{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T19:38:51Z","timestamp":1772739531552,"version":"3.50.1"},"reference-count":47,"publisher":"Emerald","issue":"4","license":[{"start":{"date-parts":[[2014,10,28]],"date-time":"2014-10-28T00:00:00Z","timestamp":1414454400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.emerald.com\/insight\/site-policies"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,10,28]]},"abstract":"<jats:sec><jats:title content-type=\"abstract-heading\">Purpose<\/jats:title><jats:p>\u2013 The purpose of this paper is to examine how pregnant women with type 1 diabetes integrate new information technology (IT) into their health management activities, using activity theory as an analytical framework.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Design\/methodology\/approach<\/jats:title><jats:p>\u2013 The research is a multiple case design, based on interviews with 15 women with type 1 diabetes who were pregnant, considering pregnancy, or had recently given birth. A thematic analysis, sensitised by activity theory, was used to analyse the data.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Findings<\/jats:title><jats:p>\u2013 Health management in this setting involves negotiations and contradictions across boundaries of interacting activities. Participants play an active role in managing their health and using new IT tools in particular ways to support their health management. Using new technologies creates both opportunities and challenges. IT-enabled healthcare devices and other information systems open up new treatment possibilities, but also generate new contradictions between interacting activity systems.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Research limitations\/implications<\/jats:title><jats:p>\u2013 The research was conducted with a small sample in a specific context of health management. Further research is needed to extend the findings to other contexts.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Practical implications<\/jats:title><jats:p>\u2013 Healthcare providers need to accommodate a bottom-up approach to the adoption and use of new technologies in settings where empowered patients play an active role in managing their health.<\/jats:p><\/jats:sec><jats:sec><jats:title content-type=\"abstract-heading\">Originality\/value<\/jats:title><jats:p>\u2013 The findings highlight opportunities to further develop activity theory to accommodate the central role that individuals play in resolving inherent contradictions and achieving alignment between multiple interacting activity systems when incorporating new IT tools into health management activities.<\/jats:p><\/jats:sec>","DOI":"10.1108\/itp-11-2013-0195","type":"journal-article","created":{"date-parts":[[2014,10,23]],"date-time":"2014-10-23T12:29:16Z","timestamp":1414067356000},"page":"463-481","source":"Crossref","is-referenced-by-count":11,"title":["The individual in multiple interacting activity systems: IT-supported diabetes management"],"prefix":"10.1108","volume":"27","author":[{"given":"Jenny","family":"Waycott","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rens","family":"Scheepers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hilary","family":"Davis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steve","family":"Howard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liz","family":"Sonenberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"140","reference":[{"key":"key2020122801544475200_b2","doi-asserted-by":"crossref","unstructured":"Aarhus, R. and Ballegaard, S.A. (2010), \u201cNegotiating boundaries: managing disease at home\u201d, Proceedings CHI, pp. 1223-1232.","DOI":"10.1145\/1753326.1753509"},{"key":"key2020122801544475200_b1","doi-asserted-by":"crossref","unstructured":"Aarhus, R. , Ballegaard, S.A. and Hansen, T.R. (2009), \u201cThe eDiary: bridging home and hospital through healthcare technology\u201d, Proceedings ESCW, pp. 63-82.","DOI":"10.1007\/978-1-84882-854-4_4"},{"key":"key2020122801544475200_b3","unstructured":"Australian Institute of Health and Welfare (2012), \u201cInsulin pump use in Australia\u201d, Diabetes Series no. 18, Canberra."},{"key":"key2020122801544475200_b5","unstructured":"Bardram, J. and Doryab, A. (2011), \u201cActivity analysis \u2013 applying activity theory to anlayze complex work in hospitals\u201d, Proceedings CSCW \u201911, pp. 455-464."},{"key":"key2020122801544475200_b6","unstructured":"B\u00f8dker, S. and Klokmose, C.N. (2012), \u201cPreparing students for (inter-)action with activity theory\u201d, International Journal of Design, Vol. 6 No. 3, pp. 99-111."},{"key":"key2020122801544475200_b7","doi-asserted-by":"crossref","unstructured":"Boulton, D. and Hammersley, M. (2006), \u201cAnalysis of unstructured data\u201d, in Sapsford, R. and Judd, V. (Eds), Data Collection and Analysis, 2nd ed., Sage Publications, London.","DOI":"10.4135\/9781849208802.n10"},{"key":"key2020122801544475200_b8","unstructured":"Chitayat, L. , Zisser, H. and Jovanovic, L. (2009), \u201cContinuous glucose monitoring during pregnancy\u201d, Diabetes Technology & Therapeutics, Vol. 11 No. S1, pp. S105-S111."},{"key":"key2020122801544475200_b9","doi-asserted-by":"crossref","unstructured":"Crawford, K. and Hasan, H. (2006), \u201cDemonstrations of the activity theory framework for research in information systems\u201d, Australasian Journal of Information Systems, Vol. 13 No. 2, pp. 49-68.","DOI":"10.3127\/ajis.v13i2.40"},{"key":"key2020122801544475200_b10","unstructured":"Creswell, J.W. (2007), Qualitative Inquiry and Research Design: Choosing Among Five Approaches, 2nd ed., Sage Publications, Thousand Oaks, CA."},{"key":"key2020122801544475200_b11","unstructured":"Engestr\u00f6m, Y. (1987), Learning by Expanding: An Activity-Theoretical Approach to Developmental Research, Orienta-Konsultit, Helsinki."},{"key":"key2020122801544475200_b13","doi-asserted-by":"crossref","unstructured":"Engestr\u00f6m, Y. (2001), \u201cExpansive learning at work: toward an activity theoretical reconceptualization\u201d, Journal of Education and Work, Vol. 14 No. 1, pp. 133-156.","DOI":"10.1080\/13639080020028747"},{"key":"key2020122801544475200_b14","doi-asserted-by":"crossref","unstructured":"Engestr\u00f6m, Y. (2007), \u201cEnriching the theory of expansive learning: lessons from journeys toward coconfiguration\u201d, Mind, Culture, and Activity, Vol. 14 Nos 1-2, pp. 23-39.","DOI":"10.1080\/10749030701307689"},{"key":"key2020122801544475200_b16","doi-asserted-by":"crossref","unstructured":"Engestr\u00f6m, Y. and Kerosuo, H. (2007), \u201cFrom workplace learning to inter-organizational learning and back: the contribution of activity theory\u201d, Journal of Workplace Learning, Vol. 19 No. 6, pp. 336-342.","DOI":"10.1108\/13665620710777084"},{"key":"key2020122801544475200_b17","doi-asserted-by":"crossref","unstructured":"Engestr\u00f6m, Y. and Sannino, A. (2010), \u201cStudies of expansive learning: foundations, findings and future challenges\u201d, Educational Research Review, Vol. 5 No. 1, pp. 1-24.","DOI":"10.1016\/j.edurev.2009.12.002"},{"key":"key2020122801544475200_b18","unstructured":"Fitzpatrick, G. (2011), \u201cNew challenges for health IT \u2013 design fit for life. Keynote address\u201d, Proceedings of the Conference on Design 4 Health, pp. 121-135."},{"key":"key2020122801544475200_b19","unstructured":"Fox, S. (2011), The Social Life of Information, The PEW Internet and American Life Project, Washington, DC."},{"key":"key2020122801544475200_b20","doi-asserted-by":"crossref","unstructured":"Gonzales, M.J. and Riek, L.D. (2013), \u201cCo-designing patient-centered health communication tools for cancer care\u201d, Proceedings of the 7th ACM\/IEEE International Conference on Pervasive Computing Technologies for Healthcare, Venice, 5-8 May.","DOI":"10.4108\/icst.pervasivehealth.2013.252109"},{"key":"key2020122801544475200_b21","doi-asserted-by":"crossref","unstructured":"Greig, G. , Entwistle, V.A. and Beech, N. (2012), \u201cAddressing complex healthcare problems in diverse settings: insights from activity theory\u201d, Social Science and Medicine, Vol. 74 No. 3, pp. 305-312.","DOI":"10.1016\/j.socscimed.2011.02.006"},{"key":"key2020122801544475200_b22","doi-asserted-by":"crossref","unstructured":"Hasan, H. and Pfaff, C.C. (2012), \u201cAn activity-theory analysis of corporate wikis\u201d, Information Technology & People, Vol. 25 No. 4, pp. 423-437.","DOI":"10.1108\/09593841211278802"},{"key":"key2020122801544475200_b23","doi-asserted-by":"crossref","unstructured":"Hasu, M. and Engestr\u00f6m, Y. (2000), \u201cMeasurement in action: an activity-theoretical perspective on producer-user interaction\u201d, International Journal of Human-Computer Studies, Vol. 53 No. 1, pp. 61-89.","DOI":"10.1006\/ijhc.2000.0375"},{"key":"key2020122801544475200_b24","doi-asserted-by":"crossref","unstructured":"Hayrinen, K. , Saranto, K. and Nykanen, P. (2008), \u201cDefinition, structure, content, use and impacts of electronic health records: a review of the research literature\u201d, International Journal of Medical Informatics, Vol. 77 No. 5, pp. 291-304.","DOI":"10.1016\/j.ijmedinf.2007.09.001"},{"key":"key2020122801544475200_b25","unstructured":"Hirsch, I.B. (2010), \u201cPractical pearls in insulin pump therapy\u201d, Diabetes Technology & Therapeutics, Vol. 12 No. S1, pp. S23-S27."},{"key":"key2020122801544475200_b26","doi-asserted-by":"crossref","unstructured":"Johnston, A.C. , Worrell, J.L. , Di gangi, P.M. and Wasko, M. (2013), \u201cOnline health communities: an assessment of the influence of participation on patient-empowerment outcomes\u201d, Information Technology & People, Vol. 26 No. 2, pp. 213-235.","DOI":"10.1108\/ITP-02-2013-0040"},{"key":"key2020122801544475200_b27","doi-asserted-by":"crossref","unstructured":"Kaptelinin, V. and Nardi, B. (2006), Acting with Technology: Activity Theory and Interaction Design, The MIT Press, London and Cambridge, MA.","DOI":"10.5210\/fm.v12i4.1772"},{"key":"key2020122801544475200_b28","unstructured":"Kuutti, K. (1996), \u201cActivity theory as a potential framework for human-computer interaction research\u201d, in Nardi, B.E. (Ed.), Context and Consciousness: Activity Theory and Human-Computer Interaction, MIT Press, Cambridge, MA, pp. 17-44."},{"key":"key2020122801544475200_b29","unstructured":"Kvale, S. (1996), Interviews: An Introduction to Qualitative Research Interviewing, Sage, Thousand Oaks, CA."},{"key":"key2020122801544475200_b30","doi-asserted-by":"crossref","unstructured":"Lenhard, M.J. and Reeves, G.D. (2001), \u201cContinuous subcutaneous insulin infusion: a comprehensive review of insulin pump therapy\u201d, Archives of Internal Medicine, Vol. 161 No. 19, pp. 2293-2300.","DOI":"10.1001\/archinte.161.19.2293"},{"key":"key2020122801544475200_b31","doi-asserted-by":"crossref","unstructured":"Liu, L.S. , Huh, J. , Neogi, T. , Inkpen, K. and Pratt, W. (2013), \u201cHealth vlogger-viewer interaction in chronic illness management\u201d, Proceedings of the ACM Conference on Human Factors in Computing Systems, pp. 49-58.","DOI":"10.1145\/2470654.2470663"},{"key":"key2020122801544475200_b32","unstructured":"Luukkonen, I. , Korpela, M. and Mursu, A. (2011), \u201cStudying the applicability of methods: activity driven needs analysis applied to maternity pathway in Pudong\u201d, working papers on Information Systems, Sprouts, Shanghai, p. 11, available at: http:\/\/sprouts.aisnet.org\/11-172 (accessed 5 November 2013)."},{"key":"key2020122801544475200_b33","doi-asserted-by":"crossref","unstructured":"Mccarthy, J. and Wright, P. (2004), Technology as Experience, MIT Press, Boston, MA.","DOI":"10.1145\/1015530.1015549"},{"key":"key2020122801544475200_b34","unstructured":"Miles, M.B. and Huberman, A.M. (1994), Qualitative Data Analysis: An Expanded Sourcebook, Sage Publications, Thousand Oaks, CA."},{"key":"key2020122801544475200_b35","unstructured":"Moen, A. , Gregory, J. and Brennan, P.F. (2007), \u201cCross-cultural factors necessary to enable design of flexible consumer health informatics systems (CHIS)\u201d, International Journal of Medical Informatics, Vol. 76, pp. S168-S173."},{"key":"key2020122801544475200_b36","unstructured":"Mursu, A. , Luukkonen, I. , Toivanen, M. and Korpela, M. (2007), \u201cActivity theory in information systems research and practice: theoretical underpinnings for an information systems development model\u201d, No. 3, available at: http:\/\/informationr.net\/ir\/12-3\/paper311.html (accessed 5 November 2013)."},{"key":"key2020122801544475200_b37","doi-asserted-by":"crossref","unstructured":"Ritholz, M.D. , Smaldone, A. , Lee, J. , Castillo, A. , Wolpert, H. and Weinger, K. (2007), \u201cPerceptions of psychosocial factors and the insulin pump\u201d, Diabetes Care, Vol. 30, pp. 549-554.","DOI":"10.2337\/dc06-1755"},{"key":"key2020122801544475200_b38","doi-asserted-by":"crossref","unstructured":"Roth, W.-M. (2009), \u201cOn the inclusion of emotions, identity, and ethico-moral dimensions of actions\u201d, in Sannino, A. , Daniels, H. and Gutierrez, K.D. (Eds), Learning and Expanding with Activity Theory, Cambridge University Press, Cambridge, pp. 53-71.","DOI":"10.1017\/CBO9780511809989.005"},{"key":"key2020122801544475200_b39","doi-asserted-by":"crossref","unstructured":"Sannino, A. (2011), \u201cActivity theory as an activitist and interventionist theory\u201d, Theory and Psychology, Vol. 21, pp. 571-597.","DOI":"10.1177\/0959354311417485"},{"key":"key2020122801544475200_b40","doi-asserted-by":"crossref","unstructured":"Scheepers, R and Middleton, C. (2013), \u201cPersonal ICT ensembles and ubiquitous information systems environments: key issues and research implications\u201d, Communications of the Association for Information, Vol. 33, Article 22, pp. 381-392.","DOI":"10.17705\/1CAIS.03322"},{"key":"key2020122801544475200_b41","unstructured":"Scheepers, R. , Davis, H. , Sonenberg, L. and Howard, S. (2011), \u201cConsumer health ICT and the patient in the middle: adopter and\/or influencer?\u201d, Proceedings of the 15th Pacific Asia Conference on Information Systems (PACIS), Queensland University of Technology, Queensland."},{"key":"key2020122801544475200_b42","doi-asserted-by":"crossref","unstructured":"Storni, C. (2010), \u201cMultiple forms of appropriation in self-monitoring technology: reflections on the role of evaluation in future self-care\u201d, International Journal of Human Computer Interaction, Vol. 26, pp. 537-561.","DOI":"10.1080\/10447311003720001"},{"key":"key2020122801544475200_b43","unstructured":"Vygotsky, L. (1978), Mind in Society: The Development of Higher Psychological Processes, Harvard University Press, Cambridge, MA."},{"key":"key2020122801544475200_b44","doi-asserted-by":"crossref","unstructured":"Waycott, J. (2005), \u201cAppropriating tools and shaping activities: the use of PDAs in the workplace\u201d, in Hamill, L. and Lasen, A. (Eds), Mobile World: Past, Present and Future, Springer-Verlag, London, pp. 119-139.","DOI":"10.1007\/1-84628-204-7_8"},{"key":"key2020122801544475200_b45","unstructured":"Wollitzer, A.D. , Zisser, H. and Jovanovic, L. (2010), \u201cInsulin pumps and their use in pregnancy\u201d, Diabetes Technology & Therapeutics, Vol. 12, pp. S33-S35."},{"key":"key2020122801544475200_b46","unstructured":"Wyne, K. (2008), \u201cInformation technology for the treatment of diabetes: improving outcomes and controlling costs\u201d, Supplement to Journal of Managed Care Pharmacy, Vol. 14, pp. S12-S16."},{"key":"key2020122801544475200_b47","unstructured":"Yin, R.K. (2003), Case Study Research: Design and Methods, 3rd ed., Sage Publications, Thousand Oaks, CA."},{"key":"key2020122801544475200_frd1","doi-asserted-by":"crossref","unstructured":"Avis, J. (2009), \u201cTranformation or transformism: Engestrom's version of activity theory\u201d, Educational Review, Vol. 61 No. 2, pp. 151-165.","DOI":"10.1080\/00131910902844754"},{"key":"key2020122801544475200_frd2","doi-asserted-by":"crossref","unstructured":"Engestr\u00f6m, Y. (1993), \u201cDevelopmental studies of work as a test-bench of activity theory: the case of primary care medical practice\u201d, in Chaiklin, S. and Lave, J. (Eds), Understanding Practice: Perspectives on Activity and Context, Cambridge University Press, Cambridge, pp. 64-103.","DOI":"10.1017\/CBO9780511625510.004"},{"key":"key2020122801544475200_frd3","doi-asserted-by":"crossref","unstructured":"Engestr\u00f6m, Y. (2008), From Teams to Knots: Activity-Theoretical Studies of Collaboration and Learning at Work, Cambridge University Press, Cambridge.","DOI":"10.1017\/CBO9780511619847"}],"container-title":["Information Technology &amp; People"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.emeraldinsight.com\/doi\/full-xml\/10.1108\/ITP-11-2013-0195","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/ITP-11-2013-0195\/full\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.emerald.com\/insight\/content\/doi\/10.1108\/ITP-11-2013-0195\/full\/html","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T21:55:53Z","timestamp":1753394153000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.emerald.com\/itp\/article\/27\/4\/463-481\/431007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,10,28]]},"references-count":47,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2014,10,28]]}},"alternative-id":["10.1108\/ITP-11-2013-0195"],"URL":"https:\/\/doi.org\/10.1108\/itp-11-2013-0195","relation":{},"ISSN":["0959-3845"],"issn-type":[{"value":"0959-3845","type":"print"}],"subject":[],"published":{"date-parts":[[2014,10,28]]}}}