THU 01.26.23 / MILTON POSNER
Navigating the second year of his master’s degree at Khoury College nearly a decade ago, Herman Saksono — in collaboration with community groups around Boston — was zeroed in on a prevalent problem.
Although exercise greatly reduced physical and mental health issues, Black Americans and those from low-socioeconomic-status (SES) families were having a harder time meeting recommended exercise levels than white Americans were. Many factors fueling this disparity — like a lack of free time, exercise facilities, and walkable neighborhoods — were beyond Saksono’s purview as a computer scientist. So he zeroed in on an area where he could make a difference.
Historically, digital health interventions haven’t helped low-SES populations exercise more, and Saksono cited limited social support as a critical inhibitor. So he developed Storywell, an app where community members could augment their fitness data by sharing their exercise success stories on a neighborhood map. Intrigued with the motivating impact he found, and convinced that computational tools could make exercise more communal and attainable, Saksono resolved to continue.
In the years since, Saksono has taken many steps forward, first from a Northeastern PhD to a Harvard postdoctoral fellowship, then to a recent joint appointment between Khoury College and the Bouvé College of Health Sciences. Now his exercise research is poised to leap forward again, courtesy of a grant from the Google Health Equity Research Initiative. Along with collaborator and Bouvé psychology professor Jessica Hoffman, Saksono has received $50,000 — plus more than 100 Sense 2 devices from Google subsidiary Fitbit — to support Storywell’s next phase.
“Health social support technologies are often very dated and health information sharing looks like online forums. We’ve used the same format for decades and there are opportunities to go beyond that,” Saksono says. “I’m interested in new ways of connecting people to make them healthier, using algorithmic messaging to connect exercise buddies, and exploring different modalities of health information sharing.”
The app’s philosophy is based on social cognitive theory, the idea that people can better develop new behaviors if they see others model those behaviors.
“That concept comes from psychology, but people in human-computer interaction are interested in using computational tools to support it,” Saksono notes. “We couldn’t do this project without Northeastern’s interdisciplinary nature. I come from computer science, but I work with professors in design, health sciences, and psychology to connect the project with lessons learned outside computer science.”
“What makes this work so innovative is that people who live in the same neighborhoods will encourage each other by sharing their experiences and success related to physical activity,” Hoffman added. “We’ll collaborate closely with community members to design and test the app. This collaboration is essential to develop useful interventions that appeal to users and meet their needs.”
This is where community partners, including Smart from the Start and the Mattapan Food and Fitness Coalition (MFFC), become essential. Vivien Morris, founder and longtime chairperson of MFFC, said that they strive to make healthy, culturally relevant food available to all residents, and to promote spaces and opportunities for exercise in a community overwhelmingly composed of people of color.
“People [in lower-income neighborhoods] want to be more physically active, but they may have less time or fewer resources to support that compared to people in wealthier neighborhoods,” says Morris, citing government funding, parks, and green spaces as key resources. “We’ve been active in advocating for more resources to encourage people to spend more time outside.”
Years ago, as Saksono worked on a doctoral dissertation with similar goals, the MFFC connected him with community members who could speak to the realities of communities like theirs — how health could be improved, how devices could help, and how they could connect culturally with residents.
“Because of these long histories of discrimination and inequity, people have reason to expect that people bringing advice don’t have their best interests at heart,” Morris notes, citing health research efforts that harmed community health when they could have bolstered it. “That’s why engaging people, listening to their voices, understanding their history and current experiences as you analyze their environment — all of those things can make people happy to engage with new projects, ideas, and implementations.
“We’re excited to continue working alongside Herman Saksono on these projects. He’s doing great work and we know it’s going to benefit our community.”
Saksono and Hoffman will begin by identifying motivating, culturally relevant, health-related storytelling practices through focus groups with members of marginalized Boston communities. The information gleaned will inform the design of the Storywell 3 app, which will prompt users to record a story about their exercise achievements using the new audio storytelling feature. Through Fitbit output and interviews with participants, the researchers will determine the relevance of this mode of storytelling to the community; the effect of storytelling and story listening on participants’ relaxation, joyfulness, and motivation; and most importantly, whether Storywell 3 promotes physical activity in marginalized communities.
“All of my projects use technology to support health efficacy, and one way to do that is to support marginalized communities in coping with health barriers,” Saksono says. “By sharing their own strategies on being active and healthy, community members can contextualize health recommendations into something more actionable.”
Saksono has already open-sourced Storywell, so communities and researchers can use it anywhere with any fitness sensor. He also hopes that the app can facilitate activism storytelling, where people tell stories of their struggles against structural issues. “Stories can be part of a movement to challenge the lack of investment in public goods, and they can help people feel like part of a collective trying to make things better,” Saksono says. “Digital technologies can make that more powerful.”