SKINHALE
DATE: December 2022
TYPE OF WORK: Group Project, 3 Members
IMPACT: Increase the effectiveness of cognitive grounding and self-soothing techniques to mitigate traumatic stress in users.
CONTRIBUTION: Literature Review, Wearable Circuit Design, and User Testing
RESEARCH METHODS: Usability Testing, Deductive Qualitative Research
FIELD: Interaction Research, Wearable Development, Trauma-Informed Design
01. Overview
Traumatic stress responses such as anxiety can have long-term health consequences. Mindfulness practices like deep breathing and body awareness can help lower stress when coping with trauma. We explored using on-skin wearables to support mindfulness during traumatic stress through a soma design approach focusing on the user experience. As a case study, we created skINHALE, a conductive gold leaf tattoo spiral connected to a vibration motor in a crochet patch. Users can trace the spiral to guide their breathing while the vibration patch draws attention to areas of the body storing tension. skINHALE helps users ground themselves and bring attention and intention back to the body through self-soothing touch.
02. Introduction
Guiding Question: How can we design to increase post-traumatic awareness within the body?
Context:
Experiencing a traumatic event is unfortunately common and widespread with some studies estimating that up to 70 percent of people will undergo at least one traumatic event in their lifetime. Post-traumatic reactions differ across individuals and can range from psychological and emotional stress responses such as anger and fear to physical responses such as storing tension and experiencing panic attacks. In 2022, trauma has been called to attention as a pressing consideration in HCI and design research.
What is somaesthetic design?
Research shows that connecting with the body through movement-based practice such as yoga, massage, and self-soothing touch, and mindfulness techniques can support post-traumatic healing. The somaesthetic design framework or "Soma Design" focuses on the experiential body by emphasizing "a qualitative shift in interaction design to an experiential, felt, an aesthetic stance that encompasses the entire design and use cycle". Mindfulness, the meditative practice of being present and aware of one’s bodily sensations, thoughts, and feelings, can support the alleviation of traumatic stress in conjunction with movement- and touch-based practices such as yoga and massage. Soma design research related to mindfulness includes research on sensing breathing, noticing one’s heartbeat through bodily awareness, and designing prototypes to support body relaxation.
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03. Design Inspiration
Examples
On-skin interfaces are a research area that integrates design, engineering, and HCI to explore the possibilities of applying technology to the body through slim wearables applied directly to the skin. Research in this area generally focuses on the technical process, including material science and fabrication, and the design process such as considering the form and factor, applicable uses cases such as healthcare, and more broadly, user experience. For our design, we drew inspiration from Desmet’s designs for mood regulation called "Mood Wings" which is a plastic butterfly on a wristband that beats at "different rates depending on the wearers’ mood states, thereby supporting personal mood awareness". Other inspirations were taken from the vibration function of the "Apple Watch", "DuoSkin fabrication technique" which uses gold foil to create conductive skin traces, and "the breathing box" which is a deep breathing technique to calm the mind.
04. Design
Goals
Location: Allow users to access the input part of the wearable physically and visually. Increase comfort while using the input segment for prolonged periods of time. The output part of the wearable should be placed over body locations that tighten up during emotional triggers.
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Device type and form: Lightweight, easily attachable, detachable, and resistant to wear and tear. To attach the device directly to the skin, we should use skin-friendly adhesives used in cosmetics or medical domains to prevent allergic reactions.
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Visual appearance and customization: While certain symbols increase social acceptability, others promote stigmatizing societal beliefs. It is hence crucial to design skINHALE to be inconspicuous about its purpose to eliminate unintended emotional harm to the user.
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Input interface: SkINHALE interface should provide perceptible affordances to allow users to input commands using touch efficiently. It should be well-designed to prevent false touch inputs leading to accidental device activation.
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Output: The output device needs to be connected using flexible wiring to the input device. The output device feedback should be strong enough to be felt when worn over clothing but weak enough to be worn directly on the skin.
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Positive user experience: A positive user experience is strengthened by a strong feedback mechanism. To accommodate timely and prompt responses, the device needs to have strong interface connections resistant to daily wear and tear. Further, the fabrication should result in a smooth input surface and a lightweight easily attachable output device that the user would be comfortable wearing all day long.
The forearm and upper arm are easy to touch using fingers.
Shoulders, lower back, lower stomach, and neck are stress centers.
Using anthropometry, we can establishing product sizes.
Good user experience allows the user to relax and ground themselves.
Concept
SkINHALE is based on recent advances in soma design for bodily awareness. The system tries to create a touch-input epidermal device that provided feedback through vibration and lights. SkinHALE can be divided into 1 input and 2 output segments that are all connected to a single microcontroller and battery. A conventional use scenario would have the user wearing SkINHALE throughout a workday. When the user feels triggered by environmental stressors, they activate SkINHALE by pressing the butterfly icon for 3 seconds. The user then uses their finger to
trace the gold swirl pattern while taking a deep breath. A vibration motor turns on to assist the user in breathing in.
Why would someone use skINHALE over Apple watch?
Input device and LED
Output Vibrator
Input device: A swirl inspired by the Fibonacci sequence and fabricated using a gold leaf that uses capacitive touch to detect finger movement. The golden swirl that is divided into three segments (outer, middle, and inner) act as touch buttons and is connected to the microcontroller using conductive tape.
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Output LED segment: The LED is placed close to the gold leaf swirl. It is connected to the microcontroller using conductive threads.
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Output vibration motor segment: The vibration motor (along with the motor driver) is housed between a pair of knit wings and is placed on body parts (under or over clothing) that the user associates as a stress awareness point such as shoulders.
Technical Specifications
05. Fabrication
Process:
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A: Applying conductive material on the vinyl sheet
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B: Sealing metal material from the gold foil tattoo
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C: Connecting LED with conductive threads
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D: Connecting gold foil to the micro-controller with conductive tape
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​E: Vibration motor and motor driver
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F: Sealing the vibration module in the crochet wing
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G: Applying Gold foil swirl, LED, and the micro-controller on
the skin
Experimenting with sizing
Would it be possible to use designs like these as a basis for a speculative + participatory design workshop?
Iterative product design involves creating, building, and testing a product in a series of cycles and allows for continuous improvement by allowing the incorporation of feedback to resolve issues. By testing different gold spiral and crochet wing shapes and sizes we were able to find a balance between ergonomic comfort and universal accessibility.​
Lessons Learnt
Materiality matters
Using conductive wires led to breakage of connections, but insulated wires were too thick for skin tattoos. We have to use conductive thread and insulate it with a PVC sheathing.
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Location matters
The organic curves of an arm would deform the wearable and strech the connections when skin was under tension. We had to use elastic skin adhering materials to allow for deformation.
Hardware matters
To realize our design interactions and feedbacks, the microcontroller used needed to be thin but capable of connecting with multiple electronic parts. We used TinyLilly for our project.
06. Circuit Design and Coding
Circuit Connections:
The Circuit was connected as show in the picture below:
Interaction Design:
The input output conditions were establised as shown below:
Coding
The code was divided into 5 main functions:
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runMovementStart(): Switches on and off the device when the butterfly icon is pressed for more than 3 seconds.
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runMovement(): Constantly detects the location and moving direction of the finger to call triggerLEDColor() and runVibrationPattern() in a timely manner.
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triggerLEDColor(): Changes the LED color between black, red, orange, and green according to runMovement().
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printTouchChanges(): Sends capacitive touch values for the three gold foil sensors to the serial monitor.
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runVibrationPattern(): switches the vibration motor on and off according to runMovement()'s input.
07. Reflection
Feasibility of Similar Designs for Future Design Research
Our research team had one novice and two intermediate designers when it came to fabricating on-skin interfaces. The group had some prior experience working with TinyLilly, and little to no experience working with typical on-skin substrates. As a result, the fabrication process was quite challenging. Reflecting on this experience, bringing in participants to create something similar would be too difficult. It would require simplification, individual support from workshop facilitators, or removing some elements to make this a feasible approach.
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In particular, we had challenges with soldering copper wires which is not a beginner-friendly skill. In addition, we decided to have a crochet patch. While crochet is relatively easy to learn compared to fiber art techniques such as knitting or embroidery, it still requires time and practice for a beginner to learn the necessary foundations. In reflection, similar designs are not feasible without heavy modification.
Soma Designs for Trauma and Beyond
We found that skINHALE could be useful for applications beyond trauma-specific stress responses. For example, tracing an easily concealed spiral as a grounding exercise while at the dentist or before a job interview could provide temporary relief from stress. The soma approach is useful, in this case, as it extends bodily experience across different contexts and use cases. Drawing upon other theories of intimacy and social support to help survivors could be useful to extend beyond individual soma design and explore relationships that on-skin wearables may support. The design of such wearables may exist in a more speculative space, to challenge and broaden our notions around the self and the body. Because on-skin wearables have many limitations today (e.g., reusability, battery power, cost-prohibitive), taking a more speculative design approach may help to answer some current questions about which approaches may help survivors in a trauma-informed manner.
For insights on user testing please refer to the paper by clicking the icon on the right.