Cognition, Technology & Work

, Volume 15, Issue 4, pp 389–401 | Cite as

On participatory design of home-based healthcare

  • Erik GrönvallEmail author
  • Morten Kyng
Original Article


Participatory design (PD) activities in private homes challenge how we relate to the PD process, compared to PD in professional settings. Grounded in a project related to chronic dizziness among older people, we identified four challenges when performing PD with ill, weak users in their private homes. The challenges are (1) designing for, and negotiating knowledge about, the home, (2) ill, weak users and their participation in PD, (3) divergent interests of participants and (4) usable and sustainable post-project solutions. These challenges have to be carefully addressed, and we use them to reflect upon differences between a home-based PD process with non-workers, such as ours, and work-place projects, such as Utopia. Through this reflection, the paper contributes to a more general discussion on PD in non-work settings with weak users. Indeed, differences do exist between traditional PD projects in work settings, such as Utopia, and home-based PD with weak users especially in relation to knowledge about settings and how to reconcile differences in interests. The home as a place for (technology-assisted) treatment and PD must be carefully analyzed. Diverse interests and roles as well as possibilities for post-project solutions should be negotiated among all stakeholders.


Participatory design Challenges Home Healthcare Weak users Participants’ interests and motivation 



We thank the seniors and the physiotherapists participating in our project, the consortium User Driven Healthcare Innovation and the Danish Agency for Science, Technology and Innovation. We also thank Rikke Aarhus (formerly AU) and Simon Bo Larsen, Alexandra Institute for their valuable contributions to the work.


  1. Aarhus R, Ballegaard S, Hansen T (2009a) The eDiary: bridging home and hospital through healthcare technology. Paper presented at the proceedings of the eleventh European conference on computer-supported cooperative work, Vienna, Austria, 7–11 SeptemberGoogle Scholar
  2. Aarhus R, Ballegaard SA, Hansen TR (2009b) SundtHjem projektet—slutrapport (final report). Aarhus University, Aarhus, DenmarkGoogle Scholar
  3. Aarhus R, Grönvall E, Kyng M (2010a) Challenges in participation: users and their roles in the development of home-based pervasive healthcare applications. Paper presented at the 4th international ICST conference on pervasive computing technologies for healthcare 2010, Munich, Germany, 22–25 MarchGoogle Scholar
  4. Aarhus R, Grönvall E, Larsen SB (2010b) Interactive healthcare systems in the home: vestibular rehabilitation. Paper presented at the proceedings of the first international workshop on interactive systems in healthcare, Atlanta, USA, 11 AprilGoogle Scholar
  5. Axelrod L, Fitzpatrick G, Burridge J, Mawson S, Smith P, Rodden T, Rickets I (2009) The reality of homes fit for heroes: design challenges for rehabilitation technology at home. J Assist Technol 3(2):9Google Scholar
  6. Bannon L (1992) From human factors to human actors: the role of psychology and human-computer interaction studies in system design. In: Greenbaum J, Kyng M (eds) Design at work: cooperative design of computer systems. Lawrence Erlbaum, Mahwah, pp 25–44Google Scholar
  7. BDSI (2011) BDSI online publication list.ål/Sider/Publikationer.aspx.2012
  8. Bertelsen WO, Fitzpatrick G, Grönvall E, Höök K, Balaam M (2010) Therapeutic strategies—a challenge for user involvement in design. Paper presented at the workshop at NordiChi 2010, The 6th Nordic conference on human–computer interaction, Reykjavik, Iceland, 16–20 OctoberGoogle Scholar
  9. Bjerknes G, Bratteteig T (1987) Florence in wonderland: system development with nurses. In: Bjerknes G, Ehn P, Kyng M (eds) Computers and democracy—a Scandinavian challenge. Avebury, Aldershot, pp 279–295Google Scholar
  10. Bjerknes G, Ehn P, Kyng M (1987) Computers and democracy: a Scandinavian challenge. Avebury & Gower, AldershotGoogle Scholar
  11. Bødker S, Ehn P, Kammersgaard J, Kyng M, Sundblad Y (1987) A utopian experience. In: Proceedings of the 1986 conference on computers and democracy, pp 251–278Google Scholar
  12. Bødker S, Ehn P, Sjögren D, Sundblad Y (2000) Co-operative design—perspectives on 20 years with ‘the Scandinavian IT design model’. Paper presented at the proceedings of NordiCHI 2000, Stockholm, Sweden, 23–25 OctoberGoogle Scholar
  13. Clemensen J, Larsen SB, Kyng M, Kirkevold M (2007) Participatory design in health sciences: using cooperative experimental methods in developing health services and computer technology. Qual Health Res 17(1):122–130. doi: 10.1177/1049732306293664 CrossRefGoogle Scholar
  14. Clemensen J, Larsen SB, Kirkevold M, Ejskjaer N (2008) Treatment of diabetic foot ulcers in the home video consultations as an alternative to outpatient hospital care. Int J Telemed Appl 2:1–6. doi: 10.1155/2008/132890 CrossRefGoogle Scholar
  15. Crabtree A, Hemmings T, Rodden T, Cheverst K, Clarke K, Dewsbury G, Hughes J, Rouncefield M (2003) Designing with care: adapting cultural probes to inform design in sensitive settings. Paper presented at the OzCHI 2003, Brisbane, AustraliaGoogle Scholar
  16. Dickinson A, Goodman J, Syme A, Eisma R, Tiwari L, Mival O, Newell A (2003) Domesticating technology: in-home requirements gathering with frail older people. Paper presented at the 10th international conference on human—computer interaction HCI, Crete, Greece, 22–27 JuneGoogle Scholar
  17. Egglestone SR, Axelrod L, Nind T, Turk R, Wilkinson A, Burridge J, Fitzpatrick G, Mawson S, Robertson Z, Hughes AM, Ng KH, Pearson W, Shublaq N, Probert-Smith P, Rickets I, Rodden T (2009) A design framework for a home-based stroke rehabilitation system: Identifying the key components. Paper presented at the 3rd international conference on pervasive computing technologies for healthcare. Pervasive Health 2009, London, UK, 1–3 April 2009Google Scholar
  18. Ehn P, Kyng M (1991) Cardboard computers: mocking-it-up or hands-on the future. In: Greenbaum J, Kyng M (eds) Design at work: cooperative design of computer systems. Lawrence Erlbaum Associates, Inc., Hillsdale, pp 169–195Google Scholar
  19. Eisma R, Dickinson A, Goodman J, Syme A, Tiwari L, Newell AF (2004) Early user involvement in the development of information technology-related products for older people. Univ Access Inf Soc 3(2):131–140. doi: 10.1007/s10209-004-0092-z CrossRefGoogle Scholar
  20. Greenbaum J, Kyng M (1991) Design at work: cooperative design of computer systems. Lawrence Erlbaum Associates, Inc., HillsdaleGoogle Scholar
  21. Gregor P, Newell AF, Zajicek M (2002) Designing for dynamic diversity: interfaces for older people. Paper presented at the proceedings of the fifth international ACM conference on assistive technologies, Edinburgh, ScotlandGoogle Scholar
  22. Grønbæk K, Kyng M, Mogensen P (1993) CSCW challenges: cooperative design in engineering projects. Commun ACM 36(6):67–77CrossRefGoogle Scholar
  23. Grönvall E (2009) BDSI:Brugerdrevet sundhedsinnovation.
  24. Grönvall E, Kramp G (2011) LinkLights: a modular, user adaptable system to support rehabilitation practices. Paper presented at the PETRA 2011, the 4th international conference on PErvasive technologies related to assistive environments 2011, Crete, Greece, 25–27 MayGoogle Scholar
  25. Grönvall E, Conci M, Giusti L, Leonardi C (2010) The intrinsic fragility of elderly care networks: five challenges in participatory design practices. Paper presented at the therapeutic strategies—a challenge for user involvement in design—one day workshop at NordiCHI 2010, Reykjavik, Iceland, 17 OctGoogle Scholar
  26. Hillgren P-A, Linde P (2006) Collaborative articulation in healthcare settings: towards increased visibility, negotiation and mutual understanding. Paper presented at the proceedings of the 4th Nordic conference on human-computer interaction: changing roles, Oslo, Norway, 14–18 OctoberGoogle Scholar
  27. Iversen OS, Kanstrup AM, Petersen MG (2004) A visit to the ‘new Utopia’: revitalizing democracy, emancipation and quality in co-operative design. Paper presented at the proceedings of the third Nordic conference on human-computer interaction, Tampere, FinlandGoogle Scholar
  28. Kramp G, Nielsen P, Møller AS (2010) Participatory interaction in therapeutical strategies. Paper presented at the therapeutic strategies a challenge for user involvement in design, a workshop in conjunction with NordiChi 2010, Reykjavik, Iceland, 17 OctoberGoogle Scholar
  29. Kristensen M, Kyng M, Palen L (2006) Participatory design in emergency medical service: designing for future practice. Paper presented at the proceedings of the SIGCHI conference on human factors in computing systems, Montreal, Quebec, CanadaGoogle Scholar
  30. Kyng M (1998) Users and computers: a contextual approach to design of computer artifacts. Scand J Inf Syst 10(1&2):7–44Google Scholar
  31. Kyng M (2010a) Bridging the gap between politics and techniques: on the next practices of participatory design. Scand J Inf Syst 22(1):49–68Google Scholar
  32. Kyng M (2010b) On the multifaceted future of participatory design. Scand J Inf Syst 22(1):93–102Google Scholar
  33. Kyng M, Mathiassen L (1982) Systems development and trade union activities. In: Bjørn-Andertsen N (ed) Information society, for richer, for poorer. North Holland, Amsterdam, pp 247–260Google Scholar
  34. Kyng M, Nielsen ET, Kristensen M (2006) Challenges in designing interactive systems for emergency response. Paper presented at the proceedings of the 6th conference on designing interactive systems, University Park, PA, USAGoogle Scholar
  35. Lawson J, Bamiou D (2006) Dizziness in the older person. Rev Clin Gerontol 15(3–4):187–206Google Scholar
  36. Li J, Wilson L, Stapleton S, Cregan P (2006) Design of an advanced telemedicine system for emergency care. Paper presented at the proceedings of the 18th Australia conference on computer-human interaction: design: activities, artefacts and environments, Sydney, Australia, 20–24 NovemberGoogle Scholar
  37. Norman DA, Draper SW (1986) User centered system design; new perspectives on human-computer interaction. Lawrence Erlbaum, MahwahGoogle Scholar
  38. Nygaard K (1979) The ‘Iron and metal project’: trade union participation. In: Sandberg Å (ed) Computers dividing man and work—recent Scandinavian research on planning and computers from a trade union perspective. Swedish Center for Working Life, Demos Project report no. 13, Utbildningsproduktion, Malmö, Sweden, pp 94–107Google Scholar
  39. Pothula V, Chew F, Lesser T, Sharma A (2004) Falls and vestibular impairment. Clin Otolaryngol Allied Sci 29(2):179–182CrossRefGoogle Scholar
  40. Stiehl WD, Lee JK, Breazeal C, Nalin M, Morandi A, Sanna A (2009) The huggable: a platform for research in robotic companions for pediatric care. Paper presented at the proceedings of the 8th international conference on interaction design and children, Como, Italy, 3–5 JuneGoogle Scholar
  41. Sygeplejeråd D (1977) EDP-handbook for nurses (In Danish: EDB-håndbog for sygeplejersker). Dansk SygeplejerådGoogle Scholar
  42. Torsi S, Nasr N, Wright PC, Mawson SJ, Mountain GA (2009) User-centered design for supporting the self-management of chronic illnesses: an interdisciplinary approach. Paper presented at the proceedings of the 2nd international conference on pervasive technologies related to assistive environments, Corfu, GreeceGoogle Scholar
  43. Von Hippel E (2005) Democratizing innovation. MIT Press, CambridgeGoogle Scholar
  44. Zancanaro M (2010) NetCarity.

Copyright information

© Springer-Verlag London Limited 2012

Authors and Affiliations

  1. 1.Department of Computer ScienceAarhus UniversityAarhus NDenmark

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