Multiple Forms of Appropriation in Self-Monitoring Technology: Reflections on the Role of Evaluation in Future Self-Care

This article discusses implications for the design of evaluation studies of self-care technologies and practices with respect to a current shift toward technologically mediated self-care in health care. Through the notion of appropriation of technology, this article shows that as self-care devices migrated into lay patients' lives and their domestic environment, we are confronted with a series of different instances of appropriation where patient empowerment and autonomy take different forms. With a particular focus on self-monitoring devices such as blood-pressure monitors and glucose meters, the article examines a series of illustrative vignettes from an ethnographic study and discusses multiple forms of appropriation of self-care technology and the need to understand its implications on the design of studies for their evaluation. Three conclusive reflections to rethink the role of evaluation study in the current shift toward self-care are addressed: the need to move beyond technological determinism, the need to reflect on whose interests the evaluation serve, and the need to carefully rethink the very goal of evaluation studies in self-care themselves.