61 Re-visiting Design-After-Design: Reflecting Implementation Mediators Connectedness in Distributed Participatory Design Activities Nima Herman Shidende Department of Informatics University of Oslo NO-0316, Oslo, Norway shidende@yahoo.co.uk Christina Mörtberg Department of Informatics Linneaus University SE-351 95 Växjö, Sweden christina.mortberg@lnu.se ABSTRACT This paper aims at an extended understanding of the design facilitators' role, here implementation mediators, in participatory design practices. In reflecting connectedness between use and design in a distributed open source software design practice, a particular focus is devoted to the implementation mediator’s interaction between local users, global software developers, and local designers who are geographically distributed, possess different technological skills, and different work experiences. The implementation mediators’ insights are useful in the design of large information systems that involve distributed actors. A maternal and child health setting in Tanzania was the case in this study. An ethnographic study involving interactions with global developers and participative activities in local health practices were conducted. In addition, mediators connected local and global designers to configure a computer system for a particular context; configured participation, involving health workers in designing practices. We present the role of the implementation mediators and its related participatory activities by using the notion of design-after-design. We also highlight the challenges which could face implementation mediators in distributed participatory design activities. Author Keywords Distributed Participatory Design, Implementation Mediators, Design-After-Design, Health Information Systems ACM Classification Keywords D.2.10: Design, Methodologies, Human Factors, H.5.m: Participatory Design INTRODUCTION This year’s conference call inspires reflections on connectedness. We have chosen a case undertaken in Tanzania – an activity within the Health Information Systems Programme (HISP) (see e.g. Braa and Sahay, 2012) to discuss the connectedness between design and use. Specifically, we will do this by turning to Pelle Ehn (2008, p.96) and his discussion of ‘design for use before use’ and ‘designing for design after design’. Certainly, Participatory Design (PD) projects and scholars have paid attention to what happens after a system or service has been designed and implemented; that is, in the continuity of design-in-use. This had been already discussed in the 1990s when PD researchers extended the design process with the inclusion of activities performed in use (see e.g. Henderson and Kyng, 1991). However, Ehn (2008, p. 96) is more explicit in his focus on design-in-use and he writes: Rather than focusing on involving users in the design process, focus shifts towards seeing every use situation as a potential design situation. So there is design during a project (‘at project time’), but there is also design in use (‘at use time’). There is design (in use) after design (in the design project). Bratteteig et al (2012, p. 138-39) also reflect upon ‘design-after-design’. The rationale of their discussion is a shift in systems design towards software and e-services built on platforms that allow further development. Tailoring possibilities or to postpone some design decisions to design-in-use is Bratteteig et al.’s (ibid) suggestion to deal with the transformation. In reflecting the connectedness between design and use- ´design-after-design’, the focus is on the role of the design facilitator or the implementation mediator 1 (Braa and Sahay, 2012). Design facilitators have been discussed in previous PD research e.g. the facilitator’s role in future workshops (Kensing and Halskov, 1991), the ethnographer as a facilitator to enable dialogues and collaboration (Blomberg et al., 1993), and design facilitators in situated participating practices (Light and Akama, 2012). The implementation mediator is also a design facilitator who supports and enhances participatory activities. Both Puri et al. (2009) and Titlestad et al. (2009) assert that, in distributed participatory design approaches, implementation mediators’ roles are crucial to enable participation at local levels and to make interventions at global level. The 1 E.g. Latour (2005) has used the concept mediator. 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