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Shagerdi G, Ayatollahi H, Hemmat M, Zeraatkar K. The application of health information technology for the elderly care in the emergency department: a conceptual model. BMC Geriatr 2024; 24:618. [PMID: 39030512 PMCID: PMC11264990 DOI: 10.1186/s12877-024-05212-w] [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: 03/14/2024] [Accepted: 07/09/2024] [Indexed: 07/21/2024] Open
Abstract
INTRODUCTION In the emergency departments (EDs), usually the longest waiting time for treatment and discharge belongs to the elderly patients. Moreover, the number of the ED admissions for the elderly increases every year. It seems that the use of health information technology in geriatric emergency departments can help to reduce the burden of the healthcare services for this group of patients. This research aimed to develop a conceptual model for using health information technology in the geriatric emergency department. METHODS This study was conducted in 2021. The initial conceptual model was designed based on the findings derived from the previous research phases (literature review and interview with the experts). Then, the model was examined by an expert panel (n = 7). Finally, using the Delphi technique (two rounds), the components of the conceptual model were reviewed and finalized. To collect data, a questionnaire was used, and data were analyzed using descriptive statistics. RESULTS The common information technologies appropriate for the elderly care in the emergency departments included emergency department information system, clinical decision support system, electronic health records, telemedicine, personal health records, electronic questionnaires for screening, and other technologies such as picture archiving and communication systems (PACS), electronic vital sign monitoring systems, etc. The participants approved all of the proposed systems and their applications in the geriatric emergency departments. CONCLUSION The proposed model can help to design and implement the most useful information systems in the geriatric emergency departments. As the application of technology accelerates care processes, investing in this field would help to support the care plans for the elderly and improve quality of care services. Further research is recommended to investigate the efficiency and effectiveness of using these technologies in the EDs.
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Affiliation(s)
- Ghazal Shagerdi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Haleh Ayatollahi
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
| | - Morteza Hemmat
- Department of Health Information Technology, Saveh University of Medical Sciences, Saveh, Iran
| | - Kimia Zeraatkar
- Education Development Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Ahmed M, Marín M, Gangas P, Bentlage E, Louro C, Brach M. Improving the Acceptability and Implementation of Information and Communication Technology-Based Health Care Platforms for Older People With Dementia or Parkinson Disease: Qualitative Study Results of Key Stakeholders. JMIR Form Res 2024; 8:e58501. [PMID: 38935424 PMCID: PMC11240067 DOI: 10.2196/58501] [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: 03/17/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND The management of neurodegenerative diseases (NDDs) in older populations is usually demanding and involves care provision by various health care services, resulting in a greater burden on health care systems in terms of costs and resources. The convergence of various health services within integrated health care models, which are enabled and adopted jointly with information and communication technologies (ICTs), has been identified as an effective alternative health care solution. However, its widespread implementation faces formidable challenges. Both the development and implementation of integrated ICTs are linked to the collaboration and acceptance of different groups of stakeholders beyond patients and health care professionals, with reported discrepancies in the needs and preferences among these groups. OBJECTIVE Complementing a previous publication, which reported on the needs and requirements of end users in the development of the European Union-funded project PROCare4Life (Personalized Integrated Care Promoting Quality of Life for Older People), this paper aimed to report on the opinions of other key stakeholders from various fields, including academia, media, market, and decision making, for improving the acceptability and implementation of an integrated ICT-based health care platform supporting the management of NDDs. METHODS The study included 30 individual semistructured interviews that took place between June and August 2020 in 5 European countries (Germany, Italy, Portugal, Romania, and Spain). Interviews were mostly conducted online, except in cases where participants requested to be interviewed in person. In these cases, COVID-19 PROCare4Life safety procedures were applied. RESULTS This study identified 2 themes and 5 subthemes. User engagement, providing training and education, and the role played by the media were identified as strategic measures to ensure the acceptability of ICT-based health care platforms. Sustainable funding and cooperation with authorities were foreseen as additional points to be considered in the implementation process. CONCLUSIONS The importance of the user-centered design approach in ensuring the involvement of users in the development of ICT-based platforms has been highlighted. The most common challenges that hinder the acceptability and implementation of ICT-based health care platforms can be addressed by creating synergies among the efforts of users, academic stakeholders, developers, policy makers, and decision makers. To support future projects in developing ICT-based health care platforms, this study outlined the following recommendations that can be integrated when conducting research on users' needs: (1) properly identify the particular challenges faced by future user groups without neglecting their social and clinical contexts; (2) iteratively assess the digital skills of future users and their acceptance of the proposed platform; (3) align the functionalities of the ICT platform with the real needs of future users; and (4) involve key stakeholders to guide the reflection on how to implement the platform in the future. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/22463.
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Affiliation(s)
- Mona Ahmed
- Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
- Institute of General Practice and Family Medicine, University Hospital Bonn, Venusberg-Campus, Bonn, Germany
| | | | - Pilar Gangas
- International Foundation for Integrated Care, Oxford, United Kingdom
| | - Ellen Bentlage
- Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
| | | | - Michael Brach
- Institute of Sport and Exercise Sciences, University of Münster, Münster, Germany
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Zhang J, Wang H, Li Q, Luximon Y. What Is the Real-Life Experience of Older Adults on Smart Healthcare Technologies? An Exploratory Interview Study. Gerontology 2024:1-13. [PMID: 38843781 DOI: 10.1159/000539539] [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: 05/27/2024] [Indexed: 07/24/2024] Open
Abstract
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.
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Affiliation(s)
- Jiaxin Zhang
- School of System Design and Intelligent Manufacturing, Southern University of Science and Technology, Shenzhen, China,
| | - Hailiang Wang
- School of Design, The Hong Kong Polytechnic University, Hong Kong, Hong Kong, China
| | - Qingchuan Li
- School of Humanity and Social Science, Harbin Institute of Technology, Shenzhen, China
| | - Yan Luximon
- School of Design, The Hong Kong Polytechnic University, Hong Kong, Hong Kong, China
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Huang M, Ye Y. "A Matter of Life and Death": Mitigating the Gray Digital Divide in Using Health Information Technologies in the Post-Pandemic Era. HEALTH COMMUNICATION 2024:1-11. [PMID: 38808629 DOI: 10.1080/10410236.2024.2358279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
A pervasive issue in healthcare is that elderly populations have fallen far behind in using healthcare technologies, a phenomenon known as the gray digital divide. Even more concerningly, the COVID-19 pandemic has dramatically catalyzed health digitization with the potential for lasting demographic-wide impacts. Against this backdrop and drawing on both the digital divide literature and the unified theory of acceptance and use of technology (UTAUT2), we investigated elderly populations' usage of healthcare technologies through analyzing HINTS 6 (2022) survey data. Results show a widespread first- and second-level digital divide in using health information technologies (HITs) between people aged 65 and up and people aged 18-64, including Internet access, health-related Internet use, health-related social media use, health app use, use of wearable electronic health devices, telehealth visits, and accessing online medical records. Moreover, this study finds that education consistently positively predicts Internet use and use of various HITs by the elderly; income is the next reliable predictor but not as consistent as education. Health-related variables are less consistent in predicting the elderly's use of HITs. Theoretical and practical implications of these results are discussed to inform the mitigation of the gray digital divide in healthcare.
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Affiliation(s)
- Maxwell Huang
- Noble and Greenough School, Incoming Freshman at Harvard University
| | - Yinjiao Ye
- Department of Communication Studies, Harrington School of Communication and Media, University of Rhode Island
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Ferizaj D, Perotti L, Dahms R, Heimann-Steinert A. [Use of technology in old age: associations between acceptance, competence, control, interest and social indicators in individuals over 60 years old]. Z Gerontol Geriatr 2024; 57:227-234. [PMID: 37668693 PMCID: PMC11078788 DOI: 10.1007/s00391-023-02225-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/20/2023] [Indexed: 09/06/2023]
Abstract
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.
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Affiliation(s)
- Drin Ferizaj
- Department of Geriatrics and Medical Gerontology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland.
| | - Luis Perotti
- Department of Geriatrics and Medical Gerontology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Rebecca Dahms
- Department of Geriatrics and Medical Gerontology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
| | - Anika Heimann-Steinert
- Department of Geriatrics and Medical Gerontology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
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Tan BTN, Khan MI, Saleh MA, Wangchuk D, Talukder MJH, Kinght-Agarwal CR. Empowering Healthcare through Precision Medicine: Unveiling the Nexus of Social Factors and Trust. Healthcare (Basel) 2023; 11:3177. [PMID: 38132068 PMCID: PMC10743070 DOI: 10.3390/healthcare11243177] [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: 10/28/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
This study investigated the impact of social factors on the acceptance of precision medicine (PM) using a quantitative survey grounded in the Unified Theory of Acceptance and Use of Technology (UTAUT) framework. The findings revealed that social influence has a significantly positive effect on PM acceptance, while the influence of social media is found to be insignificant. Performance expectancy emerged as the most influential factor, demonstrating a significant relationship with PM acceptance. Trust plays a crucial moderating role, mitigating the impact of social factors on PM acceptance. While exploring the mediating effects of trust, we identified a significant mediation effect for social influence and performance expectancy on PM acceptance. However, the mediation effect of social media influence is insignificant. These findings highlight the importance of trust in shaping decisions regarding PM acceptance. These findings have significant implications for healthcare practitioners and policymakers aiming to promote the adoption of precision medicine in clinical practice.
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Affiliation(s)
- Bian Ted Nicholas Tan
- Canberra Business School, University of Canberra, Canberra 2617, Australia; (B.T.N.T.); (M.A.S.); (D.W.)
| | - Md. Irfanuzzaman Khan
- Canberra Business School, University of Canberra, Canberra 2617, Australia; (B.T.N.T.); (M.A.S.); (D.W.)
| | - Md. Abu Saleh
- Canberra Business School, University of Canberra, Canberra 2617, Australia; (B.T.N.T.); (M.A.S.); (D.W.)
| | - Dawa Wangchuk
- Canberra Business School, University of Canberra, Canberra 2617, Australia; (B.T.N.T.); (M.A.S.); (D.W.)
| | - Md. Jakir Hasan Talukder
- Advance Computing and Information Science, University of South Australia, Mawson Lakes, Adelaide 5095, Australia;
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Praha N, Sriyuktasuth A, Puwarawuttipanit W, Chuengsaman P, Kusakunniran W. Factors Influencing Telehealth Service Use and Health Outcomes in Patients Undergoing Continuous Ambulatory Peritoneal Dialysis: Cross-Sectional Study. J Med Internet Res 2023; 25:e48623. [PMID: 38051557 PMCID: PMC10731559 DOI: 10.2196/48623] [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: 05/01/2023] [Revised: 10/11/2023] [Accepted: 10/31/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Several studies have demonstrated the efficacy and user acceptance of telehealth in managing patients with chronic conditions, including continuous ambulatory peritoneal dialysis (CAPD). However, the rates of telehealth service use in various patient groups have been low and have declined over time, which may affect important health outcomes. Telehealth service use in patients undergoing CAPD has been recognized as a key challenge that needs to be examined further. OBJECTIVE This study aimed to explore the rates of telehealth service use over 4 months, identify factors influencing its use, and examine the relationship between telehealth service use and health outcomes in Thai people undergoing CAPD. METHODS This cross-sectional study, which was a part of a pragmatic randomized controlled trial study, was conducted at a dialysis center in Bangkok, Thailand. The study included patients who were undergoing CAPD. These patients were randomly enrolled in the intervention group to receive telehealth service and additional standard care for 4 months. Data were collected using self-reported questionnaires, including a demographic form, Functional, Communicative, and Critical Health Literacy Scale, Perceived Usefulness Questionnaire, Brief Illness Perception Questionnaire, Patient-Doctor Relationship Questionnaire, and Kidney Disease Quality of Life 36 Questionnaire. Additionally, Google Analytics was used to obtain data on the actual use of the telehealth service. These data were analyzed using descriptive statistics, repeated-measures ANOVA, and regression analyses. RESULTS A total of 159 patients were included in this study. The mean rate of telehealth service use throughout the period of 4 months was 62.06 (SD 49.71) times. The rate of telehealth service use was the highest in the first month (mean 23.48, SD 16.28 times) and the lowest in the third month (mean 11.09, SD 11.48 times). Independent variables explained 27.6% of the sample variances in telehealth service use. Older age (β=.221; P=.002), higher perceived usefulness (β=.414; P<.001), unemployment (β=-.155; P=.03), and positive illness perception (β=-.205; P=.004) were associated with a significantly higher rate of telehealth service use. Regarding the relationship between telehealth service use and health outcomes, higher rates of telehealth service use were linked to better quality of life (β=.241; P=.002) and lower peritonitis (odds ratio 0.980, 95% CI 0.962-0.997; P=.03). CONCLUSIONS This study provides valuable insights into factors impacting telehealth service use, which in turn affect health outcomes in patients undergoing CAPD.
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Affiliation(s)
- Nattaya Praha
- Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | | | | | | | - Worapan Kusakunniran
- Faculty of Information and Communication Technology, Mahidol University, Nakhon Pathom, Thailand
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Anttila M, Koivisto J, Luoma ML, Anttila H. How to adopt technologies in home care: a mixed methods study on user experiences and change of home care in Finland. BMC Health Serv Res 2023; 23:1342. [PMID: 38042800 PMCID: PMC10693073 DOI: 10.1186/s12913-023-10368-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 11/22/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND There is a need for better adoption of technology to meet the needs of home care professionals, older people, and informal caregivers. METHODS Mixed methods were used to describe and analyse quantitative and qualitative data in a Finnish governmental programme called KATI. The study was three-fold: it 1) listed what kinds of technologies were piloted and deployed in a national study, 2) provided information from the perspectives of home care professionals about requirements to use technology by using focus-group interviews, and 3) assessed experiences of how the adoption of technology changes work and work processes over time by using repeated surveys. Informants in interviews (n = 25) and surveys (n = 90) were home care professionals, who also described the perspectives of older people and informal caregivers. The conceptual models framing the study were adapted from the Technology Acceptance Model and DirVA PROVE-IT. RESULTS There were 80 technology pilots, in which variety of technologies were followed in home care. Familiarity with, commitment to and understanding of technology benefits were considered to be requirements for the technology to be used. The adoption of technology provided new skills and information about older people's wellbeing, realisation of treatment and new possibilities in home care. It developed new procedures to focus on older people's needs and motivated professionals by gained concrete aid. It enabled them to leave out some concrete procedures as unnecessary. On the other hand, there were also pessimistic and negative experiences when technology use provided nothing new or did not change anything. CONCLUSIONS The adoption of technology is dependent on the technology and its integration into the prevailing service practice. When they both work, it is possible to leave out unnecessary procedures in care, allocate resources and save time. It is possible to be aware of older people's safety and how they cope at home, find new ways to get involved in older people's lives, gain insight, and make changes at work. Continuous on-site training, modifications in service practices and communication throughout organisations is needed.
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Affiliation(s)
- Minna Anttila
- Finnish Institute for Health and Welfare, Helsinki, Finland.
| | - Juha Koivisto
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Heidi Anttila
- Finnish Institute for Health and Welfare, Helsinki, Finland
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Diel S, Doctor E, Reith R, Buck C, Eymann T. Examining supporting and constraining factors of physicians' acceptance of telemedical online consultations: a survey study. BMC Health Serv Res 2023; 23:1128. [PMID: 37858170 PMCID: PMC10588103 DOI: 10.1186/s12913-023-10032-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/14/2023] [Indexed: 10/21/2023] Open
Abstract
As healthcare demands exceed outpatient physicians' capacities, telemedicine holds far-reaching potential for both physicians and patients. It is crucial to holistically analyze physicians' acceptance of telemedical applications, such as online consultations. This study seeks to identify supporting and constraining factors that influence outpatient physicians' acceptance of telemedicine.We develop a model based on the unified theory of acceptance and use of technology (UTAUT). To empirically examine our research model, we conducted a survey among German physicians (n = 127) in 2018-2019. We used the partial least squares (PLS) modeling approach to test our model, including a mediation analysis. The results indicate that performance expectancy (β = .397, P < .001), effort expectancy (β = .134, P = .03), and social influence (β = .337, P < .001) strongly impact the intention to conduct online consultations and explain 55% of its variance. Structural conditions regarding data security comprise a key antecedent, associating with performance expectancy (β = .193, P < .001) and effort expectancy (β = .295, P < .001). Regarding potential barriers to usage intentions, we find that IT anxiety predicts performance (β = -.342, P < .001) and effort expectancy (β = -.364, P < .001), while performance expectancy fully mediates (βdirect = .022, P = .71; βindirect = -.138, P < .001) the direct relationship between IT anxiety and the intention to use telemedical applications.This research provides explanations for physicians' behavioral intention to use online consultations, underlining UTAUT's applicability in healthcare contexts. To boost acceptance, social influences, such as personal connections and networking are vital, as colleagues can serve as multipliers to reach convergence on online consultations among peers. To overcome physicians' IT anxiety, training, demonstrations, knowledge sharing, and management incentives are recommended. Furthermore, regulations and standards to build trust in the compliance of online consultations with data protection guidelines need reinforcement from policymakers and hospital management alike.
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Affiliation(s)
- Sören Diel
- Branch Business & Information Systems Engineering of the Fraunhofer FIT and FIM Research Center for Information Management, University of Bayreuth, Wittelsbacherring 10, 95444, Bayreuth, Germany
| | - Eileen Doctor
- Branch Business & Information Systems Engineering of the Fraunhofer FIT and FIM Research Center for Information Management, University of Bayreuth, Wittelsbacherring 10, 95444, Bayreuth, Germany.
| | - Riccardo Reith
- Chair of General Business Management, University of Bayreuth, Universitätsstraße 30, 95447, Bayreuth, Germany
| | - Christoph Buck
- Faculty of Informatics, Augsburg University of Applied Sciences and Branch Business & Information Systems Engineering of the Fraunhofer FIT, Alter Postweg 101, 86159, Augsburg, Germany
- QUT Business School, Centre for Future Enterprise, Queensland University of Technology, 2 George St, Brisbane, QLD-4000, Australia
| | - Torsten Eymann
- Branch Business & Information Systems Engineering of the Fraunhofer FIT and FIM Research Center for Information Management, University of Bayreuth, Wittelsbacherring 10, 95444, Bayreuth, Germany
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Fotteler ML, Kocar TD, Dallmeier D, Kohn B, Mayer S, Waibel AK, Swoboda W, Denkinger M. Use and benefit of information, communication, and assistive technology among community-dwelling older adults - a cross-sectional study. BMC Public Health 2023; 23:2004. [PMID: 37833689 PMCID: PMC10576310 DOI: 10.1186/s12889-023-16926-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Technology can support healthy aging and empower older adults to live independently. However, technology adoption by older adults, particularly assistive technology (AT), is limited and little is known about the types of AT used among older adults. This study explored the use of key information and communication technologies (ICT) and AT among community-dwelling adults aged ≥ 65. METHODS A cross-sectional study was conducted among community-dwelling adults aged ≥ 65 in southern Germany using a paper-based questionnaire. The questionnaire included questions on the three domains sociodemographic aspects, health status, and technology use. Technology use was considered separately for key ICT (smartphone, computer/laptop, and tablet) and a range of 31 different AT. Data were analyzed using descriptive statistics, univariate analyses, and Bernoulli Naïve Bayes modelling. RESULTS The questionnaire was answered by 616 participants (response rate: 24.64%). ICT were used by 497 (80.68%) participants and were associated with lower age, higher level of education, living together with someone, availability of internet connection, higher interest in technology, and better health status (p < .05). No association was found with sex and size of the hometown. The most frequently owned AT were a landline phone, a body scale, and a blood pressure monitor. Several AT related to functionality, (instrumental) activities of daily living- (IADL), and morbidity were used more frequently among non-ICT users compared to ICT-users: senior mobile phone (19.33% vs. 3.22%), in-house emergency call (13.45% vs. 1.01%), hearing aid (26.89% vs. 16.7%), personal lift (7.56% vs. 1.61%), electronic stand-up aid (4.2% vs. 0%). Those with higher interest in technology reported higher levels of benefit from technology use. CONCLUSIONS Despite the benefits older adults can gain from technology, its use remains low, especially among those with multimorbidity. Particularly newer, more innovative and (I)ADL-related AT appear underutilized. Considering the potential challenges in providing adequate care in the future, it may be crucial to support the use of these specific AT among older and frailer populations. To focus scientific and societal work, AT with a high impact on autonomy ((I)ADL/disease-related) should be distinguished from devices with a low impact on autonomy (household-/ comfort-related).
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Affiliation(s)
- Marina L Fotteler
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Wileystrasse 1, 89231, Neu-Ulm, Germany.
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany.
| | - Thomas D Kocar
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
- Agaplesion Bethesda Clinic Ulm, Ulm, Germany
| | - Dhayana Dallmeier
- Agaplesion Bethesda Clinic Ulm, Ulm, Germany
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
- Geriatric Center Ulm, Ulm, Germany
| | - Brigitte Kohn
- Agaplesion Bethesda Clinic Ulm, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
| | - Sarah Mayer
- Agaplesion Bethesda Clinic Ulm, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
| | - Ann-Kathrin Waibel
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Wileystrasse 1, 89231, Neu-Ulm, Germany
| | - Walter Swoboda
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Wileystrasse 1, 89231, Neu-Ulm, Germany
| | - Michael Denkinger
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
- Agaplesion Bethesda Clinic Ulm, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
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Gambo I, Bueno-Delgado MV, Mooses K, Melero Muñoz FJ, Zviel-Girshin R, Andrushevich A, Mrissa M, Landowska A, Taveter K. Technology adoption review for ageing well: analysis of technical solutions. Front Public Health 2023; 11:1169192. [PMID: 37799155 PMCID: PMC10549926 DOI: 10.3389/fpubh.2023.1169192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 08/07/2023] [Indexed: 10/07/2023] Open
Abstract
While several technological solutions are available for older adults to improve their wellbeing and quality of life, little is known about the gaps between the needs, provided solutions, and their adoption from a more pragmatic perspective. This paper reports on reviewing existing technological solutions for older adults, which span the work life, life in the community, and wellbeing at home. We analyzed 50 different solutions to uncover both negative and positive features of these solutions from the perspective of the impact of technology adoption on the quality of life of older adults. Our approach harnesses holistic reasoning to determine the most suitable technologies available today and provides suggestions for improvement toward designing and implementing better solutions.
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Affiliation(s)
- Ishaya Gambo
- Institute of Computer Science, University of Tartu, Tartu, Estonia
- Department of Computer Science, Obafemi Awolowo University, Ile-Ife, Nigeria
| | - M. Victoria Bueno-Delgado
- Department of Information and Communication Technologies, Universidad Politécnica de Cartagena, Antiguo Cuartel de Antigones, Cartagena, Spain
| | - Kerli Mooses
- Institute of Computer Science, University of Tartu, Tartu, Estonia
| | - Francisco J. Melero Muñoz
- Department of Information and Communication Technologies, Universidad Politécnica de Cartagena, Antiguo Cuartel de Antigones, Cartagena, Spain
- Technical Research Centre of Furniture and Wood of the Region of Murcia, Yecla, Spain
| | | | - Aliaksei Andrushevich
- HomeLab, Lucerne University of Applied Sciences and Arts, Lucerne, Switzerland
- Faculty of Applied Mathematics and Computer Science, Belarusian State University, Minsk, Belarus
| | - Michael Mrissa
- InnoRenew CoE, Izola, Slovenia
- Faculty of Mathematics, Natural Sciences and Information Technologies (FAMNIT), University of Primorska, Koper, Slovenia
| | - Agnieszka Landowska
- Department of Software Engineering, Faculty of Electronics, Telecommunications and Informatics, Gdańsk University of Technology, Gdańsk, Poland
| | - Kuldar Taveter
- Institute of Computer Science, University of Tartu, Tartu, Estonia
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12
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Happe L, Sgraja M, Hein A, Quinten V, Diekmann R. Usability and feasibility of a tablet-based e-coach for older adults in rehabilitation units to improve nutrition and physical activity: a prospective pilot study. BMC Geriatr 2023; 23:578. [PMID: 37726662 PMCID: PMC10507984 DOI: 10.1186/s12877-023-04204-6] [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: 11/24/2022] [Accepted: 07/29/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND For older adults (≥ 70 years), it is often challenging to maintain new nutrition and physical activity behaviours learned in rehabilitation. To minimize the risk of negative health consequences when returning home, an e-coach can be helpful. Aligning the program with an established concept such as the Transtheoretical Model of Behaviour Change (TTM) and guidance from healthcare professionals can optimize behaviour change. OBJECTIVE This prospective single-arm pilot study aimed to assess the usability and feasibility of a nutrition and mobility e-coach for older adults during and after rehabilitation for a period of 9 weeks. In addition, we examined the change in the TTM phase as an indicator of the participant's readiness to change or the changes made. METHODS Older adults (≥ 70 years) with nutrition deficits and/ or mobility limitations were recruited in a rehabilitation centre. Participants' phases of behaviour change in the TTM were identified by comparing current nutrition and physical activity habits via self-report with age-specific nutrition and physical activity recommendations. They received a tablet with the e-coach containing educational and interactive elements on the topics of nutrition and physical activity in older age. Participants used the e-coach and received support from healthcare professionals. The TTM phases were assessed at five times; the e-coach content was adjusted accordingly. Usability was assessed using the System Usability Scale (SUS, Score range: 0-100). Timestamps were used to evaluate how frequently participants used the e-coach: high (≥ 67% of the days), medium (66 - 33% of the days), and low (< 33% of the days). RESULTS Approximately 140 patients were approached and n = 30 recruited. Complete data sets of n = 21 persons were analysed (38% female, mean age 79.0 ± 6.0 years). The SUS was 78.6 points, 11 participants (42%) were classified as high users, 6 (39%) as medium users and 4 (19%) as low users. After nine weeks, 15 participants (71%) achieved the physical activity recommendations (baseline: 33%, n = 7). Nutrition recommendations were achieved by 14 participants (66%) after nine weeks (baseline: 24%, n = 5). CONCLUSION The e-coach seems to be usable and feasible for older adults. We identified some optimization potentials for our application that can be transferred to the development of comparable e-health interventions for vulnerable older adults.
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Affiliation(s)
- Lisa Happe
- Department of Health Services Research, Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 114, Oldenburg, Germany.
| | - Marie Sgraja
- Department of Health Services Research, Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 114, Oldenburg, Germany
| | - Andreas Hein
- Department of Health Services Research, Assistance Systems and Medical Device Technology, Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 114, Oldenburg, Germany
| | - Vincent Quinten
- Department of Health Services Research, Junior research group "nutrition and physical function in older adults", Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 114, Oldenburg, Germany
| | - Rebecca Diekmann
- Department of Health Services Research, Junior research group "nutrition and physical function in older adults", Carl von Ossietzky University Oldenburg, Ammerländer Heerstr. 114, Oldenburg, Germany
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13
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Chan DYL, Lee SWH, Teh PL. Factors influencing technology use among low-income older adults: A systematic review. Heliyon 2023; 9:e20111. [PMID: 37809586 PMCID: PMC10559849 DOI: 10.1016/j.heliyon.2023.e20111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 08/30/2023] [Accepted: 09/12/2023] [Indexed: 10/10/2023] Open
Abstract
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.
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Affiliation(s)
- Diana Yian Lian Chan
- School of Business, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
- School of Pharmacy, Taylor's University Lakeside Campus, Jalan Taylor's, 47500, Subang Jaya, Selangor, Malaysia
- Gerontechnology Laboratory, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Pei-Lee Teh
- School of Business, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
- Gerontechnology Laboratory, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
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14
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Chenhuichen C, González-Senac NM. Technology enabled care and older adults: Where are we at? Rev Esp Geriatr Gerontol 2023; 58:101384. [PMID: 37481840 DOI: 10.1016/j.regg.2023.101384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/25/2023]
Affiliation(s)
- Chenhui Chenhuichen
- Geriatrics Department, Hospital Universitario de Navarra (HUN), Pamplona, Navarra, Spain.
| | - Nicolás M González-Senac
- Geriatrics Department, Hospital General Universitario Gregorio Marañon, Madrid, Spain; Instituto de Investigación Sanitaria Hospital General Universitario Gregorio Marañón, Madrid, Spain
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15
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Barua Z, Barua A. Modeling the predictors of mobile health adoption by Rohingya Refugees in Bangladesh: An extension of UTAUT2 using combined SEM-Neural network approach. J Migr Health 2023; 8:100201. [PMID: 37559674 PMCID: PMC10407243 DOI: 10.1016/j.jmh.2023.100201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/18/2023] [Accepted: 07/24/2023] [Indexed: 08/11/2023] Open
Abstract
While the healthcare facilities for the people is questionable in Bangladesh, Rohingya refugees is a burning issue for both Bangladesh and global community. Integrating Rohingya refugees into the framework of mHealth could be beneficial for both Bangladesh and Rohingya refugees in general, and in specific situation like COVID-19 outbreak. However, no research has been found on what motivates Rohingya refugees to accept mHealth in Bangladesh. Drawing on the UTAUT2 model, this study investigates the predictors of acceptance of mHealth services technologies among Rohingya refugees. The study also seeks to clarify the roles of mHealth developers, the Bangladesh government, and non-governmental organizations working with the 1.1 million Rohingya refugees in Bangladesh. Quantitative data were collected from refugee camps with the permission of the Refugee Relief and Repatriation Commissioner (RRRC). The data were analyzed in two stages using a mixed approach that combines PLS-SEM and Artificial Neural Network (ANN). This study revealed that Effort expectancy (EE, with t = 5.629, β = 0.313) and facilitating conditions (FC with t = 4.442, β = 0.269) in PLS-SEM, and FC (with 100 percent importance) and Health consciousness (HC, with 94.88 percent importance) in ANN analysis were found to be the most substantial predictors of mHealth adoption. The study also revealed that EE and FC are more important for low education group, while PE and Situational Constraint (SC) are more important for the high education group of refugees. In addition to providing insights for mHealth developers, this study particularly focuses on the role of government institutions and non-governmental social workers in working with the subjects to increase FC and HC among Rohingya refugees and bring them under mHealth services.
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Affiliation(s)
- Zapan Barua
- Department of Marketing, University of Chittagong, Chattogram 4331, Bangladesh
| | - Adita Barua
- Faculty of Business Administration, Cox's Bazar International University, Cox's Bazar 4700, Bangladesh
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16
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Garcia Reyes EP, Kelly R, Buchanan G, Waycott J. Understanding Older Adults' Experiences With Technologies for Health Self-management: Interview Study. JMIR Aging 2023; 6:e43197. [PMID: 36943333 PMCID: PMC10131633 DOI: 10.2196/43197] [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: 10/03/2022] [Revised: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Many older adults now use technologies such as wearable devices and telehealth services to support their health and well-being while living independently at home. However, older adults vary in how they use these technologies, and there is a lack of knowledge regarding the motivations that influence their acceptance and use of health-related technologies in home environments. OBJECTIVE This study aimed to understand the types of technologies that older adults use to support their health and the factors that motivate them to use their chosen technologies to support their health. In addition, we aimed to understand the factors that enable the effective use of technologies for health self-management and to identify the barriers that can negatively affect the adoption of technologies. METHODS A total of 22 older adults participated in semistructured interviews regarding their experiences of using technologies for health self-management. Interview transcripts were analyzed through an in-depth thematic analysis. RESULTS The interviews revealed that a range of technologies, such as videoconferencing software, fitness trackers, and other devices, were being used by older adults to support their health. Interviews showed that participants were motivated to use technologies to monitor health issues, to stay active and connected, and to record and change their behavior in the light of foreseen risks related to their future health status. Enablers that facilitated the effective use of technologies include social and organizational influence, convenient access to health care and safety provided by the technology, and easy setup and low cost of the technology. Barriers include information overload and a sense of futility about future health decline; telehealth being an inadequate substitute for in-person consultation; concerns about trust related to privacy and accuracy; and technologies being stigmatizing, uncomfortable to use, expensive, and unfamiliar. CONCLUSIONS This study suggested that older adults were using a variety of technologies to prevent or prepare for future health decline, evidencing a resilient attitude toward health and aging. In addition, older adults were willing to continue using the technology when there was a perceived need. The enabler mentioned by most participants was the social and organizational influence that included health care staff, family, friends, and organizations. This analysis provides a better understanding of how older adults use technologies to support their health and can guide the provision of appropriate health technologies for them.
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Affiliation(s)
- Elsy Paola Garcia Reyes
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - Ryan Kelly
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - George Buchanan
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - Jenny Waycott
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
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17
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Yunara Y, Efendi F, Makhfudli. Technology- and non-technology-based primary healthcare innovations for the elderly: A systematic review. ENFERMERIA CLINICA 2023. [DOI: 10.1016/j.enfcli.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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18
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Calegari LP, Tortorella GL, Fettermann DC. Getting Connected to M-Health Technologies through a Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4369. [PMID: 36901379 PMCID: PMC10001891 DOI: 10.3390/ijerph20054369] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/23/2023] [Accepted: 02/25/2023] [Indexed: 06/18/2023]
Abstract
The demand for mobile e-health technologies (m-health) continues with constant growth, stimulating the technological advancement of such devices. However, the customer needs to perceive the utility of these devices to incorporate them into their daily lives. Hence, this study aims to identify users' perceptions regarding the acceptance of m-health technologies based on a synthesis of meta-analysis studies on the subject in the literature. Using the relations and constructs proposed in the UTAUT2 (Unified Theory of Acceptance and Use of Technology 2) technology acceptance model, the methodological approach utilized a meta-analysis to raise the effect of the main factors on the Behavioral Intention to Use m-health technologies. Furthermore, the model proposed also estimated the moderation effect of gender, age, and timeline variables on the UTAUT2 relations. In total, the meta-analysis utilized 84 different articles, which presented 376 estimations based on a sample of 31,609 respondents. The results indicate an overall compilation of the relations, as well as the primary factors and moderating variables that determine users' acceptance of the studied m-health systems.
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Affiliation(s)
- Luiz Philipi Calegari
- Department of Industrial Engineering, Federal University of Santa Catarina, Florianópolis 8040-900, SC, Brazil
| | | | - Diego Castro Fettermann
- Department of Industrial Engineering, Federal University of Santa Catarina, Florianópolis 8040-900, SC, Brazil
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The Potential of the Remote Monitoring Digital Solutions to Sustain the Mental and Emotional Health of the Elderly during and Post COVID-19 Crisis in Romania. Healthcare (Basel) 2023; 11:healthcare11040608. [PMID: 36833143 PMCID: PMC9957364 DOI: 10.3390/healthcare11040608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/09/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
The COVID-19 pandemic amplified the elderly's aging-related dysfunctionalities and vulnerabilities. Research surveys, aimed at evaluating the socio-physical-emotional state of the elderly and obtaining data on their access to medical services and information media services during the pandemic, were carried out on Romanian respondents aged 65+. Identification and mitigation of the risk of emotional and mental long-term decline of the elderly after SARS-CoV-2 infection, based on the implementation of a specific procedure, can be performed through Remote Monitoring Digital Solutions (RMDSs). The aim of this paper is to propose a procedure for the identification and mitigation of the risk of emotional and mental long-term decline of the elderly after SARS-CoV-2 infection that comprises RMDS. The importance of using the knowledge obtained by COVID-19-related surveys corroborating the necessity of including personalized RMDS in the procedure is highlighted. The Non-invasive Monitoring System and Health Assessment of the Elderly in a Smart Environment (RO-SmartAgeing) is an RMDS designed to address the improved preventative and proactive support for diminishing this risk and to provide suitable assistance for the elderly through a safe and efficient smart environment. Its comprehensive functionalities targeted supporting primary healthcare assistance, specific medical conditions-as the mental and emotional disorders post-SARS-CoV-2 infection-and enlarged access to aging-related information, together with customizable features, illustrated the match with the requirements included in the proposed procedure.
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20
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Hijazi R, Abu Daabes A, Al-Ajlouni MI. Mobile payment service quality: a new approach for continuance intention. INTERNATIONAL JOURNAL OF QUALITY & RELIABILITY MANAGEMENT 2023. [DOI: 10.1108/ijqrm-05-2022-0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PurposeThis paper assesses the continuance intention (CI) for mobile-based payment (M-payment) services following the COVID-19 pandemic by combining the self-efficacy construct with the electronic service quality model.Design/methodology/approachThis exploratory, cross-sectional research employs qualitative and quantitative research methods; specifically, a questionnaire and interviews. A total of 403 Jordanian participants completed valid questionnaires. Mediation and moderation evaluations assessed the M-payment service quality (MPSQ), self-efficacy and health concerns (HC) to determine CI.FindingsThe results verify the significance of MPSQ and self-efficacy in developing CI and show the mediating influence of self-efficacy between MPSQ and CI. Moreover, HC negatively impact the self-efficacy/CI link.Practical implicationsThis research benefits M-payment service providers seeking to secure customer loyalty via improved M-payment services. The behavioral intention investigation will provide rich information about potential customers' CI and illuminate areas for development.Originality/valueThis research makes an original contribution to the existing M-payment literature by investigating the impact of customers' perception of service quality on their CI to utilize M-payment services, balanced with self-efficacy and HC.
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21
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Revenäs Å, Ström L, Cicchetti A, Ehn M. Towards multimodal boosting of motivation for fall-preventive physical activity in seniors: An iterative development evaluation study. Digit Health 2023; 9:20552076231180973. [PMID: 37426584 PMCID: PMC10328051 DOI: 10.1177/20552076231180973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 05/23/2023] [Indexed: 07/11/2023] Open
Abstract
Background Many seniors need to increase their physical activity (PA) and participation in fall prevention exercise. Therefore, digital systems have been developed to support fall-preventive PA. Most of them lack video coaching and PA monitoring, two functionalities that may be relevant for increasing PA. Objective To develop a prototype of a system to support seniors' fall-preventive PA, which includes also video coaching and PA monitoring, and to evaluate its feasibility and user experience. Methods A system prototype was conceived by integrating applications for step-monitoring, behavioural change support, personal calendar, video-coaching and a cloud service for data management and co-ordination. Its feasibility and user experience were evaluated in three consecutive test periods combined with technical development. In total, 11 seniors tested the system at home for four weeks with video coaching from health care professionals. Results Initially, the system's feasibility was non-satisfactory due to insufficient stability and usability. However, most problems could be addressed and amended. In the third (last) test period, both seniors and coaches experienced the system prototype to be fun, flexible and awareness-raising. Interestingly, the video coaching which made the system unique compared to similar systems was highly appreciated. Nonetheless, even the users in the last test period highlighted issues due to insufficient usability, stability and flexibility. Further improvements in these areas are needed. Conclusions Video coaching in fall-preventive PA can be valuable for both seniors and health care professionals. High reliability, usability and flexibility of systems supporting seniors are essential.
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Affiliation(s)
- Å. Revenäs
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Centre for Clinical Research, Region Västmanland – Uppsala University, Västerås, Sweden
- Orthopedic Clinic Västerås Hospital, Region Västmanland, Västerås, Sweden
| | - L. Ström
- Livanda Internetkliniken AB, Ludvika, Sweden
| | - A. Cicchetti
- School of Innovation, Design and Engineering, Mälardalen University, Västerås, Sweden
| | - M. Ehn
- School of Innovation, Design and Engineering, Mälardalen University, Västerås, Sweden
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22
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Manning SE, Wang H, Dwibedi N, Shen C, Wiener RC, Findley PA, Mitra S, Sambamoorthi U. Association of multimorbidity with the use of health information technology. Digit Health 2023; 9:20552076231163797. [PMID: 37124332 PMCID: PMC10134133 DOI: 10.1177/20552076231163797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 02/25/2023] [Indexed: 05/02/2023] Open
Abstract
Objective To examine the association of multimorbidity with health information technology use among adults in the USA. Methods We used cross-sectional study design and data from the Health Information National Trends Survey 5 Cycle 4. Health information technology use was measured with ten variables comprising access, recent use, and healthcare management. Unadjusted and adjusted logistic and multinomial logistic regressions were used to model the associations of multimorbidity with health information technology use. Results Among adults with multimorbidity, health information technology use for specific purposes ranged from 37.8% for helping make medical decisions to 51.7% for communicating with healthcare providers. In multivariable regressions, individuals with multimorbidity were more likely to report general use of health information technology (adjusted odds ratios = 1.48, 95% confidence intervals = 1.01-2.15) and more likely to use health information technology to check test results (adjusted odds ratios = 1.85, 95% confidence intervals = 1.33-2.58) compared to adults with only one chronic condition, however, there were no significant differences in other forms of health information technology use. We also observed interactive associations of multimorbidity and age on various components of health information technology use. Compared to younger adults with multimorbidity, older adults (≥ 65 years of age) with multimorbidity were less likely to use almost all aspects of health information technology. Conclusion Health information technology use disparities by age and multimorbidity were observed. Education and interventions are needed to promote health information technology use among older adults in general and specifically among older adults with multimorbidity.
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Affiliation(s)
- Sydney E Manning
- Department of Pharmacotherapy, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Hao Wang
- Department of Emergency Medicine, JPS Health Network, Integrative Emergency Services, Fort Worth, TX, USA
- Hao Wang, Department of Emergency Medicine, JPS Health Network, Integrative Emergency Services, Fort Worth, TX, USA.
| | - Nilanjana Dwibedi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV, USA
| | - Chan Shen
- Department of Health Services Research, Penn State College of Medicine, Hershey, PA, USA
- Chan Shen, Department of Health Services Research, Penn State College of Medicine, Hershey, PA, USA.
| | - R Constance Wiener
- Department of Dental Public Health and Professional Practice, School of Dentistry, West Virginia University, Morgantown, WV, USA
| | | | - Sophie Mitra
- Department of Economics, Fordham University, Bronx, NY, USA
| | - Usha Sambamoorthi
- Department of Pharmacotherapy, College of Pharmacy, Texas Center for Health Disparities, University of North Texas Health Science Center, Fort Worth, TX, USA
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23
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Rój J. What Determines the Acceptance and Use of eHealth by Older Adults in Poland? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15643. [PMID: 36497717 PMCID: PMC9738782 DOI: 10.3390/ijerph192315643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
An aging population is considered a major challenge for governments and healthcare planners. eHealth is perceived as a tool with the potential to ensure efficient healthcare. Moreover, eHealth services may help older adults to maintain longer life in good health. However, there are still several challenges to the large-scale implementation of these solutions among older adults. Therefore, the aim of this study was to explore determinants of the acceptance and use of eHealth by older adults in Poland. Data was collected by the questionnaire, and the UTAUT model was employed. This research covered older adults aged 60 to 69. The analysis of the results using nested regression analysis showed that performance expectancy has a strong significance on the older adults' acceptance and use of eHealth, followed by effort expectancy and social influence. In contrast, facilitating conditions do not have a significant influence on the acceptance and use of eHealth. These findings may also be beneficial for the government to provide relative policies to support the development and usage of eHealth services as well as for the healthcare devices industry to design more older adult-oriented products.
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Affiliation(s)
- Justyna Rój
- Department of Operational Research and Mathematical Economics, The Poznań University of Economics and Business, Al. Niepodległości 10, 61-875 Poznań, Poland
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24
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O’Connor SR, Treanor C, Ward E, Wickens RA, O’Connell A, Culliford LA, Rogers CA, Gidman EA, Peto T, Knox PC, Burton BJL, Lotery AJ, Sivaprasad S, Reeves BC, Hogg RE, Donnelly M. Patient Acceptability of Home Monitoring for Neovascular Age-Related Macular Degeneration Reactivation: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13714. [PMID: 36294292 PMCID: PMC9603709 DOI: 10.3390/ijerph192013714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/19/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Neovascular age-related macular degeneration (nAMD) is a chronic, progressive condition and the commonest cause of visual disability in older adults. This study formed part of a diagnostic test accuracy study to quantify the ability of three index home monitoring (HM) tests (one paper-based and two digital tests) to identify reactivation in nAMD. The aim of this qualitative research was to investigate patients' or participants' views about acceptability and explore adherence to weekly HM. Semi-structured interviews were held with 78/297 participants (26%), with close family members (n = 11) and with healthcare professionals involved in training participants in HM procedures (n = 9) (n = 98 in total). A directed thematic analytical approach was applied to the data using a deductive and inductive coding framework informed by theories of technology acceptance. Five themes emerged related to: 1. The role of HM; 2. Suitability of procedures and instruments; 3. Experience of HM; 4. Feasibility of HM in usual practice; and 5. Impediments to patient acceptability of HM. Various factors influenced acceptability including a patient's understanding about the purpose of monitoring. While initial training and ongoing support were regarded as essential for overcoming unfamiliarity with use of digital technology, patients viewed HM as relatively straightforward and non-burdensome. There is a need for further research about how use of performance feedback, level of support and nature of tailoring might facilitate further the implementation of routinely conducted HM. Home monitoring was acceptable to patients and they recognised its potential to reduce clinic visits during non-active treatment phases. Findings have implications for implementation of digital HM in the care of older people with nAMD and other long-term conditions.
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Affiliation(s)
- Seán R. O’Connor
- School of Psychology, Queen’s University of Belfast, Belfast BT7 1NN, UK
| | - Charlene Treanor
- Centre for Public Health, Queen’s University of Belfast, Belfast BT12 6BA, UK
| | - Elizabeth Ward
- Bristol Trials Centre (CTEU), University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK
| | - Robin A. Wickens
- Bristol Trials Centre (CTEU), University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK
- Southampton Clinical Trials Unit, University of Southampton, University Road, Southampton SO17 1BJ, UK
| | - Abby O’Connell
- Exeter Clinical Trials Unit (EXECTU), University of Exeter, St. Lukes Campus, Exeter EX1 2LT, UK
| | - Lucy A. Culliford
- Bristol Trials Centre (CTEU), University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK
| | - Chris A. Rogers
- Bristol Trials Centre (CTEU), University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK
| | - Eleanor A. Gidman
- Bristol Trials Centre (CTEU), University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK
| | - Tunde Peto
- Centre for Public Health, Queen’s University of Belfast, Belfast BT12 6BA, UK
| | - Paul C. Knox
- Department of Eye and Vision Science, University of Liverpool, Liverpool L7 8TX, UK
| | | | - Andrew J. Lotery
- Department of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Sobha Sivaprasad
- NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London EC1V 2PD, UK
| | - Barnaby C. Reeves
- Bristol Trials Centre (CTEU), University of Bristol, Bristol Royal Infirmary, Bristol BS2 8HW, UK
| | - Ruth E. Hogg
- Centre for Public Health, Queen’s University of Belfast, Belfast BT12 6BA, UK
| | - Michael Donnelly
- Centre for Public Health, Queen’s University of Belfast, Belfast BT12 6BA, UK
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Trukeschitz B, Eisenberg S, Schneider C, Schneider U. Exploring the effectiveness of a fitness-app prototype for home care service users in Austria and Italy. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2884-e2895. [PMID: 35098601 PMCID: PMC9546286 DOI: 10.1111/hsc.13733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 12/23/2021] [Accepted: 01/08/2022] [Indexed: 06/14/2023]
Abstract
An infinite number of fitness apps are available on various app stores. However, hardly any of them are fitted to the needs and requirements of care-dependent people. This paper investigates the effectiveness of a customised fitness-app prototype for increasing physical activity in home care service users. Home care service users from Austria and Italy were randomly assigned to two groups. In total, 216 participants were involved in the field trial, 104 received a tablet with the fitness app and an activity tracker (treatment group), 112 did not (control group). Regularity of physical activity, frequency of fitness exercises and walking behaviour were self-reported by participants at baseline, after 4 months and after 8 months. In addition, the frequency of using the prototype was assessed based on the fitness app's logged usage data. We estimated multilevel mixed-effects ordered logistic models to examine the effects of the intervention. After 4 months, the intervention increased the home care users' probability of agreeing strongly with being physically active on a regular basis by 28 percentage points (p < 0.001; 95% CI: 0.20, 0.36) and their probability of reporting to exercise more than once a week by 45 percentage points (p < 0.001; 95% CI: 0.32, 0.57). Walking behaviour was not affected on group-level but improved for frequent users of the activity tracker. Frequent and regular users of the fitness app benefited most and effects persisted until the end of the 8 months controlled trial. Tailoring a fitness-app prototype to the needs of care-dependent people has the potential to support people with functional limitations to engage in a more active lifestyle. Future research is encouraged to seek further insights into how new technologies can support physical activities in people with long-term care needs.
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Affiliation(s)
- Birgit Trukeschitz
- Research Institute for Economics of AgingWU Vienna University of Economics and BusinessViennaAustria
| | - Siegfried Eisenberg
- Research Institute for Economics of AgingWU Vienna University of Economics and BusinessViennaAustria
| | - Cornelia Schneider
- Institute of Computer ScienceUniversity of Applied Sciences Wiener NeustadtWiener NeustadtAustria
| | - Ulrike Schneider
- Research Institute for Economics of AgingWU Vienna University of Economics and BusinessViennaAustria
- Institute for Social Policy and Research Institute for Economics of AgingWU Vienna University of Economics and BusinessViennaAustria
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Tegegne MD, Wubante SM. Identifying Barriers to the Adoption of Information Communication Technology in Ethiopian Healthcare Systems. A Systematic Review. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:821-828. [PMID: 35959138 PMCID: PMC9362847 DOI: 10.2147/amep.s374207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/29/2022] [Indexed: 05/27/2023]
Abstract
BACKGROUND Ethiopia's government has planned to digitize the healthcare industry. However, most implementations fail due to various technological and personnel barriers. As a result, this systematic review aimed to comprehensively examine evidence regarding the barriers to adopting information communication technology in the Ethiopian healthcare system. METHODS This systematic review was conducted by searching the major databases, such as Medline, PubMed, Scopus, Science Direct, Google, Google Scholar, and other online databases. The authors looked for, analyzed, and summarized information about barriers to ICT adoption in the healthcare system. This study included nine articles that described barriers to ICT adoption in the Ethiopian healthcare system. RESULTS This systematic review identified 15 barriers to adopting ICT in the healthcare system. The reviewed articles looked into technological barriers to ICT adoption, such as ICT skill, ICT knowledge, a lack of training opportunities, a lack of computer literacy, a lack of computer access, inadequate internet connectivity, and a lack of experience with ICT were cited as barriers to ICT implementation in Ethiopia's healthcare system. Furthermore, organizational components such as Lack of job satisfaction, Lack of Refreshment training, poor staff initiation, management problem, poor infrastructure, and lack of resources remained barriers to ICT adoption in Ethiopia's healthcare system. CONCLUSION This review confirmed that lack of training in ICT, poor ICT knowledge, Poor ICT skill, and a lack of computer access were the most common barriers to adopting ICT in the Ethiopian healthcare system. Therefore, it is recommended that the emphasized barriers to ICT adoption be addressed in order to modernize the current Ethiopian healthcare system.
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Affiliation(s)
- Masresha Derese Tegegne
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sisay Maru Wubante
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Berridge C, Zhou Y, Lazar A, Porwal A, Mattek N, Gothard S, Kaye J. Control Matters in Elder Care Technology:: Evidence and Direction for Designing It In. DIS. DESIGNING INTERACTIVE SYSTEMS (CONFERENCE) 2022; 2022:1831-1848. [PMID: 35969716 PMCID: PMC9367632 DOI: 10.1145/3532106.3533471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Studies find that older adults want control over how technologies are used in their care, but how it can be operationalized through design remains to be clarified. We present findings from a large survey (n=825) of a well-characterized U.S. online cohort that provides actionable evidence of the importance of designing for control over monitoring technologies. This uniquely large, age-diverse sample allows us to compare needs across age and other characteristics with insights about future users and current older adults (n=496 >64), including those concerned about their own memory loss (n=201). All five control options, which are not currently enabled, were very or extremely important to most people across age. Findings indicate that comfort with a range of care technologies is contingent on having privacy- and other control-enabling options. We discuss opportunities for design to meet these user needs that demand course correction through attentive, creative work.
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When less intergenerational closeness helps: The influence of intergenerational physical proximity and technology attributes on technophobia among older adults. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bose S, Dun C, Zhang GQ, Walsh C, Makary MA, Hicks CW. Medicare Beneficiaries In Disadvantaged Neighborhoods Increased Telemedicine Use During The COVID-19 Pandemic. Health Aff (Millwood) 2022; 41:635-642. [PMID: 35500186 PMCID: PMC9843604 DOI: 10.1377/hlthaff.2021.01706] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Anticipating a growing need for health care during the COVID-19 pandemic, the Centers for Medicare and Medicaid Services expanded telemedicine coverage in the United States on March 6, 2020. In this study we used roughly thirty million Medicare fee-for-service claims to quantify outpatient telemedicine use before and after the Medicare telemedicine coverage waiver and to examine the association of telemedicine use with the Area Deprivation Index, a comprehensive measure of neighborhood socioeconomic disadvantage. Before the waiver, 0.42 percent of patients had at least one outpatient telemedicine visit, with no significant differences between people residing in the most versus the least disadvantaged neighborhoods. With the waiver, 9.97 percent of patients had at least one outpatient telemedicine visit, with the highest odds of utilization seen for people residing in the most disadvantaged neighborhoods. After adjustment, our data suggest that the coverage waiver increased access to telemedicine for all Medicare populations, including people residing in the most disadvantaged neighborhoods, although the odds of use were persistently lower with increasing age. Overall, these findings are encouraging, but they illuminate a need for targeted interventions to improve telemedicine access further.
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Affiliation(s)
- Sanuja Bose
- Johns Hopkins University, Baltimore, Maryland
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Aguilar-Latorre A, Oliván-Blázquez B, Porroche-Escudero A, Méndez-López F, García-Gallego V, Benedé-Azagra B, Magallón-Botaya R. The impact of the COVID-19 lockdown on depression sufferers: a qualitative study from the province of Zaragoza, Spain. BMC Public Health 2022; 22:780. [PMID: 35436858 PMCID: PMC9015282 DOI: 10.1186/s12889-022-13083-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 03/21/2022] [Indexed: 12/05/2022] Open
Abstract
Background and purpose The impact of COVID-19 and its control measures have exacerbated existing mental health conditions. Although the deleterious effects of mental health problems are well known, fewer studies have examined the links between the Social Determinants of Health (SDHs) and depression. This study provides insights into the relationship between SDHs and depression during the first strict lockdown in Spain, which lasted for a period of 7 weeks. Methods Fifty-two structured interviews were conducted with people diagnosed with depression during June 2020 in the province of Zaragoza (Spain). Interviews were conducted by telephone due to lockdown constraints. Inductive thematic content analysis was used to explore, develop, and define emergent categories of analysis, which were mapped against the SDH framework. Results Listening to people’s experiences of living with depression during lockdown provided insights into their concerns and coping strategies, which are greatly influenced by the conditions in which they live, their job and their age. Examples of these factors include access to and quality of physical spaces, including housing conditions and public spaces for socialising, social support, adverse working conditions which include caring responsibilities, and access to digital technologies and healthcare services. Conclusion SDHs have played a fundamental role in shaping people’s health and well-being during the COVID-19 pandemic, and this study has shown that they have a considerable effect on depression outcomes. Governments should consider implementing social welfare programs to tackle both psychosocial problems and material need during crisis situations.
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Affiliation(s)
| | - Bárbara Oliván-Blázquez
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain. .,Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain.
| | | | | | | | - Belén Benedé-Azagra
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.,Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Rosa Magallón-Botaya
- Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.,Aragonese Healthcare Service (SALUD), Zaragoza, Spain.,Department of Medicine, Psychiatry and Dermatology, University of Zaragoza, Zaragoza, Spain
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Venegas MD, Brooks JM, Myers AL, Storm M, Fortuna KL. Peer Support Specialists and Service Users' Perspectives on Privacy, Confidentiality, and Security of Digital Mental Health. IEEE PERVASIVE COMPUTING 2022; 21:41-50. [PMID: 35814864 PMCID: PMC9267391 DOI: 10.1109/mprv.2022.3141986] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
As the digitalization of mental health systems progresses, the ethical and social debate on the use of these mental health technologies has seldom been explored among end-users. This article explores how service users (e.g., patients and users of mental health services) and peer support specialists understand and perceive issues of privacy, confidentiality, and security of digital mental health interventions. Semi-structured qualitative interviews were conducted among service users (n = 17) and peer support specialists (n = 15) from a convenience sample at an urban community mental health center in the United States. We identified technology ownership and use, lack of technology literacy including limited understanding of privacy, confidentiality, and security as the main barriers to engagement among service users. Peers demonstrated a high level of technology engagement, literacy of digital mental health tools, and a more comprehensive awareness of digital mental health ethics. We recommend peer support specialists as a potential resource to facilitate the ethical engagement of digital mental health interventions for service users. Finally, engaging potential end-users in the development cycle of digital mental health support platforms and increased privacy regulations may lead the field to a better understanding of effective uses of technology for people with mental health conditions. This study contributes to the ongoing debate of digital mental health ethics, data justice, and digital mental health by providing a first-hand experience of digital ethics from end-users' perspectives.
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Affiliation(s)
- Maria D Venegas
- Department of Veterans Affairs GRECC, Bedford, VA, 01730, USA
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Chua CH, Seow FCL, Tang FMA, Lim LM. Factors affecting telepractice use in COVID-19. PROCEEDINGS OF SINGAPORE HEALTHCARE 2022. [PMCID: PMC8872815 DOI: 10.1177/20101058221074120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background The use of telepractice as an alternate method of delivering healthcare to people increased significantly after COVID-19 became a global pandemic. Objectives This study aimed to identify factors contributing to the accelerated adoption of telepractice during COVID-19 in Singapore. It also sought to examine whether there are differences in the perspectives of staff in nursing facilities and caregivers in personal homes towards telepractice. Methods A cross-sectional mixed method design was used. A survey with 20 items was adapted from the Telehealth Usability Questionnaire and translated into Mandarin. Anonymous responses were obtained from 70 patients and caregivers who had received speech therapy services via telepractice from a restructured hospital before and/or during Singapore’s Circuit Breaker period. Analyses were conducted using descriptive statistics and content analysis. Results Sociodemographic variables of age, gender, education level and language preference did not impact user satisfaction and the likelihood of using telepractice again. Service-related factors were more influential. Participants chose to use telepractice as it saved travelling time (24.0%), was easy to use (19.3%), improved healthcare access (17.5%) and reduced waiting time (17.5%). Although all respondents expressed satisfaction in telepractice, 35.5% from personal homes and 37.5% from nursing facilities were not keen to use it again. Amongst caregivers, 26.7% from personal homes and 37.5% from nursing facilities preferred not to continue telepractice use. Technical and logistical disruptions and the lack of ‘personal touch’ were contributing factors. Conclusion Improving technological infrastructure, providing training for users and developing guidelines would help sustain telepractice as a form of service delivery beyond COVID-19.
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Affiliation(s)
- Christine H Chua
- Speech Therapy Department, Tan Tock Seng Hospital, Singapore, Singapore
| | - Ferlin CL Seow
- Speech Therapy Department, Tan Tock Seng Hospital, Singapore, Singapore
| | - Florence MA Tang
- Speech Therapy Department, Tan Tock Seng Hospital, Singapore, Singapore
| | - Li Mei Lim
- Rehabilitation Centre, Tan Tock Seng Hospital, Singapore, Singapore
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Budhwani S, Fujioka J, Thomas-Jacques T, De Vera K, Challa P, De Silva R, Fuller K, Shahid S, Hogeveen S, Chandra S, Bhatia RS, Seto E, Shaw J. Challenges and strategies for promoting health equity in virtual care: findings and policy directions from a scoping review of reviews. J Am Med Inform Assoc 2022; 29:990-999. [PMID: 35187571 PMCID: PMC9006706 DOI: 10.1093/jamia/ocac022] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/12/2022] [Accepted: 02/16/2022] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE We sought to understand and synthesize review-level evidence on the challenges associated with accessibility of virtual care among underserved population groups and to identify strategies that can improve access to, uptake of, and engagement with virtual care for these populations. MATERIALS AND METHODS A scoping review of reviews was conducted (protocol available at doi: 10.2196/22847). A total of 14 028 records were retrieved from MEDLINE, EMBASE, CINAHL, Scopus, and Epistemonikos databases. Data were abstracted, and challenges and strategies were identified and summarized for each underserved population group and across population groups. RESULTS A total of 37 reviews were included. Commonly occurring challenges and strategies were grouped into 6 key thematic areas based on similarities across communities: (1) the person's orientation toward health-related needs, (2) the person's orientation toward health-related technology, (3) the person's digital literacy, (4) technology design, (5) health system structure and organization, and (6) social and structural determinants of access to technology-enabled care. We suggest 4 important directions for policy development: (1) investment in digital health literacy education and training, (2) inclusive digital health technology design, (3) incentivizing inclusive digital health care, and (4) investment in affordable and accessible infrastructure. DISCUSSION AND CONCLUSION Challenges associated with accessibility of virtual care among underserved population groups can occur at the individual, technological, health system, and social/structural determinant levels. Although the policy approaches suggested by our review are likely to be difficult to achieve in a given policy context, they are essential to a more equitable future for virtual care.
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Affiliation(s)
- Suman Budhwani
- Women’s College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada
| | - Jamie Fujioka
- Women’s College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada
| | - Tyla Thomas-Jacques
- Women’s College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada
| | - Kristina De Vera
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Priyanka Challa
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Ryan De Silva
- Women’s College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada
| | - Kaitlin Fuller
- University of Toronto Libraries, University of Toronto, Toronto, Ontario, Canada
| | - Simone Shahid
- Women’s College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada
| | - Sophie Hogeveen
- Women’s College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada
| | - Shivani Chandra
- Women’s College Hospital Institute for Health System Solutions and Virtual Care, Toronto, Ontario, Canada
| | - R Sacha Bhatia
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada,Ontario Health, Toronto, Ontario, Canada
| | - Emily Seto
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada,Centre for Global eHealth Innovation, University Health Network, Techna Institute, Toronto, Ontario, Canada
| | - James Shaw
- Corresponding Author: James Shaw, PhD, Women’s College Hospital Institute for Health System Solutions & Virtual Care, 76 Grenville Street, Toronto, ON M5S 1B3, Canada;
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Perdana A, Mokhtar IA. Seniors' adoption of digital devices and virtual event platforms in Singapore during Covid-19. TECHNOLOGY IN SOCIETY 2022; 68:101817. [PMID: 34785827 PMCID: PMC8588606 DOI: 10.1016/j.techsoc.2021.101817] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/18/2021] [Accepted: 11/08/2021] [Indexed: 05/27/2023]
Abstract
In Singapore, with the nationwide implementation of Covid-19 physical restrictions and safe management measures (SMMs) in place because of the pandemic, the seniors' regular routines and daily social activities have been disrupted. Prior research on seniors' adoption of digital technologies has primarily focused on health-related purposes such as nutrition and exercise and managing old-age related diseases. However, there is limited research done to understand how seniors use digital technologies for other purposes, such as social networks or leisure activities, that can help seniors socialise and reduce loneliness despite ongoing SMMs and restrictions on social distancing and physical interactions because of the Covid-19 pandemic. In particular, the use of virtual event platforms can make it easier for seniors to communicate and socialise with their peers, thus keeping social isolation and loneliness at bay. In this paper, we discuss seniors' relationship with technology, guided by the social exchange theory. We also share the methodological framework that guided this small-scale study on the use of virtual event platforms, along with the research instruments and measurements required for data collection. The research findings of this study, conducted with 144 respondents aged 60 years old and above, are discussed and further analysed with their theoretical contributions and implications for practice.
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Affiliation(s)
- Arif Perdana
- Monash University, Indonesia
- Singapore Institute of Technology, Singapore
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Yu J, de Antonio A, Villalba-Mora E. Design of an Integrated Acceptance Framework for Older Users and eHealth: Influential Factor Analysis. J Med Internet Res 2022; 24:e31920. [PMID: 35089155 PMCID: PMC8838594 DOI: 10.2196/31920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/21/2021] [Accepted: 11/27/2021] [Indexed: 11/16/2022] Open
Abstract
Background eHealth and telehealth play a crucial role in assisting older adults who visit hospitals frequently or who live in nursing homes and can benefit from staying at home while being cared for. Adapting to new technologies can be difficult for older people. Thus, to better apply these technologies to older adults’ lives, many studies have analyzed the acceptance factors for this particular population. However, there is not yet a consensual framework that can be used in further development and to search for solutions. Objective This paper aims to present an integrated acceptance framework (IAF) for older users’ acceptance of eHealth based on 43 studies selected through a systematic review. Methods We conducted a 4-step study. First, through a systematic review in the field of eHealth from 2010 to 2020, the acceptance factors and basic data for analysis were extracted. Second, we conducted a thematic analysis to group the factors into themes to propose an integrated framework for acceptance. Third, we defined a metric to evaluate the impact of the factors addressed in the studies. Finally, the differences among the important IAF factors were analyzed according to the participants’ health conditions, verification time, and year. Results Through a systematic review, 731 studies were found in 5 major databases, resulting in 43 (5.9%) selected studies using the PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) methodology. First, the research methods and acceptance factors for eHealth were compared and analyzed, extracting a total of 105 acceptance factors, which were grouped later, resulting in an IAF. A total of 5 dimensions (ie, personal, user–technology relational, technological, service-related, and environmental) emerged, with a total of 23 factors. In addition, we assessed the quality of evidence and then conducted a stratification analysis to reveal the more appropriate factors depending on the health condition and assessment time. Finally, we assessed the factors and dimensions that have recently become more important. Conclusions The result of this investigation is a framework for conducting research on eHealth acceptance. To elaborately analyze the impact of the factors of the proposed framework, the criteria for evaluating the evidence from the studies that have the extracted factors are presented. Through this process, the impact of each factor in the IAF has been presented, in addition to the framework proposal. Moreover, a meta-analysis of the current status of research is presented, highlighting the areas where specific measures are needed to facilitate eHealth acceptance.
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Affiliation(s)
- Jiyeon Yu
- Research Group on Human-Computer Interaction and Advanced Interactive Systems, Madrid HCI Lab, Universidad Politécnica de Madrid, Madrid, Spain
| | - Angelica de Antonio
- Research Group on Human-Computer Interaction and Advanced Interactive Systems, Madrid HCI Lab, Universidad Politécnica de Madrid, Madrid, Spain
| | - Elena Villalba-Mora
- Centre for Biomedical Technology (CTB), Universidad Politécnica de Madrid, Madrid, Spain.,Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
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Martín-García AV, Redolat R, Pinazo-Hernandis S. Factors Influencing Intention to Technological Use in Older Adults. The TAM Model Aplication. Res Aging 2021; 44:573-588. [PMID: 34962846 DOI: 10.1177/01640275211063797] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The use of digital technology by older adults has improved in recent years in response to the need for their functional adaptation to an increasingly technological social context. Understanding this type of technological adaptation has recently become an important field of inquiry in both social and gerontological studies. Working within this framework, the aim of this study is to identify the main determinants that influence the intention of older people to use digital technology in their daily lives, using the Technological Acceptance Model. A study was carried out with the participation of 1155 people over 65 years of age in Spain. Confirmatory Factor Analysis and structural equation models (SEM) were performed. The results show that the TAM is a useful model to explain the intention of older adults to use Digital Technology, showing a high predictive power, highlighting Perceived Usefulness and Perceived Ease of Use as the main predictor variables.
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Affiliation(s)
| | - Rosa Redolat
- Department of Psychobiology, 16781University of Valencia, Valencia, Spain
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Svistova J, Harris C, Fogarty B, Kulp C, Lee A. Use of Telehealth Amid the COVID-19 Pandemic: Experiences of Mental Health Providers Serving Rural Youth and Elderly in Pennsylvania. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 49:530-538. [PMID: 34846613 PMCID: PMC8630285 DOI: 10.1007/s10488-021-01181-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 11/13/2022]
Abstract
Stay-at-home orders and public health safety concerns precipitated by the COVID-19 pandemic facilitated rapid changes in policy and reimbursement regulations and resulted in the sudden uptake of telehealth in mental health practices across the United States. This study explored how mental health service providers experienced the use of telehealth in serving their rural clients who are youth and older adults. A purposive sampling strategy was employed to identify and recruit mental health service providers and insurance agency representatives for this study. By means of online focus groups, this statewide study explored the experiences of 147 mental health and public insurance providers using telehealth to serve rural youth and elderly in Pennsylvania amid the pandemic in 2020. NVivo 12 qualitative analysis software was used in data analysis. The findings suggest that telehealth is perceived as both: silver linings during the pandemic (service continuation during the pandemic, improved parental involvement and responsiveness, easing the transportation challenges, and decrease in no-show rates) and some roadblocks to success (Not for every youth!, Technology challenges among the older adults, and “Dead zones” without internet and cellphone reception). Policy and practice recommendations are suggested including incentives for proactive telehealth uptake, telehealth parity laws and reimbursement policies, and incentivizing innovative use of technology for specific populations and therapeutic modalities. Continuous policy support and organizational efforts to provide customized telemental health are called for to remediate rural disparities in access to mental health services beyond the pandemic period.
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Affiliation(s)
- Juliana Svistova
- Department of Social Work, Kutztown University of Pennsylvania, 15200 Kutztown Rd, Kutztown, PA, 19530, USA
| | - Christopher Harris
- Department of Social Work, Kutztown University of Pennsylvania, 15200 Kutztown Rd, Kutztown, PA, 19530, USA
| | - Barbe Fogarty
- Department of Social Work, Kutztown University of Pennsylvania, 15200 Kutztown Rd, Kutztown, PA, 19530, USA
| | - Christina Kulp
- Department of Social Work, Kutztown University of Pennsylvania, 15200 Kutztown Rd, Kutztown, PA, 19530, USA
| | - Ahyoung Lee
- Ewha Institute for Age Integration Research, Ewha Womans University, 52, Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Korea.
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Dagher L, Nedunchezhian S, El Hajjar AH, Zhang Y, Deffer O, Russell A, Pottle C, Marrouche N. A Cardiovascular Clinic Patients' Survey to Assess Challenges and Opportunities of Digital Health Adoption During the COVID-19 Pandemic Digital Health Survey During COVID-19. CARDIOVASCULAR DIGITAL HEALTH JOURNAL 2021; 3:31-39. [PMID: 34812430 PMCID: PMC8600804 DOI: 10.1016/j.cvdhj.2021.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background COVID-19 boosted healthcare digitalization and personalization in cardiology. However, understanding patient attitudes and engagement behaviors is essential to achieve successful acceptance and implementation of digital health technologies in personalized care. Objective This study aims to understand current and future trends in wearable device and telemedicine use in the cardiology clinic patient population, recognize patients’ attitude towards digital health before and after COVID-19, and identify potential socioeconomic and racial/ethnic differences in adoption of digital health tools in a New Orleans patient population. Methods A cross-sectional survey was distributed to Tulane Cardiology Clinic patients between September 2020 and January 2021. Basic demographic information, medical comorbidities, device usage, and opinions on digital health tools were collected. Results Survey responses from 299 participants (average age = 54 years, 50.8% female, 24.4% African American) showed that digital health use was more prevalent in younger, healthier, and more educated individuals. Wearable use was also higher among White patients compared to African American patients. Patients cited costs and technology knowledge as primary deterrents for using wearables, despite being more inclined to use wearables for disease monitoring (41%). While wearable use did not increase after COVID-19 (36.6% pre-COVID vs 35.4% post-COVID, P = .77), telemedicine use rose significantly (10.8% pre-COVID vs 24.3% during COVID, P < .0001). Patients mostly noted telemedicine’s effectiveness in overcoming difficult healthcare access barriers. Additionally, most patients are in support of wearables and telemedicine either complementing or replacing routine tests and traditional clinical visits. Conclusion Demographic and socioeconomic disparities negatively impact wearable health device and telemedicine adoption within cardiovascular clinic patients. Although telemedicine use increased after COVID-19, this effect was not observed for wearables, reflecting significant economic and digital literacy challenges underlying wearable acceptance.
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Affiliation(s)
- Lilas Dagher
- Tulane Research Innovation and Arrhythmia Discoveries- TRIAD Center. Tulane University School of Medicine, New Orleans, LA, USA
| | - Saihariharan Nedunchezhian
- Tulane Research Innovation and Arrhythmia Discoveries- TRIAD Center. Tulane University School of Medicine, New Orleans, LA, USA
| | - Abdel Hadi El Hajjar
- Tulane Research Innovation and Arrhythmia Discoveries- TRIAD Center. Tulane University School of Medicine, New Orleans, LA, USA
| | - Yichi Zhang
- Tulane Research Innovation and Arrhythmia Discoveries- TRIAD Center. Tulane University School of Medicine, New Orleans, LA, USA
| | - Orlando Deffer
- Tulane Research Innovation and Arrhythmia Discoveries- TRIAD Center. Tulane University School of Medicine, New Orleans, LA, USA
| | - Ashley Russell
- Tulane Research Innovation and Arrhythmia Discoveries- TRIAD Center. Tulane University School of Medicine, New Orleans, LA, USA
| | - Christopher Pottle
- Tulane Research Innovation and Arrhythmia Discoveries- TRIAD Center. Tulane University School of Medicine, New Orleans, LA, USA
| | - Nassir Marrouche
- Tulane Research Innovation and Arrhythmia Discoveries- TRIAD Center. Tulane University School of Medicine, New Orleans, LA, USA
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Dash A, Sahoo AK. Physician’s perception of E-consultation adoption amid of COVID-19 pandemic. VINE JOURNAL OF INFORMATION AND KNOWLEDGE MANAGEMENT SYSTEMS 2021. [DOI: 10.1108/vjikms-06-2021-0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to investigate physicians’ perceptions of e-consultation adoption, which has the potential to bridge existing gaps in the current health-care system, using the unified theory of acceptance and use of technology (UTAUT2) framework.
Design/methodology/approach
The judgemental sampling method was embraced to collect primary data from 337 physicians from Delhi-National Capital Region who had experience with e-consultation. A number of hypotheses was developed and tested using structural equation model based on UTAUT2.
Findings
The study’s findings revealed an affirmative and significant relation between a physician’s intention to embrace e-consultation and facilitating conditions, effort expectancy, social influence and performance expectancy; however, habit and experience are not significantly linked to it.
Originality/value
This study will not only add to the existing body of knowledge about e-consultation adoption, but it will also assist electronic health service providers in devising strategies to encourage the usage of e-consultation services in emerging economies such as India where people are deprived of the right to access better health care due to lack of physical infrastructure.
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Park M, Bui LK, Jeong M, Choi EJ, Lee N, Kwak M, Kim J, Kim J, Jung J, Giap TTT, Guk H, Na J. ICT-based person-centered community care platform (IPC3P) to enhance shared decision-making for integrated health and social care services. Int J Med Inform 2021; 156:104590. [PMID: 34619572 DOI: 10.1016/j.ijmedinf.2021.104590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/08/2021] [Accepted: 09/19/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Community care is a care model with the aim of shifting care services from being hospital based toward community-based care. Advances in platforms based on information and communications technology (ICT) with a person-centered approach provide the potential to improve the delivery of health and social care services toward community-based settings. OBJECTIVES The aims of this study were to describe the ICT-Based Person-Centered Community Care Platform (IPC3P) and to determine its impact on health- and social-care-related shared decision-making and quality of life among community residents. METHODS An online platform was developed with the aim of enhancing community care. The platform had four components: (1) comprehensive health and social needs assessment system, (2) personalized community care planning, (3) needs-based health and social care services delivery, and (4) health community engagement. Community residents were invited to use and evaluate the impact of the IPC3P on their quality of life and shared decision-making regarding health and social care services. They provided feedback about the platform by completing two surveys: at baseline (before using the platform) and 6 months after using the platform. RESULTS Data of 164 community residents were analyzed in this study. Between baseline and after using the platform, the quality of life reported by the participants increased significantly in all domains, with clear improvements also noted for shared decision-making about health and social care services. The IPC3P received positive feedback from the participants for its usability, familiarity, and ease of use. Some participants also reported their desire for the addition of more functions that support health communities. CONCLUSION The IPC3P has the potential to enhance the involvement of community residents in their own care. The findings of this study can be used to support the wider implementation of the IPC3P to promote person-centered community care.
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Affiliation(s)
- Myonghwa Park
- CNU Community Care Center, College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Linh Khanh Bui
- CNU Community Care Center, College of Nursing, Chungnam National University, Daejeon, Republic of Korea.
| | - Miri Jeong
- Department of Nursing, Joongbu University, Geumsan, Republic of Korea
| | - Eun Jeong Choi
- Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Nayoung Lee
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea; Dongtan City Hospital, Gyeonggi-do, Republic of Korea
| | - Minjung Kwak
- College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Jahyeon Kim
- CNU Community Care Center, College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Jinju Kim
- CNU Community Care Center, College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Jihye Jung
- CNU Community Care Center, College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Thi-Thanh-Tinh Giap
- CNU Community Care Center, College of Nursing, Chungnam National University, Daejeon, Republic of Korea
| | - Hyunjeong Guk
- Mindlle Health Welfare Social Cooperative, Daejeon, Republic of Korea
| | - Junsik Na
- Mindlle Health Welfare Social Cooperative, Daejeon, Republic of Korea
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Huang H, Chen Z, Cao S, Xiao M, Xie L, Zhao Q. Adoption Intention and Factors Influencing the Use of Gerontechnology in Chinese Community-Dwelling Older Adults: A Mixed-Methods Study. Front Public Health 2021; 9:687048. [PMID: 34604153 PMCID: PMC8484701 DOI: 10.3389/fpubh.2021.687048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/11/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To explore the Chinese community-dwelling intention of older adults to adopt gerontechnology and its influencing factors. Design: A mixed-methods sequential explanatory design with an inductive approach was employed. In phase 1, a self-made questionnaire was administered from August 2018 to December 2019. Multifactor logistic regression was used to analyze the adoption intention and factors influencing the use of gerontechnology. In phase 2, participants completed a semistructured interview to explore the adoption intention of a specific form of gerontechnology, Smart Aged Care Platform, from May to July 2020. Setting: Twelve communities in three districts of Chongqing, China. Participants: Community-dwelling older adults were included. Results: A total of 1,180 older adults completed the quantitative study; two-thirds of them (68.7%) showed adoption intention toward gerontechnology. Nineteen participants (10 users and nine nonusers) completed the qualitative study and four themes were explored. Through a summarized understanding of the qualitative and quantitative data, a conceptual model of influencing factors, namely, predictive, enabling, and need factors, was constructed. Conclusions: This study reveals that most Chinese community-dwelling older adults welcome the emergence of new technologies. However, there was a significant difference in the adoption intention of gerontechnology in Chinese community-dwelling older adults based on their sociodemographic and psychographic characteristics. Our findings extend previous technology acceptance models and theories and contribute to the existing resource base.
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Affiliation(s)
- Huanhuan Huang
- First Clinical College, Chongqing Medical University, Chongqing, China.,Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhiyu Chen
- First Clinical College, Chongqing Medical University, Chongqing, China.,Department of Orthopedic, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Songmei Cao
- First Clinical College, Chongqing Medical University, Chongqing, China.,Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Liling Xie
- Department of Nursing, The First Branch of First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Scheerens C, Gilissen J, Volow AM, Powell JL, Ferguson CM, Farrell D, Li B, Berry C, Sudore RL. Developing eHealth tools for diverse older adults: Lessons learned from the PREPARE for Your Care Program. J Am Geriatr Soc 2021; 69:2939-2949. [PMID: 34081773 PMCID: PMC8497394 DOI: 10.1111/jgs.17284] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/03/2021] [Accepted: 05/03/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND/OBJECTIVES Electronic Health (eHealth) tools offer opportunities for people to access health information online; yet, most tools are not designed to meet the unique needs of diverse older adults, leading to health disparities. Our goal was to provide guidance for the development of eHealth tools for diverse older populations for use in geriatric care models. DESIGN Guidance for eHealth tools was compiled from user design resources and eHealth design literature. Pragmatic examples were provided from an evidenced-based eHealth tool called PREPAREforYourCare.org (PREPARE). We used quantitative feasibility data from PREPARE research studies and qualitative analysis of PREPARE focus groups, cognitive interviews, and feedback from randomized trials to further inform our recommendations. RESULTS Guidance and lessons learned include: (1) define clear objectives and a conceptual framework; (2) co-create with the target population; (3) optimize the design and layout for accessibility and ease of use, such as text at the 5th grade reading level, closed captioning, etc.; (4) use simple, standardized navigation design; (5) use actionable information to enhance behavior change, such as modeling of behaviors; (6) align accompanying written materials with the eHealth tool; and (7) create tracking mechanisms for ongoing user feedback. PREPARE is used as a case example to provide pragmatic illustrations for how the guidance may be operationalized. CONCLUSION eHealth tools can be tailored to the unique characteristics, preferences, and needs of diverse older populations. Following the "lessons learned" may help decrease health disparities among diverse older adults and ensure eHealth tools are readily accessible and culturally appropriate.
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Affiliation(s)
- Charlotte Scheerens
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
- Department of Public Health and Primary Health Care, Ghent University, Ghent, Belgium
| | - Joni Gilissen
- Department of Public Health and Primary Health Care, Ghent University, Ghent, Belgium
- Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute (GBHI), University of California, San Francisco, California, USA
| | - Aiesha M Volow
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
| | - Jana L Powell
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
| | - Clarissa M Ferguson
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
| | | | - Brookelle Li
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
| | | | - Rebecca L Sudore
- Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
- Innovation and Implementation Center on Aging and Palliative Care, Division of Geriatrics, University of California, San Francisco, California, USA
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[Adherence to digital health interventions: definitions, methods, and open questions]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:1278-1284. [PMID: 34559252 PMCID: PMC8492574 DOI: 10.1007/s00103-021-03415-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 08/23/2021] [Indexed: 02/08/2023]
Abstract
Many digital interventions rely on the participation of their users to have a positive impact. In various areas it can be observed that the use of digital interventions is often reduced or fully discontinued by the users after a short period of time. This is seen as one of the main factors that can limit the effectiveness of digital interventions. In this context, the concept of adherence to digital interventions is becoming increasingly important. Adherence to digital interventions is roughly defined as "the degree to which the user followed the program as it was designed," which can also be paraphrased as "intended use" or "use as it is designed." However, both the theoretical-conceptual and practical discussions regarding adherence to digital interventions still receive too little attention.The aim of this narrative review article is to shed more light on the concept of adherence to digital interventions and to distinguish it from related concepts. It also discusses the methods and metrics that can be used to operationalize adherence and the predictors that positively influence adherence. Finally, needs for action to better address adherence are considered critically.
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44
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Dash A, Sahoo AK. Moderating effect of gender on adoption of digital health consultation: a patient perspective study. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2021. [DOI: 10.1108/ijphm-01-2021-0012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to understand the factors influencing the adoption decision of patients towards digital consultation in India with gender as a moderating variable. This study is based on the unified theory of acceptance and use of technology (UTAUT2) framework for examining the factors influencing adoption decisions for digital consultation and to what extent this leads to continuous usage intention.
Design/methodology/approach
Based on the UTAUT2 framework, this study proposed a set of hypotheses that were tested using structural equation modeling. This study was based on primary data collected from 462 sample respondents using the judgemental sampling method who had experience of using digital health consultation in India.
Findings
Findings of this study revealed significant and positive causation in the behavioural intention (BI) of a patient to adopt digital health consultation arising out of performance expectancy, effort expectancy, social influence, facilitating condition and price value; however, habit is insignificantly associated with the same. Furthermore, the results of this study also revealed that the BI of a patient towards digital health consultation is significantly moderated by their gender.
Originality/value
This study conceptually strengthens the present body of literature on the adoption behaviour by contributing certain new dimensions in the context of digital health consultations and will also help policymakers and service providers in crafting their strategy for promoting the adoption of digital health consultation.
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Mendez KJW, Budhathoki C, Labrique AB, Sadak T, Tanner EK, Han HR. Factors Associated With Intention to Adopt mHealth Apps Among Dementia Caregivers With a Chronic Condition: Cross-sectional, Correlational Study. JMIR Mhealth Uhealth 2021; 9:e27926. [PMID: 34463637 PMCID: PMC8441609 DOI: 10.2196/27926] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 04/26/2021] [Accepted: 06/04/2021] [Indexed: 12/19/2022] Open
Abstract
Background In the United States, nearly 80% of family caregivers of people with dementia have at least one chronic condition. Dementia caregivers experience high stress and burden that adversely affect their health and self-management. mHealth apps can improve health and self-management among dementia caregivers with a chronic condition. However, mHealth app adoption by dementia caregivers is low, and reasons for this are not well understood. Objective The purpose of this study is to explore factors associated with dementia caregivers’ intention to adopt mHealth apps for chronic disease self-management. Methods We conducted a cross-sectional, correlational study and recruited a convenience sample of dementia caregivers. We created a survey using validated instruments and collected data through computer-assisted telephone interviews and web-based surveys. Before the COVID-19 pandemic, we recruited dementia caregivers through community-based strategies, such as attending community events. After nationwide closures due to the pandemic, the team focused on web-based recruitment. Multiple logistic regression analyses were used to test the relationships between the independent and dependent variables. Results Our sample of 117 caregivers had an average age of 53 (SD 17.4) years, 16 (SD 3.3) years of education, and 4 (SD 2.5) chronic conditions. The caregivers were predominantly women (92/117, 78.6%) and minorities (63/117, 53.8%), experienced some to extreme income difficulties (64/117, 54.7%), and were the child or child-in-law (53/117, 45.3%) of the person with dementia. In logistic regression models adjusting for the control variables, caregiver burden (odds ratio [OR] 1.3, 95% CI 0.57-2.8; P=.57), time spent caregiving per week (OR 1.7, 95% CI 0.77-3.9; P=.18), and burden of chronic disease and treatment (OR 2.3, 95% CI 0.91-5.7; P=.08) were not significantly associated with the intention to adopt mHealth apps. In the final multiple logistic regression model, only perceived usefulness (OR 23, 95% CI 5.6-97; P<.001) and the interaction term for caregivers’ education and burden of chronic disease and treatment (OR 31, 95% CI 2.2-430; P=.01) were significantly associated with their intention to adopt mHealth apps. Perceived ease of use (OR 2.4, 95% CI 0.67-8.7; P=.18) and social influence (OR 1.8, 95% CI 0.58-5.7; P=.31) were not significantly associated with the intention to adopt mHealth apps. Conclusions When designing mHealth app interventions for dementia caregivers with a chronic condition, it is important to consider caregivers’ perceptions about how well mHealth apps can help their self-management and which app features would be most useful for self-management. Caregiving factors may not be relevant to caregivers’ intention to adopt mHealth apps. This is promising because mHealth strategies may overcome barriers to caregivers’ self-management. Future research should investigate reasons why caregivers with a low education level and low burden of chronic disease and treatment have significantly lower intention to adopt mHealth apps for self-management.
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Affiliation(s)
| | - Chakra Budhathoki
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Alain Bernard Labrique
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Tatiana Sadak
- School of Nursing, University of Washington, Seattle, WA, United States
| | - Elizabeth K Tanner
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
| | - Hae Ra Han
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States.,Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Binyamin SS, Zafar BA. Proposing a mobile apps acceptance model for users in the health area: A systematic literature review and meta-analysis. Health Informatics J 2021; 27:1460458220976737. [PMID: 33438494 DOI: 10.1177/1460458220976737] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Due to rapid advancements in the field of information and communication technologies, mobile health (mHealth) has become a significant topic in the delivery of healthcare. Despite the perceived advantages and the large number of mHealth initiatives, the success of mHealth ultimately relies on whether these initiatives are used; their benefits will be diminished should people not use them. Previous literature has found that the adoption of mHealth by users is not yet widespread, and little research has been conducted on this problem. Therefore, this study identifies the antecedents of the intention to use mHealth and proposes a general model that might prove beneficial in explaining the acceptance of mHealth. The authors performed a quantitative meta-analysis of 49 journal papers published over the past 10 years and systematically reviewed the evidence regarding the most commonly identified factors that may affect the acceptance of mHealth. The findings indicate that the proposed model includes the seven most commonly used relationships in the selected articles. More specifically, the model assumes that perceived usefulness positively affects perceived ease of use and user behavioral intention to use mHealth is commonly influenced by five factors: perceived usefulness, perceived ease of use, attitude toward behavior, subjective norms, and facilitating conditions. The results of this work provide important insights into the predictors of mHealth acceptance for future researchers and practitioners.
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Pirzada P, Wilde A, Doherty GH, Harris-Birtill D. Ethics and acceptance of smart homes for older adults. Inform Health Soc Care 2021; 47:10-37. [PMID: 34240661 DOI: 10.1080/17538157.2021.1923500] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Societal challenges associated with caring for the physical and mental health of older adults worldwide have grown at an unprecedented pace, increasing demand for health-care services and technologies Despite the development of several assistive systems tailored to older adults, the rate of adoption of health technologies is low. This review discusses the ethical and acceptability challenges resulting in low adoption of health technologies specifically focused on smart homes for older adults. The findings have been structured in two categories: Ethical Considerations (Privacy, Social Support, and Autonomy) and Technology Aspects (User Context, Usability, and Training). The findings conclude that older adults community is more likely to adopt assistive systems when four key criteria are met. The technology should: be personalized toward their needs, protect their dignity and independence, provide user control, and not be isolating. Finally, we recommend researchers and developers working on assistive systems to: (1) provide interfaces via smart devices to control and configure the monitoring system with feedback for the user, (2) include various sensors/devices to architect a smart home solution in a way that is easy to integrate in daily life, and (3) define policies about data ownership.
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Affiliation(s)
- Pireh Pirzada
- School of Computer Science, University of St Andrews, St Andrews, UK
| | - Adriana Wilde
- Centre for Health Technologies, University of Southampton, Southampton, UK.,Department of Digital Technologies, University of Winchester, Winchester, UK
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Lin C, Clingan SE, Cousins SJ, Valdez J, Mooney LJ, Hser YI. The impact of COVID-19 on substance use disorder treatment in California: Service providers' perspectives. J Subst Abuse Treat 2021; 133:108544. [PMID: 34183213 PMCID: PMC8702565 DOI: 10.1016/j.jsat.2021.108544] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/18/2021] [Accepted: 06/14/2021] [Indexed: 01/29/2023]
Abstract
Background The COVID-19 pandemic has had a profound impact on the U.S. health care system, including addiction treatment. The objective of this study is to describe the impact of COVID on the delivery of treatment for substance use disorders (SUDs) from the perspectives of service providers. Methods Between May and September 2020, 61 service providers from 16 SUD treatment sites in California participated in virtual focus groups that lasted about an hour. We recorded the discussions and transcribed them verbatim. Two qualitative analysts independently conducted content analysis to identify themes from the transcripts. Results At the beginning of the pandemic, service providers observed a slight decrease in patient admissions, followed by an uptick in patient flow due to increased mental health issues, alcohol use, and relapse. Many of the clinics adopted flexible service delivery modes, such as curbside dosing and extended take-home medication, to enable social distancing in clinic settings. Approximately half of the clinic encounters offered telemedicime, and a considerable proportion of patients preferred to use telephone-based services rather than video-based services. Internet instability and technical difficulties limited the use of telemedicine among their patients. Conclusion COVID has been challenging for SUD treatment, but health care systems rapidly reacted with adjustments that may result in long-term changes in SUD service delivery. Telemedicine-based services have played a major role in ensuring uninterrupted patient care. Providers need organizational, technical, and logistical support to improve and sustain telemedicine services that increase access to quality care for their patients.
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Affiliation(s)
- Chunqing Lin
- Integrated Substance Abuse Programs, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA; Semel Institute-Center for Community Health, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
| | - Sarah E Clingan
- Integrated Substance Abuse Programs, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Sarah J Cousins
- Integrated Substance Abuse Programs, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Jonathan Valdez
- Integrated Substance Abuse Programs, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Larissa J Mooney
- Integrated Substance Abuse Programs, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA; Department of Psychiatry, Veterans Affairs Greater Los Angeles Healthcare System, USA
| | - Yih-Ing Hser
- Integrated Substance Abuse Programs, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
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Jaana M, Paré G. Comparison of Mobile Health Technology Use for Self-Tracking Between Older Adults and the General Adult Population in Canada: Cross-Sectional Survey. JMIR Mhealth Uhealth 2020; 8:e24718. [PMID: 33104517 PMCID: PMC7717921 DOI: 10.2196/24718] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/23/2020] [Accepted: 10/23/2020] [Indexed: 01/22/2023] Open
Abstract
Background The burden of population aging and chronic conditions has been reported worldwide. Older adults, especially those with high needs, experience social isolation and have high rates of emergency visits and limited satisfaction with the care they receive. Mobile health (mHealth) technologies present opportunities to address these challenges. To date, limited information is available on Canadian older adults’ attitudes toward and use of mHealth technologies for self-tracking purposes—an area that is increasingly important and relevant during the COVID-19 era. Objective This study presents contributions to an underresearched area on older adults and mHealth technology use. The aim of this study was to compare older adults’ use of mHealth technologies to that of the general adult population in Canada and to investigate the factors that affect their use. Methods A cross-sectional survey on mHealth and digital self-tracking was conducted. A web-based questionnaire was administered to a national sample of 4109 Canadian residents who spoke either English or French. The survey instrument consisted of 3 sections assessing the following items: (1) demographic characteristics, health status, and comorbidities; (2) familiarity with and use of mHealth technologies (ie, mobile apps, consumer smart devices/wearables such as vital signs monitors, bathroom scales, fitness trackers, intelligent clothing); and (3) factors influencing the continued use of mHealth technologies. Results Significant differences were observed between the older adults and the general adult population in the use of smart technologies and internet (P<.001). Approximately 47.4% (323/682) of the older adults in the community reported using smartphones and 49.8% (340/682) indicated using digital tablets. Only 19.6% (91/463) of the older adults using smartphones/digital tablets reported downloading mobile apps, and 12.3% (47/383) of the older adults who heard of smart devices/wearables indicated using them. The majority of the mobile apps downloaded by older adults was health-related; interestingly, their use was sustained over a longer period of time (P=.007) by the older adults compared to that by the general population. Approximately 62.7% (428/682) of the older adults reported tracking their health measures, but the majority did so manually. Older adults with one or more chronic conditions were mostly nontrackers (odds ratio 0.439 and 0.431 for traditional trackers and digital trackers, respectively). No significant differences were observed between the older adults and the general adult population with regard to satisfaction with mHealth technologies and their intention to continue using them. Conclusions Leveraging mHealth technologies in partnership with health care providers and sharing of health/well-being data with health care professionals and family members remain very limited. A culture shift in the provision of care to older adults is deemed necessary to keep up with the development of mHealth technologies and the changing demographics and expectations of patients and their caregivers.
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Affiliation(s)
- Mirou Jaana
- Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
| | - Guy Paré
- Research Chair in Digital Health, HEC Montreal, Montreal, QC, Canada
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