Ageing with apps: A Foucauldian study exploring older people’s use of apps in managing their physical health
DOI:
https://doi.org/10.7146/mk.v39i74.132346Keywords:
Foucault, self-tracking, apps, physical health, older people, ageingAbstract
This article explores the incorporation of mobile applications in older people’s physical health management through the lens of Foucault’s concepts on self-governance. Based on ten interviews with older Danes, the article posits that physical health management practices constitute practices of self-governance, involving participants’ attunement to both physical activity and bodily phenomena, which are both facilitated and optimized through app-based self-tracking. The findings align the rationales driving participants’ efforts with the trajectory of the governmental concept of active ageing. Using apps thus becomes intertwined with participants’ efforts towards ageing successfully, consequently taking on a dual function: Apps strengthen the adherence to norms of conduct for achieving an optimal ageing process by allowing for ubiquitous self-monitoring and self-assessment. Simultaneously, I argue that apps may also act as a gatekeeper, as lacking the technical competencies to efficiently use apps hinders effective health management and thus clashes with efforts conforming to active ageing.
References
Arnhold, M., Quade, M., & Kirch, W. (2014). Mobile applications for diabetics: A systematic review and expert-based usability evaluation considering the special requirements of diabetes patients age 50 years or older. Journal of Medical Internet Research, 16(4), 34–51. https://doi.org/10.2196/jmir.2968
Aslam, A., van Luenen, S., Aslam, S., van Bodegom, D., & Chavannes, N. H. (2020). A systematic review on the use of mHealth to increase physical activity in older people. Clinical eHealth, 3, 31–39. https://doi.org/10.1016/j.ceh.2020.04.002
Baes-Jørgensen, J. (2021). Ældreboom sætter sundheds - og plejeudgifter under hårdt pres. Kommunernes Landsforening. https://www.kl.dk/nyheder/momentum/2021/2021-8/aeldreboom-saetter-sundheds-og-plejeudgifter-under-haardt-pres/
Bakardjieva, M., & Gaden, G. (2012). Web 2.0 technologies of the self. Philosophy & Technology, 25(3), 399–413. https://doi.org/10.1007/s13347-011-0032-9
Bayer, A. (2017). Methodological challenges of research in older people. In H. M. Fillit, K. Rockwood, J. & Young (Eds.), Brocklehurst’s textbook of geriatric medicine and gerontology (8th ed.) (pp. 27–34). Else-vier. https://doi.org/10.7748/nop.29.2.15.s17
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology,3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Braun, V., & Clarke, V. (2012). Thematic analysis. In H. Cooper (Ed.), APA handbook of research methods in psychology: Vol 2 (p p . 57–71). American Psychological Association. https://doi.org/10.1037/13620-004
Braun, V., & Clarke, V. (2021). One size fits all? What counts as quality practice in (reflexive) thematic analy-sis? Qualitative Research in Psychology, 18(3), 328–352. https://doi.org/10.1080/14780887.2020.1769238
Bryman, A. (2016). Social research methods (5th ed.). Oxford University Press.
Caldeira, C., Bietz, M., & Chen, Y. (2016). Looking for the unusual: How older adults utilize self-tracking techniques for health management. PervasiveHealth: Pervasive Computing Technologies for Healthcare, (10). https://doi.org/10.4108/eai.16-5-2016.2263771
Cao, Y., Li, J., Qin, X., & Hu, B. (2020). Examining the effect of overload on the MHealth application resis-tance behavior of elderly users: An SOR perspective. International Journal of Environmental Research and Public Health, 17(18), 6658. https://www.mdpi.com/1660-4601/17/18/6658
Castro, P. C., Romano, L. B., Frohlich, D., Lorenzi, L. J., Campos, L. B., Paixão, A., Angélica de Oliveira Gomes, G. (2020). Tailoring digital apps to support active ageing in a low income community. PLOS ONE, 15(12) , 1–21. https://doi.org/10.1371/journal.pone.0242192
Cozza, M., Crevani, L., Hallin, A., & Schaeffer, J. (2019). Future ageing: Welfare technology practices for our future older selves. Futures, 109, 117–129. https://doi.org/10.1016/j.futures.2018.03.011
Danmarks Statistik [Statistics Denmark]. (2021). Befolkningsfremskrivning. https://www.dst.dk/da/Statistik/emner/befolkning-og-valg/befolkning-og-befolkningsfremskrivning/befolkningsfremskrivning
Dean, M. (2010). Governmentality: Power and rule in modern society (2nd ed.). Sage.Dyk, S. V., Lessenich, S., Denninger, T., & Richter, A. (2013). The many meanings of “active ageing”: Confront-ing public discourse with older people’s stories. Recherches sociologiques et anthropologiques: RS&A,44(1), 97–115. https://doi.org/10.4000/rsa.932
Ehn, M., Eriksson, L. C., Åkerberg, N., & Johansson, A.-C. (2018). Activity monitors as support for older per-sons’ physical activity in daily life: Qualitative study of the users’ experiences. JMIR Mhealth Uhealth, 6(2), e34. https://doi.org/10.2196/mhealth.8345
E-sundhedsobservatoriet [The E-health Observatory]. (2022). Mod et bæredygtigt digitalt sundhedsvæsen. https://2022.e-sundhedsobservatoriet.dk/
Evans, A. B., & Nistrup, A. (2020). Constructing the ethical active older subject: A Foucauldian discourse analysis of active ageing policies in Copenhagen, Denmark. International Journal of Sport Policy and Politics, 12(4), 617–635. https://doi.org/10.1080/19406940.2020.1827005
Foucault, M. (1988). Technologies of the self. In L. M. Martin, H. Gutman, & P. H. Hutton (Eds.), Technologies of the self: A seminar with Michel Foucault (pp. 16–49. The University of Massachusetts Press. Foucault, M. (1995). Discipline and punish: The birth of the prison. Vintage Books.
Foucault, M., & Rabinow, P. (1997). Ethics: Subjectivity and truth. The New Press.Foucault, M., & Senellart, M. (Eds.). (2009). Security, territory, population: Lectures at the Collége de France, 197 7-78 . Palgrave MacMillan. https://doi.org/10.22439/fs.v0i5.1412
Galletta, A. (2013). Mastering the semi-structured interview and beyond: From research design to analysis and publication. NYU Press. https://doi.org/10.18574/nyu/9780814732939.001.0001
Goodyear, V. A., Armour, K. M., & Wood, H. (2019). Young people learning about health: The role of apps and wearable devices. Learning, Media and Technology, 44(2), 193 –210 . https://doi.org/10.1080/17439884.2019.1539011
Gregersen, K. (1992). Dansk standard for udskrifter og registrering af talesprog. SNAK, 5–6.Helbostad, J. L., Vereijken, B., Becker, C., Todd, C., Taraldsen, K., Pijnappels, M., Aminian, K., Mellone, S. (2017). Mobile health applications to promote active and healthy ageing. Sensors, 17(622). https://doi.org/10.3390/s17030622
Implement Consulting Group. (2019, January 4). Analyse af guide til sundhedsapps. Sundhedsdatastyrelsen. https://sundhedsdatastyrelsen.dk/-/media/sds/filer/strategi-og-projekter/strategi-digital-sundhed/analyse-af-guide-til-sundhedsapps-04,-d-,01,-d-,19.pdf?la=da
Karlsen, M. P., & Villadsen, K. (2017). Sundhed og magt: perspektiver på biopolitik og ledelsesteknologi. Hans Reitzel. https://doi.org/10.22439/dansoc.v28i2.5616
Katz, S., & Marshall, B. L. (2018). Tracked and fit: FitBits, brain games, and the quantified aging body. Jour-nal of Aging Studies, 45, 63–68. https://doi.org/10.1016/j.jaging.2018.01.009
Knudsen, S. G. (2019). Governing lifestyle: The rationality and practice of type 2 diabetes care in Denmark[Doctoral dissertation, Department of Social Sciences and Business, Roskilde University, Denmark]
Kristensen, D. B. (2022). The optimised and enhanced self: Experiences of the self and the making of societal values. In M. Bruun, A. Wahlberg, R. Douglas-Jones, C. Hasse, K. Høyer, D. B. Kristensen, & B. R. Winthereik (Eds.), The Palgrave handbook of the anthropology of technology. Palgrave Macmillan. https://doi.org/10.1007/978-981-16-7084-8
Kristensen, D. B., Petersen, M. A., Barrett, B. A., Grue, A., & Simonsen, A. F. (2014). Et lykkeligere, sundere og mere effektivt liv. Tidsskriftet Antropologi, 70. https://doi.org/10.7146/ta.v0i70.107038
Lifková, A. (2019). Digital power: Self-tracking technologies through Michel Foucault lens. Politické vedy, 22(4), 81–101. https://doi.org/10.24040/politickevedy.2019.22.4.81-101
Lin, T. T. C., Bautista, J. R., & Core, R. (2020). Seniors and mobiles: A qualitative inquiry of mHealth adoption among Singapore seniors. Informatics for Health and Social Care, 45(4) , 3 6 0 –373 . https://doi.org/10.1080/17538157.2020.1755974
Lister, M., Dovey, J., Giddings, S., Grant, I., & Kelly, K. (2009). New media: A critical introduction. Routledge. https://doi.org/10.4324/9780203884829Lomborg, S., & Frandsen, K. (2016). Self-tracking as communication. Information, Communication & Soci-ety, 19(7), 1015–1027. https://doi.org/10.1080/1369118X.2015.1067710
Lupton, D. (2013). Quantifying the body: Monitoring and measuring health in the age of mHealth technologies. Critical Public Health, 23(4), 393–403. https://doi.org/10.1080/09581596.2013.794931
Lupton, D. (2016). The quantified self. Polity Press.Marhánkova, J. H. (2010). Leisure in old age: Disciplinary practices surrounding the discourse of active ageing. International Journal of Ageing and Later Life: IJAL, 6(1), 5–32. https://doi.org/10.3384/ijal.1652-8670.11615
Naaldenberg, J., Vaanager, L., Koelen, M., & Leeuwis, C. (2012). Aging populations’ everyday life perspectives on healthy aging: New insights for policy and strategies at the local level. Journal of Applied Gerontol-ogy, 31(6), 711–733. https://doi.org/10.1177/0733464810397703
Nilsson, G., Ekstam, L., Axmon, A., & Andersson, J. (2021). Old overnight: Experiences of age-based recom-mendations in response to the COVID-19 pandemic in Sweden. Journal of Aging & Social Policy, 33(4 -5), 359–379. https://doi.org/10.1080/08959420.2021.1925042
Ohrnberger, J., Fichera, E., & Sutton, M. (2017). The relationship between physical and mental health: A mediation analysis. Social Science & Medicine, 195, 42–49.https://doi.org/10.1016/j.socscimed.2017.11.008
Onyeaka, H. K., Romero, P., Healy, B. C., & Celano, C. M. (2021). Age differences in the use of health infor-mation technology among adults in the United States: An analysis of the health information national trends survey. Journal of Aging and Health, 33(1-2), 147–154. https://doi.org/10.1177/0898264320966266
Oxlund, B., & Whyte, S. R. (2014). Measuring and managing bodies in the later life course. Journal of Popu-lation Ageing, 7(3), 217–230. https://doi.org/10.1007/s12062-014-9104-9
Paiva, J. O. V., Andrade, R. M. C., de Oliveira, P. A. M., Duarte, P., Santos, I. S., Evangelista, A. L. de P., Theophilo, R. L., de Andrade, L. O. M., & Barreto, I. C. de H. C. (2020). Mobile applications for elderly healthcare: A systematic mapping. PLOS ONE, 15(7), e0236091–e0236091. https://doi.org/10.1371/journal.pone.0236091
Petersen, M. L., Mahnke, M. S., & Nielsen, M. (2022). Practices of self-tracking in infertility treatment: How bodily awareness is constituted. Qualitative Health Communication, 1(2) , 35 – 47. https://doi.org/10.7146/qhc.v1i2.130468
Petrakaki, D., Hilberg, E., & Waring, J. (2018). Between empowerment and self-discipline: Governing patients’ conduct through technological self-care. Social Science & Medicine (1982), 213, 146–153. https://doi.org/10.1016/j.socscimed.2018.07.043
Pike, E. (2015). Physical activity and narratives of successful ageing. In C. Phoenix, & E. Tulle (Eds.), Physical activity and sport in later life: Critical perspectives (pp. 21–31). Palgrave Macmillan. https://doi.org/10.1007/978-1-137-42932-2_3
Ramirez, R. (2017, July 6–7). Technologies of the self: How are digital tools affecting human ontologies? Proceeding of the Fifth Conference on Computation, Communication, Aesthetics& X, Lisbon, Portugal. http://2017.xcoax.org/xCoAx2017.pdf
Rose, N. (2007). The politics of life itself: Biomedicine, power and subjectivity in the twenty-first century. Princeton University Press. https://doi.org/10.1086/597744
Rowe, J. W., & Kahn, R. L. (1997). Successful aging. The Gerontologist, 37(4) , 433 – 440. https://doi.org/10.1093/geront/37.4.433
Sanders, R. (2017). Self-tracking in the digital era: Biopower, patriarchy, and the new biometric body proj-ects. Body & Society, 23(1), 36–63. https://doi.org/10.1177/1357034X16660366
Schlomann, A. (2017). A case study on older adults’ long-term use of an activity tracker. Gerontechnology,16(2), 115–124. https://doi.org/10.4017/g t.2017.16 .2.0 07.0 0
Schlomann, A., von Storch, K., Rasche, P., & Rietz, C. (2016). Means of motivation or of stress? The use of fitness trackers for self-monitoring by older adults. HeilberufeSCIENCE, 7(3), 111–116. https://doi.org/10.1007/s16024-016-0275-6
Schwennesen, N. (2019). Surveillance entanglements digital data flows and ageing bodies in motion in the Danish welfare state. Anthropology & Aging, 40(2), 10–22. https://doi.org/10.5195/aa.2019.224
Seifert, A., Schlomann, A., Rietz, C., & Schelling, H. R. (2017). The use of mobile devices for physical activity tracking in older adults’ everyday life. Digital Health, 3, 2055207617740088. https://doi.org/10.1177/2055207617740 088
Sobiech, G., & Leipert, S. (2021). Older women being active in fitness gyms: Benefits or constraints? Results from a qualitative interview study (southern Germany and east coast of USA). German Journal of Exercise and Sport Research, 51(4), 457–467. https://doi.org/10.1007/s12662-021-00777-9
Stampe, K. (2020). Digitally enabled chronic disease self-management: Embodiment of digital artefacts in JIA patients’ everyday life [Doctoral dissertation, Aarhus University, Denmark]. https://pure.au.dk/portal/files/20137648/Final_Version_PhD_Thesis_KathrineStampe.pdf
Steward, E., & Roy, A. (2014). Subjectivity. In T. Teo (Ed.), Encyclopedia of critical psychology (pp. 1876–1880). Springer Science + Business Media New York. Sundhedsdatastyrelsen [The Danish Health Data Authority]. (2019). Strategi for digital sundhed 2018–2022: Porteføljeoverblik med status over indsatser. https://sundhedsdatastyrelsen.dk/-/media/sds/filer/strategi-og-projekter/strategi-digital-sundhed/status_strategi_for_digital_sundhed.pdf
Sundhedsministeriet [The Danish Ministry of Health]. (2022, March). Sundhedsreformen: Gør Danmark sundere. https://sum.dk/temaer/sundhedsreformen
Sundhedsstyrelsen [The Danish Health Authority]. (2015). Forebyggelse på ældreområdet: Håndbog til kommunerne. https://www.sst.dk/da/aeldre/forebyggelse/~/media/06270654E0FD44EFB919F2112ABF794D.ashx
Tulle, E. (2015). Physical activity and sedentary behaviour: A vital politics of old age? In C. Phoenix, & E. Tulle (Eds.), Physical activity and sport in later life: Critical perspectives (pp. 9–20). Palgrave Macmillan. https://doi.org/10.1007/978-1-137-42932-2_2
Urban, M. (2017). ‘This really takes it out of you!’ The senses and emotions in digital health practices of the elderly. Digital Health, 3, 2055207617701778 . https://doi.org/10.1177/2055207617701778
Villadsen, K., & Mik-Meyer, N. (2007). Magtens former: Sociologiske perspektiver på statens møde med borgeren. Hans Reitzels Forlag. World Health Organization. (October, 2006). Constitution of the World Health Organization. https://www.who.int/governance/eb/who_constitution_en.pdf
Ældresagen [DaneAge Association]. (2019). Digital adfærd og præferencer: November 2019. https://www.aeldresagen.dk/presse/viden-om-aeldre/analyser-og-undersoegelser/digital-adfaerd-og-praefer-encer-2019
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 author and journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright Author and Journal.
Articles published after January 1 2024 are licensed under CCBY 4.0.
Articles published until December 31 2023 are licensed under CCBYNCND.
Articles submitted to MedieKultur should not be submitted to or published in other journals.