helps people advocate healthy eating
to others in their
perceptions of neighborhood safety
and help parents feel more comfortable in allowing their children
to be physically active.
These examples illustrate how
HCI practitioners can address
health disparities by designing
tools that help users cope with
the ramifications of inequality, encourage change within the
existing structures that shape
their communities, and facilitate
changes in their environments.
In each approach, there is an
explicit focus on the conditions
that characterize local communities and the structural influences that underlie them.
March + April 2013
in schools, workplaces, eateries,
and other public spaces are made
more conducive to healthy living.
As HCI researchers and designers,
we have the exciting opportunity
to pave the way for technological innovation in this area.
To begin exploring the design
opportunities, I created a tool
called Community Mosaic (CM).
Like Eat Well, CM helps users
advocate healthy eating to others
in their community, but it makes
this advocacy much more publicly
visible. In CM, users take photos
documenting how they are trying
to eat healthfully and write text
messages describing their experi-
ences. They then send a picture
and/or text message to the system
phone number, at which point their
messages are visualized on a large,
interactive public display located
in the local YMCA (see Figure 2).
CM users advocate healthy eating
as they provide concrete examples
of how to do it. In a field deploy-
ment of CM, users began to sub-
tly shift the power relationships
within their community. Local food
vendors held a lot of power in the
community because they controlled
what foods were available (often
high-fat and high-sugar options)
and had the means to consistently
advertise unhealthy foods. CM
helped residents take back some
of this power, as people used the
tool to draw residents away from
unhealthy options and encourage
them toward healthier dishes. The
persistent public presence of the
CM display (and the emphasis on
nutritious foods therein) helped
facilitate this power shift.
As technology becomes increasingly accessible even to impoverished populations, it is a promising
platform for helping users overcome and tear down local barriers.
Technology alone cannot eliminate health disparities and alter
the structural forces that impede
health management, but it can
be part of the solution. Going forward, HCI researchers must collect
evidence regarding the impact of
activist tools. We need to examine
topics such as intervention dose, that
is, how long people need to interact
with a tool for sustained change
to take place. Working with policy
researchers, sociologists, and those
within the health sciences can help
us better understand how our tools
can fit into the broader effort to
end health disparities.
The impact of activist tools may
go beyond the more traditional
measures of weight loss, behavior
change, and physiological outcomes. Such measures are clearly
necessary to demonstrate effectiveness, but it will also be critical
to examine how these systems
facilitate a sense of empowerment.