Designing Consumer Health Information Technology to Support Biform and Articulation Work: A Qualitative Study of Diet and Nutrition Management as Patient Work.

Courtney C Rogers,Thomas J Moutinho,Rupa S Valdez,Xiaoyue Liu

doi:10.2196/27452

Courtney C Rogers, Thomas J Moutinho + Show 2 more

Open Access

https://doi.org/10.2196/27452

Copy DOI

Abstract

BackgroundDiet and nutrition management is an integral component of Crohn disease (CD) management. This type of management is highly variable and individualized and, thus, requires personalized approaches. Consumer health information technology (CHIT) designed to support CD management has typically supported this task as everyday life work and, not necessarily, as illness work. Moreover, CHIT has rarely supported the ways in which diet and nutrition management requires coordination between multiple forms of patient work.ObjectiveThe purpose of this study was to investigate diet and nutrition management as biform work, identify components of articulation work, and provide guidance on how to design CHIT to support this work.MethodsWe performed a qualitative study in which we recruited participants from CD-related Facebook pages and groups.ResultsSemistructured interviews with 21 individuals showed that diet and nutrition management strategies were highly individualized and variable. Four themes emerged from the data, emphasizing the interactions of diet and nutrition with physical, emotional, information, and technology-enabled management.ConclusionsThis study shows that the extent to which diet and nutrition management is biform work fluctuates over time and that articulation work can be continuous and unplanned. The design guidance specifies the need for patient-facing technologies to support interactions among diet and nutrition and other management activities such as medication intake, stress reduction, and information seeking, as well as to respond to the ways in which diet and nutrition management needs change over time.

Highlights

Crohn disease (CD), a type of Inflammatory Bowel Disease (IBD), affects approximately 3 million people in the United States [1]
Semistructured interviews with 21 individuals showed that diet and nutrition management strategies were highly individualized and variable
Four themes emerged from the data, emphasizing the interactions of diet and nutrition with physical, emotional, information, and technology-enabled management

Summary

Introduction

Crohn disease (CD), a type of Inflammatory Bowel Disease (IBD), affects approximately 3 million people in the United States [1]. One self-management strategy is to identify and eliminate foods that intensify symptoms [17], typically by adopting an elimination diet and food journaling [19]. Adherence to these methods is demanding, due to social pressures to eat at restaurants, stigma associated with food journaling, difficulty entering reliable dietary information, and difficulty maintaining the habit of journaling [19]. Diet and nutrition management is an integral component of Crohn disease (CD) management This type of management is highly variable and individualized and, requires personalized approaches. CHIT has rarely supported the ways in which diet and nutrition management requires coordination between multiple forms of patient work

Results

Discussion

Conclusion