Gerontechnology acceptance by elderly Hong Kong Chinese: a senior technology acceptance model (STAM)

Assessing virtual reality acceptance in long-term care facilities: a quantitative study with older adults

PURPOSE

Our study aimed to investigate the factors associated with the acceptance of virtual reality (VR) games among older adults living in LTC, with a particular emphasis on identifying social and individual factors that have been overlooked in existing technology acceptance models.

MATERIALS AND METHODS

We conducted VR gaming sessions, followed by a composite questionnaire to explore the factors associated with the acceptance of VR games among residents of LTC with a focus on technology acceptance models (TAM) and social factors derived from Selective Optimization with Compensation (SOC) theory and Socioemotional Selectivity Theory (SST).

RESULTS

We studied 20 older adults aged 65 and older. Participants were moderately sedentary, with the majority of them having prior gaming experience. Participants with prior gaming experience had higher mean scores in most SOC theory and SST subscales, except for elective selection. Participants perceived the technology as useful and easy to use, with no heightened gaming-related anxiety. Significant correlations were found between perceived ease of use and selection strategies, and between attitudes towards gaming and elective selection strategies. No significant score differences were observed between male and female participants.

CONCLUSIONS

The positive correlation between VR acceptance and using SOC strategies suggests a positive response to straightforward experiences. Our study highlights VR exergaming's potential benefits for encouraging LTC residents' engagement in valued activities and pursuing goals. Moreover, social theories of aging can inform technology acceptance and guide the design and marketing of VR exergames to better suit older adults' needs and preferences in LTC.IMPLICATIONS FOR REHABILITATIONThe findings of this study have important implications for rehabilitation programs aimed at enhancing physical activity (PA) and engagement among older adults living in long-term care (LTC) facilities. The use of virtual reality (VR) games can be an important tool to promote PA and improve the overall well-being of LTC residents. Based on the results, the following implications can be drawn:Integrating VR exergaming in rehabilitation:The positive perception of VR technology's usefulness and ease of use among older adults in LTC suggests that VR exergaming can be effectively integrated into rehabilitation programs. Healthcare professionals and rehabilitation specialists in LTC facilities can consider incorporating VR-based exercise routines and gaming sessions to motivate and engage residents in physical activities. By doing so, they can create enjoyable and interactive rehabilitation experiences that may lead to improved adherence to exercise regimens.Addressing social factors for VR acceptance:Our study highlights the significance of social factors derived from theories of aging, such as Selective Optimization with Compensation (SOC) and Socioemotional Selectivity Theory (SST), in influencing VR acceptance among LTC residents. Rehabilitation programs should take into account these social aspects and create a supportive and encouraging environment for older adults to engage with VR exergames. Encouraging social interactions and providing opportunities for residents to share their experiences with VR gaming may enhance acceptance and overall engagement.Tailoring VR exergames for older adults:The correlation between VR acceptance and the use of SOC strategies indicates that customized experiences may be well-received by LTC residents. Game developers and rehabilitation specialists should consider designing VR exergames that align with the specific preferences and needs of older adults. This could involve providing choices and options for users to optimize their gaming experiences based on their individual abilities and interests.Recognizing gaming experience:Our study highlights that prior gaming experience positively influenced participants' attitudes towards VR gaming. Rehabilitation professionals should acknowledge and leverage this prior experience when introducing VR exergaming to older adults in LTC. By incorporating elements familiar to older adults or providing guidance for those new to gaming, rehabilitation programs can foster a more seamless and enjoyable transition to VR exergames.Promoting goal pursuit and valued activities:Our study suggests that VR exergaming has the potential to encourage LTC residents' engagement in valued activities and goal pursuit. Rehabilitation programs can utilize VR exergaming as a means to help residents achieve specific rehabilitation goals and engage in activities that are meaningful to them. This approach can contribute to a sense of purpose and satisfaction in the rehabilitation process.Overall, the integration of VR exergaming in rehabilitation for older adults in LTC facilities has promising implications for improving physical activity levels, enhancing engagement, and addressing the holistic well-being of residents. By considering the social factors influencing VR acceptance and tailoring experiences to individual preferences, rehabilitation professionals can optimize the potential benefits of VR technology in LTC settings.

Voice assistants' influence on loneliness in older adults: a systematic review

Purpose: This review aims to examine how the use of voice assistants influences loneliness in older adults.

Materials and methods: This study follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases such as CINAHL, APA PsycINFO, MEDLINE, PubMed, Web of Science, ScienceDirect, Scopus, SciELO, Google Scholar, and IEEE Xplore were used. We implemented search strategies in English to locate studies published between January 2010 and January 2023, including those examining the impact of voice assistant usage on loneliness in older adults. Descriptive information was examined, assessing its quality with the Mixed Methods Appraisal Tool.

Results: A total of 499 studies were yielded from the initial search, with 13 included in the final analysis. Positive outcomes in reducing loneliness were reported in 84.6% of these studies. There was a prevalence of quasi-experimental studies, alongside heterogeneous measurement instruments, scarce use of standardized tests, and small samples predominantly consisting of women. Commercial voice assistants were the most commonly utilized.

Conclusions: Voice assistants show potential in mitigating feelings of loneliness in older adults. Adequate training and adaptation to specific needs seem essential to maximize their effectiveness. In particular, voice assistants available in the consumer market hold significant potential in this area. Further research is necessary to comprehend their impact, encompassing potential risks and ethical considerations.

Loneliness and Mode of Social Contact in Late Life

OBJECTIVES

Social contact may alleviate loneliness, but little is known about within-person daily fluctuations in loneliness and social encounters. Older adults who feel lonely may engage in different modes of social contact (in-person, phone, digital). This study asked how different forms of contact are associated with loneliness throughout the day.

METHODS

Participants were 313 community-dwelling older adults (aged 65-90). They completed ecological momentary assessments reporting on their social encounters (e.g., type of social partner, mode of contact) and their loneliness every 3 hr for 5-6 days. We differentiated close social ties from ties not identified as close (i.e., weak ties).

RESULTS

We examined within-person effects using multilevel models. Findings revealed that momentary loneliness predicted a greater likelihood of phone contact in the next 3 hr. However, only in-person contact was associated with lower levels of loneliness. Regarding close and weak ties, momentary loneliness was associated with more in-person and phone contact with close ties, yet fewer in-person contacts with weak ties. In-person contact with both close and weak ties predicted lower levels of loneliness.

DISCUSSION

Although older adults engage in both in-person and phone contact when they feel lonely, it appears that only in-person contact may reduce loneliness. Digital contact was not widely adopted as a response to momentary loneliness among these older adults. Findings underscore older adults' willingness to maintain regular contact with close ties. Interventions addressing older adults who are lonely may consider innovative approaches to increase in-person contact.

The experiences of daily smartphone use among older adults in Brazil: A grounded theory analysis

Background

Digital inclusion of older people is an important agenda for the future and well-being of the older population, as it represents a form of social inclusion with significant gains for healthy aging. The present study aimed to understand the experiences of Brazilian older adults who use smartphones and the implications in their daily lives.

Method

A qualitative study was developed using a constructivist grounded approach. Older people (≥60 years) with prior access to a smartphone were invited to participate in the study. Participation took place through semi-structured, audio-recorded interviews. Data collection and analysis occurred simultaneously using a constant comparative approach. Data management and analysis used the Atlas.ti® software.

Results

Overall, 37 older people participated, with an average age of 70.60 ± 6.95 years, predominantly female (n = 33), white (n = 25), married (n = 26) and retired (n = 27). The first sample group included 27 older people with family support and the second group included 10 older people without family support (who lived alone in their homes). A core category emerged from the data analysis-"Expanding the personal and social development of older adults through smartphone communication"-around which three main categories emerged: 1) The smartphone as "a window to the world"; 2) The problem of misinformation and fake news on virtual networks; 3) Technological paradoxes in the use of smartphones.

Conclusions

The digital transition associated with smartphone use brings unimaginable benefits to older adults who adopt positive habits to improve their well-being and expand their social connections, following efforts proposed by the Decade of Healthy Aging. However, older adults still face disparities and experience a significant digital divide, which represents a major challenge. Barriers to access are further aggravated in developing countries. We hope this study contributes to public health policies on digital inclusion and healthy aging.

The transformation of 20-year social participation policies of older people in China: Network analysis and text analysis

BACKGROUND

Social participation of older adults is a crucial component of China's aged care services and an important strategy for actively addressing the aging population. Analyzing policy texts on older people's social participation can inform future policy formulation and the development of relevant programs.

OBJECTIVES

This study aims to quantitatively analyze the transformation of China's social participation policies for older people from 1999 to 2023, employing institutional network analysis and policy text analysis.

METHOD

A two-dimensional policy analysis framework was constructed based on the perspective of "policy tools and social participation stages." Using Rost Content Mining 6.0 and Nvivo 11.0 Plus software, 55 national-level policy texts were coded. Structural analysis of policy-issuing subjects and topic words was conducted to visualize the findings.

RESULTS

The analysis revealed that the policy-issuing subjects demonstrated strong authority but weak coordination, with a lack of communication and cooperation across subjects. The use of policy tools was imbalanced, with an over-reliance on supply-type tools and insufficient use of demand-type tools. Additionally, the lack of effective policy tools to support various social participation stages has limited policy implementation.

CONCLUSION

With technological advancement and changing needs of the elderly population, there is a need for a more systematic and forward-looking top-level design of elderly social participation policies: accelerating the systematization and precision of technological elements in policies for elderly social participation, integrating social organizations via technological platforms to mobilize diverse stakeholder engagement, and addressing the digital divide between the elderly and new technologies is imperative.

Virtual Reality Mental Health Interventions in Geriatric Care for Functional or Well-being Enhancement - A Scoping Review

PURPOSE

It has become common to use Virtual Reality (VR) for mental health interventions; however, its use in care of the elederly is limited, especially regarding mood and well-being. In this review, we summarize the results of current VR-based mental health interventions for this population.

METHODS

Peer-reviewed journal articles on immersive VR mental health intervention in seniors, published until 2022, were included.

RESULTS

There were 2697 results found in the database search, of which 40 articles met the inclusion criteria and were included in the final analysis. Most studies did not use an experimental design with randomized controlled trials and follow-up sessions. Function-oriented and entertainment-oriented intervention studies were categorized. VR-based geriatric mental interventions have grown rapidly since 2018, especially the number of interventions that promote wellbeing. The function-oriented interventions used active interactions with varied devices. Entertainment-oriented interaction was primarily passive, seldomly using hand controllers for moving activities. Generally, VR interventions improved the mental health of older adults.

CONCLUSION

Geriatric rehabilitation can benefit from this innovative technology to maintain cognitive functions and to improve the well-being of seniors. They have potential for use in aging care and in retirement homes. Future VR interventions may also involve promoting social interaction to combat loneliness among seniors.

Willingness to use smart fetal heart rate monitoring devices among pregnant women: an extension of the technology acceptance model

The purpose of this study was to assess the significant factors that impact pregnant women's willingness to use smart fetal heart-rate monitoring devices. We propose a research model that integrates technological factors (perceived compatibility and perceived credibility) and personal factors (health anxiety, personal physiological conditions, health consciousness, and health beliefs). The subjects of this study were Chinese women who were pregnant or had previously given birth. Data were collected and analyzed from 397 paper-and-pencil and electronic questionnaires. Our structural equation model indicated that perceived usefulness (β = 0.490, t = 7.591, p < 0.001), perceived ease of use (β = 0.352, t = 5.631, p < 0.001), health anxiety (β = 0.095, t = 2.664, p = 0.008), personal physiological conditions (β = 0.075, t = 2.142, p = 0.032), and health consciousness (β = 0.078, t = 2.110, p = 0.035) were the determinants of the intention to use smart fetal heart-rate monitoring devices, with perceived usefulness having the highest degree of influence. Furthermore, we discovered that the levels of perceived compatibility and perceived credibility did not have direct correlations with the intention to use these devices, but they did significantly influence the model. Perceived compatibility (β = 0.345, t = 6.601, p < 0.001) and perceived credibility (β = 0.519, t = 9.958, p < 0.001) significantly influences perceived ease of use. Perceived credibility (β = 0.421, t = 7.802, p < 0.001) significantly influences perceived usefulness. Based on these results, suggestions for future research are put forward.

Technology Usability for People Living With Dementia: Concept Analysis

BACKGROUND

Usability is a key indicator of the quality of technology products. In tandem with technological advancements, potential use by individuals with dementia is increasing. However, defining the usability of technology for individuals with dementia remains an ongoing challenge. The diverse and progressive nature of dementia adds complexity to the creation of universal usability criteria, highlighting the need for focused deliberations. Technological interventions offer potential benefits for people living with dementia and caregivers. Amid COVID-19, technology's role in health care access is growing, especially among older adults. Enabling the diverse population of people living with dementia to enjoy the benefits of technologies requires particular attention to their needs, desires, capabilities, and vulnerabilities to potential harm from technologies. Successful technological interventions for dementia require meticulous consideration of technology usability.

OBJECTIVE

This concept analysis aims to examine the usability of technology in the context of individuals living with dementia to establish a clear definition for usability within this specific demographic.

METHODS

The framework by Walker and Avant was used to guide this concept analysis. We conducted a literature review spanning 1984 to 2024, exploring technology usability for people with dementia through the PubMed, Web of Science, and Google Scholar databases using the keywords "technology usability" and "dementia." We also incorporated clinical definitions and integrated interview data from 29 dyads comprising individuals with mild Alzheimer dementia and their respective care partners, resulting in a total of 58 older adults. This approach aimed to offer a more comprehensive portrayal of the usability needs of individuals living with dementia, emphasizing practical application.

RESULTS

The evidence from the literature review unveiled that usability encompasses attributes such as acceptable learnability, efficiency, and satisfaction. The clinical perspective on dementia stages, subtypes, and symptoms underscores the importance of tailored technology usability assessment. Feedback from 29 dyads also emphasized the value of simplicity, clear navigation, age-sensitive design, personalized features, and audio support. Thus, design should prioritize personalized assistance for individuals living with dementia, moving away from standardized technological approaches. Synthesized from various sources, the defined usability attributes for individuals living with dementia not only encompass the general usability properties of effectiveness, efficiency, and satisfaction but also include other key factors: adaptability, personalization, intuitiveness, and simplicity, to ensure that technology is supportive and yields tangible benefits for this demographic.

CONCLUSIONS

Usability is crucial for people living with dementia when designing technological interventions. It necessitates an understanding of user characteristics, dementia stages, symptoms, needs, and tasks, as well as consideration of varied physical requirements, potential sensory loss, and age-related changes. Disease progression requires adapting to evolving symptoms. Recommendations include versatile, multifunctional technology designs; accommodating diverse needs; and adjusting software functionalities for personalization. Product feature classification can be flexible based on user conditions.

Acceptance of physical activity virtual reality games by residents of long-term care facilities: A qualitative study

BACKGROUND

Little is known about the experience and the social and contextual factors influencing the acceptance of virtual reality (VR) physical activity games among long-term care (LTC) residents. Our study aims to address this research gap by investigating the unique experience of older adults with VR games. The findings will provide valuable insights into the factors influencing VR acceptance among LTC residents and help design inclusive VR technology that meets their needs and improves physical activity (PA) and well-being.

OBJECTIVE

We aimed to: (1) investigate how participants experience VR exergames and the meaning they associate with their participation; and (2) examine the factors that influence the participant's experience in VR exergames and explore how these factors affect the overall experience.

METHODS

We used a qualitative approach that follows the principles of the Interpretive Description methodology. Selective Optimization and Compensation (SOC) theory, Socioemotional Selectivity theory (SST) and technology acceptance models underpinned the theoretical foundations of this study. We conducted semi-structured interviews with participants. 19 Participants of a LTC were interviewed: five residents and ten tenants, aged 65 to 93 years (8 female and 7 male) and four staff members. Interviews ranged from 15 to 30 minutes and were transcribed verbatim and were analyzed using thematic analysis.

RESULTS

We identified four themes based on older adults' responses that reflected their unique VR gaming experience, including (1) enjoyment, excitement, and the novel environment; (2) PA and motivation to exercise; (3) social connection and support; and (4) individual preferences and challenges. Three themes were developed based on the staff members' data to capture their perspective on the factors that influence the acceptance of VR among LTC resident including (1) relevance and personalization of the games; (2) training and guidance; and (3) organizational and individual barriers.

CONCLUSIONS

VR gaming experiences are enjoyable exciting, and novel for LTC residents and tenants and can provide physical, cognitive, social, and motivational benefits for them. Proper guidance and personalized programs can increase understanding and familiarity with VR, leading to a higher level of acceptance and engagement. Our findings emphasize the significance of social connection and support in promoting acceptance and enjoyment of VR gaming among older adults. Incorporating social theories of aging helps to gain a better understanding of how aging-related changes influence technology acceptance among older adults. This approach can inform the development of technology that better meets their needs and preferences.

Digital Phenotyping of Geriatric Depression Using a Community-Based Digital Mental Health Monitoring Platform for Socially Vulnerable Older Adults and Their Community Caregivers: 6-Week Living Lab Single-Arm Pilot Study

BACKGROUND

Despite the increasing need for digital services to support geriatric mental health, the development and implementation of digital mental health care systems for older adults have been hindered by a lack of studies involving socially vulnerable older adult users and their caregivers in natural living environments.

OBJECTIVE

This study aims to determine whether digital sensing data on heart rate variability, sleep quality, and physical activity can predict same-day or next-day depressive symptoms among socially vulnerable older adults in their everyday living environments. In addition, this study tested the feasibility of a digital mental health monitoring platform designed to inform older adult users and their community caregivers about day-to-day changes in the health status of older adults.

METHODS

A single-arm, nonrandomized living lab pilot study was conducted with socially vulnerable older adults (n=25), their community caregivers (n=16), and a managerial social worker over a 6-week period during and after the COVID-19 pandemic. Depressive symptoms were assessed daily using the 9-item Patient Health Questionnaire via scripted verbal conversations with a mobile chatbot. Digital biomarkers for depression, including heart rate variability, sleep, and physical activity, were measured using a wearable sensor (Fitbit Sense) that was worn continuously, except during charging times. Daily individualized feedback, using traffic signal signs, on the health status of older adult users regarding stress, sleep, physical activity, and health emergency status was displayed on a mobile app for the users and on a web application for their community caregivers. Multilevel modeling was used to examine whether the digital biomarkers predicted same-day or next-day depressive symptoms. Study staff conducted pre- and postsurveys in person at the homes of older adult users to monitor changes in depressive symptoms, sleep quality, and system usability.

RESULTS

Among the 31 older adult participants, 25 provided data for the living lab and 24 provided data for the pre-post test analysis. The multilevel modeling results showed that increases in daily sleep fragmentation (P=.003) and sleep efficiency (P=.001) compared with one's average were associated with an increased risk of daily depressive symptoms in older adults. The pre-post test results indicated improvements in depressive symptoms (P=.048) and sleep quality (P=.02), but not in the system usability (P=.18).

CONCLUSIONS

The findings suggest that wearable sensors assessing sleep quality may be utilized to predict daily fluctuations in depressive symptoms among socially vulnerable older adults. The results also imply that receiving individualized health feedback and sharing it with community caregivers may help improve the mental health of older adults. However, additional in-person training may be necessary to enhance usability.

TRIAL REGISTRATION

ClinicalTrials.gov NCT06270121; https://clinicaltrials.gov/study/NCT06270121.

What Is the Real-Life Experience of Older Adults on Smart Healthcare Technologies? An Exploratory Interview Study

INTRODUCTION

Smart healthcare technologies (SHCTs) exhibit the great potential to support older Hong Kong adults with their health problems. Although there are various SHCTs in the Hong Kong market, and some adoption predictors have been proposed and investigated, little is known about older users' views on and real-life experiences with these technologies. This exploratory study examined the experiences, functional needs, and barriers of three kinds of SHCT (i.e., smart wearable devices, smart health monitors, and healthcare applications) with older adults in real life.

METHODS

A convenience sampling method was applied to recruit twenty-two older adults from the Hong Kong community. The interview was designed in semi-structured and conducted in a face-to-face setting. The content analysis was used to summarize the older adults' functional needs and barriers in real life.

RESULTS

We found older adults mainly applied SHCTs to address physical health, but there are few technological solutions for mental health in practice. There are four types of barriers in using SHCT. However, social support in Hong Kong community greatly helps reduce the barriers in technology use. Based on the findings, we discussed the possible solutions based on the social and technology perspective.

CONCLUSION

Current technologies still could not fully address older adults' needs for healthy aging, and various barriers still hinder the actual adoption. By deeply understanding and considering the social context, technology innovation can facilitate the adoption of SHCT and promote a healthy aging society.

Chinese Immigrant Caregivers: Understanding Their Unmet Needs and the Co-Design of an mHealth App

BACKGROUND

Immigrant caregivers support the aging population, yet their own needs are often neglected. Mobile technology-facilitated interventions can promote caregiver health by providing easy access to self-care materials.

OBJECTIVE

This study employed a design thinking framework to examine Chinese immigrant caregivers' (CICs) unmet self-care needs and co-design an app for promoting self-care with CICs.

METHODS

Nineteen semi-structured interviews were conducted in conceptual design and prototype co-design phases.

FINDINGS

Participants reported unmet self-care needs influenced by psychological and social barriers, immigrant status, and caregiving tasks. They expressed the need to learn to keep healthy boundaries with the care recipient and respond to emergencies. Gaining knowledge was the main benefit that drew CICs' interest in using the self-care app. However, potential barriers to use included issues of curriculum design, technology anxiety, limited free time, and caregiving burdens.

DISCUSSION

The co-design process appears to be beneficial in having participants voice both barriers and preferences.

[Use of technology in old age: associations between acceptance, competence, control, interest and social indicators in individuals over 60 years old]

BACKGROUND

In addition to sociodemographic factors, action-theoretical constructs, such as technology acceptance and competence play an important role in technology use.

OBJECTIVE

This study aimed to examine the associations between technology use, sociodemographic factors, action-theoretical constructs, and technology interest.

MATERIAL AND METHODS

Data were collected from 585 study participants aged over 60 years from 14 surveys conducted between 2014 and 2020. A structural equation model was used to explain the relationships.

RESULTS

The structural equation model with covariates of survey year, age, gender, and education (n = 585) yielded the following fit indices: comparative fit index (CFI) = 0.918, Tucker-Lewis index (TLI) = 0.894, Root Mean Square Error of Approximation (RMSEA) = 0.056 [95 % confidence interval: 0.050-0.063], Standardized Root Mean Square Residual (SRMR) = 0.079, χ2 = 3051.936 (p < 0.001), χ2/degrees of freedom (df) = 18.499. The strongest associations with technology use were found for technology acceptance and competence. Additionally, technology competence showed a significant association with technology interest. Gender and technology interest were not related to technology use but it was observed that men had higher levels of technology acceptance, control, competence, and interest.

DISCUSSION

Taking technology competence beliefs into account plays a crucial role in understanding the technology usage and interest of older individuals. Additionally, gender-specific differences in the theoretical constructs of action and interest in technology have been revealed in the context of the digital divide.

Understanding Senior Adults' Needs, Preferences, and Experiences of Commercial Exergames for Health: Usability Study

BACKGROUND

Many senior adults are at risk of mental and physical disorders due to a lack of sufficient exercise. Therefore, adherent exercise should be urgently promoted to improve senior adults' muscle strength, preventing falls and conditions caused by physical and cognitive decline. However, off-the-shelf exercise games, so-called exergames, are mainly targeted at the younger generation or children, while senior adults are neglected, when this age group strongly needs exercise. Exergames could serve as a health intervention for promoting exercise.

OBJECTIVE

This study aimed to investigate senior adults' experience, perceptions, and acceptance of game technology to promote exercise in order to suggest game design guidelines.

METHODS

In this usability study, participants engaged in playing Nintendo Switch and Xbox Kinect games, after which semistructured interviews were conducted. Before the gameplay, the participants provided their background information, exercise habits, and use of technology products. Next, all participants completed a workshop including 3 activities (brief instructions on how to play the games: 20 minutes; playing the selected exergames: 80 minutes; semistructured interviews: 20 minutes) for 2 hours a day for 3 days each. The participants played the latest Nintendo Switch games (eg, Just Dance, Boxing, Ring Fit Adventure) and Xbox Kinect games (eg, Kinect Adventures!, Mini Games). Just Dance, Zumba, and Boxing were played in activity 1; Ring Fit Adventure and Mini Games in activity 2; and Kinect Adventures! in activity 3. Reflexive thematic analysis was applied to identify the relative themes generated from the interviews.

RESULTS

In total, 22 participants (mean age 70.4, SD 6.1 years) were enrolled in the workshop in May 2021. The results of the generated themes included incomprehension of game instructions, psychological perception of game technology, and game art preferences. The subthemes generated from game art preferences included favorite game genres, characters, and scenes.

CONCLUSIONS

There is a significant need for customized game tutorials considering senior adults' cognitive and physical aging. Furthermore, the adventure game genre is preferable to other games. Humanlike game characters are preferable, especially those with a fit and healthy body shape. Nature scenes are more enjoyable than indoor stages or rooms. Furthermore, the game intensity design and playing time should be carefully planned to meet the World Health Organization's criteria for physical activity in older adults. Intelligent recommendation systems might be helpful to support older adults with various health conditions. The guidelines suggested in this study might be beneficial for game design, exercise training, and game technology adoption of exergames for older adults to improve health.

Assessment of a digital intervention program with Holocaust survivors

OBJECTIVE

This study evaluated a digital intervention program with aging Holocaust survivors. Participants received a tablet device and were coupled with a volunteer who assisted them to use the tablet. The study aimed to assess which characteristics of the Holocaust survivors are linked with more frequent use of digital communication at the end of the program.

METHODS

Information was collected by telephone interviews with 91 survivors before and 54 after participating in the program. We combined this data with digital usage data from the tablets. Regression models examined the characteristics of Holocaust survivors that were related to higher frequency of using digital communication technologies during the intervention.

RESULTS

The Holocaust survivors expressed high satisfaction with the program. They increased their frequency of using digital communication technologies-text correspondence and video chats with friends and family. Regressions showed that Holocaust survivors who reported increased digital communication were characterized at the start of the intervention by having fewer post-traumatic stress symptoms, higher levels of flourishing (reflecting a more meaningful life and higher well-being), being lonelier, and were also more satisfied with the program at follow-up.

CONCLUSION

The pilot program benefited the aging Holocaust survivors. Further programs should be developed to increase the digital communication of vulnerable older populations, such as trauma survivors.

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.

What drives low-income older adults' intention to use mobility applications?

AIM

Mobility applications have the potential to support low-income older adults in facing mobility challenges. However, there is a generally lower uptake of technology in this segment. To understand factors affecting the intention to use a mobility app, we drew upon the Protection Motivation Theory, and tested a model of low-income older adults' technology adoption.

METHODS

A cross-sectional survey was conducted across seven states in Malaysia among community-dwelling low-income older adults aged ≥60 years old (n = 282). Measurement items were adapted from pre-validated scales and 7-point Likert Scales were used. Partial least squares structural equation modeling was utilized to assess the hypothesized model.

RESULTS

Mobility technology awareness was found to shape an individual's threat and coping appraisals associated with their intention to use a mobility app. The decision of a low-income older adult to adopt a mobility app as a protective action is not a direct function of threat and coping appraisals but is indirect, and mediated by the underlying cost-benefit perceptions of non-adoption and adoption of the mobility app. In terms of technology perceptions, perceived usefulness is a significant predictor, but not perceived ease of use.

CONCLUSIONS

This study entails a new model by uncovering the psychological factors encompassing mobility technology awareness, threat-coping appraisals, and cost-benefit perceptions on Technology Acceptance Model studies. These insights have important implications for the development and implementation of a mobility app among low-income older adults. Geriatr Gerontol Int 2024; 24: 342-350.

Reducing Loneliness and Improving Social Support among Older Adults through Different Modalities of Personal Voice Assistants

This study examines the potential of AI-powered personal voice assistants (PVAs) in reducing loneliness and increasing social support among older adults. With the aging population rapidly expanding, innovative solutions are essential. Prior research has indicated the effectiveness of various interactive communication technologies (ICTs) in mitigating loneliness, but studies focusing on PVAs, particularly considering their modality (audio vs. video), are limited. This research aims to fill this gap by evaluating how voice assistants, in both audio and video formats, influence perceived loneliness and social support. This study examined the impact of voice assistant technology (VAT) interventions, both audio-based (A-VAT) and video-based (V-VAT), on perceived loneliness and social support among 34 older adults living alone. Over three months, participants engaged with Amazon Alexa™ PVA through daily routines for at least 30 min. Using a hybrid natural language processing framework, interactions were analyzed. The results showed reductions in loneliness (Z = -2.99, p < 0.01; pre-study loneliness mean = 1.85, SD = 0.61; post-study loneliness mean = 1.65, SD = 0.57), increases in social support post intervention (Z = -2.23, p < 0.05; pre-study social support mean = 5.44, SD = 1.05; post-study loneliness mean = 5.65, SD = 1.20), and a correlation between increased social support and loneliness reduction when the two conditions are combined (ρ = -0.39, p < 0.05). In addition, V-VAT was more effective than A-VAT in reducing loneliness (U = 85.50, p < 0.05) and increasing social support (U = 95, p < 0.05). However, no significant correlation between changes in perceived social support and changes in perceived loneliness was observed in either intervention condition (V-VAT condition: ρ = -0.24, p = 0.37; A-VAT condition: ρ = -0.46, p = 0.06). This study's findings could significantly contribute to developing targeted interventions for improving the well-being of aging adults, addressing a critical global issue.

Barriers and facilitators to health technology adoption by older adults with chronic diseases: an integrative systematic review

BACKGROUND

In recent years, healthcare systems have progressively adopted several technologies enhancing access to healthcare for older adults and support the delivery of efficient and effective care for this specific population. These technologies include both assistive technologies designed to maintain or improve the independence, social participation and functionality of older people at home, as well as health information technology developed to manage long-term conditions. Examples of such technologies include telehealth, wearable devices and mobile health. However, despite the great promise that health technology holds for promoting independent living among older people, its actual implementation remains challenging.

METHODS

This study aimed to conduct an integrative systematic review of the research evidence on the factors that facilitate or hinder the adoption of different types of technology by older individuals with chronic diseases. For this purpose, four electronic databases (PsycArticles, Scopus, Web of Science and PubMed) were queried to search for indexed published studies. The methodological quality of the selected papers has been assessed using the Mixed Methods Appraisal Tool (MMAT).

RESULTS

Twenty-nine articles were selected, including 6.213 adults aged 60 or older. The studies have been synthesised considering the types of technological interventions and chronic diseases, as well as the main barriers and facilitators in technology acceptance. The results revealed that the majority of the selected articles focused on comorbid conditions and the utilisation of telemedicine tools. With regard to hindering and facilitating factors, five main domains were identified: demographic and socioeconomic, health-related, dispositional, technology-related and social factors.

CONCLUSION

The study results have practical implications not only for technology developers but also for all the social actors involved in the design and implementation of healthcare technologies, including formal and informal caregivers and policy stakeholders. These actors could use this work to enhance their understanding of the utilisation of technology by the ageing population. This review emphasises the factors that facilitate technology adoption and identifies barriers that impede it, with the ultimate goal of promoting health and independent living.

The factors affecting acceptance of gerontechnological products by older Turkish adults

This study investigates the attitudes of Turkish older people towards the acceptance of gerontechnological products. It included a total of 871 older individuals aged 65 and above from seven geographical regions of Türkiye. A questionnaire adopted from previous studies was applied to collect the data. The use of products of the older people was studied under the headings of (i) home and daily life technology, (ii) communication technology, (iii) health technology and (iv) education and recreation technology. As a result of the factor analysis, 16 questions were classified under: "attitudes towards using technology (AUT), facilitating conditions (FC), perceived ease of use (PEU) and gerontechnology anxiety (GA)". The effect of independent variables on the use of gerontechnological products was investigated by one-way variance analysis, and the relationship between the use of neurotechnological products and the attitudes of the older people towards accepting gerontechnological products was investigated by correlation analysis. Region, place of residence, age, gender, education level, economic and health status were found to be important in use gerontechnological products (p < 0.05). There was a high correlation between product groups as well as between product groups and attitudes. Results can be utilized in the production and dissemination of gerontechnological products to increase the level of life quality of the older people.

Healthcare providers' perception towards utilization of health information applications and its associated factors in healthcare delivery in health facilities in Cape Coast Metropolis, Ghana

BACKGROUND

Information and communication technology (ICT) has significantly advanced global healthcare, with electronic health (e-Health) applications improving health records and delivery. These innovations, including electronic health records, strengthen healthcare systems. The study investigates healthcare professionals' perceptions of health information applications and their associated factors in the Cape Coast Metropolis of Ghana's health facilities.

METHODS

We used a descriptive cross-sectional study design to collect data from 632 healthcare professionals (HCPs), in the three purposively selected health facilities in the Cape Coast municipality of Ghana, in July 2022. Shapiro-Wilk test was used to check the normality of dependent variables. Descriptive statistics were used to report means with corresponding standard deviations for continuous variables. Proportions were also reported for categorical variables. Bivariate regression analysis was conducted to determine the factors influencing the Benefits of Information Technology (BoIT); Barriers to Information Technology Use (BITU); and Motives of Information Technology Use (MoITU) in healthcare delivery. Stata SE version 15 was used for the analysis. A p-value of less than 0.05 served as the basis for considering a statistically significant accepting hypothesis.

RESULTS

Healthcare professionals (HCPs) generally perceived moderate benefits (Mean score (M) = 5.67) from information technology (IT) in healthcare. However, they slightly agreed that barriers like insufficient computers (M = 5.11), frequent system downtime (M = 5.09), low system performance (M = 5.04), and inadequate staff training (M = 4.88) hindered IT utilization. Respondents slightly agreed that training (M = 5.56), technical support (M = 5.46), and changes in work procedures (M = 5.10) motivated their IT use. Bivariate regression analysis revealed significant influences of education, working experience, healthcare profession, and IT training on attitudes towards IT utilization in healthcare delivery (BoIT, BITU, and MoITU). Additionally, the age of healthcare providers, education, and working experience significantly influenced BITU. Ultimately, age, education, working experience, healthcare profession, and IT training significantly influenced MoITU in healthcare delivery.

CONCLUSIONS

Healthcare professionals acknowledge moderate benefits of IT in healthcare but encounter barriers like inadequate resources and training. Motives for IT use include staff training and support. Bivariate regression analysis shows education, working experience, profession, and IT training significantly influence attitudes towards IT adoption. Targeted interventions and policies can enhance IT utilization in the Cape Coast Metropolis, Ghana.

Technology Acceptance of Socially Assistive Robots Among Older Adults and the Factors Influencing It: A Meta-Analysis

The purpose of this study was to deeply understand older adults' acceptance of socially assistive robots and their influencing factors and to compare the strength of the correlation between each influencing factor variable and the acceptance. The literature search was performed in five databases from their inception to January 17, 2023. The meta-analysis was performed using Review Manager 5.4 and Stata 16.0 software. Thirteen papers were included in this study. The mean value of acceptability after using the inverse variance method was 3.68. Education level is strongly related to technology acceptance; perceived ease of use, perceived usefulness, technology experience, technology attitude, perceived hedonism, and convenience are moderately related; anxiety is only weakly related.

Terms of Engagement: Understanding the Motivations, Preferences, and Attitudes of Older Adults Toward Mobile Cognitive Assessment and Training

BACKGROUND AND OBJECTIVES

The future of cognitive assessment is likely to involve mobile applications for smartphones and tablets; cognitive training is also often delivered in these formats. Unfortunately, low adherence to these programs can hinder efforts at the early detection of cognitive decline and interfere with examining cognitive training efficacy in clinical trials. We explored factors that increase adherence to these programs among older adults.

RESEARCH DESIGN AND METHODS

Focus groups were conducted with older adults (N = 21) and a younger adult comparison group (N = 21). Data were processed using reflexive thematic analysis with an inductive, bottom-up approach.

RESULTS

Three primary themes related to adherence were developed from the focus group data. Switches of engagement reflects factors that must be present; without them, engagement is unlikely. Dials of engagement reflects a cost-benefit analysis that users undergo, the outcome of which determines whether a person will be more or less likely to engage. Bracers of engagement reflects factors that nudge users toward engagement by minimizing barriers associated with the other themes. Older adults in general were more sensitive to opportunity costs, preferred more cooperative interactions, and were more likely to mention technology barriers.

DISCUSSION AND IMPLICATIONS

Our results are important for informing the design of mobile cognitive assessment and training apps for older adults. These themes provide guidance about ways apps could be modified to increase engagement and adherence, which in turn can more effectively facilitate the early detection of cognitive impairment and the evaluation of cognitive training efficacy.

A systematic review of gerontechnologies to support aging in place among community-dwelling older adults and their family caregivers

Objective

Paucity of information concerning the efficacy of gerontechnologies to support aging in place among community-dwelling older adults prevents potential users, healthcare professionals, and policymakers from making informed decisions on their use. The goal of this study was to identify gerontechnologies tested for home support in dyads of community-dwelling older adults with unimpaired cognition and their family caregivers, including their benefits and challenges. We also provide the level of evidence of the studies and recommendations to address the specific challenges preventing their use, dissemination, and implementation.

Methods

We conducted a systematic review of the literature published between 2016 and 2021 on gerontechnologies tested for home support in dyads. Two independent reviewers screened the abstracts according to the inclusion/exclusion criteria. A third reviewer resolved eligibility discrepancies. Data extraction was conducted by two independent reviewers.

Results

Of 1,441 articles screened, only 13 studies met the inclusion criteria with studies of moderate quality. Mostly, these gerontechnologies were used to monitor the older adult or the environment, to increase communication with family caregivers, to assist in daily living activities, and to provide health information. Benefits included facilitating communication, increasing safety, and reducing stress. Common challenges included difficulties using the technologies, technical problems, privacy issues, increased stress and dissatisfaction, and a mismatch between values and needs.

Conclusion

Only a few gerontechnologies have proven efficacy in supporting community-dwelling older adults and their family caregivers. The inclusion of values and preferences, co-creation with end users, designing easy-to-use technologies, and assuring training are strongly recommended to increase acceptability and dissemination.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=310803, identifier CRD42022310803.

The Role of Initial Trust in the Behavioral Intention to Use Telemedicine Among Filipino Older Adults

This study investigated the behavioral intention of Filipino older adults toward using telemedicine and the pivotal role of initial trust in influencing this intention. A cross-sectional method was employed, involving a questionnaire administered to 180 participants using convenience sampling. The structural model test results indicate that subjective norm, attitude, and notably, initial trust positively impact the behavioral intention to use telemedicine, whereas perceived behavioral control does not significantly affect intention. This underscores the significance of subjective norm and attitude in shaping behavioral intention, consistent with the Theory of Planned Behavior (TPB), while the extended construct of initial trust played a crucial role in influencing the attitude and intention of older adults, highlighting its importance in technology adoption. The study aligns with the trend of increased telemedicine adoption during the COVID-19 pandemic, emphasizing the need for trust in sensitive healthcare contexts. Establishing initial trust is vital for successful telemedicine implementation among Filipino older adults, enhancing healthcare accessibility and well-being.

Associations between perceived usefulness and willingness to use smart healthcare devices among Chinese older adults: The multiple mediating effect of technology interactivity and technology anxiety

Objective

This study aims to explore the mediating roles of technological interactivity and technological anxiety in the relationship between perceived usefulness and the willingness to use a smart health device to provide insight into the decision-making process of older adults in relation to the adoption of smart devices.

Methods

A cross-sectional survey was conducted in Jiangsu, China involving 552 older adults. The study utilized structural equation modeling (SEM) to analyze the relationship between the independent variable 'perceived usefulness' and the dependent variable 'willingness to use.' It also examined the multiple mediating effects of technological interactivity and technological anxiety between the independent and dependent variables.

Results

The results indicate that the direct effect of perceived usefulness on willingness to use was insignificant. However, technological interactivity completely mediated the relationship between perceived usefulness and willingness to use. Additionally, technological interactivity and technological anxiety were found to have a serial mediating effect on the impact of perceived usefulness on willingness to use smart healthcare devices.

Conclusions

These findings suggest that increasing older adults' intention to use smart healthcare devices requires not only raising awareness of their usefulness, but also addressing technological anxiety and enhancing the interactivity of these devices to improve the overall user experience.

Effectiveness of support from community health workers on the sustained use of a wearable monitoring device among community-dwelling older adults: A randomized trial protocol

BACKGROUND

Wearable monitoring devices, such as smartwatches and fitness bands, are health technologies for enhancing self-care management among community-dwelling older adults. While the evidence suggests that these devices can promote health, older adults often struggle to use them over the long term. Community health workers can effectively motivate older adults to change their health behaviors. This study proposes an intervention involving community health workers as peer supporters to promote sustained daily use of wearable monitoring devices among community-dwelling older adults.

METHODS

The intervention group in this randomized controlled trial will receive the Live with Wearable Monitoring Device program from trained community health workers with the support of a nurse and social workers through a one-time home visit and regular phone calls. The control group will receive only the wearable monitoring device. Data will be collected at baseline, 1 month, 3 months, and 6 months.

DISCUSSION

Merely providing older adults with wearable monitoring devices may not lead to the realization of the potential health benefits of these devices, as long-term usage can be challenging. The results of this trial can provide evidence for a new approach to enhancing self-management and community healthcare among community-dwelling older adults, ultimately improving their health outcomes.

IMPACT

Wearable monitoring devices not only enable real-time monitoring of vital signs, but can also support tailored messaging and facilitate virtual communication between users and healthcare professionals. Despite considerable health benefits, there is evidence showing that older adults largely stop using them after a few months. This study is the first to use a peer support approach to help older adults incorporate a wearable monitoring device in their daily routines in conjunction with goal setting and regular reminders. This will boost the self-care ability of the older adults, allowing them to continue physically functioning in the community.

TRIAL REGISTRATION

This study was prospectively registered at clinicaltrials.gov (identifier: NCT05269303). Registration date: 24/2/2022.

Digital Cognitive Assessment Tests for Older Adults: Systematic Literature Review

BACKGROUND

The global health pandemic has affected the increasing older adult population, especially those with mental illnesses. It is necessary to prevent cases of cognitive impairment in adults early on, and this requires the support of information and communication technologies for evaluating and training cognitive functions. This can be achieved through computer applications designed for cognitive assessment.

OBJECTIVE

In this review, we aimed to assess the state of the art of the current platforms and digital test applications for cognitive evaluation, with a focus on older adults.

METHODS

A systematic literature search was conducted on 3 databases (Web of Science, PubMed, and Scopus) to retrieve recent articles on the applications of digital tests for cognitive assessment and analyze them based on the methodology used. Four research questions were considered. Through the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology, following the application of inclusion and exclusion criteria, a total of 20 articles were finally reviewed.

RESULTS

Some gaps and trends were identified regarding the types of digital applications and technologies used, the evaluated effects on cognitive domains, and the psychometric parameters and personal characteristics considered for validation.

CONCLUSIONS

Computerized tests (similar to paper-and-pencil tests) and test batteries (on computers, tablets, or web platforms) were the predominant types of assessments. Initial studies with simulators, virtual environments, and daily-life activity games were also conducted. Diverse validation methods and psychometric properties were observed; however, there was a lack of evaluations that involved specific populations with diverse education levels, cultures, and degrees of technology acceptance. In addition, these evaluations should consider emotional and usability aspects.

The age-based digital divide in an increasingly digital world: A focus group investigation during the COVID-19 pandemic

BACKGROUND AND OBJECTIVES

Previous research has identified numerous benefits of information and communication technology (ICT) on the well-being of older adults. However, it has been increasingly recognized that older adults do not necessarily catch up with the rapidly digitalized society, known as the 'age-based digital divide'. The progress of digitalization has been accelerated during the COVID-19 pandemic, which may have widened the digital divide. This study aimed to gain a better understanding of their living experience and concerns about digital exclusion during the pandemic. The perceptions of older adults in Hong Kong, a highly digitalized, metropolitan city, towards the digital age and its impact on their daily living during the COVID-19 pandemic were explored.

RESEARCH DESIGN AND METHODS

We conducted 12 focus group interviews with 77 community-dwelling older adults during the COVID-19 pandemic. Data were analyzed using thematic analysis, applying both organization, reduction, and refinement.

RESULTS

Four themes were identified: 1) Diversified means to access community information; 2) Facilitated daily living through the usage of ICTs; 3) Concerns about age-related decline in function; and 4) Fear of digital exclusion and accelerated digitalization during the pandemic. The results indicate that ICT provided numerous benefits to the daily life of older adults, but our participants also expressed concerns about age-related losses and the fear of digital exclusion due to the ongoing digitalization of society.

DISCUSSION AND IMPLICATIONS

Our findings indicated that older adults do not necessarily benefit from technological innovations, which are becoming more pervasive during the pandemic. To create age-friendly environments that cater to the needs of all members of society in the digital age, policymakers and service providers should provide diverse choices for older adults, rather than relying solely on one-size-fits-all technological solutions.

Factors, Barriers, and Recommendations Related to Mobile Health Acceptance among the Elderly in Saudi Arabia: A Qualitative Study

The use of mobile health (mHealth) is providing value to the elderly, but their acceptance of it is lower than in other age groups. Thus, this study aims to explore the factors influencing their intention to use mHealth and identify barriers and suggested solutions among elderly people aged 50+ years in Saudi Arabia, guided by the Healthcare Technology Acceptance Model (H-TAM). In this qualitative study, 14 elderly people (six females and eight males) were recruited. Participants were included if they were Saudi, aged 50+ years, and used smartphones. Participants were engaged in semi-structured interviews, which were transcribed verbatim and thematically analyzed. Peer review was conducted and saturation was reached to maintain rigor. Three major themes emerged: (1) factors affecting intention to use, (2) concerns and barriers, and (3) solutions and recommendations. Influenced factors were identified as perceived usefulness, perceived need, perceived ease of use, perceived benefits, familiarity, trust in technology, advice acceptance, facilitating conditions (family support), and compatibility. Older participants, particularly those with lower educational attainment, displayed less familiarity with mHealth. Lack of digital literacy, health and aging issues, worry about making mistakes, and social issues emerged as central barriers. Addressing these factors in the design and promotion of mHealth can enhance its successful adoption among the elderly.

Older adults' intention to use voice assistants: Usability and emotional needs

Population aging is a global problem, and improving the well-being of older adults is an urgent issue. Voice assistants (VAs) offer hands-free voice control and friendly human-computer interaction, making them a significant solution to address the aging problem. Most extant research on VAs is fragmented, and there are relatively few studies conducted from the perspective of emotional needs. This work proposes a comprehensive research model extending the technology acceptance model (TAM) by incorporating the influencing factors subordinate to two research directions: usability and emotional needs. Usability needs include three factors: perceived convenience, security/privacy, and Internet self-efficacy. Emotional needs include humanized interaction, perceived enjoyment, and perceived companionship. A structural equation model (SEM) was used to validate the model empirically with a sample of 425 older users of VAs. The analysis results are quite consistent with the research assumptions, and the findings illustrate that companionship is the most critical factor affecting older adults' intention to adopt VA use, which demonstrates the pivotal role of VAs in meeting the emotional needs of the elderly. The most unexpected observation was seen for the relationship between perceived ease of use and behavioral intention, which was non-significant. This result confirms that when a technology is perceived as very easy to use, perceived ease of use has little to no impact on individuals' intention to use that technology. The novelty of this study lies in the investigation of older adults' behavioral intentions toward using VAs, providing valuable insights for the design and development of VAs tailored for the elderly population. Beyond the academic realm, this research serves as direct inspiration for designers, developers, and policymakers in the fields of assistive technologies and geriatric care. It offers practical insights into creating VAs that effectively address the emotional needs of older adults and enhance their quality of life. Furthermore, elderly individuals are poised to experience significant benefits from the outcomes of this study，the insights garnered from this study empower the elderly to embrace technological advancements that align with their preferences and comfort levels. This study contributes to a more comprehensive understanding of VAs and their potential to enhance the well-being of older adults, while also paving the way for future investigations in this domain. As underscored by this study's emphasis on the significance of emotional needs in technology acceptance, it encourages the adoption of more user-centered design strategies in the development of future VAs.

Older people's attitudes towards emerging technologies: A systematic literature review

Public attitudes towards technology have been studied extensively for decades, but older people were not largely involved in early studies. In recent years, with the trend of digitalisation and the rapid growth of the older population around the world, the attitudes of older people towards emerging technologies have attracted the attention of researchers. This article is a systematic review of 83 relevant studies, to summarise the factors that impact older adults' attitudes towards adopting and using technology. It is found that older people's attitudes are influenced by their personal characteristics, technology-related factors and the social context of technology adoption. The complex relationship between older people and technology is interpreted by researchers with the framing of older people's identity, the role of technology, the interaction of the above factors and the opportunity for older adults to act as co-designers.

Understanding the influencing factors and mechanism of social compensation for Chinese older adults using social media in the context of smart home: a qualitative analysis

As a new generation of necessary terminals for future homes, smart homes have become one of the essential mediums for smart aging at home. This paper aims to explore how older adults who age at home can overcome the digital divide of the new medium and achieve social participation in the home context to realize active aging. Based on the theory of social compensation, we select the smart-home smart screen, a representative new medium product in China, and carry out open coding, spindle coding, selective coding, and theoretical construction of the original interview data through the grounded theory research method. The results show that the main factors affecting the social compensation of older adults to smart home social media include user interface quality, interaction quality, content quality, and service quality, and these four factors are used as external variables to compensate older adults socially, thereby stimulating the emotional experience and perception changes at the cognitive level of older adults and then affecting the adoption and acceptance of smart home social media by older adults. This study refines the factors influencing the older adults' use of smart home social media from the perspective of social compensation. It explains the mechanism of acceptable behavior of older adults, bridging the gap in previous literature on the influencing factors and behavioral mechanisms of older adults of smart home social media. This paper provides a theoretical basis and guidance for the subsequent academic research and software development practice of social media under new technological devices to further help older adults in China achieve active and healthy aging.

Understanding acceptance of contactless monitoring technology in home-based dementia care: a cross-sectional survey study among informal caregivers

Background

There is a growing interest to support home-based dementia care via contactless monitoring (CM) technologies which do not require any body contact, and allow informal caregivers to remotely monitor the health and safety of people with dementia (PwD). However, sustainable implementation of CM technologies requires a better understanding of informal caregivers' acceptance. This study aimed to examine the (1) general acceptance of CM technology for home-based dementia care, (2) acceptance of different sensor types and use scenarios, and (3) differences between accepters and refusers of CM technology.

Method

A cross-sectional online survey was conducted among n = 304 informal caregivers of community-dwelling PwD [Mean(SD) age = 58.5 (10.7)] in the Netherlands and Germany. The survey contained a textual and graphical introduction to CM technologies, as well as questions targeting (1) general acceptance of CM technology, (2) acceptance of seven different contactless sensor types, (3) acceptance of five different use scenarios, and (4) caregivers' own and their care recipients' personal characteristics. Data were examined using descriptive and bivariate analyses.

Results

Participants' general acceptance of CM technology was slightly positive. We found significant differences in acceptability between contactless sensor types (p < .001). RF-based sensors (e.g., radar) and light sensors were considered most acceptable, whereas camera-based sensors and audio sensors (e.g., microphones, smart speakers) were seen as least acceptable for home-based dementia care. Furthermore, participants' acceptance of different use scenarios for CM technology varied significantly (p < .001). The intention to use CM technology was highest for detecting emergencies (e.g., falls, wandering), and lowest for predicting acute situations (e.g., fall prediction). Lastly, accepters and refusers of CM technology significantly differed regarding gender (p = .010), their relation with the PwD (p = .003), eHealth literacy (p = .025), personal innovativeness (p < .001), usage of safety technology (p = .002), and the PwD's type of cognitive impairment (p = .035) and housing situation (p = .023).

Conclusion

Our findings can inform the development and implementation of acceptable CM technology to support home-based dementia care. Specifically, we show which sensor types and use scenarios should be prioritized from the informal caregiver's view. Additionally, our study highlights several personal characteristics associated with informal caregivers' acceptance of CM technology that should be taken into account during implementation.

Overcoming the Digital Divide for Older Patients With Respiratory Disease: Focus Group Study

BACKGROUND

The need for and adoption of eHealth programs are growing worldwide. However, access can be limited among patients with low socioeconomic backgrounds, often resulting in a so-called "digital divide" due to a mismatch between eHealth and target populations that can gain benefit. This digital divide can result in unsuccessful eHealth implementations, which is of critical importance to health care.

OBJECTIVE

This study evaluated the opinions of elderly patients with asthma and chronic obstructive pulmonary disease (COPD) about an existing pharmacy-based personalized patient web portal that provides medication overview and information on associated diagnoses. The aim was to obtain insights on the common barriers of elderly people when using health-related websites, which can help to improve accessibility.

METHODS

This was a cross-sectional qualitative study of a patient panel of the Groningen Research Institute for Asthma and COPD in primary care. Participants were required to be older than 55 years, be Dutch speaking, have no prior experience with the study website, and be diagnosed with a chronic respiratory illness. Two focus groups were created, and they completed a 45-minute session for testing the website and a 120-minute session for semistructured interviews. The focus group sessions were recorded, transcribed verbatim, and analyzed by content analysis.

RESULTS

We enrolled 11 patients (9 women) with a mean age of 66 (SD 9) years. Of these, 5 had asthma, 3 had COPD, 2 had asthma-COPD overlap syndrome, and 1 had bronchiectasis. Participants were generally positive about the website, especially the areas providing disease-related information and the medication overview. They appreciated that the website would enable them to share this information with other health care providers. However, some difficulties were reported with navigation, such as opening a new tab, and others reported that the layout of the website was difficult either because of visual impairments or problems with navigation. It was also felt that monitoring would only be relevant if it is also checked by health care professionals as part of a treatment plan. Participants mentioned few privacy or safety concerns.

CONCLUSIONS

It is feasible to develop websites for elderly patients; however, developers must take the specific needs and limitations of elderly people into account (eg, navigation problems, poor vision, or poor hand-eye coordination). The provision of information appears to be the most important aspect of the website, and as such, we should endeavor to ensure that the layout and navigation remain basic and accessible. Patients are only motivated to use self-management applications if they are an integrated part of their treatment. The usability of the website can be improved by including older people during development and by implementing design features that can improve accessibility in this group.

Factors influencing technology use among low-income older adults: A systematic review

As the world's aging population increases, leveraging technology to support aging is proving advantageous. Notably, technology adoption studies among older adults have received increasing scholarly attention, but findings from these studies do not reflect the context of low-income older adults. Studies focusing on low-income older adults were relatively few and it remains unclear which factors influence this group's technology use. This systematic review aims to synthesize findings on factors influencing technology use among low-income older adults to provide directions and opportunities for future research in information systems. Observing the literature through the lens of Social Cognitive Theory, we identified avenues for future research and further integrated the framework with Maslow's hierarchy of needs to elucidate the phenomenon. Findings from this systematic review suggest that both personal and environmental factors, such as cognitions, affects, sociodemographic characteristics, technological and social environment are significant predictors of technology use among low-income older adults. Specifically, factors related to accessibility and affordability, such as income, perceived cost, and accessibility to technology are salient in a resource-limited setting. More importantly, the technology usage behavior elucidate the embeddedness of fundamental human needs which plays a central role underlying technology use among this segment. However, more research is needed to understand the interaction between person, environment and behavior determinant shaping technology use among low-income older adults from diverse economic and cultural setting. This study also sheds light on disciplinary gaps and the lack of investigations anchored on theoretical foundations, and suggests avenues for future research and implications for practice.

Technology Acceptance of a Social Robot (LOVOT) Among Single Older Adults in Hong Kong and Singapore: Protocol for a Multimethod Study

BACKGROUND

Given the rapidly aging nature of our global population, policy makers around the world are now emphatically promoting active aging. To address the psychosocial needs of older persons and support active aging, researchers are exploring the use of assistive technologies, specifically social robots as companions. However, there is limited evidence on the efficacy of social robots in promoting active aging for older people in the Hong Kong and Singapore contexts.

OBJECTIVE

This study presents the protocol of a study that investigates the acceptance and quality of interaction between a Japanese social robot, LOVOT, and single older adults in Hong Kong and Singapore.

METHODS

We used a baseline assessment to measure the primary outcome, participants' acceptance of technology, and a sense of loneliness, namely, the participants' differences in responses to LOVOT before and following their interaction with the social robot in this multimethod study design. The baseline assessment consisted of the Qualtrics survey, which measures senior technology acceptance, loneliness, older people's quality of life, subjective happiness, cultural values, willingness to pay, and demographic characteristics, along with the LOVOT's sociability and system usability. In the study, participants interacted with LOVOT in 3 sessions before being surveyed to measure the older people's acceptance and attitudes toward LOVOT. A pre-social robot intervention also occurred in the first session. The study was conducted in both Hong Kong and Singapore. A total of 15 single older adults (ie, individuals who live alone) from Hong Kong and another 15 from Singapore were recruited. Participants were 60-75 years of age, lived by themselves, and had no known cognitive or mental issues.

RESULTS

The study began recruiting in March 2022, and recruitment was completed at the end of October 2022. Data collection and data set construction were completed at the end of January 2023. Analysis of the data is currently being conducted, and we plan to publish the results by mid-2023.

CONCLUSIONS

At an individual level, the study will clarify if LOVOT influences single older adults' psychosocial well-being by reducing their loneliness. At a community level, the study's findings will illustrate whether LOVOT can provide increased social connectedness while decreasing individual loneliness. Last, this study's conclusions can inform policy makers to provide social robots to older people to improve their quality of life. Findings can also inform gerontechnology developers on which aspects and cultural considerations to take into account for future inventions.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/48618.

The Experience of Participating in Remotely Delivered Online Exercise Classes During the COVID-19 Pandemic Among Community-Dwelling Older Adults and Its Postpandemic Implications

The COVID-19 pandemic has accelerated the use of videoconferencing-delivered online exercise classes among community-dwelling older adults. This phenomenon is new, and no research has investigated older adults' relevant experiences and postpandemic perspectives. This study is situated in a naturalistic paradigm and adopted a descriptive qualitative methodology to understand the phenomenon. In-depth interviews were conducted with 23 older adults (aged 55-89 years) who have participated in videoconferencing-delivered online exercise since the COVID-19 pandemic. Utilizing thematic analysis, eight key themes were identified. Older adults experienced convenience, exercise regularity, technological transformation, and motivation when using this new form of exercise delivery. At the same time, they also experienced certain technological barriers and compromised quality of instructor supervision. Looking forward, older adults welcomed the increased opportunity for supervised exercise due to increased virtual capacity. They also envisaged that mobility-restricted groups such as frail older adults and caregivers would benefit from this form of exercise delivery.

Gerontechnology for better elderly care and life quality: a systematic literature review

Gerontechnology as multidisciplinary research has expanded in recent years due to its significant role in ensuring better care and improved quality of life for older adults and their caregivers. With a substantial increase in studies on reasons behind less inclination of older individuals to accept gerontechnology, barriers to its non-acceptance appear to be persistent. In addition, there is a dearth of research on the adoption of gerontechnology from the perspectives of social caregivers, given that caregivers bear a substantial burden in the form of chronic stress, which adversely affects their health and that of older people. Therefore, the aim of this study is to present a holistic perspective of older adults and their caregivers by systematically reviewing literature on gerontechnology acceptance. Adopting the preferred reported items for systematic and meta-analysis (PRISMA) framework, publications specifically on gerontechnology from 2002 to 2022 in Scopus, Web of Science and PubMed, that focused on older people (50 years and above) and caregivers (informal and formal) were reviewed. We critically evaluated 25 publications and synthesised them thematically. The results highlight that gerontechnology acceptance by older adults and their social caregivers is highly contingent on certain personal, physical, socio-cultural and technological indicators. However, this paper concludes that a generalised policy approach for gerontechnology and a better quality of life may be ineffective, considering that older adults and social caregivers constitute two heterogeneous groups.

Factors Predicting Older People's Acceptance of a Personalized Health Care Service App and the Effect of Chronic Disease: Cross-Sectional Questionnaire Study

BACKGROUND

Mobile health (mHealth) services enable real-time measurement of information on individuals' biosignals and environmental risk factors; accordingly, research on health management using mHealth is being actively conducted.

OBJECTIVE

The study aims to identify the predictors of older people's intention to use mHealth in South Korea and verify whether chronic disease moderates the effect of the identified predictors on behavioral intentions.

METHODS

A cross-sectional questionnaire study was conducted among 500 participants aged 60 to 75 years. The research hypotheses were tested using structural equation modeling, and indirect effects were verified through bootstrapping. Bootstrapping was performed 10,000 times, and the significance of the indirect effects was confirmed through the bias-corrected percentile method.

RESULTS

Of 477 participants, 278 (58.3%) had at least 1 chronic disease. Performance expectancy (β=.453; P=.003) and social influence (β=.693; P<.001) were significant predictors of behavioral intention. Bootstrapping results showed that facilitating conditions (β=.325; P=.006; 95% CI 0.115-0.759) were found to have a significant indirect effect on behavioral intention. Multigroup structural equation modeling testing the presence or absence of chronic disease revealed a significant difference in the path of device trust to performance expectancy (critical ratio=-2.165). Bootstrapping also confirmed that device trust (β=.122; P=.039; 95% CI 0.007-0.346) had a significant indirect effect on behavioral intention in people with chronic disease.

CONCLUSIONS

This study, which explored the predictors of the intention to use mHealth through a web-based survey of older people, suggests similar results to those of other studies that applied the unified theory of acceptance and use of technology model to the acceptance of mHealth. Performance expectancy, social influence, and facilitating conditions were revealed as predictors of accepting mHealth. In addition, trust in a wearable device for measuring biosignals was investigated as an additional predictor in people with chronic disease. This suggests that different strategies are needed, depending on the characteristics of users.

The intention to use mHealth applications among Dutch older adults prior and during the COVID pandemic

Background

Mobile health (mHealth) applications are widely valued for their potential to increase self-management among older adults and reduce their healthcare demands. However, the intention to use mHealth of Dutch older adults before the COVID-19 pandemic was modest. Healthcare access was considerably reduced during the pandemic and mHealth services substituted for in person health services. As older adults utilize health services more frequently and have been particularly vulnerable to the pandemic, they can be viewed to have especially benefitted from the transition toward mHealth services. Furthermore, one might expect their intention to use these services and reap the potential benefits has increased, especially during the pandemic.

Objective

The aim of this study was to examine whether the intention of Dutch older adults to use medical applications increased during the COVID pandemic and how the explanatory power of the extended Technology Acceptance Model (TAM) developed for this purpose was affected by the onset of the pandemic.

Methods

We conducted a cross-sectional survey using two samples collected before (n = 315) and after (n = 501) the onset of the pandemic. Data was collected using questionnaires which were distributed digitally and on paper, by convenience sampling and snowballing. Participants were 65 years or older, lived independently or in a senior living facility, without cognitive impairment. A controlled analysis was performed to test for significant differences in the intention to use mHealth. The before and after differences in extended TAM variables and their relationship with intention to use (ITU) were analyzed using controlled (multivariate) logistic and linear regression models. These models were also used to explore whether the onset of the pandemic had an effect on ITU not captured by the extended TAM model.

Results

While the two samples differed in ITU (p = 0.017; uncontrolled) there was no statistically significant difference in ITU in the controlled logistic regression analysis (p = 0.107). The scores of the extended TAM variables explaining intention to use were all significantly higher, except for Subjective norm and Feelings of Anxiety. The relationships of these variables with intention to use before and after the onset of the pandemic were similar, except for Social relationships which lost its significance. We found no indications of effects of the pandemic on intention to use not captured by our instrument.

Conclusion

The intention to use mHealth applications of Dutch older adults has not changed since the onset of the pandemic. The extended TAM model has robustly explained intention to use, with only minor differences after the first months of the pandemic. Interventions targeting facilitation and support are likely to promote the uptake of mHealth. Follow-up studies are needed to investigate whether the pandemic has had long term effects on the ITU of the older adult.

A study on community older people's willingness to use smart home-an extended technology acceptance model with intergenerational relationships

Introduction

Despite the potential of smart home technology to promote sustainable lifestyles, the adoption rate among older adults remains relatively low. This study aims to investigate the influence of intergenerational relationships on the acceptance of smart home services among seniors.

Methods

A survey was conducted among 298 older adults in China, and data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM). Ten predictor variables were examined to assess their impact on the willingness to use smart home services.

Results

Intergenerational relationships significantly influenced the utilization of smart home services among older adults. Specifically, intergenerational instrumental support had a direct positive effect on the behavioral intention to use smart homes. Additionally, intergenerational emotional and financial support affected life satisfaction, which subsequently influenced the behavioral intention to use smart homes.

Discussion

The assistance and guidance provided by younger generations play a crucial role in shaping the willingness of older adults to adopt smart home technology. Intergenerational support can contribute positively to enabling aging individuals to age in place through the utilization of technology.

Development of a metric to evaluate the ergonomic principles of assistive systems, based on the DIN 92419

The DIN 92419 defines six principles for assistive systems' ergonomic design. There is, however, a lack of measurement tools to evaluate assistive systems considering these principles. Consequently, this study developed a measurement tool for the quantitative evaluation of the fulfilment of each principle for assistive systems. A systematic literature review was performed to identify dimensions belonging to the principles, identify how previous research evaluated these dimensions, and develop a measurement tool for assistive systems. Findings show that scales commonly used for evaluating assistive systems disregard several aspects highlighted as relevant by research, implying the need for considering the DIN 92419 principles. Based on established scales and theoretical findings, a questionnaire, and a checklist for evaluating assistive systems were developed. The work provides a grounding for measuring relevant aspects of assistive systems. Further development is needed to substantiate the reliability and validity of the proposed questionnaire scales and items. Practitioner Summary: Responding to the gap of a holistic measurement tool to evaluate assistive systems, a systematic literature review was performed considering the DIN 92419 principles. This resulted in a comprehensive summary of relevant aspects of assistive systems that were made numerically measurable, which proposes better criteria to assess assistive systems. Abbreviations: IoT: internet of things; RQ: research question; TAM: technology acceptance model; UTAUT: unified theory of acceptance and use of technology; AaaS: adaptivity as a service; SAR: socially assistive robots; SEEV: salience, effort, expectancy, and value; PRISMA: preferred reporting items for systematic reviews and meta-analyses; HMI: human-machine interaction; HRI: human-robot interaction; BCI: brain-computer interface; QUEST: Quebec user evaluation of satisfaction with assistive technology; SUS: system usability scale; NASA-TLX: NASA task load index; ATD PA: assistive technology device predisposition assessment; Wheel Con: wheelchair use confidence scale; CATOM: caregiver assistive technology outcome measure; CBI: caregiver burden inventory; RoSAS: robotic social attributes scale; WheelCon: wheelchair use confidence scale; IMI: intrinsic motivation inventory; ATD PA: assistive technology device predisposition assessment; UEQ: User experience questionnaire; USEUQ: usefulness satisfaction and ease of use questionnaire; USPW: usability scale for power wheelchairs; UES: user engagement scale; SUTAQ: service user technology acceptability questionnaire; QUEAD: questionnaire for the evaluation of physical assistive devices; FATCAT: functional assessment tool for cognitive assistive technology; SE-HRI: human-robot interaction scale; SART: situation awareness rating technique; TSQ;WT: tele-healthcare satisfaction questionnaire-wearable technology; PAIF: participants' assessment of the intervention's feasibility; SWAT: subjective workload assessment technique; MARS-HA: measure of audiologic rehabilitation self-efficacy for hearing aids; IOI-HA: International outcome inventory for hearing aids; FMA: functional mobility assessment; FBIS: familiarity and behavioural intention survey; CSQ: client satisfaction questionnaire; COPM: canadian occupational performance measure; ATCS: assistive technology confidence scale; ACC: acceptance; SSP: safety, security and privacy; OPT: optimisation of resultant internal load; CTRL: controllability; ADAPT: adaptability; P&I: perceptibility and identifiability; AAL: ambient assisted living; VR: virtual reality; AS: assistive system; WEIRD: Western, educated, industrialised, rich, and democratic; HEART: horizontal european activities of rehabilitation technology; AAATE: advancement of assistive technology in Europe's; GATE: global collaboration on assistive technology; ATA-C: assistive technology assessment toolkit.

Social facilitation effects in online coaction: the moderating role of social comparison direction

Online and face-to-face coactions are widely used work organization modes. This study aims to investigate the effect of social comparison direction on task performance when people coact online. A total of 40 individuals were recruited to participate in a 2 (coaction type: online and face to face) × 3 (social comparison direction: upward, downward and no comparison) × 2 (phase: pre-comparison and post-comparison) within-subject experiment. The participants performed visual search tasks while their response time and search accuracy rates were measured. Results showed that the participants were reported to perform faster when they coacted online than face to face. The upward comparison led to a stronger social facilitation effect than the downward and no comparison directions, either in online or face-to-face coaction. These findings provide practical implications in the design of coaction modes for groups and teams working remotely.

Exploring E-Health Literacy and Technology-Use Anxiety among Older Adults in Korea

The COVID-19 pandemic has increased the importance of health literacy in disseminating information on health in a non-contact society. This study focused on examining the acceptance capacity by older adults of smart devices in Korea and investigating the potential differences between men and women in terms of e-health literacy and technology-use anxiety. The study included 1369 respondents who were adults over 50 years of age and used welfare centers, public health centers, senior citizen centers, and exercise centers in Seoul and Incheon. An online survey was conducted from 1 June 2021 to 24 June 2021. The study found that the older adults' low levels of digital literacy could limit their access to health information and negatively impact their health. The difference between men and women in terms of technology-use anxiety was statistically significant, with the latent mean for men being higher than that for women. The effect sizes of the potential mean differences were found to be at a medium level for e-health literacy and a significant level for technology-use anxiety. With Korea's aging population and the need for the continuous management of chronic diseases among older adults, it is essential to discuss internet-based health information for disease maintenance and treatment.

Associations Between Older Adults' Loneliness and Acceptance of Socially Assistive Robots: A Cross-Sectional Study

The use of socially assistive robots (SARs) to enable older adults (aged ≥65 years) to live independently for as long as possible has been researched for several years. Of particular interest is the way SARs can combat loneliness. A quantitative cross-sectional study was conducted with 61 older adults in living facilities in Berlin, Germany. Paper-based questionnaires were used to elicit experiences of loneliness and determine the level of acceptance of SARs. Mean score (39.3) of the loneliness scale was in the average range for this population. Mean score (56.1) of acceptance of SARs was on a moderate level. Regression analyses showed that loneliness did not influence the acceptance of SARs by older adults in the sample, which was contrary to findings in the literature. Further studies might generate more accurate data and accelerate the development of robots to make them more attractive for social purposes. [Journal of Gerontological Nursing, 49(4), 21-26.].

Developing a Healthcare Technology Acceptance Model (H-TAM) for Older Adults with Hypertension

Older adults with a chronic health condition (e.g., hypertension) use various self-management methods. Healthcare technologies have the potential to support health self-management. However, it is necessary to understand the acceptance of these technologies as a precursor to older adults' adoption and integration into their health plan. Our focus was on the factors older adults with hypertension initially consider when introduced to three new healthcare technologies that might support their health self-management. We compared their considerations for a blood pressure monitor, an electronic pillbox, and a multifunction robot to simulate incrementally more complex technologies. Twenty-three participants (aged 65-84) completed four questionnaires and a semi-structured interview. The interview transcripts were analyzed using a thematic analysis approach. We identified the factors that were frequently mentioned among the participants for each of the three healthcare technologies. The factors that older adults initially considered were familiarity, perceived benefits, perceived ease of use, perceived need for oneself, relative advantage, complexity, and perceived need for others. Upon further reflection, participants considered advice acceptance, compatibility, convenience, facilitating conditions, perceived usefulness, privacy, subjective norm, and trust. We integrated the factors that older adults considered into the Healthcare Technology Acceptance Model (H-TAM), which elucidates the complexity of healthcare technology acceptance and provides guidance for future explorations.

A Systematic Review of Navigation Assistance Systems for People With Dementia

Technological developments provide solutions to alleviate the tremendous impact on the health and autonomy due to the impact of dementia on navigation abilities. We systematically reviewed the literature on devices tested to provide assistance to people with dementia during indoor, outdoor and virtual navigation (PROSPERO ID number: 215585). Medline and Scopus databases were searched from inception. Our aim was to summarize the results from the literature to guide future developments. Twenty-three articles were included in our study. Three types of information were extracted from these studies. First, the types of navigation advice the devices provided were assessed through: (i) the sensorial modality of presentation, e.g., visual and tactile stimuli, (ii) the navigation content, e.g., landmarks, and (iii) the timing of presentation, e.g., systematically at intersections. Second, we analyzed the technology that the devices were based on, e.g., smartphone. Third, the experimental methodology used to assess the devices and the navigation outcome was evaluated. We report and discuss the results from the literature based on these three main characteristics. Finally, based on these considerations, recommendations are drawn, challenges are identified and potential solutions are suggested. Augmented reality-based devices, intelligent tutoring systems and social support should particularly further be explored.

Predicting Older Adults' Continued Computer Use After Initial Adoption

Background and Objectives

Sustained computer and internet use have the potential to help older adults in various aspects of their lives, making predicting sustained use a critical goal. However, some factors related to adoption and use (e.g., computer attitudes) change over time and with experience. To understand these dynamics, the current study modeled changes in constructs related to computer use after initial computer adoption and examined whether these changes predict continued use.

Research Design and Methods

We used data from the computer arm (N = 150, MAge = 76.15) of a 12-month field trial examining the potential benefits of computer use in older adults. Individual differences identified in the technology acceptance literature (perceived usefulness, ease of use, computer interest, computer self-efficacy, computer anxiety, quality of life, social isolation, and social support) were measured before (baseline), during (Month 6), and after the intervention (post-test). Univariate and bivariate latent change score models examined changes in each predictor and their potential causal relationship with use.

Results

Results demonstrated large interindividual differences in the change patterns of individual difference factors examined. Changes in perceived usefulness, perceived ease of use, computer interest, computer self-efficacy, and computer anxiety were correlated with but not predictive of change in use.

Discussion and Implications

Our findings demonstrate the limitation of popular constructs in technology acceptance literature in predicting continued use and point out important gaps in knowledge to be targeted in future investigations.