Designing for food choice & the difference testing makes

This is the story of time spent getting ideas out of our heads and into the world. The team at the center of this story is comprised of d.school fellows Rita and Chris along with me, Cathy. Given the current obesity and diabetes epidemics, the topic of our work was a timely one: food choice. 

The relationship between doctors and patients is often transactional. Patients describe problems, and doctors prescribe potential solutions. Our team was in the process of developing a teaching kitchen for low-income consumers and doctors that would allow both groups to form a community that tackles a shared challenge together: healthy eating. Doctors and patients would help one another use pointers to turn the idea of healthy eating into action. 

Our challenge was to break the usual doctor-helps-patient relationship and build a more collaborative engagement for both doctors and patients. We designed, developed, and, for two hours, tested three conversation-starter prototypes to set the right tone for our users’ time in the teaching kitchen. 

In the first part of our first test, we asked a pair of passersby to color in plates drawn on a sheet of paper to represent what they ate for breakfast, lunch, and dinner:

Next, we showed them the composition of the plate that’s recommended by the U.S. Department of Agriculture (USDA) and gave them a sticky note of four questions to discuss with each other: 

The activity was quick and, at least from our perspective, easy to understand. We wanted it to create a sense of responsibility for healthy eating, and we were largely successful in reaching that goal, since one participant told us, “Coloring this in made me feel more responsible.” 

We ended up changing the third question while running our prototype, adjusting it to: “How would you make your plate look more like the recommended one?”

We changed it because we realized early on in our first test that we made an incorrect assumption that everyone could use more vegetables in at least one of their meals. One of our participants, a vegetarian, had plenty of vegetables but her challenge was incorporating protein. 

We also realized that the people engaging in our initial test took an interview-style approach in addressing the questions. One person asked the other all three questions and then they switched. We wanted it to be less mechanical and more conversational. We wanted the participants to build rapport that could lead into collaboration. 

The first testing session concluded, and we had five minutes before the next one. The clock was ticking. We quickly took what we learned from the first prototype, including our goal to discourage interview-style conversations, and adapted the activity. Rather than handing the sticky note with questions to the pair, Chris facilitated, guiding the conversation by reading each question out loud. 

The pair had a few minutes to discuss each question and place sticky notes onto a Venn diagram in between questions. The diagram showed each participant what challenges they individually faced in figuring out how to eat healthy and which challenges were shared:

The interactions were more conversational with Chris’ guidance. Our prototype was working in one more aspect now. In the second iteration, partners wanted even more time to learn about one another’s thought processes, going beyond cursory details. 

One participant explained, “I wanted to learn her framework of what she thinks is healthy… and know why she cares about who touched her food.”

Bingo.

While our pair had common challenges to healthy eating, they mentioned that it was likely because they were of similar age and have similar problems. That made us wonder whether this activity would be an issue with doctors and patients who do not share as many things in common. 

We realized that, in order to find out, we needed to bring some doctors to the table. We asked three doctors the same questions we asked our testing subjects earlier. We wanted to get a sense of what answers we could expect from doctors as opposed to patients.

One doctor told us that the last time he remembered not eating healthy was many years ago in college. Another said that it is difficult for her to cook healthy meals when she’s too busy, but that she can spend extra money on prepared food those days. Since our target patient group for the teaching kitchen was low-income consumers, we decided that this activity was not ideal as our conversation starter.

So, we placed a set of supermarket advertisements in front of two potential users and asked them to go grocery shopping together, imagining that there was an empty fridge and pantry at home they needed to fill. They categorized the items into two piles—”Will Buy” or “Won’t Buy”—attaching sticky notes with their reasons to each item. 

We had intended to design this to prompt conversations about healthy eating challenges and shared tips, anticipating conversations such as, “I wouldn’t buy chickpeas, because I have no idea what to do with it”. We thought that, perhaps, another person might chime in with something along the lines of, “I love chickpeas. It’s healthy and fast!” Instead, we got conversations about price comparisons and favorite brands. 

There were also conversations about healthy food misconceptions, as the pair discussed whether frozen vegetables were still healthy and if the fats in avocado were okay to consume. 

Although the grocery shopping activity did not elicit the conversations that we wanted, we found that it may be valuable for bringing out misconceptions, which can be used to source instruction during a teaching kitchen session. So, we’re holding on to this exercise as one that can be re-designed for another purpose in the future. 

The time to host our teaching kitchen was fast-approaching. We circled back one more time to our prototyping work before we tested our model one more time on a group of about a dozen participants in the d.school community. We got the conversational, organic tone that we want to elicit at the teaching kitchen during that test. We presented the coloring plates activity but this time with Rita guiding the group through one question at a time and facilitating a group discussion to share out the different challenges and how to address them. 

There’s more that we could have done to experiment, tweak and test with an actual doctor-patient pair, which would have been helpful, but time was a very real constraint. This experience was a good reminder that even a limited amount of time spent testing and seeing people interact with your ideas can quickly bring insights and adjustments to your work in ways that a few extra hours of discussion in a meeting could not. 

We’ll be piloting a teaching kitchen that brings together doctors and patients to share the joy and challenges of their food experiences while cooking a meal together. The hope is to inspire healthy changes in eating behaviors as part of Rita’s fellowship project to promote food as medicine. If you’re interested in learning more about that, check out foodasmedicinecollaborative.org.

d.school Fellows Rita Nguyen and Chris Rudd contributed to this story. This prototype was conducted as part of the d.school's Design Guild, hosted by d.school Project Fellowships Director Thomas Both.