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Sheng Y, Bond R, Jaiswal R, Dinsmore J, Doyle J. Augmenting K-Means Clustering With Qualitative Data to Discover the Engagement Patterns of Older Adults With Multimorbidity When Using Digital Health Technologies: Proof-of-Concept Trial. J Med Internet Res 2024; 26:e46287. [PMID: 38546724 PMCID: PMC11009852 DOI: 10.2196/46287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 10/25/2023] [Accepted: 01/29/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Multiple chronic conditions (multimorbidity) are becoming more prevalent among aging populations. Digital health technologies have the potential to assist in the self-management of multimorbidity, improving the awareness and monitoring of health and well-being, supporting a better understanding of the disease, and encouraging behavior change. OBJECTIVE The aim of this study was to analyze how 60 older adults (mean age 74, SD 6.4; range 65-92 years) with multimorbidity engaged with digital symptom and well-being monitoring when using a digital health platform over a period of approximately 12 months. METHODS Principal component analysis and clustering analysis were used to group participants based on their levels of engagement, and the data analysis focused on characteristics (eg, age, sex, and chronic health conditions), engagement outcomes, and symptom outcomes of the different clusters that were discovered. RESULTS Three clusters were identified: the typical user group, the least engaged user group, and the highly engaged user group. Our findings show that age, sex, and the types of chronic health conditions do not influence engagement. The 3 primary factors influencing engagement were whether the same device was used to submit different health and well-being parameters, the number of manual operations required to take a reading, and the daily routine of the participants. The findings also indicate that higher levels of engagement may improve the participants' outcomes (eg, reduce symptom exacerbation and increase physical activity). CONCLUSIONS The findings indicate potential factors that influence older adult engagement with digital health technologies for home-based multimorbidity self-management. The least engaged user groups showed decreased health and well-being outcomes related to multimorbidity self-management. Addressing the factors highlighted in this study in the design and implementation of home-based digital health technologies may improve symptom management and physical activity outcomes for older adults self-managing multimorbidity.
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Affiliation(s)
- Yiyang Sheng
- NetwellCASALA, Dundalk Institution of Technology, Dundalk, Ireland
| | - Raymond Bond
- School of Computing, Ulster University, Jordanstown, United Kingdom
| | - Rajesh Jaiswal
- School of Enterprise Computing and Digital Transformation, Technological University Dublin, Dublin, Ireland
| | - John Dinsmore
- Trinity Centre for Practice and Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Julie Doyle
- NetwellCASALA, Dundalk Institution of Technology, Dundalk, Ireland
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Zhu D, Al Mahmud A, Liu W. Digital Storytelling Intervention for Enhancing the Social Participation of People With Mild Cognitive Impairment: Co-Design and Usability Study. JMIR Aging 2024; 7:e54138. [PMID: 38231541 PMCID: PMC10831696 DOI: 10.2196/54138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/07/2023] [Accepted: 12/07/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Community-based social participation has shown promise in delaying cognitive decline in older adults with mild cognitive impairment (MCI) who are at risk of developing dementia. Although group storytelling interventions have proven effective, the need for a skilled workforce to support people with MCI can limit broader community implementation. Technology-based interventions may offer a solution to this limitation by replicating the abilities of therapists. OBJECTIVE This study aims to co-design a digital storytelling intervention and evaluate its usability. METHODS This co-design process involved 3 stages, engaging people with MCI (n=12), their caregivers (n=4), and therapists (n=5) in Beijing, China. In the first stage, we used card sorting and voting methods to identify potential incentives for social participation and target the specific abilities that people with MCI wanted to enhance. In the second stage, we conducted brainstorming sessions with people with MCI and their caregivers to identify the potential features of a digital storytelling application named Huiyou ("meeting new friends" in Chinese). Finally, we assessed Huiyou's usability with people with MCI and therapists, leading to iterative improvements based on the usability findings. RESULTS We uncovered a crucial link between boosting the self-confidence of people with MCI and their ability to address social participation challenges. Notably, we identified memory improvement and enhanced language expression as key factors for effective communication with grandchildren. Subsequently, participants suggested features and interfaces to address these challenges, leading to the development of Huiyou, a group-based digital storytelling application featuring functions such as generating story materials, conducting memory retrieval activities, and sharing stories. It received an "excellent" rating in the User Experience Questionnaire benchmark, displaying high levels of attractiveness, dependability, stimulation, and novelty. People with MCI achieved an average task completion rate of 87% (n=19; SD 0.13) of the 22 tasks. However, feedback from people with MCI and therapists highlighted usability issues in navigation, activity management, user interface, and feature optimization, indicating a need for improved accessibility and efficiency. CONCLUSIONS The co-design approach contributed to developing the Huiyou prototype, supporting community-based social participation. User feedback highlighted the potential of Huiyou to enhance well-being and facilitate meaningful social interactions while maintaining crucial existing relationships.
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Affiliation(s)
- Di Zhu
- Centre for Design Innovation, Swinburne University of Technology, Melbourne, Australia
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Centre for Experimental Psychology Education, Beijing Normal University, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Abdullah Al Mahmud
- Centre for Design Innovation, Swinburne University of Technology, Melbourne, Australia
| | - Wei Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Centre for Experimental Psychology Education, Beijing Normal University, Faculty of Psychology, Beijing Normal University, Beijing, China
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García Montenegro P, Fedosse E, Urrutia Urrutia G. Systematization of a cognitive-communicative intervention based on reminiscence for older adults. Codas 2023; 35:e20220152. [PMID: 38055410 PMCID: PMC10903332 DOI: 10.1590/2317-1782/20232022152pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 05/31/2023] [Indexed: 12/08/2023] Open
Abstract
PURPOSE To determine the effect of the reminiscence-based cognitive-communicative intervention program (CCSP-R) on global cognitive processing and self-perception of subjective well-being. METHODS A purposive sample of 100 self-care elderly adults, with 65 composing the study group and 35 in the control group. The study group was subjected to the proposed program. The Wilcoxon test compared the outcome measures of global cognitive efficacy (MMSE) and subjective well-being (SWLS) before and after the program, whereas the Mann-Whitney U test compared the pre- and post-test differences between the two groups. RESULTS A statistically significant difference was found between the pre- and post-test of the SWLS in the study group, but not in the control group. This result was replicated in the global cognitive efficacy variable. A difference between the groups occurred in both measures, with greater benefit for the group that received the intervention. CONCLUSION The CCSP-R is a viable alternative for cognitive-communicative stimulation of functional order. The evidence of differences in performance supports its usefulness and validity for intervention in primary care or other similar contexts.
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Affiliation(s)
- Pedro García Montenegro
- Departamento de Ciencias de la Fonoaudiología, Facultad de Ciencias de la Salud, Universidad de Talca - UTALCA - Talca (VII Región del Maule), Chile
| | - Elenir Fedosse
- Programa de Pós-graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria - UFSM - Santa Maria (RS), Brasil
| | - Gabriel Urrutia Urrutia
- Departamento de Ciencias de la Fonoaudiología, Facultad de Ciencias de la Salud, Universidad de Talca - UTALCA - Talca (VII Región del Maule), Chile
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Ye B, Chu CH, Bayat S, Babineau J, How TV, Mihailidis A. Researched Apps Used in Dementia Care for People Living With Dementia and Their Informal Caregivers: Systematic Review on App Features, Security, and Usability. J Med Internet Res 2023; 25:e46188. [PMID: 37824187 PMCID: PMC10603562 DOI: 10.2196/46188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 07/28/2023] [Accepted: 09/06/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Studies have shown that mobile apps have the potential to serve as nonpharmacological interventions for dementia care, improving the quality of life of people living with dementia and their informal caregivers. However, little is known about the needs for and privacy aspects of these mobile apps in dementia care. OBJECTIVE This review seeks to understand the landscape of existing mobile apps in dementia care for people living with dementia and their caregivers with respect to app features, usability testing, privacy, and security. METHODS ACM Digital Library, Cochrane Central Register of Controlled Trials, Compendex, Embase, Inspec, Ovid MEDLINE, PsycINFO, and Scopus were searched. Studies were included if they included people with dementia living in the community, their informal caregivers, or both; focused on apps in dementia care using smartphones or tablet computers; and covered usability evaluation of the app. Records were independently screened, and 2 reviewers extracted the data. The Centre for Evidence-Based Medicine critical appraisal tool and Mixed Methods Appraisal Tool were used to assess the risk of bias in the included studies. Thematic synthesis was used, and the findings were summarized and tabulated based on each research aim. RESULTS Overall, 44 studies were included in this review, with 39 (89%) published after 2015. In total, 50 apps were included in the study, with more apps developed for people living with dementia as end users compared with caregivers. Most studies (27/44, 61%) used tablet computers. The most common app feature was cognitive stimulation. This review presented 9 app usability themes: user interface, physical considerations, screen size, interaction challenges, meeting user needs, lack of self-awareness of app needs, stigma, technological inexperience, and technical support. In total, 5 methods (questionnaires, interviews, observations, logging, and focus groups) were used to evaluate usability. There was little focus on the privacy and security aspects, including data transfer and protection, of mobile apps for people living with dementia. CONCLUSIONS The limitations of this review include 1 reviewer conducting the full-text screening, its restriction to studies published in English, and the exclusion of apps that lacked empirical usability testing. As a result, there may be an incomplete representation of the available apps in the field of dementia care. However, this review highlights significant concerns related to the usability, privacy, and security of existing mobile apps for people living with dementia and their caregivers. The findings of this review provide a valuable framework to guide app developers and researchers in the areas of privacy policy development, app development strategies, and the importance of conducting thorough usability testing for their apps. By considering these factors, future work in this field can be advanced to enhance the quality and effectiveness of dementia care apps. TRIAL REGISTRATION PROSPERO CRD42020216141; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216141. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1159/000514838.
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Affiliation(s)
- Bing Ye
- Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
- KITE, Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Charlene H Chu
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Sayeh Bayat
- Department of Biomedical Engineering, University of Calgary, Calgary, AB, Canada
| | | | - Tuck-Voon How
- KITE, Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Alex Mihailidis
- Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON, Canada
- KITE, Toronto Rehabilitation Institute, Toronto, ON, Canada
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Zhu D, Al Mahmud A, Liu W. Digital storytelling intervention to enhance social connections and participation for people with mild cognitive impairment: a research protocol. Front Psychiatry 2023; 14:1217323. [PMID: 37886113 PMCID: PMC10599142 DOI: 10.3389/fpsyt.2023.1217323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/20/2023] [Indexed: 10/28/2023] Open
Abstract
Introduction Interventions utilizing the principles of digital storytelling can improve cognitive ability by cultivating positive emotions and framing a new way to enhance social participation among people with mild cognitive impairment. However, existing research has understudied group-based storytelling, focusing instead on building individual stories and connections with family and friends. In response to this research gap, this paper proposes co-designing a digital storytelling intervention for people with Mild Cognitive Impairment (MCI) to enhance their social participation and build meaningful connections. Methods We will conduct two co-design workshops with people with MCI (n = 12), their caregivers (n = 4-12), and therapists (n = 5) in Beijing, China, to facilitate the co-development of the digital storytelling application. During the first workshop, we will utilize card sorting and voting to define potential facilitators of social participation, identifying the abilities people with MCI want to improve through storytelling. During the second workshop, we will build on these findings to facilitate people with MCI and their caregivers to visualize the interfaces. After reflexive thematic analysis of the co-design workshops, we will develop a digital storytelling application and test its usability and efficacy among people with MCI and therapists, respectively. A single-blinded field test will be conducted with 20 community-dwelling adults with MCI (Age: 65+). The testing will consist of an intervention group of 10 participants who use the co-designed digital storytelling intervention and a control group of 10 participants who will not use the co-designed intervention on the waiting list. The intervention period will extend over 7 weeks, with individual intervention sessions lasting 30 min. We will evaluate its efficacy in terms of social participation, social connectedness, self-efficacy, subjective sense of happiness, and user experience of people with MCI. Discussion This study will examine an innovative digital storytelling intervention to enhance social participation among people with MCI. This study is expected to advance the concept of community-centric social groups in social health service contexts by integrating technological solutions with the self-identified needs and lived experiences of people with MCI, increasing the motivation of people with MCI to cultivate social participation. Ethics and dissemination Swinburne University of Technology's Human Research Ethics Committee gave ethics approval for this research (Approval Number: 20226525-11105; Date: 26/09/2022). Our findings shall be reported in peer-reviewed journal articles and at relevant conferences.
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Affiliation(s)
- Di Zhu
- School of Design and Architecture, Swinburne University of Technology, Hawthorn, VIC, Australia
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Abdullah Al Mahmud
- School of Design and Architecture, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Wei Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
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Conway A, Ryan A, Harkin D, Mc Cauley C, Goode D. A review of the factors influencing adoption of digital health applications for people living with dementia. Digit Health 2023; 9:20552076231162985. [PMID: 36937696 PMCID: PMC10017937 DOI: 10.1177/20552076231162985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/23/2023] [Indexed: 03/17/2023] Open
Abstract
Objective Researchers have used various theories and models to understand technology adoption, however, with the growing interest and availability of mobile applications (apps) for people living with dementia, it is desirable to have a broader insight into how technology adoption may be further improved. This paper aims to explore the factors influencing the adoption of digital health applications for people living with dementia and add to the current literature on this topic. Methods Searches were conducted in CINHAL, Web of Science, Psych Info, ProQuest Health and Medical, IEEE Xplore and Scopus. Citation searching and handsearching were used in the identification of other studies. Results Following an assessment of relevancy, nine studies remained and are included within this review. Methodological quality was assessed using The Mixed Methods Appraisal Tool (MMAT). A thematic analysis was used for the data synthesis of included studies. Each study reported on different types of apps. Conclusion From the synthesis of included studies, four analytic themes were identified; Theme 1: Personal and contextual factors; Theme 2: Perceived value and benefit; Theme 3: Design and content of app; and Theme 4: Digital Literacy and Confidence. People are diverse and so are their reasons for the adoption of apps. These findings provide an insight into the range of factors that impact the adoption of apps for people living with dementia. Understanding the factors that impact the adoption of mobile applications is critical to their success. These findings can be beneficial for app developers and for people living with dementia and their carers.
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Affiliation(s)
- Aoife Conway
- School of Nursing and Paramedic Science, Faculty of Life & Health Sciences, Ulster University, Co. Derry, Northern Ireland
- Aoife Conway, School of Nursing and Paramedic Science, Faculty of Life & Health Sciences, Magee Campus, Ulster University, Co. Derry, Northern Ireland.
| | - Assumpta Ryan
- School of Nursing and Paramedic Science, Faculty of Life & Health Sciences, Ulster University, Co. Derry, Northern Ireland
| | - Deirdre Harkin
- School of Nursing and Paramedic Science, Faculty of Life & Health Sciences, Ulster University, Co. Derry, Northern Ireland
| | - Claire Mc Cauley
- School of Nursing and Paramedic Science, Faculty of Life & Health Sciences, Ulster University, Co. Derry, Northern Ireland
| | - Deborah Goode
- School of Nursing and Paramedic Science, Faculty of Life & Health Sciences, Ulster University, Co. Derry, Northern Ireland
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Holthe T, Halvorsrud L, Lund A. Digital Assistive Technology to Support Everyday Living in Community-Dwelling Older Adults with Mild Cognitive Impairment and Dementia. Clin Interv Aging 2022; 17:519-544. [PMID: 35464157 PMCID: PMC9031989 DOI: 10.2147/cia.s357860] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/30/2022] [Indexed: 12/04/2022] Open
Abstract
Objective The objective of this review was to explore whether knowledge about and practice of technology for older adults with mild cognitive impairment (MCI) and dementia (D) had developed since our 2017 review. Furthermore, we wanted to explore the usability and acceptability of technology in the newer trials, and how these may impact quality of life, occupational performance and human dignity. Materials and Methods We searched for primary studies published between 2017 and 2020 reusing medical subject heading (MeSH) terms in five databases – Medline, PsycINFO, Embase, Amed and Cinahl – and obtained 1452 titles. The titles were divided in six piles, two for each of the three authors. The titles were sorted utilizing the Rayyan web tool. Fourteen studies were included in this review. The Mixed Method Appraisal Tool (MMAT) was used to assess the quality of the studies examined. Results This review included almost twice as many participants as in the 2007–2017 review. Since 2017, a shift seems to have occurred toward technologies that can be worn on the body to monitor body functions and report states, or imbalances. Moreover, research interest is now focused on mobile phone apps and wearables providing reminders and timely support, rather than on separate devices at home. Conclusion The studies conducted since 2017 report on wearable and environmental digital assistive technologies and often with multiple purposes. Three strategies for support seem evident: prompting and reminding people with dementia, monitoring people with dementia at home using environmental sensors and biosensors and providing safety outdoors. Thus, there is still a need for further research on the impact of technologies promoting occupational performance, quality of life, and human dignity for independent living.
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Affiliation(s)
- Torhild Holthe
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Correspondence: Torhild Holthe, Faculty of Health Sciences, Oslo Metropolitan University, PO Box 4 St. Olavs plass, Oslo, 0130, Norway, Tel +47 911 34 088, Email
| | - Liv Halvorsrud
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Faculty of Health and Welfare, Østfold University College, Halden, Norway
| | - Anne Lund
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Oakley-Girvan I, Yunis R, Longmire M, Ouillon JS. What Works Best to Engage Participants in Mobile App Interventions and e-Health: A Scoping Review. Telemed J E Health 2021; 28:768-780. [PMID: 34637651 PMCID: PMC9231655 DOI: 10.1089/tmj.2021.0176] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background: Despite the growing popularity of mobile app interventions, specific engagement components of mobile apps have not been well studied. Methods: The objectives of this scoping review are to determine which components of mobile health intervention apps encouraged or hindered engagement, and examine how studies measured engagement. Results: A PubMed search on March 5, 2020 yielded 239 articles that featured the terms engagement, mobile app/mobile health, and adult. After applying exclusion criteria, only 54 studies were included in the final analysis. Discussion: Common app components associated with increased engagement included: personalized content/feedback, data visualization, reminders/push notifications, educational information/material, logging/self-monitoring functions, and goal-setting features. On the other hand, social media integration, social forums, poor app navigation, and technical difficulties appeared to contribute to lower engagement rates or decreased usage. Notably, the review revealed a great variability in how engagement with mobile health apps is measured due to lack of established processes. Conclusion: There is a critical need for controlled studies to provide guidelines and standards to help facilitate engagement and its measurement in research and clinical trial work using mobile health intervention apps.
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Affiliation(s)
| | - Reem Yunis
- Medable, Inc., Palo Alto, California, USA
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Boyd K, Bond R, Ryan A, Goode D, Mulvenna M. Digital reminiscence app co-created by people living with dementia and carers: Usability and eye gaze analysis. Health Expect 2021; 24:1207-1219. [PMID: 34128574 PMCID: PMC8369094 DOI: 10.1111/hex.13251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND This research reports on a pilot study that examined the usability of a reminiscence app called 'InspireD' using eye tracking technology. The InspireD app is a bespoke digital intervention aimed at supporting personalized reminiscence for people living with dementia and their carers. The app was developed and refined in two co-creation workshops and subsequently tested in a third workshop using eye tracking technology. INTERVENTION Eye tracking was used to gain insight into the user's cognition since our previous work showed that the think-aloud protocol can add to cognitive burden for people living with dementia while also making the test more unnatural. RESULTS Results showed that there were no barriers to using a wearable eye tracker in this setting and participants were able to use the reminiscence app freely. However, some tasks required prompts from the observer when difficulties arose. While prompts are not normally used in usability testing (as some argue the prompting defeats the purpose of testing), we used 'prompt frequency' as a proxy for measuring the intuitiveness of the task. There was a correlation between task completion rates and prompt frequency. Results also showed that people living with dementia had fewer gaze fixations when compared to their carers. Carers had greater fixation and saccadic frequencies when compared to people living with dementia. This perhaps indicates that people living with dementia take more time to scan and consume information on an app. A number of identified usability issues are also discussed in the paper. PATIENT OR PUBLIC CONTRIBUTION The study presents findings from three workshops which looked at user needs analysis, feedback and an eye tracking usability test combined involving 14 participants, 9 of whom were people living with dementia and the remaining 5 were carers.
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Zidaru T, Morrow EM, Stockley R. Ensuring patient and public involvement in the transition to AI-assisted mental health care: A systematic scoping review and agenda for design justice. Health Expect 2021; 24:1072-1124. [PMID: 34118185 PMCID: PMC8369091 DOI: 10.1111/hex.13299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 04/07/2021] [Accepted: 05/26/2021] [Indexed: 12/16/2022] Open
Abstract
Background Machine‐learning algorithms and big data analytics, popularly known as ‘artificial intelligence’ (AI), are being developed and taken up globally. Patient and public involvement (PPI) in the transition to AI‐assisted health care is essential for design justice based on diverse patient needs. Objective To inform the future development of PPI in AI‐assisted health care by exploring public engagement in the conceptualization, design, development, testing, implementation, use and evaluation of AI technologies for mental health. Methods Systematic scoping review drawing on design justice principles, and (i) structured searches of Web of Science (all databases) and Ovid (MEDLINE, PsycINFO, Global Health and Embase); (ii) handsearching (reference and citation tracking); (iii) grey literature; and (iv) inductive thematic analysis, tested at a workshop with health researchers. Results The review identified 144 articles that met inclusion criteria. Three main themes reflect the challenges and opportunities associated with PPI in AI‐assisted mental health care: (a) applications of AI technologies in mental health care; (b) ethics of public engagement in AI‐assisted care; and (c) public engagement in the planning, development, implementation, evaluation and diffusion of AI technologies. Conclusion The new data‐rich health landscape creates multiple ethical issues and opportunities for the development of PPI in relation to AI technologies. Further research is needed to understand effective modes of public engagement in the context of AI technologies, to examine pressing ethical and safety issues and to develop new methods of PPI at every stage, from concept design to the final review of technology in practice. Principles of design justice can guide this agenda.
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Affiliation(s)
- Teodor Zidaru
- Department of Anthropology, London School of Economics and Political Science (LSE), London, UK
| | | | - Rich Stockley
- Surrey Heartlands Health and Care Partnership, Guildford and Waverley CCG, Guildford, UK.,Insight and Feedback Team, Nursing Directorate, NHS England and NHS Improvement, London, UK.,Surrey County Council, Kingston upon Thames, UK
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Appel L, Ali S, Narag T, Mozeson K, Pasat Z, Orchanian-Cheff A, Campos JL. Virtual reality to promote wellbeing in persons with dementia: A scoping review. J Rehabil Assist Technol Eng 2021; 8:20556683211053952. [PMID: 35024166 PMCID: PMC8743938 DOI: 10.1177/20556683211053952] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/12/2021] [Accepted: 10/01/2021] [Indexed: 11/17/2022] Open
Abstract
Virtual Reality (VR) technologies have increasingly been considered potentially valuable tools in dementia-related research and could serve as non-pharmacological therapy to improve quality of life (QoL) and wellbeing for persons with dementia (PwD). In this scoping review, we summarize peer-reviewed articles published up to Jan-21, 2021, on the use of VR to promote wellbeing in PwD. Eighteen manuscripts (reporting on 19 studies) met the inclusion criteria, with a majority published in the past 2 years. Two reviewers independently coded the articles regarding A) intended clinical outcomes and effectiveness of the interventions, B) study sample (characteristics of the participants), C) intervention administration (by whom, what setting), D) experimental methods (design/instruments), and E) technical properties of the VR-systems (hardware/devices and software/content). Emotional outcomes were by far the most common objectives of the interventions, reported in seventeen (89.5%) of the included articles. Outcomes addressing social engagement and personhood in PwD have not been thoroughly explored using VR. Based on the positive impact of VR, future opportunities lie in identifying special features and customization of the hardware/software to afford the most benefit to different sub-groups of the target population. Overall, this review found that VR represents a promising tool for promoting wellbeing in PwD, with positive or neutral impact reported on emotional, social, and functional aspects of wellbeing.
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Affiliation(s)
- Lora Appel
- School of Health Policy and Management, Faculty of Health, York University, Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
| | - Suad Ali
- School of Health Policy and Management, Faculty of Health, York University, Toronto, ON, Canada
| | - Tanya Narag
- School of Health Policy and Management, Faculty of Health, York University, Toronto, ON, Canada
| | - Krystyna Mozeson
- School of Health Policy and Management, Faculty of Health, York University, Toronto, ON, Canada
| | - Zain Pasat
- McMaster University, Hamilton, ON, Canada
| | | | - Jennifer L Campos
- KITE Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
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Potts C, Bond R, Ryan A, Mulvenna M, McCauley C, Laird E, Goode D. Ecological Momentary Assessment Within a Digital Health Intervention for Reminiscence in Persons With Dementia and Caregivers: User Engagement Study. JMIR Mhealth Uhealth 2020; 8:e17120. [PMID: 32420890 PMCID: PMC7381015 DOI: 10.2196/17120] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 03/02/2020] [Accepted: 05/14/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND User-interaction event logs provide rich and large data sets that can provide valuable insights into how people engage with technology. Approaches such as ecological momentary assessment (EMA) can be used to gather accurate real-time data in an individual's natural environment by asking questions at any given instant. OBJECTIVE The purpose of this study was to evaluate user engagement and responses to EMA questions using InspireD, an app used for reminiscence by persons with dementia and their caregivers. Research findings can be used to inform EMA use within digital health interventions. METHODS A feasibility trial was conducted in which participants (n=56) used the InspireD app over a 12-week period. Participants were a mean age of 73 (SD 13) and were either persons with dementia (n=28) or their caregivers (n=28). Questions, which they could either answer or choose to dismiss, were presented to participants at various instants after reminiscence with personal or generic photos, videos, and music. Presentation and dismissal rates for questions were compared by hour of the day and by trial week to investigate user engagement. RESULTS Overall engagement was high, with 69.1% of questions answered when presented. Questions that were presented in the evening had the lowest dismissal rate; the dismissal rate for questions presented at 9 PM was significantly lower than the dismissal rate for questions presented at 11 AM (9 PM: 10%; 11 AM: 50%; χ21=21.4, P<.001). Questions asked following reminiscence with personal media, especially those asked after personal photos, were less likely to be answered compared to those asked after other media. In contrast, questions asked after the user had listened to generic media, in particular those asked after generic music, were much more likely to be answered. CONCLUSIONS The main limitation of our study was the lack of generalizability of results to a larger population given the quasi-experimental design and older demographic where half of participants were persons with dementia; however, this study shows that older people are willing to participate and engage in EMA. Based on this study, we propose a series of recommendations for app design to increase user engagement with EMA. These include presenting questions no more than once per day, after 8 PM in the evening, and only if the user is not trying to complete a task within the app.
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Affiliation(s)
- Courtney Potts
- Ulster University, School of Computing, Jordanstown, United Kingdom
| | - Raymond Bond
- Ulster University, School of Computing, Jordanstown, United Kingdom
| | - Assumpta Ryan
- Ulster University, Institute of Nursing and Health Research, Derry, United Kingdom
| | - Maurice Mulvenna
- Ulster University, School of Computing, Jordanstown, United Kingdom
| | - Claire McCauley
- Ulster University, Institute of Nursing and Health Research, Derry, United Kingdom
| | - Elizabeth Laird
- Ulster University, Institute of Nursing and Health Research, Derry, United Kingdom
| | - Deborah Goode
- Ulster University, Institute of Nursing and Health Research, Derry, United Kingdom
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Moon S, Park K. The effect of digital reminiscence therapy on people with dementia: a pilot randomized controlled trial. BMC Geriatr 2020; 20:166. [PMID: 32375661 PMCID: PMC7204054 DOI: 10.1186/s12877-020-01563-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/20/2020] [Indexed: 12/31/2022] Open
Abstract
Background Reminiscence therapy (RT) can improve various dysfunctions in people with dementia (PWD), but it may not be a cost-effective intervention. Digital RT allows multiple users to participate in a therapy simultaneously. Moreover, digital RT offers convenience, such as for uploading personal materials and presenting individual triggers of personal memories. This pilot study aimed to evaluate the effect of digital RT through a comparison with conventional RT and to develop a strategy for designing larger RCTs. Methods An Android application and digital content were developed for digital RT. Overall, 49 PWD enrolled in nine daycare centers in Korea met the inclusion criteria. Eight sessions of digital RT in an intervention group (n = 25) and storytelling in a control group (n = 24) with no digital materials were performed over 4 weeks from February to June 2019. Cognition, depression, behavioral and psychological symptoms of dementia (BPSD), and engagement were measured as the primary outcomes to evaluate the effect of digital RT. All outcomes except for engagement were evaluated at baseline before the intervention (T0), post-intervention (T1), and 4 weeks after the intervention (T2). Engagement was measured at the first and last intervention sessions. Differences in cognition, depression and BPSD between groups and across time points (T0, T1, and T2) were analyzed by repeated measures ANOVA. Differences in engagement between the groups and time points (the first and last sessions) were analyzed by independent t-tests. This study adhered to the CONSORT guidelines. Results Depression (F = 7.62, p = .001, partial η2 = .17) was significantly decreased at T1 and T2, and engagement (t = − 2.71, p = .011) was significantly increased at the last session in the digital RT group compared to the control group. However, cognition (F = 0.13, p = .821) and BPSD (F = 0.67, p = .485) were not significantly different between groups and time points. Conclusions Digital RT proved an innovative approach to manage PWD and will thus help PWD achieve a better mood and have more opportunities to engage in social interactions. Trial registration KCT0003446 in the Clinical Research Information Service. Registered 24 January 2019, https://cris.nih.go.kr/cris/search/search_result_st01.jsp?seq=14391
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Affiliation(s)
- SeolHwa Moon
- College of Nursing, Hanyang University, 222 Wangsimni-ro, Sungdong-gu, Seoul, 04763, Korea
| | - Kyongok Park
- Department of Nursing, Gangneung-Wonju National University, 150 Namwon-ro, Heungeop-myeon, Wonju-si, Gangwon-do, 26403, Korea.
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