BackgroundThe quantified self, self-monitoring or life-logging movement is a trend to incorporate technology into data acquisition on aspects of a person's daily life in terms of inputs (eg food consumed), states (eg mood), and performance (mental and physical). Consumer self-monitoring mobile phone apps have been widely studied and used to promote healthy behavior changes. Data collected through life-logging apps also have the potential to support clinical care.ObjectiveWe sought to develop an in-depth understanding of providers’ facilitators and barriers to successfully integrating life-log data into their practices and creating better experiences. We specifically investigated three research questions: How do providers currently use patient-collected life-log data in clinical practice? What are provider concerns and needs with respect to this data? What are the constraints for providers to integrate this type of data into their workflows?MethodsWe interviewed 21 health care providers—physicians, dietitians, a nurse practitioner, and a behavioral psychologist—who work with obese and irritable bowel syndrome patients. We transcribed and analyzed interviews according to thematic analysis and an affinity diagramming process.ResultsProviders reported using self-monitoring data to enhance provider-patient communication, develop personalized treatment plans, and to motivate and educate patients, in addition to using them as diagnostic and adherence tools. However, limitations associated with current systems and workflows create barriers to regular and effective review of this data. These barriers include a lack of time to review detailed records, questions about providers' expertise to review it, and skepticism about additional benefits offered by reviewing data. Current self-monitoring tools also often lack flexibility, standardized formats, and mechanisms to share data with providers.ConclusionsVariations in provider needs affect tracking and reviewing needs. Systems to support diagnosis might require better reliability and resolution, while systems to support interaction should support collaborative reflection and communication. Automatic synthesis of data logs could help providers focus on educational goals while communication of contextual information might help providers better understand patient values. We also discuss how current mobile apps and provider systems do, and do not, support these goals, and future design opportunities to realize the potential benefits of using life-logging tools in clinical care.

Although food journaling is understood to be both important and difficult, little work has empirically documented the specific challenges people experience with food journals. We identify key challenges in a qualitative study combining a survey of 141 current and lapsed food journalers with analysis of 5,526 posts in community forums for three mobile food journals. Analyzing themes in this data, we find and discuss barriers to reliable food entry, negative nudges caused by current techniques, and challenges with social features. Our results motivate research exploring a wider range of approaches to food journal design and technology.

Food choices are among the most frequent and important health decisions in everyday life, but remain notoriously difficult to capture. This work examines opportunities for lightweight photo-based capture in mobile food journals. We first report on a survey of 257 people, examining how they define healthy eating, their experiences and challenges with existing food journaling methods, and their ability to interpret nutritional information that can be captured in a food journal. We then report on interviews and a field study with 27 participants using a lightweight, photo-based food journal for between 4 to 8 weeks. We discuss mismatches between motivations and current designs, challenges of current approaches to food journaling, and opportunities for photos as an alternative to the pervasive but often inappropriate emphasis on quantitative tracking in mobile food journals.

Poor air quality is a growing global health concern that impacts millions of people worldwide. Although we are beginning to understand the health impacts of air pollution, it remains a challenge to provide people with the information they need to be able to make health-conscious choices. The CitiSense system gives individuals the realtime tools they need to be able to identify when and where they are exposed to poor air. We present the results of a qualitative study regarding a 4-week "in the wild" deployment of the CitiSense air-quality sensor and system. We focus on how the 16 participants responded to their new-found information about their environment, how they shared information, and what kinds of actions were enabled by having access to real-time air-quality data. Quantitative data gathered through the course of the study frames participant responses by showing what levels of pollution were experienced and what activities heightened exposure. We found that CitiSense's real-time graphical displays and everywhere monitoring provided a critical bridge between data and experience, enabling sophisticated in-the-world sensemaking and sharing with those nearby. This in turn affected behavior and attitudes, leading to shifts in how users reasoned about their world, and how they assessed their personal choices and impact.