This practice-based research project explored how participatory design practice can help discover the barriers and facilitators of digital self-management devices, to reveal preferable user-centred design principles for long term condition innovation. Participants with type 1 diabetes were recruited as a contextual vehicle for this inquiry, due to the symbiotic relationship that those who self-manage this condition have with their digital self-management devices: like a flash/continuous glucose monitor and/or an insulin pump.

Participatory design methods were adopted to conduct semi-structured interviews to understand the lived experience of using self-management devices, as well as an interactive situational mapping activity to discover relationships beyond each user - which resulted in a synthesised stakeholder relational map. Then a collaborative participatory workshop featuring generative activities; relational map validation and co-analysis, what if provocations and provotype generation, and alternative now contextual interventions - towards the co-creation of self-management design principles.

From situational and thematic analysis of the six interactive interviews conducted and a participatory workshop with three users, the following self-management principle findings emerged; self-management relations go beyond a singular user and their devices, self-management trust needs to consider the holistic user experience and self-management education and experiential insight is key. This research concluded by reflecting on how the participatory design process helped drive user-centred design innovation - which was evident in the principles delivered as they respond to participants suggesting that relations, trust and education beyond the end-user have not been fully considered within the design of current self-management products and services. Therefore, participatory design approaches can help develop preferable relationships to digital self-management practice for users with long-term conditions and consider how self-management support systems could be transformed, collaboratively with users, towards preferable futures.