An interactionist framework for understanding the acceptance, rejection and use of health and care technologies

My research makes an empirically informed, theoretical contribution to understanding how health and care technologies are accepted, rejected and used by older people and stroke survivors. Current research on health and care technologies such as telecare and telerehabilitation systems has not tended to investigate questions such as what the technologies mean to users, how users appropriate and interact with the technologies on a daily basis, and the significance that these technologies can have within the context of users' everyday lives. Drawing on key concepts from structural symbolic interactionism, the life course perspective and the domestication framework, my research explores the relationships between users and technologies in contexts. These relationships are negotiated through interaction, are meaningful and unfold over time as individuals navigate the life course. A collective case study research design is adopted focusing on how users appropriate and interact with telecare and telerehabilitation systems. Two cases are supported by data from qualitative interviews with older people (n=19) and stroke survivors (n=4), respectively. Data analysis is conducted in light of an analytical framework, which draws attention to users' interpretations of the technologies, and the processes of meaning making and social interaction. These processes shape a technology's acceptance, rejection and use. Findings suggest that individuals interpret health and care technologies in different ways and that meaning is constructed through processes of appropriation and interaction. It is through interaction, with technologies and with others, that meanings are negotiated. These meanings are shaped by individuals' identities and roles, and their agency and capacity to participate in situated action. I contribute an interactionist framework that conceptualises these complex relationships. The framework provides a means of exploring and understanding the acceptance, rejection and use of health and care technologies that does not under- or over-play individual agency or the affordances and 'scripts' of these technologies.