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. 2022;12(6):1071-1084.
doi: 10.1007/s12553-022-00707-1. Epub 2022 Nov 13.

Revisiting agency and medical health technology: actor network theory and breast cancer survivors' perspectives on an adherence tool

Mark L Cabling  1 , Fabrizio Drago  2 , Jeanine Turner  3 , Alejandra Hurtado-de-Mendoza  1 , Vanessa B Sheppard  4
Affiliations

Revisiting agency and medical health technology: actor network theory and breast cancer survivors' perspectives on an adherence tool

Mark L Cabling et al. Health Technol (Berl). 2022.

Abstract

Purpose: Optimal treatment adherence is critical in the management of breast cancer patients/survivors taking hormonal therapy. However, lack of adherence is common. Many technologies have been developed to encourage medication intake, such as reminders on phones or digital pills, with varying degrees of success.

Methods: To explore the role of technology in medical adherence requires a framework that considers all complexities of technology, from software to the end user's beliefs. Actor Network Theory (ANT) defines technology based on its technical, social, and abstract components. We conducted three focus groups, which we analyzed using a thematic analysis to determine topics in breast cancer survivors' discussions of these technologies. We also conducted a deductive content analysis using ANT concepts as codes.

Results: In discussing the use of technology to improve medical adherence, participants had an empowering view of technology (48.8%) a neutral one (41.5%) or a disempowering view (9.8%). When it comes to their medication adherence, breast cancer survivors taking hormonal therapy perceived technology as something on which they could assert agency while their own agency dictated their adherence behaviors.

Conclusions: In line with a non-technologically deterministic view of medical technologies, this finding shows that technology can be both constraining and enabling, depending on the specific context of human use. This networked understanding of technology in terms of social dynamics has relevant implications in designing interventions that use technology to improve adherence.

Keywords: Actor Network Theory; Adherence; Breast Cancer; Hormonal therapy; Medical Technology.

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Conflict of interest statement

Conflict of interestThe authors have no relevant financial or non-financial interests to disclose.

Figures

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Phase I of data analysis
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Phase II of data analysis
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Actor Network Theory’s sociotechnical view of medical technology
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Women’s breast cancer experiences
See this image and copyright information in PMC

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