Identifying and Planning for Individualized Change: Patient-Provider Collaboration Using Lightweight Food Diaries in Healthy Eating and Irritable Bowel Syndrome

Abstract

Identifying and planning strategies that support a healthy lifestyle or manage a chronic disease often require patient-provider collaboration. For example, people with healthy eating goals often share everyday food, exercise, or sleep data with health coaches or nutritionists to find opportunities for change, and patients with irritable bowel syndrome (IBS) often gather food and symptom data as part of working with providers to diagnose and manage symptoms. However, a lack of effective support often prevents health experts from reviewing large amounts of data in time-constrained visits, prevents focusing on individual goals, and prevents generating correct, individualized, and actionable recommendations. To examine how to design photo-based diaries to help people and health experts exchange knowledge and focus on collaboration goals when reviewing the data together, we designed and developed Foodprint, a photo-based food diary. Foodprint includes three components: (1) A mobile app supporting lightweight data collection, (2) a web app with photo-based visualization and quantitative visualizations supporting collaborative reflection, and (3) a pre-visit note communicating an individual's expectations and questions to experts. We deployed Foodprint in two studies: (1) with 17 people with healthy eating goals and 7 health experts, and (2) with 16 IBS patients and 8 health experts. Building upon the lens of boundary negotiating artifacts and findings from two field studies, our research contributes design principles to (1) prepare individuals to collect data relevant to their health goals and for collaboration, (2) help health experts focus on an individual's eating context, experiences, and goals in collaborative review, and (3) support individuals and experts to develop individualized, actionable plans and strategies.

Keywords: Self-tracking; collaboration; food; patient-generated health data; patient-provider collaboration; personal informatics.

Fig. 1.

Foodprint for healthy eating. Left: Mobile app presenting recorded food. Middle: Mobile app asking for (optional) additional details about food. Right: Web app presenting food and mood relationships.

Fig. 2.

Foodprint for IBS. Left: Mobile app presenting recorded food. Middle: Mobile app asking for symptom severity. Right: Web app presenting food and symptom relationships based on symptom severity.

Fig. 3.

Foodprint photo-based visualizations. Left: Web app presenting food photos chronologically, available for both healthy eating and IBS participants. Right: Web app presenting food and IBS symptoms relationship over time, with x-axis representing the record date and y-axis representing time of day. Each block was colored based on symptom severity. Users can click on the colored block to view photos of food eaten up to when symptoms were recorded (e.g., 4 hours ago).

Fig. 4.

Bubble and bar chart in the IBS nutrient analysis report showing correlation between a nutrient (Starch) and a symptom (Abdominal Pain). Every meal was represented as one bubble and categorized by the amount of nutrient (e.g., starch) contained in the meal and the symptom severity.