Co-Designing Food Trackers with Dietitians

Identifying design opportunities for food tracker customization

Figure 1. Search results for “food tracking” from the Google Play store.

Food tracking has become a popular practice. It helps people be aware of their diet and make informed food choices. The data collected through food tracking also have clinical values for health providers: they assess patients’ nutrients intake and provide appropriate treatment. But these values only manifest when the data are relevant to individual patients’ needs. For example, irritable bowel syndrome (IBS) patients need to track symptoms and food triggers, and eating disorder patients need to capture their emotion towards food to develop mindfulness. While patient types and their tracking needs vary, mainstream food tracking tools such as MyFitnessPal do not support these diverse and sophisticated needs.

Instead, many of them support collecting nutrition facts and calorie counting (Figure 1), which provides little flexibility for people to choose what to track and how to track their food. As a result, people turn to other tools that are not designed for food tracking, such as spreadsheets, social media, and bullet journals (Figure 2).

Figure 2. People track their food in unconventional ways: spreadsheet, Instagram posts, and bullet journals.

The mismatch between the design of existing tracking tools and individuals’ tracking needs suggests that food tracking tools should be customizable. Thus, we set out to understand the information that patients need to track from a dietitian’s perspective, and rethink the design of food trackers to support their information needs. Specifically, we want to figure out what patients need to track to facilitate working with dietitians (Tracking needs), and how to customize food trackers to support patients’ and dietitians’ needs (Tailoring tracker design).

Co-Design Workshops

To answer the research questions, we conducted individual co-design workshops with six registered dietitians. During the workshop, we asked each dietitian participant to describe two typical patient personas that they commonly see, and to create a food tracker for each persona.

Patient Persona

Our dietitian participants (P#) created 12 patient personas with common attributes as well as unique characteristics in terms of age, gender, symptoms, and goals. Based on their primary dietary problems, we grouped the patient personas into four groups: diabetes (D-#), weight management (WM-#), eating disorder (ED-#), and gastrointestinal distress (GI-#). Figure 3 illustrates three examples of patient personas created by the participants.

Figure 3. Three examples of patient personas (ED-1: an eating disorder patient described by P2; ED-3: an eating disorder patient described by P5; WM-4: a weight management patient described by P4).

Design Widgets

By looking at the commonly used input types in personal tracking tools, we prepared a set of paper-based design widgets, including numeric, textbox, audio, image, checklist, and Likert scale (Figure 4). During the workshops, participants used these widgets as building blocks to design trackers for each patient persona by choosing any widgets they liked to use, modifying existing widgets, and creating their own widgets.

Figure 4. The paper-based prototyping widgets we created for dietitian participants.

Tailoring Tracker Design: Context and Reflection Matter

We identified 32 tracking items and grouped them into five tracking needs: food, reflection, symptoms, activity, and physical status. Depending on patients’ conditions and dietitians’ practice, the necessity and importance of these tracking needs vary. Participants tailored the tracker design not only based on what to track, but also when to track, how to track, what to share, and how to support tracking through add-on features (e.g., reminder, rewards, education resources).

Figure 5. P4 was creating a food tracker for WM-4.

Figure 6(a) is a custom tracker designed for ED-1, who has anorexia nervosa (a type of eating disorder). This patient needs to track basic food information including food items, meal type, and eating time; the food items can be logged using a textbox, photo, or audio input. Additionally, reflecting on her body image, things to be proud of, and self-care behaviors would create positive feelings. As an eating disorder patient, it is important to capture the eating disorder behaviors she has (e.g., over-restricting eating). Because the patient tends to over exercise, the dietitian also wants her to monitor exercise type and duration.

Figure 6. The digitized version of paper-based food trackers for ED-1 (a) and WM-4 (b). Items grouped together are meant to be tracked together at the same time. Icons next to the title represent alternative ways to capture the information (e.g., taking a photo is an alternative way to capture food items).

Figure 6(b) is designed for a weight management patient (WM-4). Her tracking needs focus more on food (eating time, meal type, food items, eating location, portion size, nutrition facts) and less on reflection. This patient needs to log her food before and after eating (preferably by photo). To build trust in her internal body cues, she needs to reflect on her hunger/fullness level before and after eating. Additionally, the dietitian added a tracking item for water intake because of the patient’s goal to drink enough water.

Tracking the same item using different formats

We found that although participants sometimes came up with similar tracking items, they tended to capture the information differently based on their practicing style. For example, both P6 and P5 wanted to collect their patients’ mood. P6 liked to use emojis because they are “simple and straightforward”, while P5 used a checklist with an option of audio input, and explained that “audio-recording may afford patients to record frank thoughts without feeling “shame about the things they logged.”

Figure 7. Tracking mood information differently: emoji (P6, WM-5) and checklist plus audio input (P5, ED-3).

Supporting Personalized Tracking Experience

In this work, we were surprised to observe the diversity of treatment style, while identifying commonalities across dietitians. As such, we see opportunities in supporting dietitians to create and share “tracking templates” for different patients, which can be uploaded for other dietitians to search, download, adopt, and modify. This approach can reduce efforts required to customize and configure trackers from scratch whilst satisfying the basic tracking needs.

Our lab is currently developing a mobile tracking platform called OmniTrack (Figure 8). OmniTrack is a flexible self-tracking tool that allows people to create their own trackers by configuring what to track and how to track. Leveraging OmniTrack, we can create tracking templates and deploy them in real-world settings, allowing dietitians and patients to customize based on their tracking needs.

Figure 8. Screenshot from OmniTrack: a list of trackers (left) and a list of tracking attributes (right).

If you are interested in reading more about the co-design studies with dietitians, please check out our 2019 CHI paper:

Yuhan Luo, Peiyi Liu, Eun Kyoung Choe (2019). Co-Designing Food Trackers with Dietitians: Identifying Design Opportunities for Food Tracker Customization. Proceedings of the SIGCHI Conference on Human Factors in Computing Systems (CHI).