Participatory Surveillance and Candidacy

Actively involving people in self-monitoring and management during their pregnancy is an emerging clinical and social practice. Self-monitoring of blood pressure and self-testing for proteinuria, key diagnostic tests for pre-eclampsia, are becoming commonplace in hypertensive pregnancies. While evidence exists on the acceptability and feasibility of self-monitoring blood pressure, evidence for self-testing for proteinuria in pregnancy is thin, with little knowledge of how it might affect the traditional structures of maternity care. As part of a diagnostic accuracy study on self-testing for proteinuria, pregnant people and healthcare professionals were recruited to a qualitative study to understand their experiences of, and attitudes to, self-testing. Multiple qualitative methods were used, including interviews, focus groups, and free text postcards. A discourse analysis was conducted to understand how self-testing might inform and reshape routine antenatal care. Analysis revealed a tension between the empowering concept of participatory surveillance, which pregnant people and healthcare professionals were broadly positive about, and the adjudications made by healthcare professionals about the candidacy, or suitability , of certain pregnant people to self-test. Candidacy is a framework for understanding what influences access to healthcare for socially disadvantaged groups, including professional judgments that impact access to interventions. While participatory surveillance was felt to have the potential to empower pregnant people in antenatal care, the loss of the traditional clinical gaze was disquieting for some, and pregnant people and healthcare professionals were reluctant to cede professional responsibility

Candidacy · Family medicine · Health care · Political science · Qualitative research · Sociology · Global Maternal and Child Health · Maternal and fetal healthcare · Medicine · Nursing · Pregnancy and preeclampsia studies · Psychology

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• Making sense of qualitative data analysis

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• Conducting a critical interpretive synthesis of the literature on access to healthcare by vulnerable groups

  Open Access•Mary Dixon-Woods, Debbie Cavers et al.•BMC Medical Research Methodology•2006

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• Empowerment through health self-testing apps? Revisiting empowerment as a process

  Open Access•Alexandra Kapeller, Iris Loosman•Medicine Health Care and Philosophy•2023

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• ‘The best thing for the baby’

  D Lupton, Deborah A Lupton•Health Risk & Society•2011

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• Precious cargo’

  Open Access•D Lupton•Critical Public Health•2012

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• Online social networking as participatory surveillance

  Open Access•Anders Albrechtslund•First Monday•1969

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• Childbirth Within the Risk Society

  Open Access•Mandie Scamell•Sociology Compass•2014

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• Types of Self-Surveillance

  Open Access•Paulo Roberto Givaldi Vaz, Paulo Vaz et al.•Surveillance & Society•2002

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• Young people’s uses of wearable healthy lifestyle technologies; surveillance, self-surveillance and resistance

  Victoria Goodyear, Charlotte Kerner et al.•Sport Education and Society•2017

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• Using thematic analysis in psychology

  Open Access•Braun, Virginia Braun et al.•Qualitative Research in Psychology•2006

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• But I Gathered My Courage

  Open Access•Jonas Wachinger, Daniel Kibuuka Musoke et al.•Qualitative Health Research•2021

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• You Probably Won't Notice Any Symptoms

  Open Access•Lisa Hinton, A Chisholm et al.•Qualitative Health Research•2021

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