Holistic Women's Health Tracking | Participatory Design |
Holistic Women's Health Tracking | Participatory Design |
Aim: To design for an often ignored user group when it comes to health technologies - women.
Process: We conduct a literature review, interviews and participatory design workshops with women, and ultimately outline a set of design recommendations for a fitness tracker that fits the nuances of the female body.
Team: This research has been done with Sushmita Vavilala, under Dr. Pushpendra Singh.
Outcome: This research has been published as a poster in India HCI 2022. It can be accessed here.
Tools: Miro, Figma
Motivation
“Fitness trackers can be wildly inaccurate because a woman’s resting heartbeat changes throughout her menstrual cycle. This bad data can give women a warped view of reality: technology is trying to tell them how they are performing but the results are wildly inaccurate because it assumes they are men.”
- WIRED
Introduction
The data captured by health and fitness tools is immensely personal and is intertwined with one’s complex identity - this includes convergences of age, sex, class, and ethnicity. However, by using a one-size-fits-all approach, the design of these health and fitness tools flattens the importance of gendered experiences and personal needs. In response to this, we aim to critically examine the implications of the normalization and universality of health trackers. We aim to explore the relationship between women and their fitness trackers through semi-structured interviews and participatory workshops.
Our findings unearth an underlying sense of disconnect and distrust between women and their health trackers, and we expand on the gap between what women expect from these devices and what they receive. Finally, we analyze and outline the implications of universalism on this relationship and explore how to bridge this disconnect through inclusive design considerations that move away from these health trackers’ universal, gender-agnostic design.
Literature Review
We conducted a literature review of 35 academic papers to understand western ‘universalist’ design and its implications on minority groups. We also researched technological intervention in women’s health and feminist design principles. We found that little attention has been brought to the impact of the universality of health-tech devices, especially on the women who use them. It is necessary to bring to light the implications of a ’gender-agnostic’ view of health technology in order to advance efforts towards the total disposal of universality in health devices.
Process
Semi-structured Interviews
Aim: To explore women's relationships with their trackers, so that we can better understand their pain points and what they perceive as an ideal tracker.
Research Questions
Based on our literature review, we came up with the following research questions.
How is the relationship between women and their fitness trackers?
What drives this relationship?
How does this relationship impact these women?
How can this relationship be improved?
Participatory Workshop
Aim: When designing for minority groups, it is crucial to involve them in the process. We conduct 3 exercises to co-design fitness trackers with women.
Design Recommendations
Aim: We use our findings to draw attention to the holistic and nuanced nature of women’s health and come up with design recommendations for health trackers to accommodate their unique health needs.
Semi-Structured Interviews
Methodology:
9 participants
Ages 18-55
Women who use fitness trackers
20-30 minutes each
Analysis:
Affinity mapping on Miro
Discussion:
Through conducting our semi-structured interviews we came to learn that one’s relationship with their health tracker was largely influenced by their own unique health experiences and needs. Thus, we decided to conduct a participatory workshop with women, with the aim to help our participants reflect on their health needs and experiences, explore the influence of age, ethnicity and sex on these unique health needs, understand how these unique health needs impacts their relationships with their health trackers, and most importantly, to empower their unheard voices and opinions and have a say in how they would like their unique health needs to be accommodated by these trackers.
Participatory Workshop
Methodology
8 participants
Ages 18-55
Women who use fitness trackers
3 activities - Body Maps, Cycle Diagrams, Ideation
Body Maps
Inspired by Madeline Balaam, participants were each given the outline of a body and asked to map onto it their individual health needs. Participants were then asked to draw lines on the body map, connecting related health needs with each other. This provided participants an avenue to better understand and learn about their bodies and unique needs.
Ideation
A table was created which consisted of four columns: ‘Likes’, ‘Dislikes’, ‘Questions/Concerns’, and ‘New features’. The participants were asked to fill in these columns one by one, guided by prompts surrounding reflection and discussion about health trackers.
Cycle Diagrams
This activity required participants to mark all significant events of their day onto a circle which represented a typical day in their lives. They were then asked to recall instances where they used their health tracker during the day, and mark those on the circle. Our primary aim for this activity was to understand how and how often various participants tracked or self-reported their data.
Results
After data collection from our participatory workshop and interviews, we analysed the responses using affinity mapping. The responses were categorized 4 broad themes, as can be seen in the following examples:
Personalization
"[I] experience somewhat moderate to intense PMS which increases my heart rate, but my tracker does not consider that" - P1.
"I couldn’t personalize Google fit for my period as much as I wanted... didn’t help me track [my] irregular cycle and I could only log 5 days" - P7.
“When I’m on my period, it’s not that I don’t want to complete my 10,000 step goal - I just physically can’t. On the worst of those days, even getting out of bed for me feels like a success, but my [tracker] doesn’t see it that way.” - P5
“Doesn't let me override calorie requirement or nutrient requirement which may be needed as females have unique needs. For example, with the onset of menopause I have become deficient in Calcium and Vitamin D. But, I cannot reflect this on my food app.” - P6
Complexity
"Cumbersome", "Stressful", "Overwhelming", "Too many features", "Confusing"
“My fitness apps collectively meet all of my needs, but not individually”. - P7
"apps require manual input of too much data, it gets very cumbersome" - P1
"Sometimes too many features/too much knowledge/end up doing nothing with all features" - P4
Privacy
"Data security is an issue. How the company uses these data and the policies are not very well defined, so many times users are taken as subjects for data collection" - P3.
"As my fitness app talks to google tracker, it should make sure that it does not reveal any of my details to Google; I am not sure if it is ensuring that" - P9
"Possibility of location tracking can be unsafe for women" - P4
Accuracy
Tracking vitals for females is different. Inaccurate if using the same metrics as males.- P1
"My app doesn’t give me any scientific explanations or background information on how it is working. How am I to trust such a black box algorithm?”. - P9
“Calorie intake calculation is currently ‘guesswork’ in fitness trackers.” - P10
"It should show what details are being taken into account when creating nutrient/calorie requirement" - P5
Design Implications
Bases on the analysis of the data done above, we formulated the following design implications for the design of health trackers for women:
Enhanced Cycle Tracking
Improve cycle tracking capabilities to accommodate irregular cycles and offer more than 5 days of tracking, giving women greater control and insights into their reproductive health.
Adjustable Goals
Allow users to customize their fitness goals, especially during periods when they may have physical limitations. Recognize and celebrate small achievements to promote motivation.
Customized Nutrition Tracking
Implement features for users to input and customize nutrient and calorie requirements. Provide options to account for unique needs, such as menopause-related nutrient deficiencies.
Modular Features
Create a modular design that allows users to select the specific features they need, reducing confusion and stress associated with a multitude of options.
Transparent Data Handling
Clearly communicate how user data is collected, used, and secured. Develop well-defined privacy policies and ensure data is not shared with third parties without explicit consent.
Privacy Controls
Enable users to set specific privacy preferences, particularly regarding data sharing with other apps or services. Ensure location tracking can be easily disabled to address safety concerns.
Gender-Based Metrics
Recognize that vital metrics can differ between genders. Provide options for users to input gender-related data, adjusting fitness recommendations and goals accordingly.
Algorithm Transparency
Offer scientific explanations and background information about the algorithms used for tracking and analysis. Build trust by providing users with insights into how their fitness data is processed.
Discussion
We emphasize the importance of taking into account the uniqueness of one’s body when designing personal health technology. It is necessary to consider unique user groups when designing for them to bridge the disconnect between these groups and the technologies they use. We must avoid the inadvertent shunning of such groups, especially in an exponentially technologically-advancing world. We call for researchers, designers and engineers to research and build health trackers that recognize and incorporate the personal, fluctuating, and holistic nature of women’s health.
Our research employed a participatory qualitative approach to explore the relationship between women and their health trackers through reviewing literature, semi-structured interviews, and participatory design workshops. Our findings highlight a great variety of unique health needs and concerns of women unaccounted for by their health trackers due to their universal, gender-agnostic nature.
We analyzed and outlined the implications of this universalism, which unearthed an underlying sense of disconnect and distrust between women and their health trackers in various aspects such as accuracy, privacy, etc.