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Contents -- 1 Introduction -- References -- Personal Health and Autonomy: An Uneasy Relationship -- 2 Unobtrusiveness in mHealth Design and Use: A Systematic Literature Study -- Abstract -- 2.1 Introduction -- 2.2 Method -- 2.3 Results -- 2.3.1 Defining Obtrusiveness and Unobtrusiveness -- 2.3.2 Common Characteristics of Obtrusiveness -- 2.3.3 Implications of Unobtrusiveness -- 2.3.4 Diminishing Obtrusiveness via Personalisation and Control -- 2.4 Analysis -- 2.5 Conclusion -- Acknowledgments -- Bibliography -- 3 eHealth and Privacy in U.S. Employer Wellness Programs -- Abstract -- 3.1 Introduction -- 3.2 Employer-Sponsored Wellness Programs -- 3.3 Personal Health Information in Wellness Programs -- 3.4 Privacy, Surveillance and Wellness Programs -- 3.4.1 Informational Privacy -- 3.4.2 Physical Integrity -- 3.4.3 Decisional Autonomy -- 3.5 Conclusions, Recommendations and Further Research -- Acknowledgments -- References -- 4 Use of a Wearable Device to Promote Healthy Behaviors Among Employees of a Small-to-Medium Enterprise in the Netherlands -- Abstract -- 4.1 Introduction -- 4.2 Methods -- 4.2.1 The Case -- 4.2.2 Data Collection -- 4.3 Results -- 4.3.1 Fun Gadgets, with Preconditions -- 4.3.2 Initial Expectations: No Personal Health Change, but Team Benefits -- 4.3.3 Experiences: Caloric Input Hassles and Data Accuracy -- Increased Number of Steps -- 4.3.4 Socio-ethical Dilemmas -- 4.4 Discussion -- Acknowledgments -- References -- Surveillance Practices for Risk Management -- 5 Selling Passive Monitoring to Manage Risk in Independent Living: Frontline Workers in a Bind -- Abstract -- 5.1 Introduction -- 5.2 Methods -- 5.2.1 Participants and Recruitment -- 5.2.2 Data Collection and Analysis -- 5.3 Findings -- 5.3.1 The Remote Monitoring System as Intervention -- 5.3.2 Ambivalence Under Organizational Pressure

The availability of medical and health information on the world wide web has led to a long discussion about the reliability of that information. Various medical, political, and independent organizations have created user-friendly tools for finding reliable medical/health information on the web and have been faced with the challenge of (re)defining what it means for information to be reliable. Little attention has been given to the work of reviewing web-based information and applying selection criteria to individual sites. In this article, the authors examine how guidelines are applied in practice and discuss how the selection criteria and the practices of applying them reinforce distinctions (such as those between lay and expert, global and local, nonprofit and commercial, etc.) that current medical sociology and informatics literature suggests have been broken down by internet technologies and the availability of web-based medical information.

This article juxtaposes the history of the book to the current discussions about lay health information on the Internet in order to thoroughly open up the notion of "reliability" that underlies these discussions. It uses the parallels between the two media to improve understanding of what actors are involved and what issues are at stake, as well as how this is consequential for the reliability that is constructed.

Eind jaren negentig, enkele jaren nadat het wereldwijde web open toegang tot het internet mogelijk had gemaakt, zagen we de opkomst van zelfbenoemde 'internetonderzoekers' in vrijwel alle academische disciplines. Toen al uitten deze onderzoekers hun bezorgdheid over de relatie tussen kwalitatief onderzoek en het internet. Zij vroegen zich af of de bestaande 'offline' methoden bruikbaar waren voor de studie naar het internet en het gebruik ervan in diverse contexten. Deze discussies richtten zich toen vooral op de vraag of de bestaande methoden overgenomen konden worden, of dat het nodig was om nieuwe, specifieke onderzoeksmethoden voor het web te ontwikkelen (zie: Jones, 1999; Mann & Stewart, 2000).

Purpose– The purpose of this paper is to improve the general operationalization of an "active patient," by examining the specific activities and skills expected of active patients.Design/methodology/approach– Expected activities and necessary skills were studied through a qualitative case study into the development and use of an assistive technology (i.e. web site) aimed at stimulating active patient-ship. Interviews, observations and document analysis were used to capture and explore designers' inscribing practices and their consequences regarding expected competences and activities of patients using the web site.Findings– Designers inscribed two "co-design roles" that active patients were expected to perform on the web site (co-designing their own healthcare and co-designing the healthcare of peers), for which at least eight different competencies were needed. The absence of skills or facilities to apply these skills resulted in incomplete use, a different use than intended by designers and non-use of the web site.Practical implications– Technological choices and inscribing processes determine who is able or facilitated to become active and who is not. Due to inscribed co-design roles, it also influences the extent to which already active peers are able to perform health-related activities. Different users with different conditions should be taken into account in the design as specific group characteristics can influence level of individual activity.Originality/value– This study is, as far as the authors know, the first that examines the "active patient" concept by studying an assistive technology and using scripting literature, resulting in an improved understanding of what it means to become "active" in terms of skills and activities.

We explore the role of two metaphors for innovation and infrastructure integration in the development of a regional patient portal. Our premise is that metaphors have real consequences for agenda setting and decision-making; we view them as operationalizations of sociotechnical imaginaries. Drawing on our formative study of the portal project, we focus on the generative character of metaphors and argue that they are constitutive elements of information infrastructures. While the two metaphors in our study helped to make imaginaries of 'integrated' and 'personalized' health care more defi nite, cognizable, and classifi able, they also concealed the politics of infrastructural work. We argue that the act of 'spelling out' metaphors can open up a space for new imaginaries and alternative strategies. With this study we aim to contribute to existing knowledge about infrastructural work, and to renew the interest among STS scholars for the role of discursive attributes in information infrastructures.