UNIVERSITY PARK, Pa. — Erika Poole recalls that her dad had his first heart attack in his 30s when he was walking on the beach. The second one happened when she was 9 or 10 years old. "I basically grew up watching him go into the hospital every single year," she says.
"I remember visiting him in the cardiac ward. I particularly remember all the fruit baskets," she notes with a wry chuckle.
The young girl who watched her father's health crises is now a Penn State researcher who wants to do something to help others like him. "He was basically a two-pack a day smoker, and every bad thing he could possibly do, he did. It's heartbreaking to see that, and to see how preventable it all could be by making slightly smarter choices."
Poole, an assistant professor in the College of Information Sciences and Technology, has dedicated her career to helping people make those smarter choices.
"We all deserve to live lives free from the pain and suffering of chronic disease," she declares. "I use social, technical and ecological perspectives to design and evaluate technologies for improving personal health and well-being. My research is at the point where human-computer interaction (HCI) and consumer health informatics meet."
Her recent work includes a large study of adolescents and "exergaming," the use of video games that promote physical participation. Another study looked at the use of text messaging in smoking cessation programs. Currently, Poole is helping to develop guidelines for human-centered design of health technologies that make use of smart phones and other mobile devices. The latter is a cross-disciplinary project pulling together technology experts with health professionals, aimed at encouraging designs for health-related apps that people will actually use.
A lot of fake science has made the job a little tougher.
"In the mobile health app area, for instance, it's like the Wild West," Poole says. "There have been apps that claim to let you take a picture of something on your skin to diagnose melanoma. Or another that claims that if you shine a light on yourself you can cure acne."
According to Poole, one of the big challenges facing technologies for health monitoring and behavior change is that it's hard for consumers to tell what works from what doesn't -- complicated by the fact that the commercial marketplace and science aren't always in alignment.
Even when developers have the best of intentions, they're still learning how these technologies can fit into the daily lives of consumers without being intrusive, annoying or embarrassing, Poole says. "We're still figuring out how these technologies can fit into existing healthcare delivery systems, too."
"When it comes to designing the technologies," she adds, "it is possible for your phone or a wearable device to track all kinds of information about your body and your daily life habits, but we don't yet have robust understanding of how to present this information in ways that promote behavior changes, and remain interesting and motivating to consumers after the initial novelty fades."
One target audience is teenagers.
"There is a period when a person is no longer a child -- but not yet quite an adult -- when they and our health system lose each other for a while," she says. Mobile technologies may be particularly useful for teens to make better health-related decisions.
Another focus is the prevention and management of chronic conditions, a reality that typically begins to confront people in their 30s and 40s. Even though they may have learned some bad habits and appear to be heading in the wrong direction, she explains, these years are something of a sweet spot for interventions, especially if a person really wants to change.
"Behavior change is really hard. We don't have it all figured out," Poole says. "But the individual and societal benefits are clear. Life changes -- positive and negative -- can provide motivation. Heart attacks might be a wakeup call for some, but having a child might be the motivation for others."
But human factors can subvert the best technological intentions.
"What if your company says you'll get a reduction in your premium if you walk so many steps a day? Well, we know that there are going to be some people who will throw their mobile phones in the dryer and set it tumbling," she says with a laugh, "or give it to a soccer player to carry during a match, just to game the system."
It's very much like the inexplicable behavior that 9-year-old saw as her father kept doing things that landed him in the hospital every year.
It's a problem she's still trying to solve.
Erika Poole is an assistant professor of information sciences and technology and a member of the Center for Integrated Healthcare Delivery Systems. Poole co-directs the Health Information Technologies research group with Madhu Reddy. She can be reached at epoole@ist.psu.edu.