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 Jr; Xiaoyue Liu; Rupa S Valdez

doi:10.2196/27452

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

JMIR Hum Factors. 2021 Aug 10;8(3):e27452. doi: 10.2196/27452.

Authors

Courtney C Rogers^#¹, Thomas J Moutinho Jr², Xiaoyue Liu³, Rupa S Valdez^{1

4}

Affiliations

¹ Department of Engineering Systems and Environment, University of Virginia, Charlottesville, VA, United States.
² Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, United States.
³ School of Nursing, University of Virginia, Charlottesville, VA, United States.
⁴ Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States.

^# Contributed equally.

PMID: 34383664
PMCID: PMC8386363
DOI: 10.2196/27452

Abstract

Background: Diet 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.

Objective: The 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.

Methods: We performed a qualitative study in which we recruited participants from CD-related Facebook pages and groups.

Results: 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.

Conclusions: This 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.

Keywords: Crohn disease; articulation work; chronic disease; consumer health information technology; context; diet; inflammatory bowel diseases; nutrition; patient work; qualitative research; self-management; user-centered design.

©Courtney C Rogers, Thomas J Moutinho Jr, Xiaoyue Liu, Rupa S Valdez. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 10.08.2021.