Image Courtesy of HKS Inc.

Image Courtesy of HKS Inc.

Point-of-Decision Design (PODD) | Healthy Choice. Healthy Campus. 

Read the Final Report here

Read the Visual Design Guide here

Read the Executive Summary here


Upali Nanda,  Michelle Eichinger, Jessica Hedge, Shelli Dent, Giyoung Park, Timothy Lalowski, Sheba Ross, Ileana Rodriguez, and Erin Peavey

AIA Upjohn Grant, HKS Inc., Patcraft, DuPont, and McCarthy


The objective of this research was to:

1) Understand the chronic problem of obesity on college campuses and the link to diet and activity decisions

2) Discern how and "where" college students make decisions about physical activity and nutrition

3) Synthesize design strategies implemented at the points-of-decision to prompt healthy decisions amongst the myriad choices on typical college campuses

4) Generate a design guide for practitioners to aid point-of-decision design for college students

5) Develop a research concept for future research bringing together the fields of public health and architecture around points-of-decision design


US college campuses can be considered obesogenic environments given the high levels of obesity prevalent today. This is highly impactful on students' mental health and academic performance. Habits formed in college can define post-college life, establishing a critical window of influence that deserves our attention. A key challenge for students is poor decision making regarding healthy choices on basic issues like physical activity and diet. Can design help in this critical decision making?


Utilizing a socio-ecological approach that takes advantage of human interactions within our environments, we see opportunities for providing environmental modifications that make healthy living, easy living. Students face many choices every day, including physical activity and diet, which directly impact their health and wellbeing. The premise behind developing our concept, point-of-decision design (PODD), is that healthy decision-making can be "prompted" by our physical environments through the implementation of effective design intervention strategies at critical points-of-decision throughout the college campus. In many ways, this study focuses on the "tipping point" defined in the dictionary as "the point as which a series of small changes or incidents becomes significant enough to cause a larger, more important change." So what is the tipping point for students to make a healthy decision?  This is what we are calling the point-of decision design.

A preliminary scan of the literature was conducted to compile and assess previous design strategies utilized in health-promoting college campuses and explore any research linking design to decision making amongst students. Design strategies identified were then summarized. This preliminary review found that point-of-decision design has been used by the CDC for tobacco cessation, and later stairwell use, but has not been extensively incorporated by the design community to asses critical points of the most impact. Informed by the literature review, a cross-disciplinary Ideation Session was arranged, inviting 36 participants from all over the US, including: campus facilities planners, architects, designers, public health and student health experts, and undergraduate and graduate students. the basis of the Ideation Session was to discuss critical points-of-decision on college campuses and deliberate upon design strategies at these PODs that can promote healthy choices. A follow-up survey was sent to all attendees to clarify themes emergent from the session. Integrating prior research and the session results, a set ofvisual design guidelines was generated and included in the report. Additionally, a 2-page Letter of Intent for the Robert Wood Johnson Foundation Investigator-Initiated Research Grant was developed with community partners.


Some of the key findings about the value of the Lean-Integrated Project delivery model are listed as:

1. Current literature on designing healthy campuses is more biased towards movement and physical activity than diet. A gap exists that is an opportunity for future design research.

2. Using design for better decision-making is not a very well understood construct. Literature focuses on how healthy context can be created, but not as much on how design can be a catalyst for healthier decisions.

3. Current thinking on healthy college colleges focuses on urban design and campus planning strategies, whereas our findings show that decisions about activity/diet could be made by students before ever stepping into campus. Leveraging technology/ smartphones as part of the design solution is imperative.

4. Point-of-decision is a person-centric - not a place-centric, construct across settings. Understanding diverse user personas and mapping their journeys can aid in determining points of decision. Key points of decision emergent from this literature review include: the smartphone, path, home, dining facility, courtyard, bed, car, corridor, recreation center, classroom, parking location, public space, workstation and online.

5. Behavioral decisions students make are often influences by a range of factors; such factors can be sorted into 4 key constructs: Availability, Access, Affordability, and Appeal.

6. Design strategies to address a person-centered framework that can respond to a myriad of dynamic influences must be considered along a design continuum ranging from information and product design to interior, architecture and urban design. Some strategies emergent from the lit review and ideation include: farmers' markets, communal kitchens, healthy food offerings and placement, hydration stations, recharge zones, open flex spaces, mixed use buildings, lighting strategies, street trees, bike parking systems, and street furnishings.


This research project had relatively small scope, limited by an insufficient library of literature and a one-time ideation session funded by a seed grant. Although the Ideation Session was more cross-disciplinary than many others, a few disciplines such as product design and behavioral economics can be included for more comprehensive future sessions. Additionally, more empirical research on student decision making, the role of the environment in these decisions, and robust case studies are needed at a much larger scale if we are to change our thinking about design as not only a latent context, but an active trigger, in changing health across our college communities.