Examining Opportunities for Goal-Directed Self-Tracking to Support Chronic Condition Management

Abstract

Although self-tracking offers potential for a more complete, accurate, and longer-term understanding of personal health, many people struggle with or fail to achieve their goals for health-related self-tracking. This paper investigates how to address challenges that result from current self-tracking tools leaving a person's goals for their data unstated and lacking explicit support. We examine supporting people and health providers in expressing and pursuing their tracking-related goals via goal-directed self-tracking, a novel method to represent relationships between tracking goals and underlying data. Informed by a reanalysis of data from a prior study of migraine tracking goals, we created a paper prototype to explore whether and how goal-directed self-tracking could address current disconnects between the goals people have for data in their chronic condition management and the tools they use to support such goals. We examined this prototype in interviews with 14 people with migraine and 5 health providers. Our findings indicate the potential for scaffolding goal-directed self-tracking to: 1) elicit different types and hierarchies of management and tracking goals; 2) help people prepare for all stages of self-tracking towards a specific goal; and 3) contribute additional expertise in patient-provider collaboration. Based on our findings, we present implications for the design of tools that explicitly represent and support an individual's specific self-tracking goals.

The Importance of Starting With Goals in N-of-1 Studies

“…In this viewpoint article, we examine and reflect on findings from our n-of-1 research. Across this research, we have surveyed 1,396 people with chronic conditions, and conducted interviews, participatory design sessions, or focus groups with 108 people with chronic conditions and 32 health providers (9,(15)(16)(17)(18)(19)(20)(21). We also draw on three field deployments of novel prototype systems with 48 people (22,23).…”

“…Finally, we examined how self-experimentation could help people determine causality between a symptom and trigger ( 22 ). We designed, developed, and evaluated a system to support such self-experimentation, and investigated how Bayesian analyses could better answer the questions people want to answer via self-experiments ( 20 ). Together, these studies provide insights around how n-of-1 tools can help people form and test hypotheses about their personal IBS triggers.…”

“…We first investigated challenges and pitfalls people currently face, characterizing distinct types of migraine tracking goals people would like to pursue. We then developed and investigated goal-directed self-tracking , a new method that scaffolds the process of deciding what, when, and how to track toward a specific goal, and analyzes and visualizes the resulting data to support that goal ( 20 ).…”

“…Added flexibility for configuration requires a system to also support understanding how to configure for one’s goals. This problem is particularly salient in n-of-1 tools, where people may not know what goals are achievable or reasonable ( 20 ) or how to translate their goals into tracking plans ( 28 ).…”

“…Providers can also be removed from the lived experience of self-tracking, leading them to recommend burdensome tracking routines ( 16 , 20 ). For example, providers might assume patients want the most validated answers possible and recommend rigorous but high-burden tracking (e.g., paper diaries detailing every consumed food).…”