Page - 58 - in Applied Interdisciplinary Theory in Health Informatics - Knowledge Base for Practitioners

AT was used to help understand usage of this mHealth system from the perspective of the users and to provide analysis on the key drivers of use. This study was able to bridge the gap between the limited understanding of how innovations are adopted in practice, and how this relates to specific characteristics of the technical system and users. AT was used to study routine use of the system by the observation of subjects (community health workers, pregnant women and clinic managers) and the processes of registration activities, as well as the connection between the tools and the community involved in these activities. The analysed data were used to provide a broader understanding of user needs and to implement the requirements into an improved contextual technology fit. This use case also illustrates the reiterative approach applied, in accordance with a UCD framework, commencing with an evaluation of the system in deployment and then using that analysis to inform the requirements of a system redesign (see Table 3). Table 3. Application of UCD and AT in evaluating the implementation of MomConnect. UCD Lifecycle Stage UCD Principle Application of UCD and AT in the Use Case Understand and specify the context of use Gain a clear understanding of users, healthcare tasks and environment. This stage consists of examining the user context. Drawing on the features of UCD, potential users were collaborated with throughout the process. It helped to establish who the users of the system are and to understand the context of use. AT facilitated the breaking down and binding of entities with design tasks and goals. It facilitated the understanding of the influence of the mHealth solution in the context of existing work practices, tools and the broader context of the health facility. Establish the user and/ or organisational requirements Formal specification of user requirements, inferred from the defined context of use. This included gathering the information that informs the design of the system. Open-ended interviews and observation were conducted with community health workers and clinic managers to understand key drivers and constraints of use. AT was used as a framework to provide a structured set of concepts used to analyse the goal-oriented action. AT was used to analyse the dynamics of mHealth use by the facility staff. Produce design solutions The design solutions are produced while trying to meet user requirements as much as possible. The findings were used to inform the proposed concept of affordance that is focused on distinguishing between the situation where user groups and work practices in facilities are centrally or peripherally targeted by the designers. It was also used to contribute to theory more broadly by developing an Activity Theory-framed approach to affordance actualisation. Evaluate design against requirements The design is evaluated. UCD facilitated a continuous evaluation of the system following deployment. In this case, after an initial round of data collection, the researcher returned to the field some months later, to conduct additional observation sessions so that they could develop a fuller picture of how the usage practices were playing out. A.GoodandO.Omisade /LinkingActivityTheorywithUserCentredDesign58