Toward Health Information Technology that Supports Overweight and Obese Women in Addressing Emotion- and Stress-Related Eating (a Mixed Methods Approach)
Barbarin, Andrea
2017
Abstract
Extensive research shows that negative emotions and stress can prompt eating behavior that is in excess of physiological nutritional needs. Additionally, research indicates that women are more likely than men to cope with negative emotions and stress by overeating. There is a dearth of Human-Computer Interaction (HCI) research related to Health Information Technology (HIT) interventions that address overeating in context of negative emotions and stress. As a result, there is little guidance for HCI design and evaluation in this area. The study uses a convergent mixed methods design to understand how HIT can support overweight/obese women curb emotion- and stressed-related eating (ESRE), with the ultimate goal of sustained weight management. In the interview study strand, cross sectional semi-structured interviews (N = 22) explore ESRE behavior in overweight/obese women (BMI ≥ 25). The survey study strand, consisting of a questionnaire (N = 430) administered to overweight/obese women, comprises data about user characteristics, stress, ESRE, and coping, and digital access and skills. The thesis found that that overweight/obese women who engage in ESRE encountered stressors that spanned from daily hassles, persistent challenges, and life-changing losses; they also experience stressors related to serving as caretakers and social support providers. They used food as a coping response to the stress they encounter, and tend to associate food with social support. Furthermore, some have characteristics that make them particularly vulnerable to ESRE behavior. This thesis suggests that HIT should assist users before their coping eating response is triggered. Additionally, HIT should support women in becoming aware of their tendencies to associate food with social support. The thesis also found that overweight/obese women who engage in ESRE need to be supported in both the acute and chronic dimensions of their ESRE behavior. Their acute needs include instrumental support for eating awareness in- the- moment as they are making food choices that could be ESRE, as well as in the form of a just-in-time distraction intervention to prevent them from engaging in ESRE. Their chronic needs include support for holistic goals and motivation to address their ESRE, emotional support for encouragement in weight loss efforts, and informational support for appraisal to understand ESRE and change thought patterns for lasting behavior change. This thesis suggests that HIT needs to allowi for more self-experimentation and tailoring opportunities. Finally, the thesis found that stress and self-blame contribute to ESRE behavior, and that the relative influence stress and self-blame had on ESRE differs by racial groups. This thesis suggests that HIT avoid content and design choices that may incite feelings of self-blame. The thesis’ contribution is that it fills a gap in the literature by using an interpretivist approach to understand the ESRE experiences of overweight/obese women, which permits insight into previously-undescribed aspects of the experience. Additionally, the thesis relates the lived experience of ESRE to HIT design, and highlights ESRE behavior in context of socioeconomic factors. It also makes the contribution of applying the concept of self-blame to a sample of overweight/obese women who are largely not diagnosed with an eating disorder. Finally, it explores how self-blame could be taken into account in the design of HIT for weight management.Subjects
Health Informatics Information Obesity Women Stress Eating Emotional Eating
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