Older adults' motivated choice for technological innovation: evidence for benefit-driven selectivity

Factors influencing older adults' acceptance of voice assistants

Introduction

Voice assistants (VAs) have the potential to uphold and enhance the quality of life for older adults. However, the extent to which older adults accept and benefit from VAs may be relatively modest.

Methods

This study developed a comprehensive model combined with product and personal characteristics to explain the acceptance of VAs among older adults, using semi-structured interviews (Study 1) and questionnaires (Study 2).

Results

Results revealed that in terms of product characteristics, perceived usefulness and perceived enjoyment significantly affect behavior intention. Regarding personal characteristics of older adults, technological self-efficacy and dispositional resistance to change significantly affect behavior intention. However, no direct impact of perceived ease of use and perceived trust on behavior intention. Additionally, perceived enjoyment influenced both perceived ease of use and perceived usefulness.

Discussion

Results suggested the significant role of technology self-efficacy and dispositional resistance to change in predicting the acceptance of VAs among older adults. Our newly developed model offers valuable insights for tailoring VAs to this demographic during design and implementation.

Coadaptation Between Smart Technologies and Older Adults Over Time: Protocol for a Scoping Review

BACKGROUND

The Internet of Things (IoT) has gained significant attention due to advancements in technology and has potential applications in meeting the needs of an aging population. Smart technologies, a subset of IoT, can support older adults in aging in place, promoting independent living and improving their quality of life. However, there is a lack of research on how older adults and smart technologies coadapt over time to maximize their benefits and sustain adoption.

OBJECTIVE

We will aim to comprehensively review and analyze the existing scientific literature pertaining to the coadaptation between smart technologies and older adults. The primary focus will be to investigate the extent and nature of this coadaptation process and explore how older adults and technology coevolve over time to enhance older adults' experience with technology.

METHODS

This scoping review will follow the methodology outlined in the Joanna Briggs Institute Reviewer's Manual and adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews) guidelines for reporting. Peer-reviewed articles will be searched in databases like Ovid MEDLINE, OVID Embase, PEDro, OVID PsycINFO, EBSCO CINAHL, the Cochrane Library, Scopus, IEEE Xplore, Web of Science, and Global Index Medicus. The research team will create a data extraction form covering study characteristics, participant characteristics, underlying models and frameworks, research findings, implications for technology coadaptation, and any identified study limitations. A directed content analysis approach will be used, incorporating the Selection, Optimization, and Compensation framework and Sex- and Gender-Based Analysis Plus theoretical framework.

RESULTS

The results of this study are expected in January 2024.

CONCLUSIONS

This scoping review endeavors to present a thorough overview of the available evidence concerning how smart technologies interact with older adults over an extended period. The insights gained from this review will lay the groundwork for a research program that explores how older adults adapt to and use smart technologies throughout their lives, ultimately leading to improved user satisfaction and experience and facilitating aging in place with tailored support and user-centered design principles.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/51129.

Integration of a Smartphone HF-Dedicated App in the Remote Monitoring of Heart Failure Patients with Cardiac Implantable Electronic Devices: Patient Access, Acceptance, and Adherence to Use

(200 w) Introduction. Remote monitoring (RM) of cardiac implantable electronic device (CIED) diagnostics helps to identify patients potentially at risk of worsening heart failure (HF). Additionally, knowledge of patient HF-related symptoms is crucial for decision making. Patient smartphone applications may represent an ideal option to remotely collect this information.

PURPOSE

To assess real-world HF patient access, acceptance, and adherence to use of an HF-dedicated smartphone application (HF app).

METHODS

In this study, 10 Italian hospitals administered a survey on smartphone/app use to HF patients with CIED. The subgroup who accepted it downloaded the HF app. Mean 1-year adherence of the HF app use was evaluated.

RESULTS

A total of 495 patients (67 ± 13 years, 79% males, 26% NYHA III-IV) completed the survey, of which 84% had access to smartphones and 85% were willing to use the HF app. In total, 311/495 (63%) downloaded the HF app. Patients who downloaded the HF app were younger and had higher school qualification. Patients who were ≥60 years old had higher mean 1-year adherence (54.1%) than their younger counterparts (42.7%; p < 0.001). Hospitals with RM-dedicated staff had higher mean 1-year patient adherence (64.0% vs. 33.5%; p < 0.001). Adherence to HF app decreased from 63.3% (weeks_1-13) to 42.2% (weeks_40-52, p < 0.001).

CONCLUSIONS

High access and acceptance of smartphones/apps by HF patients with CIED allow HF app use for RM of patient signs/symptoms. Younger patients with higher school qualifications are more likely to accept HF app; however, older patients have higher long-term adherence.

The Factors Influencing Older Adults' Decisions Surrounding Adoption of Technology: Quantitative Experimental Study

BACKGROUND

The rapid diffusion of technology apps may support older adults' independence and improve the quality of their lives. Models for predicting technology acceptance in older adults are sparse, based on broad questions related to general technology acceptance, and largely not grounded in theories of aging.

OBJECTIVE

This study aimed to use a mixed methods approach involving 5 technologies to comprehensively assess the causal relationships among factors that influence older adults' willingness to adopt the technologies.

METHODS

In total, 187 men and women aged 65 to 92 years participated in the study. Participants were given presentations on 5 different technologies spanning domains that included transportation, leisure, health, and new learning and provided ratings of each technology on various measures hypothesized to influence adoption. They were also administered other instruments to collect data on their actual and self-assessed cognitive abilities, rates of discounting of the technologies with respect to willingness to invest time to attain higher skills in the technologies, general technology experience, and attitudes toward technology. We used the machine learning technique of k-fold cross-validated regressions to select variables that predicted participants' willingness to adopt the technologies.

RESULTS

Willingness to adopt technologies was most impacted by 3 variables: perceived value of the technologies (β=.54), perceived improvement in quality of life attainable from the technologies (β=.24), and confidence in being able to use the technologies (β=.15). These variables, in turn, were mostly facilitated or inhibited by the perceived effort required to learn to use the technologies, a positive attitude toward technology as reflected in the optimism component of the technology readiness scale, the degree to which technologies were discounted, and the perceived help needed to learn to use the technologies.

CONCLUSIONS

Our findings demonstrate that participants' willingness to adopt technologies is mainly determined by perceptions of 3 aspects of the technologies; these aspects possibly mediate many relationships with willingness to adopt. We discuss the implications of these findings for the design and marketing of technology products for older consumers.

Exploring the Benefits of Proactive Participation among Adults and Older People by Writing Blogs

The use of Information and Communication Technologies (ICTs) for information-seeking, social contact and leisure activities is increasing in adults and older people. However, little is known about adults and older people who are already actively using ICTs to write a blog. The aim of this paper is to describe the benefits adults and older people gain from having a blog. Twenty-three older adult bloggers (aged 60-83 years; most of them with college degrees and retired) from Spain who, at the time of the study had an active blog were interviewed. A thematic analysis identified four different benefits related to blogging: (1) a general sense of satisfaction from producing the blog; (2) relational benefits; (3) cognitive benefits; and (4) identity benefits. Results showed that adults and older people experienced a variety of benefits that broadens the distinction between personal and social benefits found in previous research. Blogging in later life challenges the traditional passive/consumer and online user experience view of adults and older people and seems to be a good example of proactive participation through websites.

Impact of Actual Use Behavior of Healthcare Wearable Devices on Quality of Life: A Cross-Sectional Survey of People with Dementia and Their Caregivers in Ghana

The increasing prevalence of dementia has necessitated the introduction and use of healthcare wearable devices to augment the healthcare services delivered to people with dementia (PWDs). Unfortunately, evidence on user feedback and the real impact of the actual use of these devices on the quality of life of PWDs has not been fully explored, especially in the context of developing countries. This study, therefore, seeks to evaluate the impact of actual use behavior (AUB) of healthcare wearable devices on the quality of life (QoL) of PWDs in Ghana by using constructs from the extended Unified Theory of Acceptance and Use of Technology (UTAUT2) model and the SF-36 quality of life instrument. Data were collected from people with dementia and, in some cases, caregivers (acting as proxies) in three administrative regions of Ghana using structured questionnaires. Of the 420 questionnaires distributed, 356 were returned, giving a response rate of (356/420, 84.8%). Three hundred and twenty (320) responses were used for further analysis, employing the Partial Least Squares based on Structural Equation Modeling. The results showed a significant positive relationship between AUB and QoL (p < 0.001). Other predictors such as behavioral intention, facilitating conditions, effort expectancy and social influence were also found to significantly impact the actual use behavior of healthcare wearable devices among PWDs. The study also revealed that 4% (14) of patients rated their reported health transition associated with the use of healthcare wearable devices as excellent, 42.5% (136) as very good, and 39.4% (126) as good, respectively at the time of the study compared to a year ago. This study provided empirical evidence of the positive impact of the actual use of healthcare wearable devices on the quality of life of PWDs and further highlighted the factors that drive actual use behavior among PWDs in Ghana. Based on the findings of this study, stakeholders need to create the necessary conditions that will facilitate the adoption and use of healthcare wearable devices, as this will help improve the quality of life, reduce the burden of the disease on caregivers, and enable independent living of PWDs.

Unconscious or conscious? The impacts of habit and social support receipt on older adults' continued participation in online health communities

Purpose

Online health communities (OHCs) can be complementary to healthcare systems to improve the health behaviors of older adults with chronic diseases. This study aims to examine the impacts of habit and social support receipt on older adults' continued participation in OHCs. Particularly, the authors discussed the influences of social support received in two ways: social support received by initiating threads (direct social support receipt) and social support received by being exposed to the threads initiated by others (indirect social support receipt).

Design/methodology/approach

Based on the dual-process model (i.e. conscious process and unconscious process), the authors developed the research model. Data from one of the biggest online diabetes communities in Europe were collected. Besides, we used the support vector machine algorithm for social support classification and used the Cox proportion hazards model for model validation.

Findings

Older adults' continued participation is influenced by habit and indirect informational support. Habit moderates the relationship between direct informational support receipt and older adults' continued participation. Furthermore, direct and indirect emotional support receipt are both not associated with older adults' continued participation, regardless of their habit strength.

Originality/value

This is the first study investigating older adults' continued participation in OHCs based on the dual-process model. The findings of this study reveal that older adults' continued participation is determined by both the habit and specific conscious evaluation of benefits based on the social support receipt.

Overcoming Barriers for Older Adults to Maintain Virtual Community and Social Connections during the COVID-19 Pandemic

OBJECTIVES

We describe the evaluation of remote training, an innovative use of technology to maintain older adults' virtual connection with their community and socialization, which were disrupted by the pandemic. Remote training was conducted via telephone using principles of cognitive rehabilitation and delivered by trained clinicians.

METHODS

We thematically analyzed trainer reflection notes and interviews with older adult participants.

RESULTS

The main facilitators were technology training with exposure, and the main barrier was fear of technology.

CONCLUSIONS

We describe how telephone-based training grounded in principles of cognitive rehabilitation can be used to remotely train older adults to use new technology and to help them maintain their community-based connections and engage in socialization.

CLINICAL IMPLICATIONS

Fear of technology during the pandemic can cause significant impairment in social functioning for older adults, at least when the only method for socialization is technology mediated such as during the COVID-19 pandemic. Empathically delivered remote training in an understanding manner can reduce fear and increase social and community connections in the era of physical distancing.

The digital inclusion of older people in Spain: technological support services for seniors as predictor

While life expectancy increases in developed countries and there is evidence that demonstrates the potential of the internet to optimise or compensate for the losses associated with ageing, there is a high proportion of older people who continue to be disconnected from the digital world. In this scenario, the technological support offered by public institutions has the potential to be an accessible source for the digital literacy of older people. This study, using the model of digital inequality, had the aim of analysing the ability of these institutional supports to determine and predict the digital inclusion of older people. The sample was retired adults (over 54 years) residing in Spain who are users of technological support services in four organisational contexts: nursing homes, senior community centres, University Programs for Seniors and adult education programmes. Through binary logistic regression analysis, we found that the ability of the availability of literacy support to determine and predict access, autonomy, skills and use of the internet for social connectivity depends on the social and organisational context of the technology support service. These findings support empirically the situated nature of technological support for the digital inclusion of older people and provide a useful comparative vision for the design of accessible support services adapted to the needs of its users.

Telerehabilitation in Italy During the COVID-19 Lockdown: A Feasibility and Acceptability Study

This study examined the feasibility and acceptability of a telerehabilitation program during the COVID-19 pandemic in a sample of adult patients with physical disabilities. Of the twenty-three patients enrolled, 11 agreed to participate in a video-based telerehabilitation program. Barriers and facilitators to the adoption of telerehabilitation were identified and clinical, demographic, and psychological variables were analysed as predictors of success. Age, cognitive reserve, and resilience were significant predictors of satisfaction with telerehabilitation (p<0.05). The telerehabilitation program was perceived as feasible and was well accepted by patients, despite some technology challenges. However, patients who took advantage of telerehabilitation perceived differences in the quality of service and preferred traditional in-person treatment to service delivery via telerehabilitation.

Investigating Older Adults' Willingness to Invest Time to Acquire Technology Skills Using a Discounting Approach

Background and Objectives

Delay discounting is a common behavioral phenomenon that can influence decision making. A person with a higher discounting rate (DR) will have a stronger preference for smaller, more immediate rewards over larger, delayed rewards than will a person with a lower DR. This study used a novel approach to investigate, among a diverse sample of older adults, discounting of the time people were willing to invest to acquire technology skills across various technologies.

Research Design and Methods

One hundred and eighty-seven male and female adults 65-92 years of age participated in the study and were given presentations on 5 different technologies spanning domains that included transportation, leisure, health, and new learning. A measure of discounting was computed based on participants' assessments of how much additional time they would be willing to spend to acquire increased skill levels on each of the technologies and their ratings of importance of attaining those skill levels. Measures of participants' perceived value of the technologies, technology readiness, and self-assessed cognitive abilities were also collected.

Results

The findings indicated a significant and robust effect of lower DRs with increasing age. Higher perceived value of the technologies and higher levels of positive technology readiness predicted willingness to invest more time to learn the technologies, whereas self-assessments of cognitive abilities predicted the levels of technology skills that participants desired on the 5 technologies.

Discussion and Implications

Our findings demonstrate that for realistic decision-making scenarios related to the acquisition of technology skills, DRs decrease with increasing age, even within an older adult cohort, and that discounting is related to the perceived value of the technology. The findings also have important implications for the design and marketing of technology products for older consumers.

Factors Affecting the Initial Engagement of Older Adults in the Use of Interactive Technology

Smart environments and the use of interactive technology has the potential to improve the quality of life for the senior community as well as to support the connections among the senior community and the world outside their community. In addition to the increasing number of studies in the field of aging and technologies, research is needed to understand the practical issues of user focus, adoption, and engagement for older adults to accept interactive technologies in their lives. In this study, we use two commercial technological interventions (uDraw and GrandPad) to understand technology-related perceptions and behaviors of older adults. We present five case studies that emerge from empirical observations of initial engagement with technology through research methods such as focus group discussions, in-depth interviews, observations, and diary studies. The contributions of this study are identification of the key factors that influence the initial engagement with interactive technology for older adults.

A Commentary on Blue Zones®: A Critical Review of Age-Friendly Environments in the 21st Century and Beyond

This paper explores the intersection of the World Health Organization’s (WHO) concepts of age-friendly communities and The Blue Zones^® checklists and how the potential of integrating the two frameworks for the development of a contemporary framework can address the current gaps in the literature as well as consider the inclusion of technology and environmental press. The commentary presented here sets out initial thoughts and explorations that have the potential to impact societies on a global scale and provides recommendations for a roadmap to consider new ways to think about the impact of health and wellbeing of older adults and their families. Additionally, this paper highlights both the strengths and the weaknesses of the aforementioned checklists and frameworks by examining the literature including the WHO age-friendly framework, the smart age-friendly ecosystem (SAfE) framework and the Blue Zones^® checklists. We argue that gaps exist in the current literature and take a critical approach as a way to be inclusive of technology and the environments in which older adults live. This commentary contributes to the fields of gerontology, gerontechnology, anthropology, and geography, because we are proposing a roadmap which sets out the need for future work which requires multi- and interdisciplinary research to be conducted for the respective checklists to evolve.

Gerontechnological factors affecting successful aging of elderly

In this article, the gerontological factors affecting the successful aging of the elderly have been uncovered, the quality of life and successful aging issues have been related to gerontology and investigated on a different dimension. It has been emphasized that the importance of gerontechnology on the successful aging, creation of awareness through formal and non-formal education, qualitative and quantitative researches should be increased. Qualitative and quantitative researches on the subject were evaluated together, gerontology and gerontechnology were considered together with successful aging, and gerontology functions and ergonomics should be taken into consideration in increasing quality of life. In addition, the concept of geronsafety, a new concept in gerontology, has been put forward, emphasizing the effects of safety on gerontology and successful aging.

Mobile technology adoption across the lifespan: A mixed methods investigation to clarify adoption stages, and the influence of diffusion attributes

We conducted a multi-study, mixed-methods, longitudinal investigation to examine how mobile technology diffuses across the lifespan, in real time, within a multi-generational population, while seeking local knowledge through community-based participatory research. Using qualitative methods (QUAL), we examined technology adoption within and across three iterations (16 weeks) of a nine-wave longitudinal community technology-training workshop, situated within a 15-wave study. In parallel, we interrogated existing conceptualization and operationalization of diffusion of technology variables, then deductively evaluated the dominant DOI-related variables re-conceptualized through the community study in a large cross-sectional quantitative (QUAN) investigation. We interpreted our results consistently and iteratively with a mixed-methods approach that included conceptualization, operationalization, and empirical testing. We discovered that oft-conflated concepts of knowledge, use, and ownership represent distinct stages of adoption. Our findings suggest constant feedback/permeable boundaries between these stages, and that DOI attributes may influence mobile technology adoption stages differentially. We suggest that innovators seeking to facilitate mobile technology adoption should focus on reducing complexity, and establishing calibration of complexity perceptions. We propose a lifespan mobile technology diffusion model, and call to question the language used in investigations related to the digital divide. We strive to clarify labels that may stereotype vulnerable populations, such as older adults. Our research contributes to theories of technology adoption - particularly after the introduction of digital communication - the diffusion of innovations in the community over time, and technology adoption process as affected by interpersonal communication and relationships, including among the technologically undercapitalized and the digitally privileged.

Examining the Effect of Overload on the MHealth Application Resistance Behavior of Elderly Users: An SOR Perspective

Aging has increased the burden of social medical care. Mobile health (mHealth) services provide an effective way to alleviate this pressure. However, the actual usage of mHealth services for elderly users is still very low. The extant studies mainly focused on elderly users’ mHealth adoption behavior, but resistance behavior has not been sufficiently explored by previous research. A present study tried to remedy this research gap by examining the effect of overload factors on the mHealth application resistance behavior based on the stimulus-organism-response (SOR) framework. The results indicated that information overload and system feature overload of an mHealth application increased the fatigue and technostress of the elderly user, which further increased their resistance behavior. Meanwhile, we integrated the intergeneration support with the SOR model to identify the buffer factor of the elderly user’s resistance behavior. The results showed that intergenerational support not only directly decrease the elderly user’s mHealth application resistance behavior, but also moderates (weaken) the effects of fatigue and technostress on resistance behavior. The present study also provided several valuable theoretical and practical implications.

Hospital patients' perceptions of using a technology-based intervention to participate in their nutrition care: A qualitative descriptive study

BACKGROUND & AIMS

Promoting patient participation in health care is a worldwide health care priority. When patients participate in their nutrition care during hospitalisation, they are more likely to meet their dietary needs. Patient participation is a potential solution to hospital malnutrition, for which inadequate dietary intake is the major modifiable risk factor. Our team developed a health information technology (HIT) intervention aiming to improve patients' dietary intakes during hospitalisation by engaging them in their nutrition care. The aim of this study was to explore patient perceptions and acceptability of the intervention.

METHODS

This qualitative descriptive study was conducted at a tertiary teaching hospital in Australia. Participants were a subset of patients from a larger feasibility study, selected using maximum variation purposive sampling to include a broad representation of patients in terms of age, gender and experience with technology. All patients had used the HIT intervention to participate in their nutrition care in hospital, through nutritional goal setting and dietary intake monitoring. A semi-structured interview guide was used to collect qualitative data on patients' perceptions of the intervention, focusing on acceptability. Data were analysed thematically.

FINDINGS

11 patients participated in interviews, from which two main themes emerged. The first captured patients' experiences and perceptions of using technology to participate in their nutrition care. Patients found it easy to use, useful and valuable, but still valued interaction with researchers and hospital staff. The second theme portrayed the spectrum of participation, from simply learning about nutrition, to self-monitoring and evaluating, to changing behaviour. Participants enjoyed gaining new knowledge and awareness around nutrition. Most self-monitored their food intake and evaluated their goals, and some changed what foods they ordered based on what they had learned.

CONCLUSIONS

Patients responded positively to the intervention, likely because they found it valuable and easy to use. These findings are promising for potential future use of HIT to engage hospital patients in care. Future research should investigate the effects of HIT interventions on patient-centred outcomes in hospital.

Barriers to older adults' uptake of mobile-based mental health interventions

Background

To address increasing demand of mental healthcare treatments for older adults and the need to reduce delivery costs, healthcare providers are turning to mobile applications. The importance of psychological barriers have been highlighted in the uptake of mobile-based mental health interventions and efforts have been made to identify these barriers in order to facilitate initial uptake and acceptance. However, limited research has focused on older adults’ awareness of these applications and factors that might be hindering their use.

Objective

The purpose of this study was to explore the perceived barriers that older adults experience in the uptake of mobile-based mental health interventions.

Methods

Semi-structured interviews were conducted with a sample of 10 older adults, 50 years or older (female = 7, mean age = 68 years), who experienced periods of low mood. National Health Service applications were demonstrated to facilitate conversation and explore participants’ understanding of mental health and mobile-based mental health interventions. Thematic analysis was used to analyse the interview transcripts.

Results

The social ecological model was adopted as an organising framework for the thematic analysis which identified six distinct barriers to older adults’ uptake of mobile-based mental health interventions: mental electronic-health (e-health) awareness, interaction with technology, discontinuation, ‘seeing’ facilitates therapeutic alliance, incongruent role of the general practitioner and privacy and confidentiality.

Conclusions

Older adults experience a number of barriers to uptake ranging from the individual level to a macro, organisational level. The practical implications of these barriers are discussed such as the need for increased awareness of mobile-based mental health interventions among older adults.

Factors Affecting Caregivers' Acceptance of the Use of Wearable Devices by Patients With Dementia: An Extension of the Unified Theory of Acceptance and Use of Technology Model

PURPOSE

This study aims to examine the factors affecting caregivers' acceptance of the use of wearable devices by patients with dementia by extending the Unified Theory of Acceptance and Use of Technology (UTAUT) model with 2 additional constructs: resistance to change (RC) and technology anxiety (TA).

METHODS

A structured online questionnaire was developed and distributed to caregivers who have either dealt previously with or were currently taking care of patients with dementia in sub-Saharan Africa. The selection of countries for the study was purely based on the availability of caregivers of patients with dementia and their readiness to take part in the survey. Questionnaire data from 350 respondents were analyzed and the hypothesis tested using partial least squares based on structural equation modeling.

RESULT

The results of the extended model show that social influence, effort expectancy, facilitating conditions, and behavioral intention (BI) all had P < .05, thus were statistically significant in explaining the perceived BI and actual use of health-care wearable devices among patients with dementia as reported by caregivers. However, P value for RC and TA was greater than .05, hence were insignificant.

Exploring Older Adults' Beliefs About the Use of Intelligent Assistants for Consumer Health Information Management: A Participatory Design Study

BACKGROUND

Intelligent assistants (IAs), also known as intelligent agents, use artificial intelligence to help users achieve a goal or complete a task. IAs represent a potential solution for providing older adults with individualized assistance at home, for example, to reduce social isolation, serve as memory aids, or help with disease management. However, to design IAs for health that are beneficial and accepted by older adults, it is important to understand their beliefs about IAs, how they would like to interact with IAs for consumer health, and how they desire to integrate IAs into their homes.

OBJECTIVE

We explore older adults' mental models and beliefs about IAs, the tasks they want IAs to support, and how they would like to interact with IAs for consumer health. For the purpose of this study, we focus on IAs in the context of consumer health information management and search.

METHODS

We present findings from an exploratory, qualitative study that investigated older adults' perspectives of IAs that aid with consumer health information search and management tasks. Eighteen older adults participated in a multiphase, participatory design workshop in which we engaged them in discussion, brainstorming, and design activities that helped us identify their current challenges managing and finding health information at home. We also explored their beliefs and ideas for an IA to assist them with consumer health tasks. We used participatory design activities to identify areas in which they felt IAs might be useful, but also to uncover the reasoning behind the ideas they presented. Discussions were audio-recorded and later transcribed. We compiled design artifacts collected during the study to supplement researcher transcripts and notes. Thematic analysis was used to analyze data.

RESULTS

We found that participants saw IAs as potentially useful for providing recommendations, facilitating collaboration between themselves and other caregivers, and for alerts of serious illness. However, they also desired familiar and natural interactions with IAs (eg, using voice) that could, if need be, provide fluid and unconstrained interactions, reason about their symptoms, and provide information or advice. Other participants discussed the need for flexible IAs that could be used by those with low technical resources or skills.

CONCLUSIONS

From our findings, we present a discussion of three key components of participants' mental models, including the people, behaviors, and interactions they described that were important for IAs for consumer health information management and seeking. We then discuss the role of access, transparency, caregivers, and autonomy in design for addressing participants' concerns about privacy and trust as well as its role in assisting others that may interact with an IA on the older adults' behalf.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1145/3240925.3240972.

Assessment of Heart Failure Patients' Interest in Mobile Health Apps for Self-Care: Survey Study

BACKGROUND

Heart failure is a serious public health concern that afflicts millions of individuals in the United States. Development of behaviors that promote heart failure self-care may be imperative to reduce complications and avoid hospital re-admissions. Mobile health solutions, such as activity trackers and smartphone apps, could potentially help to promote self-care through remote tracking and issuing reminders.

OBJECTIVE

The objective of this study was to ascertain heart failure patients' interest in a smartphone app to assist them in managing their treatment and symptoms and to determine factors that influence their interest in such an app.

METHODS

In the clinic waiting room on the day of their outpatient clinic appointments, 50 heart failure patients participated in a self-administered survey. The survey comprised 139 questions from previously published, institutional review board-approved questionnaires. The survey measured patients' interest in and experience using technology as well as their function, heart failure symptoms, and heart failure self-care behaviors. The Minnesota Living with Heart Failure Questionnaire (MLHFQ) was among the 11 questionnaires and was used to measure the heart failure patients' health-related quality of life through patient-reported outcomes.

RESULTS

Participants were aged 64.5 years on average, 32% (16/50) of the participants were women, and 91% (41/45) of the participants were determined to be New York Heart Association Class II or higher. More than 60% (30/50) of the survey participants expressed interest in several potential features of a smartphone app designed for heart failure patients. Participant age correlated negatively with interest in tracking, tips, and reminders in multivariate regression analysis (P<.05). In contrast, MLHFQ scores (worse health status) produced positive correlations with these interests (P<.05).

CONCLUSIONS

The majority of heart failure patients showed interest in activity tracking, heart failure symptom management tips, and reminder features of a smartphone app. Desirable features and an understanding of factors that influence patient interest in a smartphone app for heart failure self-care may allow researchers to address common concerns and to develop apps that demonstrate the potential benefits of mobile technology.

Senior citizens’ acceptance of connected health technologies in their homes

Purpose

The objective of this paper is to focus on seniors’ acceptance of the usage of connected healthcare technologies in their homes. The authors integrated into technology acceptance model (TAM) several latent variables such as social presence, trust and degree of intrusiveness perceived with the use of connected health technologies.

Design/methodology/approach

The authors distributed the survey by post to 605 seniors. The authors targeted elderly people using connected health technologies (assistive alarm, telecare, sensors, etc.) at home and/or receiving healthcare at home. The authors received 213 questionnaires back. As The authors had several latent variables, the authors used partial least squares (PLS), a variance-based structural equation modeling method.

Findings

The results show that the level of trust in these technologies impacts significantly the perception of usefulness and the degree of intrusiveness. In parallel, the degree of usefulness of these technologies impacts positively elderly people’s intention to accept their usage. Finally, one can claim that the perception of the social presence with the use of these technologies impacts positively the degree of perceived usefulness, trust and intrusiveness.

Research limitations/implications

The sample covers a population benefiting from similar connected health technologies. It was difficult to distinguish and interpret the added value of each technology separately. As more and more elderly people use or are least familiarizing themselves with a range of connected technologies it would be interesting to identify which sets of connected technologies contribute the most to a positive feeling of social presence.

Social implications

These results are particularly relevant to stakeholders in the health industry in their quest to improve their products/services. A better understanding of the relation that the elderly have with connected health technologies is an essential prerequisite to supporting the development of new solutions capable of meeting the specific needs of our seniors.

Originality/value

The authors want to apply the TAM to connected health technologies designed for elderly people and the authors also want to extend it by integrating the social presence, trust and degree of intrusiveness variables to our research model.

Understanding the use and non-use of social communication technologies by older adults: A qualitative test and extension of the UTAUT model

Technology has the ability to foster social engagement, but a sizable divide exists between older and younger adults in the use of social communication technologies. The goal of the current study was to gain a better understanding of older adults' perspectives on social communication technologies, including those with higher adoption rates such as email and those with lower adoption rates such as social networking sites (e.g., Facebook, Instagram). Semi-structured group interviews were conducted with either users or non-users of social networking sites to gain insight into issues of adoption and non-adoption of social communication technologies. The Unified Theory of Acceptance and Use of Technology model (UTAUT) was adapted and used to categorize the interview content. We found support for a benefit-driven account of social communication technology acceptance and usage, with participants most frequently discussing the degree social communication technologies would or would not help them attain gains in social connectedness, entertainment, and/or information sharing. However, the UTAUT was not sufficient in fully capturing the group-interview content, with additional categories being necessary. For instance, trust in social networking sites (privacy and security concerns) was frequently discussed by both users and non-users. The current results broaden theories of technology acceptance by identifying facilitators and barriers to technology use in the older adult population.

A Spanish Adaptation of the Computer and Mobile Device Proficiency Questionnaires (CPQ and MDPQ) for Older Adults

Technology can help support the goal of many older adults to live independently, though cognitive, attitudinal, and other barriers often result in a “digital divide” in which older adults use and adopt new technology at a lower rate compared to younger adults. Due to the many potential benefits of technology it is not surprising that interest in tools that assess technology proficiency among older adults has increased. These tools can help support older adult technology research and training. However, to understand these issues more broadly, especially cross-cultural determinants of technology proficiency, translated, validated, and standardized measures of proficiency are necessary. For example, according to the last Eurobarometer (European Commission, 2015), Spain has experienced the largest increase in technology adoption among European Union nations in the past few years, indicating potential cultural mediation of technology adoption and use. To benefit the investigation of cross-cultural differences and their causes, we adapted the Mobile Device Proficiency Questionnaire (MDPQ) and Computer Proficiency Questionnaire (CPQ) for older adults in Spain, including the full and brief forms of each measure. Consistent with English versions of the questionnaires, the scales and their subscales were found to be reliable and valid measures of mobile device and computer proficiency in Spanish older adults. However, in contrast to earlier studies, the factor structure for both questionnaires simplified into two factors for the population under study. We conclude that the Spanish versions of the MDPQ and CPQ can be employed as useful tools for measuring mobile device and computer proficiency in the Spanish older adult population for research and training purposes.

Looking for Age Differences in Self-Driving Vehicles: Examining the Effects of Automation Reliability, Driving Risk, and Physical Impairment on Trust

PURPOSE

Self-driving cars are an extremely high level of autonomous technology and represent a promising technology that may help older adults safely maintain independence. However, human behavior with automation is complex and not straightforward (Parasuraman and Riley, 1997; Parasuraman, 2000; Rovira et al., 2007; Parasuraman and Wickens, 2008; Parasuraman and Manzey, 2010; Parasuraman et al., 2012). In addition, because no fully self-driving vehicles are yet available to the public, most research has been limited to subjective survey-based assessments that depend on the respondents' limited knowledge based on second-hand reports and do not reflect the complex situational and dispositional factors known to affect trust and technology adoption.

METHODS

To address these issues, the current study examined the specific factors that affect younger and older adults' trust in self-driving vehicles.

RESULTS

The results showed that trust in self-driving vehicles depended on multiple interacting variables, such as the age of the respondent, risk during travel, impairment level of the hypothesized driver, and whether the self-driving car was reliable.

CONCLUSION

The primary contribution of this work is that, contrary to existing opinion surveys which suggest broad distrust in self-driving cars, the ratings of trust in self-driving cars varied with situational characteristics (reliability, driver impairment, risk level). Specifically, individuals reported less trust in the self-driving car when there was a failure with the car technology; and more trust in the technology in a low risk driving situation with an unimpaired driver when the automation was unreliable.

Identifying Features that Enhance Older Adults' Acceptance of Robots: A Mixed Methods Study

BACKGROUND

With global aging, robots are considered a promising solution for handling the shortage of aged care and companionships. However, these technologies would serve little purpose if their intended users do not accept them. While the socioemotional selectivity theory predicts that older adults would accept robots that offer emotionally meaningful relationships, selective optimization with compensation model predicts that older adults would accept robots that compensate for their functional losses.

OBJECTIVE

The present study aims to understand older adults' expectations for robots and to compare older adults' acceptance ratings for 2 existing robots: one of them is a more human-like and more service-oriented robot and the other one is a more animal-like and more companion-oriented robot.

METHODS

A mixed methods study was conducted with 33 healthy, community-dwelling Taiwanese older adults (age range: 59-82 years). Participants first completed a semi-structured interview regarding their ideal robot. After receiving information about the 2 existing robots, they then completed the Unified Theory of Acceptance and Use of Technology questionnaires to report their pre-implementation acceptance of the 2 robots.

RESULTS

Interviews were transcribed for conventional content analysis with satisfactory inter-rater reliability. From the interview data, a collection of older adults' ideal robot characteristics emerged with highlights of humanlike qualities. From the questionnaire data, respondents showed a higher level of acceptance toward the more service-oriented robot than the more companion-oriented robot in terms of attitude, perceived adaptiveness, and perceived usefulness. From the mixed methods analyses, the finding that older adults had a higher level of positive attitude towards the more service-oriented robot than the more companion-oriented robot was predicted by higher expectation or preference for robots with more service-related functions.

CONCLUSION

This study identified older adults' preference toward more functional and humanlike robots. Our findings provide practical suggestions for future robot designs that target the older population.

Machinery-Related Perceived Risks and Safety Attitudes in Senior Swedish Farmers

OBJECTIVES

To perform an ergonomic analysis of work and machinery-related risks in a group of Swedish older farmers, investigating farmers' attitudes and perceptions about: 1) health status and work motivation, 2) physical and cognitive workload and difficulties in the interaction with machinery and technological innovations, and 3) risks and safety practices.

METHODS

Nine Swedish male farmers aged 65+ were administered a semi-structured interview and a questionnaire.

RESULTS

Participants perceived themselves as being in good health and considered farming as a good proxy of their health status. They reported an increased physical workload but did not describe any cognitive workload. Technology was reported to have low usability, and thus its benefits cannot be fully exploited. Older farmers acknowledged the existence of "new risks" related to the aging process and mainly referred to the common sense and previous experience as the best safety practices.

CONCLUSION

Multilevel interventions focused on the capabilities and limits of the older farmers should be developed, involving both training activities and design solutions for the machinery that can support older farmers' health and safety.

Predictors of Attitudes Toward Autonomous Vehicles: The Roles of Age, Gender, Prior Knowledge, and Personality

Autonomous vehicles (AVs) hold considerable promise for maintaining aging adults’ mobility as they develop impairments in driving skill. Nonetheless, attitudes can be a significant barrier to adoption as has been shown for other technologies. We investigated how different introductions to AV, video with a driver in the front seat, the rear seat, and a written description, affected attitudes, as well as how individual difference variables such as age, gender, prior knowledge, and personality traits predict attitudes within a middle-aged (Median age = 34, IQR = 20, n = 441) Amazon Mechanical Turk sample. The 16-item attitude survey uncovered three factors: Concern with AV, Eagerness to Adopt AV technology, and Willingness to Relinquish Driving Control. ANOVAs showed that only age (younger less concerned) and gender, (females more concerned) were significant factors in Concern with AV. Only gender affected Willingness to Relinquish Driving Control, with males more willing. Multiple regressions that included previous knowledge level and personality traits showed a different pattern. Female gender and greater conscientiousness were associated with greater Concern about AV. Prior knowledge of AV was associated with less concern. Emotional stability and openness to experience were positive predictors of Eagerness to Adopt AV, whereas conscientiousness was a negative predictor. Prior knowledge and openness to experience, positively, and extraversion, negatively, were associated with being willing to relinquish driving control. These results suggest that different information dissemination campaigns are needed to persuade consumers to adopt AV technology. We discuss potential approaches.

Ambient Assisted Living as Support for Aging in Place: Quantitative Users' Acceptance Study on Ultrasonic Whistles

Background

Given the fact of an aging society, new supply measures and living concepts are needed, especially as health impairments along with care dependency increase with age. As many elderly people wish to stay at home for as long as possible, ambient assisted living (AAL) represents a support for aging in place.

Objective

AAL combines medical and care technology within living environments and is, therefore, a promising approach to cope with demographic change in terms of fast-growing care needs and fewer skilled workers. Ultrasonic whistles represent one innovative technical possibility for such supportive housing solutions. Central fields of application are home automation, emergency service, and positioning. As AAL technologies affect sensitive areas of life, it is of great interest under which conditions they are accepted or rejected, taking individual user requirements into account. Hence, the aim of this study was to investigate users’ perception and evaluation of ultrasonic whistles.

Methods

In this study, we examined the acceptance of ultrasonic whistles in home care by function and room using a Web-based questionnaire. Besides an evaluation of the overall usefulness, we focused on the intention to use ultrasonic whistles; 270 participants assessed home automation, emergency service, and positioning as specific functions of ultrasonic whistles. Furthermore, bathroom, bedroom, and living room were evaluated as specific usage locations (rooms). With regard to the user’s perspective, the focus was set on age and attitudes toward aging of care receivers.

Results

This study revealed a significant influence of function (F_2,269=60.444; P<.001), room (F_2,269=41.388; P<.001), and the interaction of function and room (F_4,269=8.701; P<.001) on the acceptance of ultrasonic whistles. The use of emergency services within the bathroom represented the most accepted alternative, whereas positioning within the living room received the comparably lowest evaluations. Although user diversity played a minor role for acceptance overall, the assessment of single applications differed among user groups, particularly with regard to age differences (F_20,500=1.988; P<.01) in the evaluation of specific installation options such as automated doors.

Conclusions

The study revealed profound insights into the user-centered assessment of ultrasonic whistles in home care and discovered function and room as influencing acceptance parameters. Concerning user characteristics, age, and attitude toward aging partly affected these evaluations, forming the basis for and showing the importance of further investigations in this context.

Multi-stakeholder perspectives on information communication technology training for older adults: implications for teaching and learning

Objectives: The objective of this research was to identify and conceptualize barriers and strategies for effective implementation of information communication technology (ICT) training for older adults. Methods: A grounded theory approach was used to collect and analyze qualitative data from 61 participants in three stakeholder groups: older-adult ICT trainees, care providers and ICT trainers. Results: Care providers expressed older adults' reluctance, lack of affinity, fears and socio-contextual attributes as barriers to overcome with ICT training. ICT trainers highlighted motivation, trainer-trainee relationship, patience, self-reliance and mutual value as strategic themes. ICT trainees elucidated occupational accomplishment, challenges and a sense of competence as themes from their experience with training. Discussion: While digital literacy and skill building have traditionally been the key focus of ageing-centred ICT training, a deeper approach to address internal (personal) and external (socio-contextual) barriers, as conceptualized in the study finding, is vital in yielding successful outcomes. Implications for rehabilitation Information communication technology (ICT) is a vital resource for older adults to age-in-place and for health professionals in delivery of tele-rehabilitation. Family members and care providers realize the scope of ICT for ageing-in-place but raise doubts on the inherent motivation and abilities of older adults to adopt ICT. On the other hand, older adults who engage in one-on-one ICT training value their new-found sense of accomplishment and competence in using the Internet and social media. Graduate students who provided the training greatly appreciate their own learning experience, and stress the need for mutual trust, patience and simplicity in teaching ICT. A major precursor to imparting digital literacy and skills in older adults who lack ICT exposure is to help them overcome deep-seated attitudinal and socio-contextual barriers through a one-on-one approach.

Use of computer assistive technologies by older people with sight impairment: Perceived state of access and considerations for adoption

This study explored the perceptions of sight-impaired older people about the use of specialist equipment designed for computer users with sight loss – whether it was meeting their needs and their views on the opportunities for equality in access to computer technologies. The study employed case study research methodology: conducting observations in an Internet café specifically established for people with sight loss and semi-structured interviews with 20 participants who had sight impairments between the ages of 60 and 87 years. A thematic analysis was carried out on transcribed qualitative interview data. Qualitative analysis employed the use of NVivo version 10 for both open and axial coding. Related coded categories were eventually merged into four themes. Findings suggest that stereotyping associated with the use of assistive technologies such as screen readers and concerns about access to mainstream technologies are important factors for understanding acceptance, willingness to adopt assistive technology, or continued use of assistive technologies by sight-impaired older people. Participants perceived advancements in technology as not fully considering their needs. In conclusion, the study highlights important points for technology developers to consider for inclusive designs or cost-effective assistive technologies as social stigma remains a neglected construct for understanding acceptance, willingness to adopt assistive technology, or continued use of assistive technologies among sight-imapired older people.

Perceived Drivers and Barriers to the Adoption of eMental Health by Psychologists: The Construction of the Levels of Adoption of eMental Health Model

Background

The internet offers major opportunities in supporting mental health care, and a variety of technology-mediated mental and behavioral health services have been developed. Yet, despite growing evidence for the effectiveness of these services, their acceptance and use in clinical practice remains low. So far, the current literature still lacks a structured insight into the experienced drivers and barriers to the adoption of electronic mental health (eMental health) from the perspective of clinical psychologists.

Objective

The aim of this study was to gain an in-depth and comprehensive understanding of the drivers and barriers for psychologists in adopting eMental health tools, adding to previous work by also assessing drivers and analyzing relationships among these factors, and subsequently by developing a structured representation of the obtained findings.

Methods

The study adopted a qualitative descriptive approach consisting of in-depth semistructured interviews with clinical psychologists working in the Netherlands (N=12). On the basis of the findings, a model was constructed that was then examined through a communicative validation.

Results

In general, a key driver for psychologists to adopt eMental health is the belief and experience that it can be beneficial to them or their clients. Perceived advantages that are novel to literature include the acceleration of the treatment process, increased intimacy of the therapeutic relationship, and new treatment possibilities due to eMental health. More importantly, a relation was found between the extent to which psychologists have adopted eMental health and the particular drivers and barriers they experience. This differentiation is incorporated in the Levels of Adoption of eMental Health (LAMH) model that was developed during this study to provide a structured representation of the factors that influence the adoption of eMental health.

Conclusions

The study identified both barriers and drivers, several of which are new to the literature and found a relationship between the nature and importance of the various drivers and barriers perceived by psychologists and the extent to which they have adopted eMental health. These findings were structured in a conceptual model to further enhance the current understanding. The LAMH model facilitates further research on the process of adopting eMental health, which will subsequently enable targeted recommendations with respect to technology, training, and clinical practice to ensure that mental health care professionals as well as their clients will benefit optimally from the current (and future) range of available eMental health options.

Analyzing the changes of health condition and social capital of elderly people using wearable devices

Purpose

Rapid developments in information technology have enabled wearable devices to be applied in the health field. In elderly adults, wearable devices aid in data collection and exerts a positive effect on their social capital. This study evaluated the changes in these two parameters among elderly adults using wearable devices, and analyzed the effect of these devices on their daily lives.

Methods

We selected 18 elderly people using wearable devices, between February and May 2017. The data collected by the wearable devices included the number of steps taken, sleep duration, blood pressure, heart rate, respiratory rate, fatigue, and mood of the wearers. Using a questionnaire and the trajectory equifinality model, we interviewed and surveyed elderly adults in order to understand their health status and social capital.

Results

The health of the participants was generally good, and most were able to achieve > 8000 steps per day (p < 0.05). Mild and moderate fatigue symptoms were noted in elderly adults for 90% of the study period (p < 0.05). The number of steps, blood pressure, and heart rate changed significantly within a month. From the commencement of using the wearable devices, a steady increase was noted in the monthly number of steps. Interviews suggested that the elderly adults perceived wearable devices as having the potential to improve health and social capital.

Conclusions

By using wearable devices, the participants had a better understanding of their own health, and were willing to take health-boosting measures. The participants were also more willing to increase their social capital and expand their social network.

Perceived importance and difficulty of online activities among visually impaired persons in Nigeria

This study investigated perceived relevance of and difficulties in access to day-to-day online activities among visually impaired computer users who used screen readers. The 98 participants in the study were grouped into visually impaired adults (aged 20-59, n = 60) and visually impaired older adults (aged 60 and over, n = 38). Data were collected in structured interview questionnaires with Likert scales exploring ratings of perceived importance and difficulty of access to 11 online platforms of various internet activities. Analyses revealed that the two groups did not differ significantly in ratings of perceived importance of four major online activities, namely sending or reading email (p = 0.5224), online banking (p = 0.2833), online shopping (p = 0.1829), and health information seeking (p = 0.1414). The topmost rated activity of priority among both groups was sending and reading emails. Findings also show that, apart from sending and reading emails, activities rated as important were mostly perceived as difficult to access. The implications of the study for inclusive design and strategies and/or interventions to encourage uptake of internet use among the visually impaired population are discussed.

Challenges for Older Drivers in Urban, Suburban, and Rural Settings

Along with age-related factors, geographical settings—urban, suburban, and rural areas—also contribute to the differences in fatal crashes among older drivers. These differences in crash outcomes might be attributed to the various driving challenges faced by older drivers residing in different locations. To understand these challenges from the perspective of the older driver, a focus group study was conducted with drivers 65 and older from urban, suburban, and rural settings. Guided-group interviews were used to assess driving challenges, mobility options, opportunities for driver support systems (DSS), and alternate transportation needs. Content analysis of the interview responses resulted in four categories representing common challenges faced by older drivers across the settings: behavior of other drivers on the road, placement of road signs, reduced visibility of road signs due to age-related decline, and difficulties using in-vehicle technologies. Six categories involved location-specific challenges such as heavy traffic situations for urban and suburban drivers, and multi-destination trips for rural drivers. Countermeasures implemented by older drivers to address these challenges primarily involved route selection and avoidance. Technological advances of DSS systems provide a unique opportunity to support the information needs for route selection and avoidance preferences of drivers. Using the content analysis results, a framework was built to determine additional and modified DSS features to meet the specific challenges of older drivers in urban, suburban, and rural settings. These findings suggest that there is heterogeneity in the driving challenges and preferences of older drivers based on their location. Consequently, DSS technologies and vehicle automation need to be tailored to not only meet the driving safety and mobility needs of older drivers as a population, but also to their driving environment.

A New Tool for Assessing Mobile Device Proficiency in Older Adults: The Mobile Device Proficiency Questionnaire

Mobile device proficiency is increasingly required to participate in society. Unfortunately, there still exists a digital divide between younger and older adults, especially with respect to mobile devices (i.e., tablet computers and smartphones). Training is an important goal to ensure that older adults can reap the benefits of these devices. However, efficient/effective training depends on the ability to gauge current proficiency levels. We developed a new scale to accurately assess the mobile device proficiency of older adults: the Mobile Device Proficiency Questionnaire (MDPQ). We present and validate the MDPQ and a short 16-question version of the MDPQ (MDPQ-16). The MDPQ, its subscales, and the MDPQ-16 were found to be highly reliable and valid measures of mobile device proficiency in a large sample. We conclude that the MDPQ and MDPQ-16 may serve as useful tools for facilitating mobile device training of older adults and measuring mobile device proficiency for research purposes.

Connected Audiological Rehabilitation: 21st Century Innovations

BACKGROUND

Tele-audiology provides a means to offer audiologic rehabilitation (AR) in a cost-, resource-, and time-effective manner. If designed appropriately, it also has the capability of personalizing rehabilitation to the user in terms of content, depth of detail, etc., thus permitting selection of the best content for a particular individual. Synchronous/real-time data collection, store and forward telehealth, remote monitoring and mobile health using smartphone applications have each been applied to components of audiologic rehabilitation intervention (sensory management, instruction in the use of technology and control of the listening environment, perceptual and communication strategies training, and counseling). In this article, the current state of tele-audiological rehabilitation interventions are described and discussed.

RESULTS

The provision of AR via tele-audiology potentially provides a cost-effective mechanism for addressing barriers to the routine provision of AR beyond provisions of hearing technology. Furthermore, if designed appropriately, it has the capability of personalizing rehabilitation to the user in terms of content, depth of detail, etc., thus permitting selection of the best content for a particular individual. However, effective widespread implementation of tele-audiology will be dependent on good education of patients and clinician alike, and researchers must continue to examine the effectiveness of these new approaches to AR in order to ensure clinicians provide effective evidence-based rehabilitation to their patients.

CONCLUSIONS

While several barriers to the widespread use of tele-audiology for audiologic rehabilitation currently exist, it is concluded that through education of patients and clinicians alike, it will gain greater support from practitioners and patients over time and will become successfully and widely implemented.

Older Adults’ Perceptions of Supporting Factors of Trust in a Robot Care Provider

The older adult population is increasing worldwide, leading to an increased need for care providers. An insufficient number of professional caregivers will lead to a demand for robot care providers to mitigate this need. Trust is an essential element for older adults and robot care providers to work effectively. Trust is context dependent. Therefore, we need to understand what older adults would need to trust robot care providers, in this specific home-care context. This mixed methods study explored what older adults, who currently receive assistance from caregivers, perceive as supporting trust in robot care providers within four common home-care tasks: bathing, transferring, medication assistance, and household tasks. Older adults reported three main dimensions that support trust: professional skills, personal traits, and communication. Each of these had subthemes including those identified in prior human-robot trust literature such as ability, reliability, and safety. In addition, new dimensions perceived to impact trust emerged such as the robot’s benevolence, the material of the robot, and the companionability of the robot. The results from this study demonstrate that the older adult-robot care provider context has unique dimensions related to trust that should be considered when designing robots for home-care tasks.

Quantitative Analysis Of User Interfaces For Large Electronic Home Appliances And Mobile Devices Based On Lifestyle Categorization Of Older Users

Background/Study Context: The increasing longevity and health of older users as well as aging populations has created the need to develop senior-oriented product interfaces. This study aims to find user interface (UI) priorities according to older user groups based on their lifestyle and develop quality of UI (QUI) models for large electronic home appliances and mobile products.

METHODS

A segmentation table designed to show how older users can be categorized was created through a review of the literature to survey 252 subjects with a questionnaire. Factor analysis was performed to extract six preliminary lifestyle factors, which were then used for subsequent cluster analysis. The analysis resulted in four groups. Cross-analysis was carried out to investigate which characteristics were included in the groups. Analysis of variance was then applied to investigate the differences in the UI priorities among the user groups for various electronic devices. Finally, QUI models were developed and applied to those electronic devices.

RESULTS

Differences in UI priorities were found according to the four lifestyles ("money-oriented," "innovation-oriented," "stability- and simplicity-oriented," and "innovation- and intellectual-oriented"). Twelve QUI models were developed for four different lifestyle groups associated with different products. Three washers and three smartphones were used as an example for testing the QUI models.

CONCLUSION

The UI differences of the older user groups by the segmentation in this study using several key (i.e., demographic, socioeconomic, and physical-cognitive) variables are distinct from earlier studies made by a single variable. The differences in responses clearly indicate the benefits of integrating various factors of older users, rather than single variable, in order to design and develop more innovative and better consumer products in the future. The results of this study showed that older users with a potentially high buying power in the future are likely to have higher satisfaction when selecting products customized for their lifestyle. Designers could also use the results of UI evaluation for older users based on their lifestyle before developing products through QUI modeling. This approach would save time and costs.

Assessment of personal care and medical robots from older adults' perspective

Demographic reports indicate that population of older adults is growing significantly over the world and in particular in developed nations. Consequently, there are a noticeable number of demands for certain services such as health-care systems and assistive medical robots and devices. In today’s world, different types of robots play substantial roles specifically in medical sector to facilitate human life, especially older adults. Assistive medical robots and devices are created in various designs to fulfill specific needs of older adults. Though medical robots are utilized widely by senior citizens, it is dramatic to find out into what extent assistive robots satisfy their needs and expectations. This paper reviews various assessments of assistive medical robots from older adults’ perspectives with the purpose of identifying senior citizen’s needs, expectations, and preferences. On the other hand, these kinds of assessments inform robot designers, developers, and programmers to come up with robots fulfilling elderly’s needs while improving their life quality.

Information and Communication Technology Use Is Related to Higher Well-Being Among the Oldest-Old

Objectives

Older adults often prioritize socially meaningful goals over informational goals. Thus, we predicted that using information and communication technology (ICT) in service of socially meaningful versus informational goals relates to higher well-being among the oldest-old.

Method

We surveyed 445 adults aged 80+ (mean = 84, range = 80-93; 64% female; 26% non-White) online or via telephone. Participants reported motivations for ICT use (connect with others, learn new information) and rated their psychological and physical well-being (i.e., life satisfaction, loneliness, goal attainment, subjective health, functional limitations). We conducted regression and mediation analyses to test our hypothesis.

Results

Participants used ICT more to connect with friends/family (M = 3.66, SD = 1.28) than to learn information (M = 2.61, SD = 1.44), p < .001. Overall, ICT use predicted higher well-being across outcomes, ps ≤ .008. Motivations for use differentially mediated these effects: Social motivations mediated the relationships between ICT use and psychological well-being, whereas informational motivations mediated the relationships between ICT use and physical well-being.

Discussion

Older adults aged 80+ use ICT less than other generations, but may have much to gain. Using social versus informational technologies may enhance multiple aspects of well-being in different ways during very late life. Highlighting such benefits may increase ICT adoption among the oldest-old.

Understanding Older Adult's Perceptions of Factors that Support Trust in Human and Robot Care Providers

As the population of older adults increase so will the need for care providers, both human and robot. Trust is a key aspect to establish and maintain a successful older adult-care provider relationship. However, due to trust volatility it is essential to understand it within specific contexts. This proposed mixed methods study will explore what dimensions of trust emerge as important within the human-human and human-robot dyads in older adults and care providers. First, this study will help identify key qualities that support trust in a care provider relationship. By understanding what older adults perceive as needing to trust humans and robots for various care tasks, we can begin to provide recommendations based on user expectations for design to support trust.

Characteristics of online treatment seekers interested in a text messaging intervention for problem drinking: adults 51 and older versus middle-aged and younger adults

According to the Institute of Medicine, the vast older adult population is estimated to have mental health and substance use disorders at unprecedented rates and will place high demand on an unprepared healthcare system. Online and mobile health interventions, such as text messaging, could provide an alternative form of frontline intervention that could alleviate some of the burden on the healthcare system; however, it remains unknown what are characteristics of adults over 50 who might be interested in a mobile health behavioral intervention and how they may differ from their younger counterparts. To explore the characteristics of those interested in a text messaging intervention by age, we examined screening data for a randomized controlled trial testing a text messaging intervention to reduce drinking among 1,128 hazardous and problem drinkers, aged 21-30, 31-50, and 51 and older. Participants were recruited online through website advertising on alcoholscreening.org and moderationmanagement.org. Results demonstrated that over a quarter of individuals pursuing online and/or text messaging treatment were 51 and older. These participants reported heavy drinking, with significantly greater number of days drinking and binge drinking than the younger groups, but with fewer consequences. Across age groups, a vast majority of participants were female. Findings demonstrate that a group of adult heavy drinkers 51 and older already pursue online treatment and are interested in using a text messaging intervention to help them reduce drinking, suggesting an avenue to engage this population using an alternative frontline treatment.

How to Tackle Key Challenges in the Promotion of Physical Activity among Older Adults (65+): The AEQUIPA Network Approach

The paper introduces the theoretical framework and methods/instruments used by the Physical Activity and Health Equity: Primary Prevention for Healthy Ageing (AEQUIPA) prevention research network as an interdisciplinary approach to tackle key challenges in the promotion of physical activity among older people (65+). Drawing on the social-ecological model, the AEQUIPA network developed an interdisciplinary methodological design including quantitative/qualitative studies and systematic reviews, while combining expertise from diverse fields: public health, psychology, urban planning, sports sciences, health technology and geriatrics. AEQUIPA tackles key challenges when promoting physical activity (PA) in older adults: tailoring of interventions, fostering community readiness and participation, strengthening intersectoral collaboration, using new technological devices and evaluating intervention generated inequalities. AEQUIPA aims to strengthen the evidence base for age-specific preventive PA interventions and to yield new insights into the explanatory power of individual and contextual factors. Currently, the empirical work is still underway. First experiences indicate that thenetwork has achieved a strong regional linkage with communities, local stakeholders and individuals. However, involving inactive persons and individuals from minority groups remained challenging. A review of existing PA intervention studies among the elderly revealed the potential to assess equity effects. The results will add to the theoretical and methodological discussion on evidence-based age-specific PA interventions and will contribute to the discussion about European and national health targets.