Reconceptualizing Technology for Chronic Disease Management Activities in the Family: Supporting Collective Routines

Chronic disease management requires numerous family-based activities. Although HCI has investigated family-based chronic disease management, there is no systematic basis for technology design. Routines support adherence; thus, we used routines theory to: investigate chronic disease management activities in families; the roles of family, patients, and artifacts; activity routinization; and routine interrelationships. The 2-year study included 38 families managing type 2 diabetes and/or HIV/AIDS. Data collection involved individual and family group interviews, surveys, and home tours. Families performed 14 chronic disease management activities within five interrelated cycles, and one less-connected activity. Most families included both family members and patients in activities—although this could be problematic. Activities were typically only moderately routinized and followed cyclical activity patterns joined by sequential or concurrent interdependence. A medication-taking routine ecology had coordination difficulties. Results surface design implications for a potentially powerful new class of technologies to support family-based chronic disease management routines.