This forum is dedicated to personal health in all its many facets: decision-making, goal setting, celebration, discovery, reflection, coordination—even entertainment. We’ll look at innovations in interactive technologies and how they help address current critical healthcare challenges.

Elizabeth D. Mynatt, Editor
What Are Our Responsibilities
When Designing Sociotechnical
Health Interventions?
Katie A. Siek

University of colorado, boulder | [e-mail]

 

ceases. Based on these experiences, I started thinking more deeply about what our responsibilities are when we design sociotechnical health interventions. Here, I briefly outline some of the responsibilities and questions the community should think about before thrusting technology on the next population that could benefit from it.

 

September + October 2011

interactions

Maybe you heard a horrible statistic about a health-related issue and thought, “Technology could help with this.” Or perhaps an event in your own life prompted you to think about how technology could improve the health and wellness of others. Whenever I have an experience that highlights a potential new avenue of research, I begin by learning more about the health matter, reviewing current health informat-ics applications, and then investigating methods for learning about the needs of the target population. Then I collaborate with a multidisciplinary team to create a health intervention prototype that people use for a short period of time to validate its feasibility and effectiveness. It is this latter part that gives me pause about what I do.

I occasionally receive email messages from people at risk of an illness or already battling a chronic illness asking if they could use some part of our prototype. People are free to use what we create, but its utility for the general population—straight from our open source repository—is often questionable since it is a research project that does not come with much support after the funding

Whose Values Should
Be Considered?

When we design sociotechnical health interventions, there must be some consideration of the accepted or correct way to achieve good health. Indeed, there are many guidelines from various federal agencies to help us understand everything from what a balanced diet is to what movements our child should make at three months old. But as soon as we decide on which guideline to use in our intervention, we are implicitly applying a set of values to the population who will use that intervention. Is this what we should be doing through our design work?

One argument is that this is
exactly what we should be doing—if
it is a health intervention, it must
be backed by evidenced-based
research illustrating if people
do these steps, they should live
a healthier life. Indeed, health-
care providers traditionally treat
patients in this manner; they pro-
vide a list of dos and don’ts based
on well-established research. One
of the projects I worked on followed
this argument because we were
designing a nutrition-monitoring
application for people with chronic
kidney disease. These patients
must follow a restrictive diet; if
they don’t, serious health problems
can result. We worked with nurses,
dietitians, and a nephrologist to
identify the ideal diet for this popu-
lation [ 1]. But one of our design con-
siderations was to include foods the
population was encouraged not to
eat (for example, potassium-loaded
strawberries). We wanted to respect
the person as an individual and
provide them with the ability to
consider non-recommended foods
to test how these foods affected
their restricted dietary limits for
certain nutrients. This prompted
discussions with the research team
about how we should talk to users
who routinely record foods that
put them over their dietary limits.
There is a fine line between lectur-
ing/admonishing and having an