Professor Flis Henwood and Liz Guy (University of Brighton)

Health e-citizenship? Sociotechnical systems and self care

Friday 9 February 2007 (week 5)


This presentation explores some conceptual and methodological challenges being addressed in new project about ICTs and self care. The project - 'Supporting the self management of obesity: The role of ICTs' - is funded by the UK Department of Health ( £270K over two years) under their programme 'The Role of Technology in supporting Chronic Disease Management, Self Care and Healthy Living'. The presentation will briefly describe the project before going on to situate it within a wider social informatics research framework, where technologies are understood as 'always, already social'.

Designing a research project that fit with the Department of Health's 'technologies to support self care' programme offers real opportunities to explore the relationship between the government rhetoric and the 'lived experience' of both self care (here, in area of obesity/weight management) and engagement with ICTs- understanding both the opportunities and the barriers to ICT use and self care practices. However, as we suggest in this presentation, it also enables us to ask and answer the question as to whether, in so far as ICTs have a role to play in supporting self care, can they do so only within a neo-liberal/consumerist framework where users are configured as 'good consumers', or can ICTs support self care within a more democratic framework and support the emergence of 'active citizenship' in an e-Health context? In asking and seeking to answer these important questions, we can also reasonably hope to offer some clearer definitions and understandings of what it means to be an 'active citizen', as opposed to a 'good consumer' in the context of e-Health.

This presentation explores the two key discourses embedded in the government's agenda for e-Health- first, what Petersen and Lupton (1996) have termed 'the new public health' discourse and second, the 'information' or 'e'-society discourse. It examines how users (of both health services and of ICTs) are configured in each discourse and argues that there are tensions in each that might be productive in terms of offering real opportunities for new ways of 'being citizens' and 'doing citizenship' (in an e-health context) but that the test as to that productiveness cannot be known in advance of an investigation of practice- which is why detailed studies of 'situated use' of ICTs (such as this) continue to be important.

The presentation will discuss how the new project seeks to examine ICT use in the field of self care through both a study of everyday practice and an intervention designed to engage users and non-users in e-health design.