Empowering Lifestyle Changes and Health Identity: A transdisciplinary design methodology

Life expectancy has significantly increased for most of the global population. However, the number of years that individuals live with chronic diseases and disabilities has also increased, meaning this increased life expectancy is not always lived in good health. Prevention is seen as a solution, as lifestyle choices can affect both the number of years lived in good health and the total life expectancy. This solution shifts agency over healthcare decisions and emphasises how individuals are no longer passive recipients of care but are encouraged to take more responsibility over their health. However, health decisions cannot be seen as something isolated from our daily lives. Complex systems such as our body, society, and ecology all shape and affect how we perceive and act upon our health. This systemic relationality makes it a challenge to take more responsibility over our health.

Exploring how complex systems shape health-related behaviour can be captured by the concept of health identity. We introduce health identity through a framework that brings together three interconnected concepts: experienced health, personal values, and socio-ecological systems. Understanding the relationality between these concepts creates space to formulate small, but meaningful ‘leverage points for change’. The framework was used to develop a multi-method transdisciplinary design research methodology. The methodology explores the transformative potential to reach positive behaviour change using health identities as a relational perspective in systemic design. A focus on health identity provides a diverse, personalised, value-based view of health. This view is dynamic and supportive to account for differences over space (socio-ecological environment) and time (life stages, evolving values). The interactive nature of the methods provides personally relevant reflections that can shape and motivate positive health behaviour change that can be sustained over time.

This methodology was applied in a case study where thirteen people from diverse backgrounds explored and formulated their own health and health objectives and self-experimented to integrate their objectives over three months. Our case study demonstrates how participants can be engaged in systemic research through a methodology that is flexible, allowing them to find their own pathways of change. This systemic and human-centred approach can promote more inclusive ways for people to relate to their health and set health objectives that fit their own socio-ecological system. Insights from such a participatory approach to improve lifestyle can be shared across a range of stakeholders, including citizens, healthcare providers, and policymakers, to inform the design of more inclusive and context-aware health interventions.