kukkonen H, van Gemert-Pijnen J (this issue) Editorial: Social interaction and reflection for behaviour change. Pers Ubiquitous Comput

  63. Prochaska JO, Redding CA, Evers KE (2008) The transtheoretical model and stages of change. In: Glanz K, Rimer BK, Viswanath K (eds) Health behavior and health education. Jossey-Bass, San Francisco, pp 97–121

    Google Scholar 

  64. Russell KM, Champion VL, Monahan PO, Millon-Underwood S, Zhao Q, Spacey N, Rush NL, Paskett ED (2010) Randomized trial of a lay health advisor and computer intervention to increase mammography screening in African American women. Cancer Epidemiol Biomark Prev 19(1):201–210

    Article  Google Scholar 

  65. Salem DA, Bogat GA, Reid C (1997) Mutual help goes on-line. J Community Psychol 25(2):189–207

    Article  Google Scholar 

  66. Samsell M (2010) Mediated: the image as a performative interface in the photographic relationship. In: Coohill PT (ed) Art inspiring transmutations of life. Springer, Netherlands, pp 371–382

    Chapter  Google Scholar 

  67. Schön DA (1983) The reflective practitioner: how professionals think in action. Basic Books, New York

    Google Scholar 

  68. Thomas DR (2006) A general inductive approach for qualitative data analysis. Am J Eval 27(2):237–246

    Article  Google Scholar 

  69. Toscos T, Connelly K, Rogers Y (2012) Best intentions: health monitoring technology and children. In: CHI’12. ACM, Austin, TX, USA, pp 1431–1440

  70. Toscos T, Faber A, Connelly K, Upoma AM (2008) Encouraging physical activity in teens. In: Proceedings of pervasive health’08, pp 218–221

  71. Westlake E (2008) Friend me if you Facebook: generation Y and performative surveillance. Drama Rev 52(4):21–40

    Article  Google Scholar 

  72. Wing RR, Hill JO (2001) Successful weight loss maintenance. Annu Rev Nutr 21(1):323–341

    Article  Google Scholar 

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Acknowledgments

The author thanks the study participants, the YMCA of Atlanta and Humana for their support for this research. Beki Grinter, Vasudhara Kantroo, Hee Rin Lee, Miguel Osornio, and Mansi Sharma provided invaluable help with this work.

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Authors and Affiliations

  1. College of Computer and Information Science, Northeastern University, Boston, MA, USA

    Andrea Grimes Parker

  2. College of Health Sciences, Northeastern University, Boston, MA, USA

    Andrea Grimes Parker

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  1. Andrea Grimes Parker
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Correspondence to Andrea Grimes Parker.

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Parker, A.G. Reflection-through-performance: personal implications of documenting health behaviors for the collective. Pers Ubiquit Comput 18, 1737–1752 (2014). https://doi.org/10.1007/s00779-014-0780-5

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