Family’s health: Opportunities for non-collocated intergenerational families collaboration on healthy living

Highlights

• There is a need to further understand non-collocated family members’ current practices, needs, and challenges to collaborate on healthy living activities.

• We conducted in-depth semi-structured interviews with non-collocated family members’ – specifically elderly parents and adult children – to gain insights into existing obstacles that prevents family members to collaborate on healthy lifestyles within their family.

• We discuss how to strengthen family members’ engagement on healthy living practices and suggest design implications to support family members living apart on their efforts to cultivate health within their families.

Abstract

When a family is engaged in healthy living practices together, it enhances the quality of life for all individuals. However, when members in families are separated over distance, the everyday encouragement and support may shift and obstacles arise within the family. In this study, we investigate non-collocated family members’ practices of healthy living, their perspectives on their family’s healthy living activities, and what obstacles exist regarding collaboration on their family health. We conducted an interview study with 26 independently living participants representing “elderly parents” and “adult children” in a family dynamic. We present members’ practices and strategies for sustainable healthy living activities. We also explore members’ creative use of technology for health promotion and describe existing obstacles that prevent families to effectively collaborate in healthy living. Based on our findings, we suggest design implications to support family members living apart on their efforts to cultivate health within their families.

Introduction

Promotion of family health is an important process that goes beyond care provision. It empowers individuals to increase control over, and to improve their health (Hubley and Copeman, 2018). This process involves a combination of components, including: health education, the environment in which people live, and health policies (Fertman, Allensworth, 2016, Hubley, Copeman, 2018). To help individuals make better use of these components and make informed decisions about their health, many health promotion programs have been developed, including ones that promote collaboration among all individuals involved in care provision (Patient and Care, 2019) and others that engage families in building a familial culture of health and well-being (Johnson, 2019).

Supporting family health initiatives has garnered attention in the HCI research community (Colineau, Paris, 2012, Lukoff, Li, Zhuang, Lim, 2018, Schaefbauer, Khan, Le, Sczechowski, Siek, 2015). Although some researchers have linked family influence with individuals’ dissatisfaction with their bodies (Kluck, 2010) and family problematic communication styles with eating disorders (Steinberg and Phares, 2001), still other researchers have examined the importance of involving families – especially ones that live together in the same home – in the promotion of a healthy lifestyle, particularly when trying to help individuals adopt positive health behaviors (Edelman, Mandle, Kudzma, 2017, Fertman, Allensworth, 2016, Gillman, Rifas-Shiman, Frazier, Rockett, Camargo, Field, Berkey, Colditz, 2000). For example, Lukoff et al. (2018)’s study showed that collocated family members value both tangible and informational support on health promotion where members take action to help others such as by cooking healthy meals and giving advice. However, these kinds of support can be affected by different factors, including geographical distance. It is common to see the health care supporters living apart, e.g., the young adults who leave their parents’ house or the siblings who have their own family. The “leaving home” family members may provide or receive health support remotely (Seiffe-Krenke, 2006), which may cause the everyday encouragement and support to change compared to when members lived together. Moreover, obstacles may arise within the family, for example, with an aging parent health decline. Given that, some researchers have turned their focus from examining collocated to non-collocated family members and the unique obstacles they face when it comes to collaborating on health promotion, i.e., challenges on staying up-to-date on each other’s activities and health status when living apart (Binda, Yuan, Cope, Park, Choe, Carroll, 2018, Nurgalieva, Frik, Ceschel, Egelman, Marchese, 2019).

In this paper, we were interested in the implications of aging for families and health collaboration-related issues that may arise. We frame family health as each family member is supporting, improving, and maintaining health both personally and for the whole family (Fertman, Allensworth, 2016, Hubley, Copeman, 2018). Based on the literature, we consider health practices as a form of collective practices composed by healthy eating, physical activities/exercises, and mental care as a way to maintain a healthy lifestyle (Hubley and Copeman, 2018). In our study, we focus on non-collocated family members – specifically individuals filling the roles of “elderly parents” and “adult children” in their respective families – to identify opportunities that can be used to promote health collaboration within families even when the family members are living apart. To be more specific, we sought to answer the following research questions: (RQ1a) What factors have motivated non-collocated family members to engage in healthy behaviors? (RQ1b) How do non-collocated family members maintain their personal healthy behaviors and cultivate their family’s healthy living practices? (RQ2a) What are common obstacles that non-collocated family members encounter in cultivating their family healthy practices together? (RQ2b) How might technology design help non-collocated family members deal with those obstacles?

To answer these questions, we conducted in-depth semi-structured interviews with 26 participants filling the roles of “elderly parents” and “adult children” in a family dynamic. We contribute to research on family health informatics (Pina et al., 2017) by expanding the understanding of non-collocated family members’ current practices, needs, and challenges to collaborate on healthy living activities. We discuss how to strengthen family members’ engagement on healthy living practices, and leverage some existing strategies that influence their behaviors. In addition, we present factors related to lack of interest, consistency, and understanding as obstacles that affect family collaboration on healthy living. Thus, we recommend design directions for family-centered health technologies to help non-collocated families overcome and thrive in their efforts to cultivate healthy living within their families.

In summary, our work intends to investigate non-collocated family members’ – specifically elderly parents and adult children – current practices of healthy living, to gain insights into existing obstacles that prevents family members to collaborate on healthy lifestyles within their family, and to identify design opportunities for family-centered health technologies.