XXVII.1 January - February 2020
Page: 8
Digital Citation

Synthesizing family perspectives on health: Creative activities to stimulate health conversations

Jomara Sandbulte, Jordan Beck, Janice Whitaker, John Carroll

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Many families have difficulty following healthy behavior practices in their household. Since conversations about health and well-being can often be infrequent within families, cultivating these practices can be a challenge [1]. The Center for Human-Computer Interaction at Penn State University (PSU) sees this as an opportunity for experience design, looking into how and what family members come to know about each other's health [1], including ways in which they can coordinate, incentivize, and follow through in health management [2]. These ongoing efforts have created opportunities for collaboration on community-wide interventions, such as the Intergenerational Friends Fair, a daylong, family-friendly event promoted by the Intergenerational Leadership Institute at PSU. This event aimed to bring together participants of all ages for activities and interactive exhibits, to expand opportunities for intergenerational communication and learning. Together with the Center of Geriatric Nursing Excellence at PSU, we prepared an exhibit for this event. Here, we reflect on our experience at this event, outlining two lessons learned for researchers and designers working on family-centered projects.

Since families may struggle to find time to sit together and talk about certain topics, we decided to set up a space for families to discuss their current healthy living practices. Intending these conversations to be organic rather than forced, we created something that we hoped would connote the closeness and intimacy of home. Additionally, we provided materials (e.g., Health Bingo) as chat triggers to encourage free talking and the sharing of thoughts on healthy living practices. First, we asked participants to craft ideas in response to the question What does healthy living mean to you? in terms of what matters to them and their family, ways to promote positive health, and ways to be active. Participants were encouraged to express their ideas creatively using materials such as colored markers and pens, and A1-size white cardboard paper. Second, we encouraged family members to play Health Bingo—adapted from Bridges Together (—to include options such as drinking water, flossing, and meditation. We briefly explained the rules of the game: Each participant should circle health activities and behaviors in which they engage, compare their answers with those of their family members, and, finally, mark the ones they have in common. As they compared answers, we talked about which activities they might like to start and which they might like to do more often.

Many intergenerational families came by our exhibit and engaged in our activities. Kids loved drawing posters. They grabbed markers and got right to work drawing their ideas about healthy living. Parents were satisfied seeing kids' ideas about health and seemed motivated to reinforce healthy behaviors. We were intrigued that children frequently drew or talked about healthy eating when prompted to reflect on healthy living. For example, one child said he loved eating lemons. His mother then reinforced the importance of healthy eating and mentioned other food options, including fruits and vegetables, that could be considered healthy. They made creative suggestions of images and words that the child could incorporate into the poster (see photo). In the end, the poster had drawings of superheroes fighting bad eating habits (e.g., too much sugar) and giving healthy gifts (e.g., lemons) to kids if they were good. As a team, we felt that this family's and others' participation reinforced how a simple and direct activity could promote valuable conversation about healthy living between family members. Throughout the day, several families were able to identify healthy living practices and promote healthy behaviors by creating posters.

We decided to set up a space for families to discuss their current healthy living practices.

Health Bingo also encouraged family members to talk about their healthy living habits. For example, while an eight-year-old boy and his grandmother were playing, the grandmother watched with a big smile while the boy circled his answers. She asked several questions to get him to share more details. "What kind of healthy food do you like to eat?" she asked. The boy responded, "Broccoli! They're like little trees!" We were surprised to see that he circled almost all the activities on the Bingo card. When he was almost done, he noticed the only healthy habit left was flossing: "I need to improve my flossing!" he said. We all smiled, and his grandmother took the opportunity to reaffirm the importance of daily flossing. We all felt pleased that he arrived at this insight on his own, with minimal guidance from us.

ins01.gif Mother and child working together on their poster, using materials offered during our event.

We want to emphasize two key takeaways from our experience:

Use fun, creative activities as conversation stimuli. From previous work, and this event experience, we learned that families have a latent interest in discussing health-related topics and, once stimulated to do so, their discussions can be interesting and beneficial. How can we encourage more conversations like these? Our experience suggests that giving individuals time and space along with fun, creative ways to frame conversations produced dialogues about healthy behavior that were engaging and helpful to everyone involved. We watched a mom and her child illustrate a story about superheroes fighting bad eating habits and witnessed a young boy realize that he needs to improve his flossing habit. This realization was pleasing to his grandmother, who took the opportunity to reaffirm the importance of flossing. Given the increased interest in health informatics and family-centered design, there is a terrific opportunity for researchers and designers to innovate fun, creative artifacts and systems to promote conversations like the ones we observed. The activities we chose, poster creation and Health Bingo, allowed for fluid movement between individual and collaborative activities. Drawing could be an individual activity periodically paused so that the art makers could discuss their drawings with one another. Alternatively, family members could draw together if they chose to do so—like the mother and child who ended up illustrating a superhero fighting bad eating habits.

Synthesize different family members' perspectives when designing. During the event, we talked with people in different stages of life about healthy living. We learned that from a child's perspective, eating habits are an important aspect of health. Eating vegetables and fruits was often mentioned as a healthy living practice. When considering the viewpoint of an older individual, such as a parent and grandparent, we observed an interest in reinforcing healthy behaviors for younger generations. But it seemed they also wanted to expand healthy living practices within their families. During the conversations, parents and grandparents would often mention physical and mental activities as part of health, which may include various activities such as participating in a family community event. How can we incorporate all these perspectives when designing for families? Our experience suggests that having positive conversations around each individual's ideas about healthy living is useful for identifying differences and similarities in family members' perspectives. We see here an interesting opportunity to innovate in how a family member may present their point of view on healthy living to their family; as each person shares, it is important to synthesize all information to effectively promote collaboration on healthy living within families. Making use of artifacts (e.g., a Bingo game) to encourage conversations was one valuable approach toward fostering family collaboration in health.

back to top  References

1. Binda, J., Yuan, C.W., Cope, N., Park, H., Choe, E.K., and Carroll, J.M. Supporting effective sharing of health information among intergenerational family members. Proc. of the 12th EAI International Conference on Pervasive Computing Technologies for Healthcare. ACM, New York, 2018, 148–157;

2. Binda, J., Georgieva, E., Yang, Y., Gui, F., Beck, J., and Carroll, J.M. PhamilyHealth: A photo sharing system for intergenerational family collaboration on health. Companion of the 2018 ACM Conference on Computer Supported Cooperative Work and Social Computing. ACM, New York, 2018, 337–340;

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Jomara Sandbulte is a Ph.D. student at Pennsylvania State University's College of Information Sciences and Technology. Her research interests include health informatics and design research. [email protected]

Jordan Beck is an assistant professor of user experience design at the Milwaukee School of Engineering. His research interests include scholarly communication and the tools that shape and facilitate it. [email protected]

Janice Whitaker is the administrator and community liaison for the Center of Geriatric Nursing Excellence at Pennsylvania State University's College of Nursing. [email protected]

John M. Carroll is a distinguished professor at Pennsylvania State University's College of Information Sciences and Technology. His research interests include methods and theory for human-centered design. [email protected]

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The Digital Library is published by the Association for Computing Machinery. Copyright © 2020 ACM, Inc.

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