HEALTHY LIFESTYLE AS EXPERIENCE PRODUCT by Diploma in Experience & Product Design

I donâ&#x20AC;&#x2122;t even have enough time to sleep, so why exercise? Esther, 20

Smoking with my friends is a group bonding thing. Emmanuel, 20

Health is more important but I have to finish my studies first. Jing Yi, 20

I donâ&#x20AC;&#x2122;t exercise anymore as there is no more PE. Jocelyn, 21

EXPERIENCE DESIGN STUDIO

Healthy Lifestyle As Experience Product RESEARCH

Prologue 5

Your Friends = Your Health 6

You Are What You Feel Like Eating 7

Junk Food Junkies 8

Small Steps to Healthy Eating 9

How Do You See Your Body? 10

Sitting, the New Smoking 11

Overcoming Excuses for Not Exercising 12

The Wonders of Sleep 13

Smoking among Young Adults 14

DESIGN

Makan Quest 16

Stub-It 18

HealthBits 20

Shake It Off 22

Curo 24

Stair Racer 26

ZZZ Monster 28

Walk Ball 30

Diet Dare 31

Movinâ&#x20AC;&#x2122; 32

PROLOGUE

Healthy Lifestyle As Experience Product Why “Healthy Lifestyle As Experience Product”? Experience Design is usually purposed for commercial ends (think brand, service and product systems). How would it perform when given a problem with personal, social and public repercussions—such as lifestyle issues leading to obesity? This problem lends itself to Experience Design. Firstly, there are users whose actions we seek to change. Secondly, to change these actions we need to influence thoughts, feelings and predispositions. Thirdly, change can be effected through experience touchpoints across space and time. This constitutes the design opportunity. This problem also admits a wide range of possibilities. Design solutions could be real or virtual, simple or complex. They could be brand new, or drawn from existing elements made more relevant, accessible and usable. Design is the giving of form. Can Healthy Lifestyle be given form that is as engaging and addictive (if not more) as its nemesis, the Unhealthy Lifestyle? To make the problem more concrete, the studio brief was to formulate a design solution for the adoption of Healthy Lifestyle by young adults in tertiary institutions. This meant that designers as tertiary students themselves had easy access to users in their environment for study and testing purposes. This setup enabled designers to conveniently go and see for themselves (after Toyota’s “Genchi Genbutsu”). For research and development, these lines of enquiry were put forth: - What are the attitudes, mindsets and behaviours of young adults towards Healthy Lifestyle? - What are the influences and challenges in their environments?

- How can design solutions be generated using frameworks, concepts and tools from Experience Design? Other than the general causes of lifestyle diseases, designers brought specific insights relevant to their target audience to the studio, including: - Health is not of concern to young adults and not related to any decision to be made; - They think that since there is nothing wrong with them, there is nothing to worry or do anything about; - Any rethink or change of lifestyle would require a life-changing event or diagnosis; - They think that being health-conscious, counting calories and planning diet and exercise is not what “normal people” do; - When it comes to diet, they find it easier to go along with the preferences of friends and family, or just their own feelings; - When it comes to exercise, they can’t find time or find it embarrassing to exercise as they worry about not looking good or looking clumsy; - For those who smoke, smoking is an important social ritual and they think they can quit anytime so there is no problem; - They think that since they are now adults, they should be free to do anything they want. Designers then consulted published findings to inform their design intents. Considerations included: - How to increase awareness of the importance of a healthy diet? - How to lower barriers, real or perceived, to physical activity? - How to make visible the future health consequences of present actions? - How to wire reward circuits to desired behavioural changes? - How to leverage peer pressure to trigger, motivate and sustain transitions to Healthy Lifestyle? 5

Not surprisingly, given the digital dependency in the “always-on” lives of young adults, most designers came up with mobile app solutions. All made use of gamification to track progress and inject positive reinforcement. Designers were also creative with the design of avatars, visual cues and reward systems to establish the link between lifestyle choices and future health states. Throughout the intense seven weeks for prototype development, designers contended with the demands of functionality, usability and viability. Highlights of this studio, from research to thinking and design, are showcased in this volume. They are testament to what the designers discovered and achieved, and show how Experience Design can be harnessed for lifestyle change. The studio wishes to thank SP Design School and Health Promotion Board for making this collaboration a success. Special thanks go out to Mr Winston Chai and Mr Ng Teck Tiong of SP Design School, and Ms Brenda Tan of Health Promotion Board. We look forward to further conversations on Healthy Lifestyle As Experience Product.

KK ONG KKO: STRATEGIC THINKING & DESIGN 8 MARCH 2015

Your Friends = Your Health WRITTEN & ILLUSTRATED BY AMELIA YULIANA

Your friends have a bigger say on your health than you imagine.

Meanie Megan

Procrastinate Perry

Party Penelope

Positive Penny

Enthusiastic Ethan

Studious Stacey

Young adults in tertiary institutions live busy lives. They juggle curricular requirements, extra-curricular activities, friends, family and even work. They only make time for what is most important to them. Their health is not their top priority. They believe they are indestructible [1], thinking that “it will never happen to me, only to others”. Actually, most are concerned about their health, yet they do not practise a healthy lifestyle. In a survey I conducted with 30 young adults in tertiary institutions, more than 80% of respondents stated that they feared contracting an illness related to a family history illness. However, when asked if they were doing anything unhealthy, most answered “yes”. At their age, young adults enjoy greater say in their own behaviour, leading to many risky behaviours becoming the norm [2]. Many pull away from their families to find individuality and other individuals like them. Friends have a strong effect on their decisions. In a survey I did with 37 tertiary students, 46% of respondents said that friends influenced them to become fit and healthy, while only 22% said that their families influenced them. 11% said that

other people aside from their friends and families influenced them, while 8% said that no one influenced them at all. Young adults fall into cliques which can be classified into two categories. “Negative” cliques crave to stand out. Conformity to the whims of the leaders is the price for membership [3]. In other words, if I smoke, you’d have to smoke too. In comparison, “positive” cliques support each other to make the right decisions. They do not pressure others to go against their will. Peer pressure emerges in many ways. It can be as easy as someone asking you to do something. It can also happen indirectly. For example, after hanging out with a certain group, you tend to do the same activities together [4]. You can also pressure yourself sometimes. Being different from a group makes you feel out of place. To avoid that feeling, you might start doing the same as the group [5].

Changing one’s behaviour for the better is not an easy thing to do. First, one must feel ready to take action. Second, one must believe the plausibility of the recommended action. Lastly, there must be cues to trigger changes in behaviour. Otherwise, no action will be taken. Peer pressure can be a bad thing if you are in the wrong group leading to bad decisions. However, you have the choice to leave that group. It would empower you to make better decisions. On the other hand, if you are surrounded by friends who do well in academics and athletics, you would want to do your best like them. In this case, peer pressure can be a good thing too. Group opinion and peer pressure are powerful mechanisms that can be used to spread healthy lifestyle among young adults in tertiary institutions [6].

You Are What You Feel Like Eating WRITTEN & PHOTOGRAPHED BY KOK MEI RONG

Young adults still take healthy eating with a pinch of salt.

! K O I H S

According to Singapore’s National Health Survey 2010, approximately 2 in 5 Singaporeans aged 20 years old and above are already suffering from at least one chronic ailment [1]. Their sedentary lifestyle coupled with unhealthy eating are the main factors contributing to quicker weight gain, putting them at risk of many diseases. It is a worrying issue as the prevalence of obesity is increasing amongst the younger population of Singapore. This means that Singaporeans’ health is deteriorating at a younger age, compared to 10 years ago. Excessive consumption of fast food if left unchecked can harm one’s physical and mental health. This was graphically demonstrated in Morgan Spurlock’s 2004 documentary “Super Size Me”, documenting 30 days during which he consumed only McDonald’s items for breakfast, lunch and dinner. He felt exhausted all the time and became addicted to fast food. At the end of the experiment, he gained 11 kg, suffered severe liver dysfunction and developed symptoms of depression [2]. Although young adults may not consume fast food everyday, their unbalanced diets on an almost daily basis can take a toll on their health.

Most young adults in tertiary institutions make unhealthy food choices. They relish in tasty and visually appealing foods, such as char siew rice and ayam penyet. These foods are often fried and topped with rich, flavourful sauces, described by them as “shiok” (Singaporean slang for “extreme pleasure or the highest quality” [3]). Though “shiok”, such foods tend to be high in calories, poor in nutritional value, and pose health risks when consumed frequently. In comparison, young adults find healthy foods such as vegetables and salads unappealing and lacking in taste. Young adults are more prone to the temptations of unhealthy foods at tertiary institutions. There are many fast food restaurants on campus. Junk food is readily available through vending machines or convenience stores. Students who stay late in school are left with unhealthy food options as food courts close early. In addition, the good taste of unhealthy foods prompts them to consume more, despite health consequences. Thus, they will reach for fast and junk food given their easy accessibility on campus.

Young adults also have the habit of deciding on food based on their feelings, and often act on their cravings. They are adventurous with exploring food places with friends, especially places raved on social media. Places popular with young adults often offer highly processed, high-calorie nutrient-poor foods such as pizzas, French fries, desserts and such. Sitting, eating and chatting is the preferred social activity which leads them down the path of sedentary lifestyle and unhealthy diet. Despite increased awareness of the importance of a healthy diet, young adults still eat unhealthily. Healthy eating is not their priority. They want to enjoy themselves first. Health consequences are not visible to them yet, hence their negligence to adopt a healthy lifestyle. However, we can as individuals make small changes in the right direction. When ordering cai fan or nasi padang, we can order more vegetables instead of fried meats. Instead of going for iced lemon tea, we can drink plain water. With proper guidance, determination and support, it is not impossible to adopt a healthy lifestyle.

Junk Food Junkies WRITTEN & ILLUSTRATED BY PATRICIA YEONG PUI YEE

Young adults are addicted to junk food with dire health consequences.

Junk food consumption can be harmful to our health. It puts us at risk for serious chronic illnesses like diabetes and heart disease. In addition, it can be highly addictive. Researchers at The Scripps Research Institute in Florida conducted an experiment on rats and found that pleasure receptors in their brains deteriorated with constant consumption of junk food, leading to eating disorders like binge-eating and compulsive overeating [1]. Might junk food have the same effect on humans? Worldwide and in Singapore, young adults are eating more junk food. Researchers from University of Minnesota School of Public Health researched eating habits of Singapore residents and found that those who reported eating fast food most frequently were younger, better educated, smoked less and were more likely to be physically active.

They found that people who consumed fast food even once a week increased their risk of dying from coronary heart disease by 20% in comparison to people who avoided fast food. Eating fast food two or more times a week was also found to increase the risk of developing Type 2 diabetes by 27% [2]. Brain chemicals like dopamine, opioid and galanin produce feelings of pleasure when we consume junk food. They teach us to consume junk food over and over again, causing cravings and addiction. Experts have attributed food cravings to an evolution benefit of high-calorie food for survival and the psychological relief of stress and unhappiness [3]. Studies have shown that when we are stressed, weâ&#x20AC;&#x2122;re more likely drawn towards sugary and fatty foods such as cake [3]. In addition, food companies have spent millions of dollars perfecting junk food, such as the most satisfying amount of crunchiness in a potato chip and the ideal amount of creaminess in a cookie [4] . It is no wonder that young adults find junk food irresistible and, whether they care to know or not, addictive.

To fight food addiction, we can substitute junk food with healthy snacks. A healthy snack made up of complex carbohydrates, protein and healthy fats increases our energy levels for longer periods of time than sugary snacks. Adding healthy snacks between meals increases focus and performance [5]. When we improve our health, weâ&#x20AC;&#x2122;ll automatically experience greater mental and emotional well-being. For example, exercise not only strengthens our heart and lungs, but also releases endorphins, powerful chemicals that energise us and lift our moods. In conclusion, we can substitute junk food with healthier choices, and while we make the change for the better, we can make it a fun experience as well.

Small Steps to Healthy Eating WRITTEN & ILLUSTRATED BY SOH SHER MEI

Small steps are more effective than big leaps.

Singaporeans have been encouraged to lead a healthy lifestyle by exercising more and eating more healthily. Still, they are not having a healthy diet due to the wrong perception of a healthy diet. Why? They are encouraged to consume more whole grains, and so many think that they are eating more healthily by regular or increased consumption of whole grains, even though they are consuming too many calories, sugars and fats along the way. In a way, their whole-grain diet provides a false sense of being healthy. According to the National Nutrition Survey 2010 conducted by Singapore’s Health Promotion Board, Singaporeans are consuming excessive calories and the biggest sources are sugars and fats. From the survey results, one-third of youth aged 18 to 29 have an average of one sweetened drink a day when the guideline is two sweetened drinks a week. The increased intake of calories, sugars and fats could potentially lead to a weight gain of 5 kg a year [1]. Many people find it difficult to adopt a healthy diet based on their daily nutritional requirement. We tell ourselves that it is time to start eating healthily for every meal, but it will never

happen or we will give up half way. Why is that so? Eating healthily in Singapore where there is a wide variety of tasty but not so healthy food is the problem. Each of us have our own weaknesses for food which we find hard to overcome. It is a challenge to resist the temptations of unhealthy foods we encounter and stick to our diet plan. We find reasons and excuses to give up healthy eating. Some common excuses are: - Healthy options are hard to find when eating out; - Healthy options are more expensive or more time-consuming to prepare; - I don’t know which foods are healthy; - I go along with what my family and friends like; - It is hard to change eating habits; - It is hard to keep track of what I eat and count calories; - It is hard to formulate my daily nutritional requirement; - I see no difference when I change my diet. The best way to start eating healthier is by taking small steps gradually. This means changing bad eating habits into good eating habits slowly. Consider starting with small, manageable changes [2] . For example, if you usually skip 9

breakfast, start the day with a nutritious breakfast. If you do not eat vegetables, start having a serving of vegetables three times a week. If you consume soft drinks daily, start limiting the amount of soft drinks to three cans weekly. If you do not drink enough plain water daily, start drinking one extra glass weekly till you reach the recommended amount. Research shows that taking baby steps and not giant leaps is the best way to get lasting results. A study published in the Annals of Behavioral Medicine, found that participants who made one small, potentially permanent change in their food choices showed great improvement, compared with those who followed traditional calorie restriction [3]. Reiterating the effectiveness of this approach, Lesley Lutes, an assistant professor in the department of psychology at East Carolina University said: “When you focus on just a couple of small changes at a time, you begin to ingrain some healthy habits that last for a lifetime, rather than trying an all-ornothing approach that more often than not fails because it’s too hard to follow.” [4]

How Do You See Your Body? WRITTEN & ILLUSTRATED BY SULTAN ASHARDEEN

Healthy lifestyle begins in the mind, like having the right body image.

How often have we wanted to look like celebrities with perfect bodies? How often have we seen images of models with slim figures and chiselled abs labelled “healthy”? How often have we pinched our belly fat in dismay or disgust? Body Image includes how we perceive our bodies visually, how we feel about our physical appearance, how we think and talk to ourselves about our bodies, our sense of how other people view our bodies, our sense of our bodies in physical space and our level of connectedness to our bodies [1] . Having a positive body image means having a clear, true perception of your body shape and refusing to spend an unreasonable amount of time worrying about food, weight and calories. Having a negative body image means having a distorted perception of your body shape and feeling uncomfortable, anxious and ashamed about your body [2]. Negative body image increases the risk for extreme weight control behaviours, such as extreme dieting, exercise compulsion, laxative abuse, vomiting, smoking and use of anabolic steroids [1]. Eating disorders can be caused by family history, personality traits and

social factors. Popular media also attracts blame for perpetuating the desirability of unrealistic body types. Among 5th to 12th grade girls surveyed, 47% reported wanting to lose weight because of magazine pictures, 69% said that magazine pictures influenced their idea of what the “perfect body” looks like [3]. However, only 5% of women naturally have the body type (tall, genetically thin, broad-shouldered, narrow-hipped, long-legged and usually small-breasted) portrayed as the ideal in advertising [4]. In Singapore, the number of patients suffering from eating disorders like anorexia and bulimia has been rising sharply. Figures from Singapore General Hospital (SGH) showed that 95 youngsters aged 13 to 19 suffered from anorexia or bulimia in 2012, up from 65 in 2011 and 75 in 2010 [5] . Dr Lee Huei Yen of SGH shared that: “At SGH, we see about 11 new cases every month. Among psychiatric disorders, eating disorders have the highest mortality rate, with the rate for anorexia ranging from 5 to 15%.” The mean age of the onset of anorexia was 15.5 years and 25.4% of patients were found to be suffering from depression [6]. In a survey I conducted on young adults aged 17

to 24 studying in Singapore’s tertiary institutions, 60% of respondents admitted to losing self-esteem and confidence when they reflected on their own body in comparison to that of a celebrity. 50% of respondents exercise and work out regularly in order to look like their idols. However, there are reasons why one may never attain that “perfect body”. Firstly, one may not have access to a professional personal trainer or nutritionist. Secondly, it is not possible to always count calories in order to achieve the goal of looking the part. Lastly, it may be genetic. Some people are just born with higher muscle percentage than the rest. However, regardless of background, you can still be healthy and you don’t have to look chiselled to be healthy. Young adults should strive to be healthy, instead of striving to look like they are healthy through hurting themselves, such as starving, binging and purging, and over-exercising. Changing one’s body image can be a challenge, but it can be done. It starts with accepting yourself for who you are.

Sitting, the New Smoking WRITTEN & PHOTOGRAPHED BY JAMIE TEO JIN MEI

Mere physical activity brings tremendous health benefits.

Physical inactivity has become one of biggest health issues worldwide. Many are still unaware about its long-term health consequences. It is hard to get young adults in tertiary institutions moving, because they do not really appreciate the benefits of getting off their seats.

minutes (20% of their day) or more sitting [4]. Sitting for more than three hours a day can cut two years off a person’s life expectancy, even if you exercise regularly [5]. Sitting literally kills. Whether you exercise or not, you still need to cut down the time sitting in a chair.

and 4.8% did not want to give up on “self-treats”. I found out that young adults find planning for physical activity too much trouble, get easily distracted by peers and find fast food too tempting. They are reluctant to get up from their seats, preferring to watch television or play games on devices to de-stress.

Obesity is not just a lifestyle disease. It is a lifestyle choice. A 2010 study of health conditions of Singaporeans by Singapore’s Ministry of Health estimated that if nobody was overweight or obese, we could prevent almost 70% of the diabetes burden and almost 20% of the cardiovascular disease burden in Singapore [1]. Therefore, it is important to inculcate healthy lifestyle habits from young.

In recent years, the lifestyle of youths is getting even unhealthier. According to the 2013 AIA Healthy Living Index, Singaporeans gave themselves 6.6 out of 10 on how satisfied they were with their health overall, below the regional average of 7 [6]. Youths are always staying up late and end up sleeping only when the sun rises. They spend about 8 hours studying and 6 hours sleeping. Some even pick up unhealthy habits such as smoking and excessive consumption of alcohol and fast food.

However, I observed that youths actually enjoy exercising with friends. Scientists studied kids’ physical activity levels over 12 weeks and found that friends have a strong influence on physical activity [7]. Children changed their activity level to match that of their 4 to 6 closest friends, and changed their exercise level about 10% to better match friends in their circle [8]. Even though the study was conducted on young children, it suggests a promising opportunity for health promotion and intervention among young adults.

Physical inactivity causes as many as 1 in 10 premature deaths around the world each year, roughly as many as smoking [2]. A study published in The Lancet estimated that about 5.3 million of the 57 million deaths worldwide in 2008 could be attributed to inactivity. If physical inactivity could be reduced by just 10%, it could avert some 533,000 deaths a year; if reduced by 25%, 1.3 million deaths could be prevented [3]. Worldwide, people spend about 300

What prevents young adults from adopting the healthy lifestyle? I conducted a survey with 30 youths aged 18 to 24 studying at tertiary institutions to find out. About 47.6% of respondents cited a busy lifestyle, 23.8% cited lack of motivation to exercise, 9.5% found the healthy lifestyle a hassle, 9.5% said there were too many choices to make right, 4.8% were reluctant to change

Overcoming Excuses for Not Exercising WRITTEN & ILLUSTRATED BY TOH YI SHIN

Simple steps can be taken to address lack of motivation and time.

I don’t have money to go to the gym.

Exercising requires too much effort, I am too lazy to start.

I have no time to go exercise, there are so many things to do!

Lack of physical activity is as deadly as smoking—about 5.3 million of the 57 million deaths worldwide in 2008 could be attributed to inactivity [1]. Governments and organisations around the world feel the pressure to come up with solutions to this pandemic. Most students think that since they do not have Body Mass Index (BMI) issues, they do not have to exercise. However, exercising regularly not only improves your health, it also improves concentration, reduces stress and increases energy levels. It has been reported that Singapore teens are just not active enough. A study was done by National Institute of Education (NIE) with the help of 244 students from seven secondary schools. It was found that the number of steps the students took was 16% higher in school than outside on weekdays, and boys were more active than girls. None of the students met the national guideline of having at least one hour of moderate to vigorous physical activity a day. Blood tests on 229 participants showed that close to 12% were at risk of metabolic syndrome characterised by increased blood pressure, high blood sugar level, excess fat around the waist and abnormal cholesterol levels, putting

them at risk of heart disease, stroke and diabetes. Half of this 12% were of normal or under-weight, meaning that this was caused by sedentary lifestyle and not underlying weight or BMI issues [2] . These behaviours, if continued, will threaten their future health. Most people who do not exercise come up with many excuses. Some common excuses are lack of motivation, lack of affordability, lack of time and not knowing how to start. Among tertiary students, the most common excuses are lack of motivation and time. From my survey of 30 tertiary students aged 18 to 28, respondents said that they would expect some physical improvement (for example, more physically attractive) from exercising instead of just getting healthier. They would also hope to obtain some reward as a form of motivation, such as ActiveSG $100 credit for exercising [3]. The other excuse that most tertiary students gave was the lack of time. Most of them mentioned that they didn’t have time as they needed time for studying, besides some work part-time. Since studying is their priority, they forfeit the idea of exercising as a part of their lifestyle.

Identifying and acknowledging these excuses is the first step towards overcoming them. Motivation can be boosted by making a deal with yourself do 10 minutes of exercise (often leading to a full workout), listening to uplifting music before and during exercise, having a workout buddy, wearing a pedometer to count number of steps taken and setting up a token reward system for achieving stages of exercise [4]. To address lack of time, identify at least three 30-minute time slots per week you could use for physical activity, add physical activity to your daily routine and select activities requiring minimal time, such as walking, jogging, or stair climbing [5]. Young adults should not just be told about the dire consequences of a sedentary lifestyle, they should be introduced to simple steps to overcome specific excuses. This would have a huge impact on the future health of adult Singaporeans.

The Wonders of Sleep WRITTEN & ILLUSTRATED BY NURFADLIN FAZIRAH

The importance of a good night’s sleep is not to be lightly dismissed.

To most students, sleep is simply for rest after a long day’s work. They do not understand that quite the contrary, sleep is far more important. Sleep is essential to ensure that we are developing healthily and our body processes are maintained. This is why sleep hygiene, encompassing habits and practices that are conducive to sleeping well on a regular basis, is crucial. To have good sleep hygiene is to practise behaviour that improves sleep quality and ensures sufficient sleep duration, leading to full preparedness during the day [1]. The main obstacle to students’ sleep hygiene is their endless attachment to their phones. The National Sleep Foundation found that 95% of teens usually lie in bed with their phones till they fall asleep, checking their phones as soon as they wake up. These bad habits usually go unnoticed as students are not aware that it actually affects their sleep quality. Researchers caution against the use of electronic devices such as television, computer and cell phones before sleep, as artificial light can suppress melatonin which is our sleep hormone [2]. Poor sleep hygiene usually causes youths to feel sleepy during the day.

It also increases their susceptibility to depression, anxiety and poor physical health. These problems can affect a student’s academic achievement, causing decreased motivation to participate in school, decreased alertness and concentration [1]. Good sleep hygiene practices include avoiding naps during the day, as naps disturb the normal pattern of sleep and wakefulness. Consuming stimulants such as caffeine, nicotine, alcohol and food too close to bedtime can also disrupt sleep as your body would still be processing the consumption while in bed. Ensuring adequate exposure to natural light helps maintain a healthy sleep-wake cycle. Establishing a regular relaxing bedtime routine is also recommended so you should try to avoid emotionally upsetting conversations and activities before trying to go to sleep. Another good practice is to associate your bed with sleep, instead of using it to watch television, listen to the radio or read [3]. Sleep hygiene was never brought up or taught in schools, so students do not know any better. This lack of knowledge leads them to practise poor sleep hygiene, leading to their lack of good healthy sleep. I strongly feel, as 13

a student myself, that such knowledge should have been shared and taught to us, so that we could take better care of ourselves. Usually when being told the dire consequences of an action, people start to take notice of the importance of practicing the rituals that help them avoid these problems. Looking at examples of good sleeping habits, I admit that I don’t practise any of them and I can finally see why my body tires so easily and I always feel sleepy. Schools do acknowledge that teens are getting less and less sleep, and students are even proud when they don’t sleep as much as required, such as pulling all-nighters. However, for them to learn effectively, both mind and body must be ready and healthy. If students know what sleep hygiene is, they would probably do much better and be more attentive in class. They would be full of energy and refreshed due to a good night’s sleep, ready to take on school the next day. Brains would be fully charged and they would not feel so sluggish all the time. So knowing all this, schools should ensure that students are equipped with knowledge about sleep hygiene, so that they can live better and learn better.

Smoking among Young Adults WRITTEN & PHOTOGRAPHED BY MUHD FAQIH

Peer pressure and support can be utilized for smoking cessation.

Smoking used to be an act of rebellion. Now smokers smoke to assert their independence, or ironically, to achieve a sense of belonging. Tobacco companies encourage youths to smoke and reinforce smoking as an important rite of passage [1] [2]. They advocate a subconscious form of rebellion and sell youths the concept of attaining the unattainable. Luckily, the Singapore government restricts their reach by banning the advertising of tobacco products. They have also increased taxation on tobacco products. As an added precaution, Singapore’s Health Promotion Board is considering raising the age limit for tobacco purchase from 18 to 21 [3]. All this means that the number one factor influencing young adults to smoke is their peers. My survey of 30 students in tertiary institutions showed that most young smokers do not smoke alone and their friends play an important part in frequency and quantity smoked. Through my survey, I uncovered a few insights. Firstly, the majority tried to quit at least once. This means that they have the desire to quit. Secondly, no money means no cigarettes. If they can’t afford to buy cigarettes, they can’t

smoke until they get enough money. Thirdly, they see smoking as a social activity much like bowling or basketball. Lastly, smokers who revert to smoking after multiple attempts to quit just give up on quitting altogether. Through my research, I identified the top two reasons why Singaporean young adults are not motivated to quit smoking. First, they find smoking a hard habit to break much like nail biting. Second, they have a negative impression on alternative methods to quit smoking. For example, it has been shown that Nicotine Replacement Therapy (NRT) increases the success of initially quitting smoking by 50 to 70% [4] . Yet, many young smokers harbour the misconception that nicotine patches, gum, lozenges, inhalers, and nasal sprays contain more nicotine than cigarettes. This myth closes a proven route to smoking cessation. When smokers are in a pinch financially, they cut down their spending on cigarettes, through buying a cheaper brand, bringing a set number of cigarettes with them, sharing the cost of a pack between friends, or resorting to the bare minimum of “stenging” or “rolling” a cigarette. These two terms

are uniquely Singaporean. “Steng” refers to one smoking half a cigarette before passing the remaining half to the other person. “Rolling” takes place when one takes three puffs of a cigarette, before passing it on to the next person. By doing this, smokers are actually cutting down their nicotine intake. For a young adult smoker in Singapore, smoking is a tough habit to break. It may be daunting to quit smoking alone. It is more sensible to do it with a group of friends so that they can motivate each other. It has been shown that the success rate is higher when one quits with a group [5]. The success rate is also improved with medical help [6]. Taking into consideration the heavy influence of peers, misconceptions about NRT and the general lack of reason to quit, smokers need a little push and a lot of support to quit. It takes a large amount of willpower and determination to quit. Supportive peers are key to keep one going. For a smoking cessation programme to work, these considerations must be taken into account.

ZZZ

MAKAN QUEST Kok Mei Rong

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UH OH!

New pimples grew today.

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Grow healthy together with your avatar Your avatar grows healthier when you eat healthy food and complete makan quests.

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Accept the quest ‘Fruit Swap’?

YOU DID IT! MAKAN TIME We salute you for your determination to complete this quest!

REJECT

MAKAN TIME

QUESTS

COMPLETION

During meal times, tap on the button to play Makan Quest.

Complete food quests to grow your avatar.

A salute is given when you complete your quest.

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UH OH!

New pimples grew today.

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HAPPY AVATAR

AVATAR IN TROUBLE

UH OH!

Eating healthy food or completing quests makes your avatar happy.

Eating unhealthy food or missing quests inflicts harm.

Your avatar grows pimples when you eat oily or fried food.

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You received an audio message from Mei Rong on your avatar’s achievement. 0:05

ent you a message on completin start to eat green already!”

Mei 46

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ACHIEVEMENTS

You received an audio message from Eunice on completing the quest ‘Fruit Swap’.

GREEN EATER Had eaten greens thrice in a week

Bobby sent you a message on you being a toad: “HAHAHA, your avatar now looks like you.”

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AVATAR PROFILE

GOODIES

CONNECT WITH FRIENDS

An overview of your avatar’s mood, luck and achievements.

Earn tokens from completed quests to redeem sports accessories.

Connect with friends over each other’s makan quests.

Hey, Steng with Tom? Ron wants to steng with you!

Tom No. of cigarettes per day

10 Brand of cigarettes

Winston Reds

Quitting alone is tough. Invite your friends to quit with you on Stub-It.

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SELECT DIFFICULTY

STUB OR STENG

SEND AND RECEIVE

Choose your desired level of difficulty.

Cut down smoking when you stub or steng with your buddies.

Receive encouraging messages from your buddies. Send them one too!

21:00

100%

SET GOALS

LEVEL UP

ACHIEVEMENTS

Planning improves discipline, so set your goals on Stub-It.

Earn experience points whenever you achieve your goals.

Bravo! Your valiant efforts are rewarded with special medals.

Soh Sher Mei

January M

Youâ&#x20AC;&#x2122;re almost there!

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14 DAY

Not sure how to change your diet? HealthBits does the job for you. HealthBits analyzes your diet habits, and replaces bad habits with good habits. All within 7 days!

21:00PM 12:34

100%

21:00PM 12:34

100%

21:00PM 12:34

100%

Identify bad eating habits

CHALLENGE

PROFILE

SET REWARDS

This screen commences the start of your 7-day challenge.

Suggest rewards your friends can contribute to motivate you.

21:00PM 12:34

21:00

100%

21:00PM 12:34

100%

INPUT MEALS

ACHIEVEMENT

ANALYSIS REPORT

Key in what you have eaten during the day to keep track of your diet.

You will be rewarded with special badges to celebrate your efforts.

After 7 days, HealthBits analyses your good and bad diet habits.

12:34 21:00PM

21:00

100%

ADVISORY PLAN

SUCCESS

FAILURE

Select your preferred plan to commence your change of habits.

You will be rewarded by your friends for your success!

Oh no, there are penalties to pay for failure!

Shake It Off is here to turn your boring class break into something fun, competitive and healthy! With a vast array of the latest tunes to get you moving, you and your friends will never get bored or groggy for class again!

21:00

100%

21:00

100%

Sunrise Slash!

Show your friends what you’re made of!

MODES

THEMES

POWER MOVES

Switch between different tunes and modes to dance and jiggle with.

Other than tunes, there is a wide range of themes to challenge with.

Unleash power moves to gain extra points during a dance-off.

21:00

100%

21:00

100%

GruuveMasta

Guest S

Sound the alarm with some dangerous moves

VOTING ROUND

WEEKLY STATISTICS

UNLOCK THEMES

Vote on the funniest or best dancer among friends.

Check on your physical activity progress on a weekly basis.

Unlock exclusive themes when you achieve your goals.

21:00

Rec

100%

1:02 / 3:00

1:02 / 3:00 1:02 / 3:00

CHALLENGE

REPLAY

Get competitive with your best moves, and have fun coordinating!

Replay the best moments for voting and laugh it off too!

Healthy begins in your mind.

What is your Body Image? What is the right Body Image for you? How do you balance diet and exercise? Curo improves your health with customized diet and exercise plans using its exclusive Body Image Management System. Balance it out with Curo.

21:00

100%

21:00

100%

21:00

100%

MAIN MENU

OVERVIEW

DIET

Access key features at the home screen.

A summary of your calorie intake.

Key in what you eat for your daily meals.

21:00

100%

EXERCISE

PROFILING

BODY IMAGE ANALYSIS

Keep track of your daily physical activities.

Profile of the user.

Bring awareness of your body image to a whole new level.

21:00

100%

PROGRESS CHART

WEIGHING SCALE

BALANCED

Your weekly process at one glance.

How to balance your diet and exercise.

Enjoy the benefits of your balanced healthy lifestyle!

Toh Yi Shin

100%

Bl n e re

d Yello

21:00

Taking the stairs is never boring with Stair Racer!

21:00

100%

21:00

100%

Bl n e re

d Yello

INVITE FRIENDS

CAMPUS MAP

START GAME

Spot your friends and invite them to race you up a flight of stairs!

Browse through the campus map and see where you can play.

Familiarise yourself with the rules before starting the game.

21:00

100%

21:00

100%

1 2 3 4 5

3pts

Jaquelin

TIMER

LEADERBOARD

BENEFITS

The referee times how long each runner takes to race up the stairs.

Compete and compare with your friends on the weekly leaderboards.

Behold, Stair Racer counts up how many calories you have burnt!

ZZZ

Z Z Z Monster Nurfadlin Fazirah

ZZZ

21:00

12:34

100%

Tuesday, February 17

TIP 1

DO NOT

slide to unlock

EXERCISE promotes good sleep SHARE

TIP 2 TIP 2

DON’T eat spicy food before bed

There’s a monster. Not under your bed, but in your phone telling you to sleep! Sleep works wonders. Adopt the ZZZ Monster, your personal sleep buddy, to improve your sleep quality and enhance your health. Feel restored, recharged and ready to take on the world with ZZZ Monster!

21:00PM 12:34

100%

BEDTIME

100%

12:34 Tuesday, February 17

ZZZ

Normal Mode

21:00

Discpline Mode

DO NOT

slide to unlock

WELCOME

SELECT MODE

LOCK SCREEN

Select your preferred mode to cater to your sleep needs.

Note: “Do not slide to unlock”. A gentle reminder for you to sleep.

12:34 21:00PM

21:00PM 12:34

100%

DON’T

You have slept 7 hours!

BEDTIME

7 EXP

+ z

100%

nap during the day

Lvl 1 7/49 EXP

EXPERIENCE POINTS

HOME SCREEN

SLEEPING TIP

Exchange the number of hours you slept for experience points.

Set bedtime or access ZZZ Monster’s inventories.

ZZZ Monster provides tips for you to sleep better at night.

12:34 21:00PM

100%

EXERCISE

SingTel

21:00 6:00 pm 12:34 PM

100%

promotes good sleep

21:00PM 12:34

100%

FRIENDS

SHOP

Mandy Hoo Lvl 3 VIEW

Lvl 1

SLEEPING TIP

SHOP

FRIENDS

ZZZ Monster provides another tip for you to have a good night’s sleep.

Upgrade levels to unlock exclusive ZZZ Monsters.

Add your friends and watch how they level up with ZZZ Monster.

Jamie Teo Jin Mei

21:00

Take a Walk with Mr Walk Ball Why sit and work all day? Take a break and take a walk with Mr Walk Ball. Rejuvenate your mind and body, and add more healthy years to your life!

100%

DIET DARE Patricia Yeong Pui Yee

21:00 12:34 PM

100%

12:34 21:00PM

100%

CRUNCHY CELERY Stuff your mouth full of celery for 5 mins! Then swallow it down!

5:00

Spin the Wheel for a Crazy Diet Dare Challenge yourself and your friends to a series of crazy diet dares. Break the monotony of school with Diet Dare forfeits. Go healthy with memorable extreme fun!

Taking a stroll among greenery is no longer a bore Take on a competitive stroll with your friends and see who is the ultimate walker among the greenery!

Notes Your Friends = Your Health [1] A.D.A.M. (Animated Dissection of Anatomy for Medicine). Adolescent development. New York Times. http://www.nytimes.com/health/ guides/specialtopic/adolescent-development/ news-and-features.html [2] Debra Umberson, Robert Crosnoe, and Corinne Reczek (2010). Social Relationships and Health Behavior Across the Life Course. Annual Review of Sociology, Vol. 36: 139-157. [3] Hartwell-Walker, Marie (2014). Click or Clique: Positive and negative teen social groups. PsychCentral. http://psychcentral.com/lib/clickor-clique-positive-and-negative-teen-socialgroups/0001507 [4] Becca (2014). Peer pressure. http:// us.reachout.com/facts/factsheet/peer-pressure [5] Health Promotion Board, Singapore (2013). Taking peer pressure by the horn. http://hpb. gov.sg/HOPPortal/gamesandtools-article/HPB047064 [6] Lockton, Dan (2012). Social and Interpersonal Approaches to Design for Behaviour Change. http://ssrn.com/abstract=2124913 or http:// dx.doi.org/10.2139/ssrn.2124913 You Are What You Feel Like Eating [1] Epidemiology and Disease Control Division, Ministry of Health, Singapore. National Health Survey 2010. ISBN 978-981-08-8540-3. [2] Super Size Me, Dir. Morgan Spurlock, 2004, Film. [3] The Coxford Singlish Dictionary. talkingcock. com. Junk Food Junkies [1] Junk food addicts show same brain activity as drug addicts. The Independent. 7 April 2011. [2] Andrew O. Odegaard, Woon Puay Koh, Jian-Min Yuan, Myron D. Gross, and Mark A. Pereira (2012). Western-Style Fast Food Intake and Cardio-Metabolic Risk in an Eastern Country. Circulation. [3] Smellie, Alice (2011). Why we crave sugary snacks... and not fruit and veg MailOnline. http://www.dailymail.co.uk/health/ article-1382217/Why-crave-junk-food-fruitveg.html [4] Brodwin, Erin (2014). Science Finally Explains Why We’re So Addicted To Junk Food (And It’s Bad News). Mic. http://mic.com/articles/97654/science-finally-explains-why-we-reso-addicted-to-junk-food-and-it-s-bad-news [5] Martinez, Eliza (2011). Why are Healthy Snacks Important? livestrong.com. http:// www.livestrong.com/article/392588-why-arehealthy-snacks-important/

Small Steps to Healthy Eating [1] Poon, Chian Hui (2013). Singaporeans Overeating Despite Healthier Diet. The Straits Times. 8 February 2013. [2] Blackford, Ann (2014). Small Changes are Sometimes More Effective than a Diet Overhaul. University Of Kentucky News. 8 July 2014. [3] Lutes LD, Winett RA, Barger SD, et al (2008). Small Changes in Nutrition and Physical Activity Promote Weight Loss and Maintenance: 3-Month Evidence from the ASPIRE Randomized Trial. Annals of Behavioral Medicine 2008 Jun; 35(3): 351-7. [4] Shaffer, Alyssa (2014). 15 Teeny Tiny Changes To Lose Weight Faster. Prevention. 24 March 2014. http://abcnews.go.com/Health/15-teenytiny-lose-weight-faster/story?id=22982981 How Do You See Your Body? [1] Brown University Health Promotion. http:// www.brown.edu/Student_Services/Health_Services/Health_Education/nutrition_&_eating_ concerns/body_image.php [2] National Eating Disorder Association. http:// www.nationaleatingdisorders.org/what-bodyimage [3] Levine, Michael (1998). Prevention of Eating Problems with Elementary Children, Michael Levine. USA Today. July 1998. [4] The Renfrew Center Foundation for Eating Disorders (2003). Eating Disorders 101 Guide: A Summary of Issues, Statistics and Resources. 2003. [5] Tan, Rachel (2013). More youngsters diagnosed with eating disorders. The Straits Times. 13 Oct 2013. [6] Chandra, Anjana Motihar. Obsessed About Being Thin? Signs That You Might Be Suffering From Anorexia. HealthExchange. Sitting, the New Smoking [1] Singapore Burden Of Disease Study 2010. Report. Ministry of Health, Singapore. 10 February 2012. [2] Park, Alice (2012). Lack of Exercise as Deadly as Smoking, Study Finds. TIME. 18 July 2012. [3] Lee, I-Min et al (2012). Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. The Lancet, Volume 380, Issue 9838, 219 - 229. [4] Park, Alice (2012). Get Up! Sitting Less Can Add Years to Your Life. TIME. 10 July 2012. [5] Katzmarzyk, Peter and Lee, I-Min (2012). Sedentary behaviour and life expectancy in the USA: a cause-deleted life table analysis. BMJ Open. [6] Teng, Amelia (2013). Singaporeans are sleep-deprived and do not exercise enough. YourHealth, AsiaOne. 24 October 2013. [7] Park, Alice (2012). The Upside of Peer Pressure: Social Networks Help Kids Exercise More. TIME. 28 May 2012. [8] Gesell SB, Tesdahl E, Ruchman E (2012). The distribution of physical activity in an after-school friendship network. Pediatrics.doi. org/10.2139/ssrn.2124913

Overcoming Excuses for Not Exercising [1] Park, Alice (2012). Lack of exercise as deadly as smoking study finds. TIME. 18 July 2012. [2] Mann, Denise (2011). Only 12% of High School Students Get Enough Exercise. WebMd. 16 June 2011. [3] Davie, Sandra (2014). Health Risk for S’pore Teens – They Are Not Active Enough: Study. The Straits Times. 17 February 2014. [4] ActiveSG$100 for Singaporeans to play sport. Today. 26 Apr 2014. [5] Murphy, Sam (2008). Get up and get going. The Guardian. 18 March 2008. [6] Centers for Disease Control and Prevention. Overcoming Barriers to Physical Activity. Physical Activity for Everyone. 22 May 2007. doi.org/10.2139/ssrn.2124913 The Wonders of Sleep [1] Effendi, Ferry (2013). Sleep hygiene behavior among Balinese adolescent. 18 November 2013. www.sciedu.ca/journal/index.php/jnep/ article/view/3217 [2] Nicholson, Christie (2011). Electronic Gadgets Before Bed Can Hinder Sleep. 7 March 2011. http://www.scientificamerican.com/ podcast/episode/electornic-gadgets-beforebed-can-h-11-03-07/ [3] Thorpy, Michael (2004). Sleep Hygiene. National Sleep Foundation. 23 December 2014. http://sleepfoundation.org/ask-the-expert/ sleep-hygiene. Smoking among Young Adults [1] R. J. Reynolds Tobacco Company. 1981 segmentation study. 1981. http://www.rjrtdocs. com. [2] Business Information Analysis Corporation. RJR young adult motivational research. 1985. www.library.ucsf.edu/tobacco/mangini. [3] Siau, Ming En (2014). HPB considers raising legal age for smoking. Today. 21 May 2014. [4] Stead, LF and Lancaster, T (2005). Group behaviour therapy programmes for smoking cessation. Cochrane Database of Systematic Reviews 2005, Issue 2. [5] Boyd, KA & Briggs, AH (2009). Cost-effectiveness of pharmacy and group behavioural support smoking cessation services in Glasgow. Addiction Volume 104, Issue 2. [6] Stead LF, Perera R, Bullen C, Mant D, Hartmann-Boyce J, Cahill K, Lancaster T (2012). Can nicotine replacement therapy (NRT) help people quit smoking? Tobacco Addiction Group. 14 November 2012.

Healthy Lifestyle

Diploma in Experience and Product Design The Diploma in Experience and Product

As Experience Product was a DXPD Experience Design Studio

Design (DXPD) trains students to engage in

publication may be reproduced, stored in a

conducted by

various design research methods, leading

retrieval system or transmitted in any form

KKO: Strategic Thinking & Design

to the creation of meaningful and relevant

or by any means, electronic, mechanical,

in collaboration with SP Design School

engagements. Equipped with an array of skills

photocopying, recording or otherwise

and Health Promotion Board.

and knowledge from materials exploration,

without prior consent from the copyright

haptic experimentation to prototyping,

owners.

Studio Leader & Editor (Publication) KK Ong Project Manager (Publication) Amelia Yuliana Binte Jamil Assistant Art Director (Publication) Kok Mei Rong Assistant Copy Editor (Publication) Muhammad Faqih Bin Razali

ideation and design communication, students are able to create and design experiences

While the publisher and author(s) have

through both tangible and intangible forms

taken all reasonable care in the preparation

of products and services as the medium.

of this publication, the publisher and the author(s) make no representation, express

KKO: Strategic Thinking & Design KKO: Strategic Thinking & Design is a

or implied, with regards to the accuracy of

brand, experience and communication

and cannot accept any legal responsibility or

design consultancy based in Singapore, with

liability for any errors or omissions from the

expertise in the services, entertainment, arts

publication or the consequences thereof.

the information contained in the publication

and education sectors. Products and services that are referred to Health Promotion Board Established in 2001, the Health Promotion

in this publication may be either trademarks

Board (HPB) has a vision to build a nation

owners. The publisher and author(s) make no

Studio Members Amelia Yuliana Binte Jamil

of healthy people. Although residents in

claim to these trademarks or their respective

Singapore today enjoy good health with high

logotypes.

Chua Siew Lee

life expectancy and low mortality rates, we

Eunice Chua Kiat Ling

want to further improve our health status

Ho Yun Long

and continue to enjoy good health as we age.

Jamie Teo Jin Mei

To achieve this, HPB assumes the role of the

Kok Mei Rong

main driver for national health promotion

Muhammad Faqih Bin Razali

and disease prevention programmes. Our

Nicholas Boay Kai Xun

goal is to increase the quality and years of

Nur Aqirah Binte Rosle

healthy life and prevent illness, disability and

Nurfadlin Fazirah Binte Abdul Manaf

premature death.

Studio Facilitator Sultan Ashardeen

Patricia Yeong Pui Yee Soh Sher Mei Sultan Ashardeen Toh Yi Shin

or registered trademarks of their respective

I am embarrassed to exercise by myself. Jia Li, 20

Healthy food does not taste that good. Chin Yee, 20

Smoking doesnâ&#x20AC;&#x2122;t affect me much, Iâ&#x20AC;&#x2122;m supplementing it with exercise. Phyucyn, 19

As long as I am alive and breathing well, then I am healthy enough. Tisya, 20