Thesis
Redesigning personal food environments
to promote wellness
Advisors
Mark Baskinger, School of Design, Carnegie Mellon University
Mark Gross, School of Architecture, Carnegie Mellon University
Jessica Wisdom, Department of Social & Decision Sciences, Carnegie Mellon University
Summary
A variety of influences in our immediate, everyday environments can cause us to make poor food choices and to overeat – influences like super-sized portions in cafeterias and restaurants; bulk packaging in supermarkets; big dishes and serving spoons that encourage us to pile on more food than we should; snack foods sitting around, tempting us constantly at work and at home. By redesigning people’s immediate physical environments, I aim to counteract some of these negative influences to support healthy eating behaviors and promote wellness.
Introduction
A recent National Health and Nutrition Examination Survey found that between 2007-2008, about one-third of adults in the U.S. were obese and more than two-thirds were either obese or overweight (Flegal et al, 2010). Obesity has risen dramatically in the U.S. over the past twenty years and, according to The Centers for Disease Control and Prevention, is a major risk factor for the leading causes of death in the nation, including cardiovascular disease, type 2 diabetes, and certain cancers. The rise has been attributed in part to the development of “obesogenic environments,” a term describing the external influences that promote overeating, unhealthy foods, and physical inactivity (Swinburn et al., 1999). Faced with this widespread yet nebulous threat to public health, researchers have adopted an ecological approach to analyzing the many interconnected personal and environmental factors that influence health and eating.
An ecological approach emphasizes the connections between people and environment. It also recognizes that behavior and environment not only influence each other, but that they do so at multiple levels of interaction ranging from macroscale to microscale (Swinburn et al., 1999; Story et al., 2008). Macroscale environmental factors refer to the upstream influences that impact behavior on a population level, such as regional and global transportation networks, advertising campaigns, agricultural and food policies, and food distribution outlets. Microscale environmental factors refer to influences within the individual’s immediate settings, such as package and portion size, plate shape, room layout, lighting, and dining companions (Rolls, 2003; Wansink, 2004; Sobal et al., 2007; Wells, 2007; Wansink, 2008).
Interventions at multiple levels, collectively spanning physical, sociocultural, economic, and political dimensions, are likely needed to transform obesogenic environments into health-promoting ones. While policy makers wrangle with the food industry over proposed upstream changes like soda taxes and bans on trans fat, relatively few interventions have been attempted at the microscale level in which individuals live and interact on a daily basis (Story et al., 2008). Simple changes at home, like serving dinner on salad plates instead of dinner plates, minimizing distractions like television, and serving vegetables family-style while keeping the other serving dishes out of sight at mealtime, could significantly reduce the number of calories people consume (Wansink, 2006). An ecological approach to combating obesity and promoting wellness requires the design of personal environments that support healthy food choices and eating behaviors. By learning how people make food decisions, how aware they are of environmental influences on those decisions, and how resulting behaviors affect health, interaction designers can reshape these environments to support, rather than sabotage, people’s efforts to live healthfully within the larger ecosystem of food environments.
Project goals
The goal of this project is to redesign aspects of microscale settings that influence food choice and eating behavior – what I am calling the personal food environments – to promote wellness and complement interventions at higher levels. Prerequisite to this goal will be understanding the present relationships between individuals and personal food environments, and particularly the ways in which people shape or cope with aspects of those environments that challenge their health aspirations. Throughout the process, I will use an ecological approach to investigate the relationships between food information, food quality, eating behaviors, eating environments, and food distribution environments.
Approach
Domain Exploration
I will begin by mapping the system territory of the problem: the personal food environments and the factors that influence people’s food choices and eating behaviors within those environments. This will involve a literature review of existing research within economics, marketing, medicine, nutrition science, psychology, and public health. As part of this literature review, I will examine previous, related attempts to shape food choice and consumption behavior through environmental interventions and identify the principles of environmental psychology that influence the effectiveness of design solutions.
Research
To understand where environmental redesign efforts have low-cost, high potential for impact, I will conduct interviews to learn about people’s food experiences, rituals, and attitudes and make observations of personal food environments such as supermarkets, restaurants, kitchens, dining rooms, and vending machines. During this phase, I will identify participants to involve in longer-term study. I plan to document these participants’ day-to-day food environments and behaviors, possibly through a photo food journal or some other self-reporting mechanism.
Prototyping & Evaluation
After synthesizing my research, I will create a series of prototypes with increasing fidelity, from sketch to working artifact. Depending on what my research reveals, the strategy I adopt in the prototyping phase may include increasing individual awareness of the ambient signals and cues that influence food decisions, altering personal food environments to support individual eating plans, and/or making the long-term consequences of impulse food choices personally salient. I plan to iterate between prototyping and evaluation, involving more participants as refinement progresses.
Deliverables
By the end of the project, I will have produced a research report describing my process, final design criteria, and conclusions, as well as one to four working prototypes of different concepts that can be used to shape the influences of personal food environments on behavior.
Reading List
Austin, S.B., Melly, S.J., Sanchez, B.N., Patel, A., Buka, S. and Gortmaker, S.L. Clustering of Fast-Food Restaurants Around Schools: A Novel Application of Spatial Statistics to the Study of Food Environments. American Journal of Public Health 95, 9 (September 2005), 1575-1581.
Brownell, K.D., Kersh, R., Ludwig, D.S., Post, R.C., Puhl, R.M., Schwartz, M.B. and Willett, W.C. Personal Responsibility and Obesity: A Constructive Approach To A Controversial Issue. Health Affairs 29, 3 (March 2010), 378-386.
Brownell, K.D. and Horgen, K. B. 2004. Food Fight: The Inside Story of The Food Industry, America’s Obesity Crisis, and What We Can Do About It (1st ed.). McGraw-Hill.
Flegal, K. M., Carroll, M. D., Ogden, C. L., & Curtin, L. R. Prevalence and Trends in Obesity Among US Adults, 1999-2008. JAMA: The Journal of the American Medical Association 303, 3 (2010), 235-241.
Horowitz, C., Colson, K.A., Hebert, P.L. and Lancaster, K. Barriers to Buying Healthy Foods for People With Diabetes: Evidence of Environmental Disparities. American Journal of Public Health 94, 9 (September 2004), 1549-1554.
Johnson, R. K., Appel, L. J., Brands, M., Howard, B. V., Lefevre, M., Lustig, R. H., Sacks, F., et al. (2009). Dietary Sugars Intake and Cardiovascular Health: A Scientific Statement From the American Heart Association. Circulation, 120(11), 1011-1020.
Loewenstein, G., Brennan, T., Volpp, K.G. Asymmetric Paternalism to Improve Health Behaviors. The Journal of the American Medical Association 298, 20 (2007), 2415-2417.
Nestle, M. 2007. Food Politics: How the Food Industry Influences Nutrition, and Health, Revised and Expanded Edition (2nd ed.). University of California Press.
Rolls, B. J. Supersizing of America: Portion size and the obesity epidemic. Nutrition Today 38, 2 (2003), 42-53.
Sallis, J.F., Owen, N. “Ecological Models of Health Behavior.” In Health Behavior and Health Education: Theory, Research, and Practice 3rd Edition, edited by K. Glanz, B.K. Rimer, and F.M. Lewis. Jossey-Bass, San Francisco, CA, USA, 2002. 462-480.
Sobal, J. and Wansink, B. Kitchenscapes, Tablescapes, Platescapes, and Foodscapes: Influences of Microscale Built Environments on Food Intake. Environment and Behavior 39, 1 (2007), 124-142.
Story, M., Kaphingst, K. M., Robinson-O’Brien, R., & Glanz, K. Creating Healthy Food and Eating Environments: Policy and Environmental Approaches. Annual Review of Public Health 29, 1 (2008), 253-272.
Thaler, R. H. 2008. Nudge. Yale University Press.
Wansink, B. Environmental Factors That Increase the Food Intake and Consumption Volume of Unknowing Consumers. Annual Review of Nutrition 24, 1 (2004), 455-479.
Wansink, B. 2006. Mindless Eating: Why We Eat More Than We Think (1st ed.). New York: Bantam Books.
Wansink, B. and Sobal, J. Mindless Eating: The 200 Daily Food Decisions We Overlook. Environment and Behavior 39, 1 (January 2007), 106-123.
Wells, N. M., Ashdown, S. P., Davies, E. H. S., Cowett, F. D., & Yang, Y. Environment, Design, and Obesity: Opportunities for Interdisciplinary Collaborative Research. Environment and Behavior 39, 1 (January 2007), 6-33.