Navigating Legitimacy in the Development of Obstructive Sleep Apnea Diagnostics: A Qualitative Study.

IntroductionHealth technology innovations often challenge established practices, roles, and norms, which can impede their adoption and diffusion across healthcare systems. This study explores how those involved in sleep research and innovation facilitate adoption and diffusion of diagnostic solutions for obstructive sleep apnea (OSA) by addressing perceived legitimacy concerns-conceptualized here as cognitive, moral, and pragmatic legitimacy pressures-during solution development. We refer to these efforts as navigating legitimacy.MethodsThe study draws on 24 thematic interviews with individuals involved in sleep research and innovation in Finland (e.g., researchers, diagnostic device developers, clinicians). Interview transcripts were analyzed using inductive and deductive thematic analysis.ResultsThe analysis indicated that respondents navigate legitimacy through contextual and ongoing legitimacy-building activities that combine discursive and material aspects. These activities exert influence on how the diagnostic solution takes shape, highlighting that diagnostic innovation is profoundly embedded within social and institutional contexts.ConclusionPractically, our research provides valuable insights for researchers, developers, and policymakers into the dynamics through which digital health innovation is developed.