User involvement – Digitizing Life

A New Conversational Tool to Promote Positive Body Image

Body Image Dissatisfaction Can Decrease Quality of Life

Eating disorders are relatively common among young adults, especially among females or elite athletes. A major risk factor for developing an eating disorder is body image dissatisfaction which indicates a negative attitude towards one’s own physical appearance. Current technologies in the market are focused mostly on nutrition by measuring and tracking calorie intake in order to optimise the dietary choices. The social media landscape is filled with certain beauty ideals representing only certain body types and shapes as more normative or successful than others [1]. As a result, these kinds of technologies can contribute to body image dissatisfaction, unhealthy eating habits, or disordered eating behaviours. Eating disorders often remain unrecognized, and they can significantly decrease the quality of life particularly for young adults who may be vulnerable to societal pressures on physical appearance.

TrueBalance – A New Conversational Tool to Promote Positive Body Image

To provide an alternative solution to the mainstream nutrition technologies, we have developed a new conversational tool called TrueBalance for the recognition and raising awareness of body image dissatisfaction that can maintain unhealthy eating habits. TrueBalance allows the person to have an autonomous text-based conversation on any topic regarding physical appearance, eating habits, fear of gaining weight or anxiety related to food intake. TrueBalance integrates biomedical determinants that might lead to eating disorders, and applies the principles of Cognitive Behavioural Therapy (CBT) [2] to provide conversational support that helps users in identifying unhelpful thoughts and reformulating these thoughts into more constructive thinking patterns [3]. TrueBalance provides its suggestions based on previous scientific knowledge on eating disorders in a value-sensitive manner. TrueBalance does not collect personal information from the user (such as names or other personal details), which means that all dialogues remain anonymous. We hope that this tool could be used in the promotion of positive body image, prevention of eating disorders or as a complementary method along with working together with a professional therapist.

Initial Feedback from Psychologists and Young Adults Shows Promising Results

TrueBalance has been tested with a psychologist and young adults from the age group of under 30 to understand the benefits and challenges of using this technology for the promotion of positive body image. Psychologists see the benefits of using this tool in the education of cognitive behavioral therapists, since TrueBalance can generate different cognitive strategies for raising awareness and overcoming negative thoughts on body image or eating. Young adults have appreciated the possibility to have an anonymous dialogue on sensitive topics that resembles conversation with a friend. This can help users to reflect and raise awareness of their body image satisfaction, emotions related to food and eating, or concerns regarding physical appearance. More user studies are nevertheless needed to understand the potential implementation and ethical challenges of using this technology in health promotion.

Future Research with New Participants is Needed

It will be important to ensure that this type of technology will have positive impacts on users’ self-image, body image and emotional well-being. For that reason, we are now looking for young adults from the age group of 20-30 interested in trying TrueBalance for a short period of time, and sharing their insights, feedback and challenges with this technology with us. Participation includes:

1) Short online meeting, where we will demonstrate how to use TrueBalance, and what kind of questions or topics you can talk with it. We will give you the instructions of how you can use TrueBalance. You will also answer an anonymised survey on body image satisfaction.

2) You will use TrueBalance in your home for 1 week, a minimum of 3 times. You can select the time and length of using TrueBalance yourself, but we encourage you to use it as often as you like. Using TrueBalance is entirely anonymous, and we will not be able to connect your conversation with your personal data.

3) Follow-up online interview, where we will ask you questions about the user experience of interacting with TrueBalance. You will be asked to fill a questionnaire about body image satisfaction.

A small financial compensation (gift card) will be awarded to all participants.

All young adults between the ages of 20 and 30 are welcome to participate. No prior technical knowledge is needed.

If you are interested in participating, you can respond to this invitation by sending ‘Yes’ along with your name, to rnwja@kth.se or use the registration link: https://tinyurl.com/2a2hxedv. The schedule for the participation can be decided based on your availability.

Your participation contributes to new knowledge about the benefits of conversational technologies in health promotion. At the same time, you get an insight into the ongoing technology development. Participation is completely voluntary and you can choose to cancel your participation in the study at any time. Your privacy will be respected, and no person will be identified from the published material. All information about you is completely anonymised.

Research team:

Sanna Kuoppamäki, Assistant Professor, KTH
Arzu Güneysu, Associate Professor, Umeå University
Razan Jaber, Researcher, KTH
Beatrice Vincenci, Lecturer, Birmingham City University
Josefin Rehn Hamrin, Master student graduate, KTH
Natalia Slusarek, Master student graduate, KTH
Xuan Zhang, Master student graduate, KI

References:

[1] Castellanos Silva, R., & Steins, G. (2023). Social media and body dissatisfaction in young adults: An experimental investigation of the effects of different image content and influencing constructs. Frontiers in Psychology, 14, 1037932. https://doi.org/10.3389/fpsyg.2023.1037932

[2] Agras, W. S., & Bohon, C. (2021). Cognitive Behavioral Therapy for the Eating Disorders. Annual Review of Clinical Psychology, 17(1), 417–438. https://doi.org/10.1146/annurev-clinpsy-081219-110907

[3] Hamrin, J. R. (2024). Enhancing Support for Eating Disorders: Developing a Conversational Agent Integrating Biomedical Insights and Cognitive Behavioral Therapy. Master thesis, School of Engineering Sciences. http://kth.diva-portal.org/smash/record.jsf?pid=diva2%3A1869718&dswid=9873

Exploring AI-mediated mindfulness practice to promote older adults’ well-being

Mindfulness can improve mental and physical well-being

Mindfulness has become a common self-care practice to improve mental and physical well-being, decrease symptoms of stress and improve relaxation and concentration.  Mindfulness can be defined as a state that can be achieved through focusing one’s awareness on the present using mind and breath. Mindfulness can be used as a part of self-care practice, or as mindfulness-based intervention (MBIs). Mindfulness-based interventions are used as a prevention and treatment for depression, anxiety, stress and other psychiatric disorders, and they can be practiced through various exercises and assignments aimed at developing mindfulness through formal practice and in daily life. 

New research project about mindfulness in later life

At KTH we are investigating if and how AI-mediated mindfulness practice could promote the well-being of older adults aged 65 and over. The project explores the use of mobile applications in mindfulness practice and aims to design a new conversational mindfulness application through participatory design with older adults.

Older adults could significantly benefit from mindfulness practice, but most mobile health applications are not developed based on their unique needs and interests. Conversational applications, such as chatbots or virtual assistants can decrease many technology adoption barriers that older adults typically experience with digital technologies and improve the interactivity with the device.

What are the benefits of mindfulness practice in daily life?

Mindfulness practice has shown to be associated with reduced levels of stress, anxiety and depressive symptoms. Mindfulness can facilitate compassionate and self-compassionate thinking, which may reduce negative emotions and thoughts experienced in daily life. Mindfulness can also be used as a treatment for physical symptoms, such as chronic pain, fatigue and shortness of breath.

Mindfulness technologies today consist of mobile health applications or videos providing guided mindfulness training. In this project, we aim to use and develop a conversational mobile application that can provide a more personalised, adaptive and accessible mindfulness experience in comparison to traditional methods of mindfulness practice. This application can be designed to have customisable guidance, interactive features, reminders, progress tracking and social features.

“I am interested in mindfulness – how can I participate in the project”?

We are looking for older adults aged 65 and over who would like to use a mindfulness application for a 3-week period at their home. Participation includes an interview before and after using the application. No previous experience of mindfulness is needed, but we recommend that you are comfortable with using a mobile application in Swedish.

We will soon open the link for registration on the KTH website. You can also register by sending your contact information to to: mccarren@kth.se.

By participating in the study, you will have a possibility to test a mobile application in mindfulness practice and contribute to increased scientific knowledge and understanding of the benefits of mindfulness for older adults.

Research team:

Lucy McCarren, PhD student, Department of Biomedical Engineering and Health Systems, KTH

Sanna Kuoppamäki, Assistant Professor, Department of Biomedical Engineering and Health Systems, KTH

Ethnographic study of two robot laboratories: ideas about future technology users emerge in engineering practice.

Generally, it is often assumed that technology development activities are distinct from the use context. Now we know that, rather than distinct, users are enacted as part of ongoing technology design activities. It are precisely the practices in which engineers are engaged that shape their ideas about future users. This is the finding of our most recent ethnographic study published in the journal Social Studies of Science.

As engineers build and develop new technologies, how do they imagine future users? Considering the rapid progress and development of artificial intelligence and robotics, and growing fears surrounding their impact on future societies, this has become a pertinent question. Ideas about future users can impact how new technologies are designed and implemented in our future societies.

Engineering practices evoke user images

So, how do engineers imagine future users? To answer this question, we joined engineers working in two robot laboratories over a period of 6 months, and observed how they developed their technologies and articulated ideas about future users. What we found is that user images and design activities are related. Engineers develop ideas about possible use scenarios as these ideas are evoked by specific design activities; or – how we call them – ‘image-evoking activities’.

To better understand this phenomenon, we need to look at the detailed work that is done in the laboratories: As engineers go about their everyday work, they engage in different sub-actions, such as writing a software code, testing how codes affects the robot’s movements, or sharing these insights within the online community. Together, these sub-actions form broader activities, each with its own goal. We found four such activities from our observations: to distinguish technology work from other types of work, to expand what is technologically possible, to universalize the applicability of the developed technologies, and to make robots human-like.

With ‘image-evoking’, we mean that each of these activities evoked a set of use scenarios. For example, universalizing applicability caused the engineers to imagine scenarios of users in diverse industries, and making robots human-like came with images of robots replacing humans, in a variety of settings. To think about this breadth and variety of possible use scenarios available to engineers, it may be helpful to envision how these different scenarios form a ‘user image landscape’, with some images far in the background, some blurred and some rather self-evident.

How can this help technology development?

Well, technologies may fail if they do not correspond to the users’ wishes or desires. So, there is a need for suitable user images, to ensure that millions of investments into robotics and artificial intelligence do not go to waste. Our study speaks to this need. Through developing a better understanding of how users are imagined in practice, we are now beginning to learn how and where we can improve these images; and better tailor them to our needs and expectations.

Crucially, our findings suggest that we need to be more aware of the locales in which technologies are constructed. We have shown how ideas about future users are created in engineering practice, and these can have an impact on how future technologies are constructed. This means that the user is created within the laboratory, as part of ongoing design practices. So, if we are to change certain practices or ways of imagining future users, we need to consider that our interventions, like user involvement or participatory design, need to fit into the practical realities in the laboratories. They need to connect to what the engineers’ everyday work looks like.

Everyday engineering in robot laboratories

What are the future roles for robots and humans, based on our study?

In our case, multiple future use scenarios became apparent: robots in different industries, in factories, in hospitals, in care facilities. Robots replacing human work, or parts of what humans do at the moment. These all seem possible future scenarios. However, the impact of robots and increased automatization on our future society is the subject of ongoing debates. Millions of jobs might be threatened, but robots could also function as providing assistance or creating new jobs.

In this context, our study shows that there is a lot to learn by studying the context in which robots are built and created. And it implies that we do have to ask ourselves: What roles do we really want for robots and artificial intelligence to fulfill? Do we want them to replace humans? What are our societal needs? Only if we become clearer about our own desires can robot engineers possibly attend to them.

You found this discussion interesting? Please share your opinion in the comments below, or contact me. I am looking forward to hear your ideas!

You can find our original research article published online here for free

Björn Fischer is a PhD student in Technology and Health at KTH in Sweden. His current research focuses on science and technology studies, with a particular interest in engineering and design practices, and the link between technology and use. He is particularly concerned with understanding how technologies can be developed to suit the needs of older people. 
Email: bjorfisc@kth.se

New study shows that older people’s involvement matters, but it hasn’t reached its full potential.

Among companies, engineers and policy-makers, involving older people in design projects is an intervention of increasing popularity. Our new study just published shows that involving older people is important for engineers and older users, but current practices may miss opportunities. In our study, we reviewed previous design projects that involved older people in design processes, and investigated how this involvement mattered for the design outcome. We found that the most common outcomes of older adults’ involvement were: 1) An increased learning by the designers about older people’s lives and needs. 2) A change in design based on the feedback and comments obtained by older people. 3) An appreciation by the older participants of being part in such technological procedures.

Link with technology acceptance and adoption

Interestingly, though, we did not find any evidence that acceptance and adoption were immediate consequences of user involvement of older people. Acceptance and adoption, however, are often tirelessly proclaimed as the ultimate goals for involving older people: The idea is that, through involvement, technologies could be tailored better to the needs of older people, and thereby achieve a higher acceptance within the older population. Our study shows that, despite involvement, not many of these technologies eventually find their way into the homes of older people. Current practices of involving older people, it seems, have not reached their full potential just yet. But why is that?

As our study indicates, there may be a general underappreciation of the complexities of involving older people. User involvement, as it appeared in our research, is not a linear model where you feed some older people into technology design, and “adoption” or “acceptance” automatically emerge at the other end. Rather, it is an equation that is far more complicated than that, with multiple variables: What roles do the older people play in the process? What images and stereotypes exist about older people? At which level or stage in the design process are they supposed to contribute? For what purposes are they involved? How are they selected in the first place? And, how do designers themselves drive the involvement process? Each variable can take a different value, and the outcome can look drastically different.

How, then, can we reach the full potential of user involvement?

Well, our research suggests that we need to break down the equation of user involvement, and critically examine its terms and parameters. Often, older people are involved as passive receivers of technologies, suffering from physical decay and biomedical ailments. If technologies are to become more appealing to the older population, we might want to question these assumptions, and invert parts of our ways of thinking. Perhaps, we can involve older people differently, in more active roles, at higher levels, and with less stereotypical views. What technologies could be built, then?

Following the findings of our research, we feel optimistic that older people’s involvement remains important for both older technology users and engineers, and believe that we should continue to explore what else it may offer. As we begin to re-define how to include older people in design projects, yet undiscovered technologies may lie just around the corner.

If you found this discussion interesting, and wish to share your opinion: Please feel free to contact me. I am eager to hear your ideas!

You can find our original review article published open access: https://doi.org/10.1093/geront/gnz163

Björn Fischer is a PhD student in Technology and Health at KTH in Sweden. His current research focuses on the social study of technology, with a particular interest in engineering and design practices, and user involvement. He is particularly concerned with understanding how technologies can be developed to suit the expectations of older people. Email: bjorfisc@kth.se