User Experience of Type 1 Diabetes Technologies

Project: Exploring the influence that context and individual differences has on the experience and practice of self-management of Type 1 Diabetes using situated methods

PhD Researcher: Aisling Ann O’Kane

Supervisors: Ann Blandford and Yvonne Rogers


Adults with Type 1 Diabetes have choices about what technologies to use to self-manage their chronic condition. They can use glucose meters, insulin pumps, continuous glucose monitors, smartphone apps, and other mobile technologies to support their everyday care. However, little is known about how user experience might influence what they choose to adopt or how they choose to use technologies when practicing self-management. A series of situated exploratory qualitative studies were conducted to examine contextual factors that influence the use of self-care technology “in the wild.” Autoethnography was used to gain empathy for the everyday use of a mobile medical device and to set up a mixed method user study, involving contextual interviews, a diary study, and the observation of a diabetes technology group meet-up. A combined bottom-up thematic analysis of the data from the user studies uncovered commonalities among the users in how context influenced the use, carrying, adoption, and misuse of these devices. However, large variability in how user experience impacted self-care for the 41 participants was also revealed. Although these self-care technologies were effective, efficient, and easy to learn for the participants from a human factors engineering perspective, context specific issues arose that impacted decisions to use them. The physical environment, the social situation, the cultural context, and individual differences influence these choices. Quality of life can be impacted by the design of Type 1 Diabetes technologies, and people sometimes prioritise quality of life over immediate or long-term health benefits. This research points to the need to study the use of these mobile medical devices in-situ to understand how their design can influence adoption and use in everyday life. However, the variety of everyday self-care contexts and the diversity of possible user preferences do not lead to straightforward or universal design implications. Future work should look at the influence of design of other self-management technologies that are being developed to deal with the move of healthcare outside of clinical setting and focus on empowering adults to make personal choices about their self-care technologies that suit the context of their, sometimes messy, everyday lives.

A.A. O’Kane, S.Y. Park, H. Mentis, A. Blandford, Y. Chen. “Turning to peers: integrating understanding of the self, the condition, and others’ experiences in making sense of complex chronic conditions” Journal of CSCW, under review.

C. Vincent, G. Niezen, A.A. O’Kane, and K. Stawarz. “Can standards and regulations keep up with health technology?” Journal of Medical Informatics Research (JMIR) mHealth and uHealth, vol. 3, no. 2, e64, June 2015.

A.A. O’Kane, Y. Rogers, and A. Blandford. “Concealing or Revealing Mobile Medical Devices? Designing for Onstage and Offstage Presentation” in Proceedings of CHI 2015, 2015, pp.1689-1698.

A.A. O’Kane. “Situated User Experience with Take-Home Technology Influences Adherence to Self-Management Plans for Adults with Type 1 Diabetes,” e-poster presented at Advanced Technologies and Treatments for Diabetes (ATTD 2015), Paris, France, February 18-21, 2015 and in the Journal of Diabetes Technology & Therapeutics, 2015, vol. 17, pp. A128-A129 (abstract only).

A.A. O’Kane, Y. Rogers, and A. Blandford. “Gaining Empathy for Non-Routine Mobile Device Use Through Autoethnography” in Proceedings of CHI 2014, 2014, pp. 987-990.

S. Taneva, A.A. O’Kane, R. Ratwani, B. Hilligoss, A. Rajkomar, A. Thieme, and K. Groth. “Establishing and Maintaining Relationships in Healthcare Fieldwork,” in Fieldwork for Healthcare: Guidance for Investigating Human Factors in Computing Systems, Morgan & Claypool Publishers, 2014.

A.A. O’Kane and A. Blandford. “Beyond Medical Usability Engineering: Exploring the Influence of Affective Experience on the Use of Type 1 Diabetes Technologies” poster presented at Advanced Technologies and Treatments for Diabetes (ATTD 2014), Vienna, Austria, February 5-8, 2014 and in the Journal of Diabetes Technology & Therapeutics vol. 16, pp. A150 (in title only).

A.A. O’Kane. “Beyond Medical Usability Engineering: Type 1 Diabetes Technologies and User Experience in The Wild” poster presented at the Workshop for Interactive Systems in Healthcare (WISH 2013) co-located with the American Medical Informatics Association (AMIA) Annual Symposium, Washington D.C., USA, November 17, 2013.

Dissertation: A.A. O’Kane.  Individual Differences and Contextual Factors Influence the Experience and Practice of Self-Care with Type 1 Diabetes Technologies. University College London Computer Science Doctoral Dissertation. Expected January 2016.