Logo: to the web site of Uppsala University

It has traditionally been assumed that information systems describe physical reality. However, this assumption is becoming obsolete as digital infrastructures are increasingly part of real-world experiences. Digital infrastructures (ubiquitous and scalable information systems) no longer merely map physical reality representations onto digital objects but increasingly assume an active role in creating, shaping, and governing physical reality. We currently witness an "ontological reversal", where conceptual models and digital infrastructures change physical reality. Still, the fundamental assumption remains that physical reality is the only real world. However, to fully embrace the implications of the ontological reversal, conceptual modeling needs an "institutional turn" that abandons the idea that physical reality always takes priority. Institutional reality, which includes, for example, institutional entities such as organizations, contracts, and payment transactions, is not simply part of physical reality detached from digital infrastructures. Digital infrastructures are part of institutional reality. Accordingly, the research question we address is: What are the fundamental constructs in the design of digital infrastructures that constitute and transform institutional reality? In answering this question, we develop a foundation for conceptual modeling, which we illustrate by modeling the institution of open banking and its associated digital infrastructure. In the article, we identify digital institutional entities, digital agents regulated by software, and digital institutional actions as critical constructs for modeling digital infrastructures in institutional contexts. In so doing, we show how conceptual modeling can improve our understanding of the digital transformation of institutional reality and the prescriptive role of conceptual modeling. We also generate theoretical insights about the need for legitimacy and liability that advance the study and practice of digital infrastructure design and its consequences.

Background: Informal caregivers, often family members or friends, play a crucial role in supporting individuals with chronic illnesses, disabilities, or age-related needs. However, the demands of caregiving can be overwhelming, leading to stress, burnout, and negative impacts on caregivers’ well-being. IT applications have emerged as potential solutions to support informal caregivers, but their design and evaluation often lack a comprehensive understanding of caregivers’ needs and preferences. By understanding caregivers’ perspectives on these issues, this review aimed to inform the development of more effective and user-centered IT solutions that truly support caregivers’ needs.

Objective: The purpose of this study was to conduct a scoping review to outline design recommendations for IT applications gathered from informal caregivers. In addition, this study presents evaluations of the use of IT applications by informal caregivers.

Methods: A five-step scoping review methodology was used to map relevant literature in the following manner: (1) research question identification, (2) relevant study identification, (3) selection of pertinent studies for review, (4) data charting from the selected literature, and (5) summarization and reporting of results. A structured search was conducted across the PubMed, Scopus, IEEE Xplore Digital Library, Web of Science, and ACM Digital Library databases. In addition, reference list hand searches and keyword searches in Google Scholar were undertaken. The inclusion criteria comprised research articles (journal and conference) focusing on IT applications tailored for informal caregivers, primarily qualitative studies. Two reviewers independently identified articles for review and extracted the data. Conflicts were resolved through discussion, with a third reviewer consulted if consensus could not be attained. Thematic analysis was used to analyze the data.

Results: A total of 82 articles were selected for the scoping review—44 (54%) related to design and 39 (48%) related to evaluation of IT applications. Six overarching themes emerged related to designing IT applications: information access, support systems, streamlining care-related tasks, fostering informal caregivers’ well-being, communication with formal health care professionals, and task support. Furthermore, 3 broad themes emerged related to the evaluation of IT applications for informal caregivers: facilitators of using IT applications, barriers to using IT applications, and suggestions for improving IT applications for informal caregivers.

Conclusions: To our knowledge, this is the first study to map the literature on the design and evaluation of IT applications for informal caregivers. This scoping review outlines current practices and recommendations for designing and evaluating the use of IT applications for informal caregivers. It identifies 6 key design themes and 3 evaluation themes, offering valuable insights for future development in this field. These findings provide a road map for enhancing user-centric IT solutions in informal caregiver support technologies.

Objectives: This paper introduces HealthCheck, a novel evaluation method for persuasive mobile health applications, aiming to fill the critical gap in quick and effective evaluation tools for this domain. Methods: Following Design Science Research, HealthCheck was developed through problem identification, solution design, implementation, evaluation, and iterative refinement. The implementation involved testing with seven experts to assess its applicability and effectiveness. Results: Feedback from the evaluators indicated that while a few heuristics in HealthCheck were considered irrelevant by some, the majority found the heuristics to be both pertinent and beneficial, especially within the caregiving context. This feedback highlights the practical value of HealthCheck and its potential to offer meaningful insights into improving the usability of persuasive eHealth applications. Conclusion: The study shows HealthCheck effectively evaluates persuasive mobile health applications, offering actionable insights to enhance usability. This validates the relevance and robustness of HealthCheck’s heuristics, advancing information systems and human-computer interaction research.

Objective: Informal caregivers such as relatives or close friends of patients are essential for caregiving at home. However, caregiving is a complex experience that may affect the caregivers’ well-being. Therefore, there is a need to provide support for caregivers, which we address in this article by proposing design suggestions for an e-coaching application. This study identifies the unmet needs of caregivers in Sweden and provides design suggestions for an e-coaching application using the persuasive system design (PSD) model. The PSD model offers a systematic approach to designing IT interventions.

Methods: A qualitative research design was used, and semi-structured interviews were conducted with 13 informal caregivers from different municipalities in Sweden. A thematic analysis was performed to analyze the data. The PSD model was used to map the needs emerging from this analysis to propose design suggestions for an e-coaching application for caregivers.

Results: Six needs were identified, and based on them, we proposed design suggestions for an e-coaching application using the PSD model. These unmet needs are monitoring and guidance, assistance to avail formal care services, access to practical information without being overwhelmed, feeling of community, access to informal support, and grief acceptance. The last two needs could not be mapped using the existing PSD model, resulting in an extended PSD model.

Conclusion: This study revealed the important needs of informal caregivers based on which design suggestions for an e-coaching application were presented. We also proposed an adapted PSD model. This adapted PSD model can be further used for designing digital interventions in caregiving.

Background: Informal caregivers are vital in caring for their family and friends at home who may have illnesses or disabilities. In particular, the demands for caregiving can be even more challenging for those with limited resources, support systems, and language barriers, such as immigrant informal caregivers. They face complex challenges in providing care for their relatives. These challenges can be related to sociocultural diversity, language barriers, and health care system navigation. Acknowledging the global context of the increasing number of immigrants is essential in designing inclusive mobile health apps.

Objective: This study aims to investigate the needs of immigrant informal caregivers in Sweden and discuss the application of the Persuasive System Design Model (PSDM) to develop an e-coaching prototype. By addressing the unique challenges faced by immigrant informal caregivers, this study will contribute to the development of more effective and inclusive mobile health apps.

Methods: The participants were considered immigrants and included in the study if they and their parents were born outside of Sweden. Through various channels, such as the National Association of Relatives, rehabilitation departments at municipalities, and immigrant groups, we recruited 13 immigrant informal caregivers. These immigrant informal caregivers were primarily women aged 18 to 40 years. Most participants belonged to the Middle Eastern region whereas some were from North Africa. However, all of them spoke Arabic. We used semistructured interviews to gather data from the participants in Arabic, which were translated into English. Data were analyzed using thematic analysis and discussed in relation to the extended PSDM. The needs of the caregivers were compared with the description of persuasive design principles, and a design principle was chosen based on the match. The PSDM was extended if the need description did not match any principles. Several brainstorming and prototyping sessions were conducted to design the mobile e-coaching app.

Results: Immigrant informal caregivers have various needs in their caregiving role. They reported a need for training on the illness and future caregiving needs, assistance with understanding the Swedish language and culture, and help with accessing internet-based information and services. They also required recognition and appreciation for their efforts, additional informal support, and easy access to health care services, which can be important for their mental health. The PSDM was adapted to the informal caregiving context by adding “facilitating conditions” and “verbal encouragement” as additional persuasive design principles. This study also presents the subsequent mobile e-coaching app for immigrant informal caregivers in Sweden.

Conclusions: This study revealed important immigrant informal caregivers’ needs based on which design suggestions for a mobile e-coaching app were presented. We also proposed an adapted PSDM, for the informal caregiving context. The adapted PSDM can be further used to design digital interventions for caregiving.

Being an informal caregiver is not easy, and might cause physical and psychosocial burden, especially in the long run. However, the formal health care system has little support for informal caregivers who experience abandonment and lack information. Mobile health can potentially be an efficient and cost-effective way of supporting informal caregivers. However, research has shown that mHealth systems often have problems with usability, and people do not use the systems for more than a short period. Therefore, this paper explores the design of an mHealth app using Persuasive Design, an established design framework. This paper presents the design of the first version of the e-coaching application using the persuasive design framework and unmet needs of informal caregivers from the literature. This prototype version will be updated based on interview data from informal caregivers in Sweden.

Background: A growing number of informal caregivers in many countries are important for effective functioning of health care in our society. Hence, they must receive the required support and services to continue providing care. IT applications can be used to support informal caregivers in their caregiving activities. However, evidence-informed guidelines for developing such IT applications and their evaluation are scarce. Hence, this scoping review can aid researchers and designers by providing design recommendations for IT apps for caregivers and potentially improve the design of IT applications for caregivers to meet their needs better.

Objective: This study aims to describe the proposal for a scoping review of current practices and recommendations in designing and evaluating IT applications for informal caregivers. The scoping review will also discuss the opportunities and challenges in designing these IT applications.

Methods: We will use a 5-step scoping review methodology to map relevant literature published as follows: (1) identify the research question, (2) identify relevant studies, (3) select relevant studies for review, (4) chart the data from selected literature, and (5) summarize and report results. A structured search will be conducted in PubMed, Scopus, IEEE digital library, Web of Science, and ACM Digital Library databases. In addition, hand searches of reference lists and keyword searches in Google Scholar will also be conducted. Inclusion criteria will be researched (journal and conference) articles focused on IT applications designed for use by informal caregivers and study type to be qualitative studies. Two reviewers will independently identify articles for review and extract data. Conflicts will be discussed, and a third reviewer will be consulted if a consensus cannot be reached. These data will be analyzed using thematic analysis.

Results: The results from this scoping review will be presented in a narrative form, and additional data on study characteristics will be presented in diagrams or tabular format. Uppsala University first initiated this scoping review protocol in December 2021 as part of the European Union–funded project ENTWINE. This work was also supported by the Swedish Research Council and the Swedish Cancer Society. The results will be presented in August 2023 and will be disseminated through a report to the European Union and a peer-reviewed journal publication. In addition, the team plans to share its findings on various public platforms, including social media, blog posts, and relevant conferences and workshops.

Conclusions: This is, to our knowledge, the first study to map the literature on the design and evaluation of IT applications for informal caregivers. The scoping review’s results will detail the requirements, design suggestions, and user preferences, as well as the usability criteria and features of IT applications for informal caregivers. A mapping of studies could inform the design and implementation of future IT applications for informal caregivers.

This paper complements an earlier (2019) literature review on workarounds in information systems research by including research that has influenced or been published in core IS outlets during the last five years (2018–2022). Our study captures research that strengthened, widened, and challenged theoretical insights from the previous review. It also provides additional insights and develops seven themes of theoretical insight. The 31 new papers and our updated analysis are most evident in the three themes: Workarounds and power, Temporality of workarounds, and Managing workarounds. We also found additional studies using the term ‘workaround’ differently to the extent that they have not applied the term to the same empirical phenomena, which questions the validity of some theoretical claims. We also found significantly more studies that used quantitative data-collection methods than the previous review.

In this paper, we present three current research projects that explore how digital transformation can be a positive force to help address the causes and mitigate the consequences of climate change. Drawing on the Scandinavian approach to information systems (IS), we advocate a stakeholder-centric approach that can help inform the climate change discourse and assist in developing green digital practices and services. Finally, we propose a research agenda stating that green IS researchers need to engage in co-creative collaborative research and that green IS research should focus on normative design theory, design principles, and actual designs.