Feedforward: A Mobile Design Strategy that Supports Emotive Learning for Preventive Health Practices and Enduring Lifestyle Change

In 2008, lifestyle diseases accounted for 50% of the reported deaths in the United States, which were preventable by changing daily behaviors. Among the diseases, Obesity affects 32% of the current population. While many health programs provide information and tools for diet and fitness management, most participants relapse after the first year. The high relapse rate may be due in part to a disconnect between reflective and emotive learning---we "know" which behaviors are healthy, but "feel" compelled to act in accordance with unhealthy habits. Furthermore, more than two thirds of the population tend to discount future outcomes when choosing between immediate and future rewards. Designed conditions that support the anticipatory process of emotive learning may enable participants to change deep-seated biases and experience enduring lifestyle change.;This study proposes and tests feedforward as a design theory. Feedforward refers to conceptually associated designed conditions and/or stimuli, which a person passively experiences before a target situation. Feedforward biases goal states, mindsets, and interpretations of subsequent situations. Over time, the mindset promoted by feedforward becomes contextually associated with the target situation---the constraints introduced by feedforward influence our predictive model, or bias, of the situation. The term "feedforward" formalizes the body of research regarding anticipatory cues and suggests it as a way in which design can foster intended emotive learning for lifestyle change. While cognitive neuroscientific research provides the backdrop for this study, the recent emergence of mobile technologies positions possible applications within the subtle contexts of daily life. Leveraging design prior to decisions and actions could frame situations in ways that align with our intended lifestyle; it could influence and impact our ability to adopt healthy behaviors and achieve long-lasting lifestyle change.;Feedforward was tested in terms of its ability to support emotive learning for preventive health practices and enduring lifestyle change. Specifically, the study tested the extent to which designed mobile interaction that primes for a future health-oriented mindset before meal and snack times influenced preferences, behaviors, and biases toward healthy eating practices among young adult college students at risk for obesity. Feedforward took the form of lock screen images sent to participants' mobile phones within the hour preceding meal and snack time for one week. The treatment images consisted of images with two or three words intended to prime for future health. The effects were measured in three phases over five weeks. The first phase provided a baseline measure before exposure to the treatment. Measurements for the second phase occurred immediately after a week of exposure to the treatment. Measurements for the third phase took place two weeks after exposure to the treatment. The three dependent variables---perceived desirability, consumption behaviors, and future health biases---were measured using two instruments each, for a total of six forms of data collection. Data were analyzed using repeated measures analysis of variance (ANVOA) and chi square tests. The results suggest that the treatment most affected participants' future health bias, followed by short-term effects on the perceived desirability of health foods, and inconsistent effects on the proportion of health food consumed. The study evidences the ability of feedforward to foster intended emotive learning for enduring lifestyle change.