{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T09:32:53Z","timestamp":1782984773234,"version":"3.54.5"},"reference-count":54,"publisher":"Emerald","issue":"1","license":[{"start":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T00:00:00Z","timestamp":1698624000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.emerald.com\/insight\/site-policies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ITP"],"published-print":{"date-parts":[[2025,1,8]]},"abstract":"Purpose<\/jats:title>Designing digital artifacts is not a linear, straightforward process. This is particularly true when applying a user-centered design approach, or co-design, with users who are unable to participate in the design process. Although the reduced participation of a particular user group may harm the end result, the literature on solving this issue is sparse. In this article, proxy design is outlined as a method for involving a user group as proxy users to speak on behalf of a group that is difficult to reach. The article investigates the following research question: How can roleplaying be embedded in co-design to engage users as proxies on behalf of those who are unable to represent themselves?<\/jats:p><\/jats:sec>Design\/methodology\/approach<\/jats:title>The article presents a design ethnography spanning three years at a cancer rehabilitation clinic, where digital artifacts were designed to be used collaboratively by nurses and patients. The empirical data were analyzed using content analysis and consisted of 20 observation days at the clinic, six proxy design workshops, 21 telephone consultations between patients and nurses, and log data from the digital artifact.<\/jats:p><\/jats:sec>Findings<\/jats:title>The article shows that simulated consultations, with nurses roleplaying as proxies for patients ignited and initiated the design process and enabled an efficient in-depth understanding of patients. Moreover, the article reveals how proxy design as a method further expanded the design. The study findings illustrate: (1) proxy design as a method for initiating design, (2) proxy design as an embedded element in co-design and (3) six design guidelines that should be considered when engaging in proxy design.<\/jats:p><\/jats:sec>Originality\/value<\/jats:title>The main contribution is the conceptualization of proxy design as a method that can ignite and initiate the co-design process when important users are unreachable, vulnerable or unable to represent themselves in the co-design process. More specifically, based on the empirical findings from a design ethnography that involved nurses as proxy users speaking on behalf of patients, the article shows that roleplaying in proxy design is a fitting way of initiating the design process, outlining proxy design as an embedded element of co-design.<\/jats:p><\/jats:sec>","DOI":"10.1108\/itp-07-2021-0539","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T10:08:26Z","timestamp":1698401306000},"page":"531-552","source":"Crossref","is-referenced-by-count":12,"title":["Proxy design: a method for involving proxy users to speak on\u00a0behalf of vulnerable or\u00a0unreachable users in co-design"],"prefix":"10.1108","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4563-0001","authenticated-orcid":false,"given":"Anna Sigridur","family":"Islind","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5547-9395","authenticated-orcid":false,"given":"Johan","family":"Lundin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8796-343X","authenticated-orcid":false,"given":"Katerina","family":"Cerna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Lindroth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"\u00c5keflo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar","family":"Steineck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"140","published-online":{"date-parts":[[2023,10,30]]},"reference":[{"issue":"2","key":"key2025010610134841200_ref001","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1207\/s15327051hci0902_1","article-title":"Representations and requirements: the value of ethnography in system design","volume":"9","year":"1994","journal-title":"Human-Computer Interaction"},{"issue":"5","key":"key2025010610134841200_ref002","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1145\/3414462","article-title":"Dreaming of immersive interactions to navigate forced distributed collaboration during Covid-19","volume":"27","year":"2020","journal-title":"Interactions"},{"issue":"1","key":"key2025010610134841200_ref003","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1111\/isj.12055","article-title":"Design ethnography in information systems","volume":"25","year":"2015","journal-title":"Information Systems Journal"},{"key":"key2025010610134841200_ref004","article-title":"The promise of empathy: design, disability, and knowing the \u2018Other\u2019","year":"2019"},{"issue":"1","key":"key2025010610134841200_ref005","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1145\/291224.291229","article-title":"Contextual design","volume":"6","year":"1999","journal-title":"Interactions"},{"key":"key2025010610134841200_ref006","article-title":"Participatory design with proxies: developing a desktop-PDA system to support people with aphasia","year":"2006"},{"key":"key2025010610134841200_ref007","article-title":"Making online participatory design work: understanding the digital ecologies of older adults","year":"2021"},{"issue":"5","key":"key2025010610134841200_ref008","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1007\/s10606-020-09383-z","article-title":"Changing categorical work in healthcare: the use of patient-generated health data in cancer rehabilitation","volume":"29","year":"2020","journal-title":"Computer Supported Cooperative Work (CSCW)"},{"key":"key2025010610134841200_ref009","first-page":"2","article-title":"Designing interactive life story multimedia for a family affected by Alzheimer's disease: a case study","volume-title":"Paper Presented at the CHI\u201905 Extended Abstracts on Human Factors in Computing Systems","year":"2005"},{"issue":"78","key":"key2025010610134841200_ref010","first-page":"153","article-title":"The ethnographically informed participatory design of a PD application to support communication","volume":"77","year":"2003","journal-title":"ACM SIGACCESS Accessibility and Computing"},{"key":"key2025010610134841200_ref011","article-title":"Smartphones to facilitate communication and improve social skills of children with severe autism spectrum disorder: special education teachers as proxies","year":"2008"},{"key":"key2025010610134841200_ref012","article-title":"The mimesis effect: the effect of roles on player choice in interactive narrative roleplaying games","year":"2016"},{"key":"key2025010610134841200_ref013","article-title":"Implications for design","year":"2006"},{"key":"key2025010610134841200_ref014","article-title":"Behavioral response to phishing risk","year":"2007"},{"key":"key2025010610134841200_ref015","article-title":"Platform-supported cooperative work","year":"2021"},{"issue":"3","key":"key2025010610134841200_ref016","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1145\/1714458.1714460","article-title":"Computer usage by children with Down syndrome: challenges and future research","volume":"2","year":"2010","journal-title":"ACM Transactions on Accessible Computing (TACCESS)"},{"key":"key2025010610134841200_ref017","article-title":"Conducting empirical experiments involving participants with spinal cord injuries","year":"2005"},{"key":"key2025010610134841200_ref018","article-title":"Identifying and exploring design trade-offs in human-centered design","year":"2018"},{"issue":"1","key":"key2025010610134841200_ref019","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1080\/0144929X.2019.1634153","article-title":"Exploring design trade-offs for achieving social inclusion in multi-tiered design problems","volume":"39","year":"2020","journal-title":"Behaviour and Information Technology"},{"issue":"2","key":"key2025010610134841200_ref020","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.nedt.2003.10.001","article-title":"Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness","volume":"24","year":"2004","journal-title":"Nurse Education Today"},{"key":"key2025010610134841200_ref021","first-page":"1","article-title":"Covid-19: a remote assessment in primary care","volume":"368","year":"2020","journal-title":"BMJ"},{"key":"key2025010610134841200_ref022","article-title":"Theorizing in design science research: inductive versus deductive approaches","year":"2011"},{"key":"key2025010610134841200_ref023","first-page":"7","year":"2019"},{"key":"key2025010610134841200_ref024","article-title":"Heteroglossia: in-situ story ideation with the crowd","year":"2020"},{"key":"key2025010610134841200_ref025","year":"2018","journal-title":"Platformization: co-designing Digital Platforms in Practice"},{"key":"key2025010610134841200_ref026","first-page":"166","article-title":"Co-design as a driver of change","volume":"17","year":"2022","journal-title":"Performance Paradigm"},{"issue":"1","key":"key2025010610134841200_ref027","first-page":"1","article-title":"From co-design to co-care: designing a collaborative practice in care","volume":"11","year":"2018","journal-title":"Systems, Signs and Actions"},{"issue":"8","key":"key2025010610134841200_ref028","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1108\/JWL-05-2020-0082","article-title":"Learning sustainable work through critical design: a case study of a hackathon to prepare the future workforce","volume":"32","year":"2020","journal-title":"Journal of Workplace Learning"},{"issue":"4","key":"key2025010610134841200_ref029","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s12553-019-00332-5","article-title":"Co-designing a digital platform with boundary objects: bringing together heterogeneous users in healthcare","volume":"9","year":"2019","journal-title":"Health and Technology"},{"key":"key2025010610134841200_ref030","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1007\/s10606-019-09350-3","article-title":"The virtual clinic: two-sided affordances in consultation practice","volume":"28","year":"2019","journal-title":"Computer Supported Cooperative Work (CSCW)"},{"issue":"1","key":"key2025010610134841200_ref031","first-page":"3","article-title":"Designing for prolonged mastery. On involving old people in participatory design","volume":"28","year":"2016","journal-title":"Scandinavian Journal of Information Systems"},{"issue":"2","key":"key2025010610134841200_ref032","first-page":"1","article-title":"The digital is different: emergence and relationality in critical realist research","volume":"32","year":"2022","journal-title":"Information and Organization"},{"key":"key2025010610134841200_ref033","first-page":"21","article-title":"Heritage: having a say","volume-title":"Routledge International Handbook of Participatory Design","year":"2013"},{"issue":"3","key":"key2025010610134841200_ref034","first-page":"601","article-title":"Patient responsibility reallocation: a user-centered approach to support nurses' handling of nurse calls","volume":"19","year":"2015","journal-title":"Personal and Ubiquitous Computing"},{"key":"key2025010610134841200_ref035","volume-title":"Research Methods in Human-Computer Interaction","year":"2017"},{"key":"key2025010610134841200_ref036","article-title":"Learning through exploration: how children, adults, and older adults interact with a new feature-rich application","year":"2020"},{"issue":"2","key":"key2025010610134841200_ref037","first-page":"138","article-title":"Technology and its solutions in the era of COVID-19 crisis: a review of literature","volume":"4","year":"2020","journal-title":"Evidence Based Health Policy, Management and Economics"},{"issue":"4","key":"key2025010610134841200_ref038","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1037\/h0040525","article-title":"Behavioral study of obedience","volume":"67","year":"1963","journal-title":"The Journal of Abnormal and Social Psychology"},{"key":"key2025010610134841200_ref039","volume-title":"Designing Technology for and with Special Populations: An Exploration of Participatory Design with People with Aphasia","year":"2004"},{"key":"key2025010610134841200_ref040","volume-title":"Online Tools for Co-design: User Involvement through the Innovation Process","year":"2008"},{"key":"key2025010610134841200_ref041","article-title":"Tick box design: a bounded and packageable co-design method for large workshops","volume":"33","year":"2022","journal-title":"International Journal of Child-Computer Interaction"},{"issue":"1","key":"key2025010610134841200_ref042","first-page":"5","article-title":"Co-creation and the new landscapes of design","volume":"4","year":"2008","journal-title":"Co-Design"},{"key":"key2025010610134841200_ref043","first-page":"417","article-title":"The limits of ethnography: combining social sciences for CSCW","year":"1994"},{"key":"key2025010610134841200_ref044","volume-title":"Crafting the Future","year":"2013"},{"issue":"1","key":"key2025010610134841200_ref045","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1108\/ITP-07-2015-0155","article-title":"Digitalization as institutional work: a case of designing a tool for changing diabetes care","volume":"30","year":"2017","journal-title":"Information Technology and People"},{"key":"key2025010610134841200_ref046","first-page":"343","article-title":"Quick and dirty: lightweight methods for heavyweight research","year":"2014"},{"key":"key2025010610134841200_ref047","first-page":"1","article-title":"Sociotechnical co-design with general pediatricians: ripple effects through collaboration in action","year":"2020"},{"key":"key2025010610134841200_ref048","volume-title":"Engaged Scholarship: A Guide for Organizational and Social Research","year":"2007"},{"issue":"6","key":"key2025010610134841200_ref049","first-page":"1011","article-title":"Between personal and common: the design of hybrid information spaces","volume":"28","year":"2019","journal-title":"Computer Supported Cooperative Work (CSCW)"},{"key":"key2025010610134841200_ref050","article-title":"Sensitizing scenarios: sensitizing designer teams to theory","year":"2020"},{"key":"key2025010610134841200_ref051","article-title":"The quantified patient in the doctor's office: challenges and opportunities","year":"2016"},{"key":"key2025010610134841200_ref052","article-title":"Choice architecture, friend or foe? Future designers' perspective on ethics and digital nudges","year":"2022"},{"key":"key2025010610134841200_ref053","article-title":"Empathy and experience in HCI","year":"2008"},{"key":"key2025010610134841200_ref054","volume-title":"The Stanford Prison Experiment","year":"1971"}],"container-title":["Information Technology & People"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/ITP-07-2021-0539\/full\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/ITP-07-2021-0539\/full\/html","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T21:55:13Z","timestamp":1753394113000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.emerald.com\/itp\/article\/38\/1\/531-552\/1241236"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,30]]},"references-count":54,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,10,30]]},"published-print":{"date-parts":[[2025,1,8]]}},"alternative-id":["10.1108\/ITP-07-2021-0539"],"URL":"https:\/\/doi.org\/10.1108\/itp-07-2021-0539","relation":{},"ISSN":["0959-3845"],"issn-type":[{"value":"0959-3845","type":"print"}],"subject":[],"published":{"date-parts":[[2023,10,30]]}}}