Greenhalgh, Trisha, Shaw, Sara, Wherton, Joe, Hughes, Gemma, Lynch, Jenni, A'Court, Christine, Hinder, Sue, Fahy, Nick, Byrne, Emma, Finlayson, Alexander, Sorell, Tom, Procter, Rob and Stones, Rob (2016) SCALS : a fourth-generation study of assisted living technologies in their organisational, social, political and policy context. BMJ Open, 6 (2). e010208. doi:10.1136/bmjopen-2015-010208 ISSN 2044-6055.

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Abstract

Introduction: Research to date into assisted living technologies broadly consists of 3 generations: technical design, experimental trials and qualitative studies of the patient experience. We describe a fourth generation paradigm: studies of assisted living technologies in their organisational, social, political and policy context. Fourth-generation studies are necessarily organic and emergent; they view
technology as part of a dynamic, networked and potentially unstable system. They use co-design methods to generate and stabilise local solutions, taking account of context.
Methods and analysis: SCALS (Studies in Co-creating Assisted Living Solutions) consists (currently) of 5 organisational case studies, each an English health or social care organisation striving to introduce
technology-supported services to support independent living in people with health and/or social care needs. Treating these cases as complex systems, we seek to explore interdependencies, emergence and conflict. We employ a co-design approach informed by the principles of action research to help participating organisations establish, refine and evaluate their service. To that end, we are conducting in-depth
ethnographic studies of people’s experience of assisted living technologies (micro level), embedded in evolving organisational case studies that use interviews, ethnography and document analysis (meso level), and exploring the wider national and international context for assisted living technologies and policy (macro level). Data will be analysed using a sociotechnical framework developed from structuration theory.
Ethics and dissemination: Research ethics approval for the first 4 case studies has been granted. An important outcome will be lessons learned from individual co-design case studies. We will document the studies’ credibility and rigour, and assess the transferability of findings to other settings while also recognising unique aspects of the contexts in which they were generated. Academic outputs will include a cross-case analysis and progress in theory and method of fourth-generation assisted living technology research. We will produce practical guidance for organisations, policymakers, designers and
service users.

Item Type:	Journal Article
Subjects:	H Social Sciences > H Social Sciences (General) Q Science > Q Science (General) R Medicine > R Medicine (General)
Divisions:	Faculty of Science, Engineering and Medicine > Science > Computer Science
Library of Congress Subject Headings (LCSH):	Life care communities
Journal or Publication Title:	BMJ Open
Publisher:	BMJ
ISSN:	2044-6055
Official Date:	15 February 2016
Dates:	Date Event 15 February 2016 Published 23 November 2015 Accepted 8 October 2015 Submitted
Volume:	6
Number:	2
Number of Pages:	14
Article Number:	e010208
DOI:	10.1136/bmjopen-2015-010208
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	20 February 2016
Funder:	Wellcome Trust (London, England), National Institute for Health Research (Great Britain) (NIHR)
Grant number:	WT104830MA (WT), RP-DG-1213-10003 (NIHR)

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