An extensive literature on participatory design with older adults has, thus far, little to say about the support older adults need when involved in online activities. Our research suggests that to empower older adults in participatory design, scaffolding work has to be done. Scaffolding interactions - creating temporary instructional support to help the learning of participants - is a common approach in participatory design. Yet, when applied in online participatory design with older adults, the traditional understanding of the concept does not match the way older adults' learn. Hence, we argue for a new understanding of this term, which we call situated scaffolding. We illustrate our argument with a case where older adults collaborate online as part of a participatory design project. We unpack the different dimensions of situated scaffolding and discuss how this novel understanding can be used to further inform sustainable participatory design for and with older adults.

Abstract Categorical work in chronic care is increasingly dependent on digital technologies for remote patient care. However, remote care takes many forms and while various types of digital technologies are currently being used, we lack a nuanced understanding of how to design such technologies for specific novel usages. In this paper, we focus on digital technologies for patient-generated health data and how their use changes categorical work in chronic care. Our aim is to understand how categorical work changes, which novel forms of categorical work emerge and what the implications are for the care relation. This paper is based on an ethnographic study of healthcare professionals’ work at a pelvic cancer rehabilitation clinic and their interactions with patients. In this setting, supportive talks between patients and nurses are central. To understand the complexities of categorical work in chronic care when patient-generated health data are introduced, we contrast the traditional supportive talks with supportive talks where the nurses had access to the patients’ patient-generated health data. We identify and analyze challenges connected to novel forms of categorical work. Specifically, we focus on categorical work and how it can undergo changes. Our empirical findings show how changes occur in the way patients’ lived experience of the chronic disease aligns with the categories from chronic care, as well as in the way the nurse works with clinical categories during the talk. These insights help us further understand the implications of patient generated-data use in supportive talks. We contribute to an improved understanding of the use of patient-generated health data in clinical practice and based on this, we identify design implications for how to make categorical work more collaborative.

Telecare has the potential to increase the quality of care while also decreasing costs. However, despite great potential, efficiency in care practices and cost reduction remain hypothetical. Within computer supported cooperative work (CSCW), one focus of telecare research has been on awareness support in distributed real-time communication in comparison to physical meetings since face-to-face consultations have been known as the “gold standard” of conducting care. Research has shown that it is hard to maintain qualities such as awareness through video-mediated meetings. In this research, the goal has not been to mimic the qualities of face-to-face consultations but rather to document the qualities of three types of patient meetings (consultations) and to understand in what kinds of situations each consultation type is a viable option. In this paper, we focus on the essential qualities of i) face-to-face consultations, ii) video-based consultations, and iii) telephone consultations and shed light on their affordances. The research contribution includes an extension of the affordance lens to incorporate socio-technical, two-sided affordances, that constitute important aspects for understanding complexity when heterogeneous actors co-existing in a practice, where affordances can differ for different “sides” in the complex practice—a view that is fruitful when dealing with heterogeneous actors and a set of analog and digital tools in a practice.