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Woo YS, Shin GI, Park HY. Empowering older adults: evaluating the impact of a smartphone education app on independent living. Front Public Health 2024; 12:1403978. [PMID: 39220447 PMCID: PMC11363426 DOI: 10.3389/fpubh.2024.1403978] [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: 04/23/2024] [Accepted: 07/23/2024] [Indexed: 09/04/2024] Open
Abstract
Purpose As science and technology advance, older people's ability to use smart devices in their daily living is becoming more demanding. This study addresses the increasing use of smartphones by the older adults, who often struggle with technology due to lack of competence. We developed an educational app tailored for older adults users and compare its effectiveness with existing educational videos. Methods An app was created based on the learning characteristics of the older adults, using the ADDIE model, and compared with traditional video education. It involved six participants aged 65 or older, and convenience sampling method was used, evaluating the app and video through usability assessments and eye tracking. Quantitative and qualitative analyzes were conducted with focus groups under the researcher's control. Results The app received higher usability scores than the video in content, motivation, and interaction. Eye tracking showed users paid more consistent attention to the app. Conclusion The smartphone app facilitates learning for the older adults without the constraints of time and place, improving their quality of life and technology skills. Eye tracking can be instrumental in future app development for this demographic.
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Affiliation(s)
- Ye-Shin Woo
- Occupational Therapy Department, College of Software Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
| | - Ga-in Shin
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- National Traffic Injury Rehabilitation Research Institute, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Republic of Korea
| | - Hae Yean Park
- Occupational Therapy Department, College of Software Digital Healthcare Convergence, Yonsei University, Wonju, Republic of Korea
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Bahadori F, Abolfathi Momtaz Y, Mohammadi Shahboulaghi F, Zandieh Z. Information and Communication Technology Adoption Strategies Among Iranian Older Adults: A Qualitative Evaluation. Gerontol Geriatr Med 2024; 10:23337214241246315. [PMID: 38633750 PMCID: PMC11022677 DOI: 10.1177/23337214241246315] [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: 12/22/2023] [Revised: 02/22/2024] [Accepted: 03/09/2024] [Indexed: 04/19/2024] Open
Abstract
In today's world, it is unavoidable for older adults to use technology, which causes some challenges for them. In this qualitative study, we used grounded theory to evaluate information and communication technology (ICT) adoption strategies among Iranian older adults. The participants included 18 older adults, five experts, and five family members of older adults. The data collection method included conducting semi-structured interviews, taking field notes, and observation. The data were analyzed using the Corbin and Strauss approach. Three main themes were extracted as follows: support from others, effort for learning, and smart choice. The subthemes of support from others included creativity in educating older adults; having access to an educational supporter; and receiving informational, emotional, and financial support. The subthemes of effort for learning included utilizing aids, adaptive measures, shortcut techniques, and self-learning. The subthemes of smart choice included physical characteristics, technical features, price sensitivity, and availability of an active sales representative. Accordingly, it is essential to teach older adults to increase their ICT adoption rate and continued use of technology. In this respect, developing a standard ICT manual for older adults can be beneficial.
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Affiliation(s)
- Farzaneh Bahadori
- University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | | | - Zhale Zandieh
- University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Eppinger B, Ruel A, Bolenz F. Diminished State Space Theory of Human Aging. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023:17456916231204811. [PMID: 37931229 DOI: 10.1177/17456916231204811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Many new technologies, such as smartphones, computers, or public-access systems (like ticket-vending machines), are a challenge for older adults. One feature that these technologies have in common is that they involve underlying, partially observable, structures (state spaces) that determine the actions that are necessary to reach a certain goal (e.g., to move from one menu to another, to change a function, or to activate a new service). In this work we provide a theoretical, neurocomputational account to explain these behavioral difficulties in older adults. Based on recent findings from age-comparative computational- and cognitive-neuroscience studies, we propose that age-related impairments in complex goal-directed behavior result from an underlying deficit in the representation of state spaces of cognitive tasks. Furthermore, we suggest that these age-related deficits in adaptive decision-making are due to impoverished neural representations in the orbitofrontal cortex and hippocampus.
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Affiliation(s)
- Ben Eppinger
- Institute of Psychology, University of Greifswald
- Department of Psychology, Concordia University
- PERFORM Centre, Concordia University
- Faculty of Psychology, Technische Universität Dresden
| | - Alexa Ruel
- Department of Psychology, Concordia University
- PERFORM Centre, Concordia University
- Institute of Psychology, University of Hamburg
| | - Florian Bolenz
- Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany
- Science of Intelligence/Cluster of Excellence, Technical University of Berlin
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Mcintyre D, Chiang J, Thiagalingam A, Tong A, Chow CK. Engagement and fidelity of a cardiovascular disease prevention-focused digital health intervention in cardiology outpatient waiting rooms: a mixed-methods study. BMJ Qual Saf 2023; 32:655-664. [PMID: 35803709 DOI: 10.1136/bmjqs-2021-014664] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/20/2022] [Indexed: 11/04/2022]
Abstract
INTRODUCTION We delivered a video-based, cardiovascular disease prevention focused intervention in cardiology waiting rooms that increased motivation to improve cardiovascular risk behaviours and satisfaction with clinic services. To better understand the potential generalisability and scalability of such waiting room interventions, this study evaluated the fidelity of intervention delivery and barriers and enablers to implementation. METHODS Mixed-methods process evaluation conducted among intervention participants in a randomised clinical trial. Data sources included (1) Participant screening logs, (2) Intervention delivery platform data and (3) Semi structured interviews performed with participants. Qualitative data were described using inductive thematic analysis. RESULTS The tablet-based intervention was delivered to 220 patients (112 (50.9%) male, mean age 54.2 (SD 15.4) years). Of 765 videos opened, 636 (83.1%) were watched to completion. Most videos opened were rated (738/765, 96.5%) and video ratings were predominantly positive (661/738, (89.6%) satisfied or highly satisfied). Younger and more educated participants were more likely to rate videos highly (relative risk (RR) 1.73 (95% CI 1.28 to 2.32) and RR 1.26 (95% CI 1.07 to 1.49)) but less likely to watch videos to completion (younger: RR 0.27 (95% CI 0.17 to 0.43), more educated: RR 0.90 (95% CI 0.85 to 0.96)). Of 39 invited, 21 (53.8%) participated in semistructured interviews. Thematic analysis of responses suggested reported behaviour change post intervention may be due to increased awareness of cardiovascular risk, reduced anxiety and intrinsic motivation from delivery within a cardiology waiting room. Lack of reinforcement and limited personalisation were barriers. CONCLUSION The current analysis demonstrates that engagement with a digitally delivered clinic waiting room educational intervention was high, providing explanation for its efficacy in improving motivation to change cardiovascular risk behaviours. The high fidelity of delivery demonstrates potential for scaling of such interventions across waiting rooms. Recall bias and low response rate may bias self-reported engagement measures. TRIAL REGISTRATION NUMBER ANZCTR12618001725257.
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Affiliation(s)
- Daniel Mcintyre
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia
| | - Jason Chiang
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia
| | - Aravinda Thiagalingam
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia
- Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
| | - Allison Tong
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Clara Kayei Chow
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Westmead, New South Wales, Australia
- Cardiology, Westmead Hospital, Westmead, New South Wales, Australia
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Chen C, Lifset ET, Han Y, Roy A, Hogarth M, Moore AA, Farcas E, Weibel N. Screen or No Screen? Lessons Learnt from a Real-World Deployment Study of Using Voice Assistants With and Without Touchscreen for Older Adults. ASSETS. ANNUAL ACM CONFERENCE ON ASSISTIVE TECHNOLOGIES 2023; 2023:52. [PMID: 39086515 PMCID: PMC11290471 DOI: 10.1145/3597638.3608378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/02/2024]
Abstract
While voice user interfaces offer increased accessibility due to hands-free and eyes-free interactions, older adults often have challenges such as constructing structured requests and perceiving how such devices operate. Voice-first user interfaces have the potential to address these challenges by enabling multimodal interactions. Standalone voice + touchscreen Voice Assistants (VAs), such as Echo Show, are specific types of devices that adopt such interfaces and are gaining popularity. However, the affordances of the additional touchscreen for older adults are unknown. Through a 40-day real-world deployment with older adults living independently, we present a within-subjects study (N = 16; age M = 82.5, SD = 7.77, min. = 70, max. = 97) to understand how a built-in touchscreen might benefit older adults during device setup, conducting self-report diary survey, and general uses. We found that while participants appreciated the visual outputs, they still preferred to respond via speech instead of touch. We identified six design implications that can inform future innovations of senior-friendly VAs for managing healthcare and improving quality of life.
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Affiliation(s)
- Chen Chen
- Computer Science and Engineering, University of California San Diego, La Jolla, CA, United States
| | - Ella T Lifset
- Biological Sciences, University of California San Diego, La Jolla, CA, United States
| | - Yichen Han
- Electrical and Computer Engineering, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Arkajyoti Roy
- Department of Mathematics, University of California San Diego, La Jolla, CA, United States
| | - Michael Hogarth
- School of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Alison A Moore
- School of Medicine, University of California San Diego, La Jolla, CA, United States
| | - Emilia Farcas
- Qualcomm Institute, University of California San Diego, La Jolla, CA, United States
| | - Nadir Weibel
- Computer Science and Engineering, University of California San Diego, La Jolla, CA, United States
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Gomez-Hernandez M, Ferre X, Moral C, Villalba-Mora E. Design Guidelines of Mobile Apps for Older Adults: Systematic Review and Thematic Analysis. JMIR Mhealth Uhealth 2023; 11:e43186. [PMID: 37733401 PMCID: PMC10557006 DOI: 10.2196/43186] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 06/20/2023] [Accepted: 07/11/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Mobile apps are fundamental tools in today's society for practical and social endeavors. However, these technologies are often not usable for older users. Given the increased use of mobile apps by this group of users and the impact that certain services may have on their quality of life, such as mobile health, personal finance, or online administrative procedures, a clear set of guidelines for mobile app designers is needed. Existing recommendations for older adults focus on investigations with certain groups of older adults or have not been extracted from experimental results. OBJECTIVE In this research work, we systematically reviewed the scientific literature that provided recommendations for the design of mobile apps based on usability testing with older adults and organized such recommendations into a meaningful set of design guidelines. METHODS We conducted a systematic literature review of journal and conference articles from 2010 to 2021. We included articles that carried out usability tests with populations aged >60 years and presented transferable guidelines on mobile software design, resulting in a final set of 40 articles. We then carried out a thematic analysis with 3 rounds of analysis to provide meaning to an otherwise diverse set of recommendations. At this stage, we discarded recommendations that were made by just 1 article, were based on a specific mobile app and were therefore nontransferrable, were based on other authors' literature (as opposed to recommendations based on the results of usability tests), or were not sufficiently argued. With the remaining recommendations, we identified commonalities, wrote a faithful statement for each guideline, used a common language for the entire set, and organized the guidelines into categories, thereby giving shape to an otherwise diverse set of recommendations. RESULTS Among the 27 resulting guidelines, the rules Simplify and Increase the size and distance between interactive controls were transversal and of the greatest significance. The rest of the guidelines were divided into 5 categories (Help & Training, Navigation, Visual Design, Cognitive Load, and Interaction) and consequent subcategories in Visual Design (Layout, Icons, and Appearance) and Interaction (Input and Output). The recommendations were structured, explained in detail, and illustrated with applied examples extracted from the selected studies, where appropriate. We discussed the design implications of applying these guidelines, contextualized with relevant studies. We also discussed the limitations of the approach followed, stressing the need for further experimentation to gain a better understanding of how older adults use mobile apps and how to better design such apps with these users in mind. CONCLUSIONS The compiled guidelines support the design of mobile apps that cater to the needs of older adults because they are based on the results of actual usability tests with users aged >60 years.
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Affiliation(s)
- Miguel Gomez-Hernandez
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Pozuelo de Alarcón, Spain
- Emerging Technologies Research Lab, Department of Human-Centred Computing, Monash University, Melbourne, Australia
| | - Xavier Ferre
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Pozuelo de Alarcón, Spain
- School of Software Engineering, Tongji University, Shanghai, China
| | - Cristian Moral
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Pozuelo de Alarcón, Spain
| | - Elena Villalba-Mora
- Center for Biomedical Technology, Universidad Politécnica de Madrid, Pozuelo de Alarcón, Spain
- Biomedical Research Networking Center in Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Madrid, Spain
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Li H, Glecia A. Impact of Social Isolation and Digital Divide on Mental Health and Wellbeing in Patients with Mental Health Disorders during COVID-19: A Multiple Case Study. Issues Ment Health Nurs 2023; 44:313-320. [PMID: 36989507 DOI: 10.1080/01612840.2023.2189957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
The positive relationship between social connections and mental health and wellbeing has been widely documented. During the initial stage of the pandemic, COVID-19 associated restrictions had given rise to social isolation that had a negative effect on individuals' mental health and wellbeing, particularly among patients with preexisting mental health disorders. To abridge physical distance, digital technology had become a primary method of communication and social engagement. However, not everyone had access to internet and devices required to connect online due to the digital divide, especially among marginalized populations. The purpose of this multiple case study was to explore experiences of social isolation and the digital divide among patients with mental health disorders, and its impact on their mental health and wellbeing. Our findings revealed that social isolation was the major contributing factor to the intensification of mental health symptoms, while the digital divide (e.g., financial constraints and low proficiency in digital technology) was recognized as a barrier to making social connections via digital technologies. Nurses should engage with communities and policymakers in developing strategies to address the social determinants of health disparities during the current pandemic, other disruptive pandemics and beyond.
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Affiliation(s)
- Hua Li
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - Alana Glecia
- Department of Sociology, University of Saskatchewan, Saskatoon, SK, Canada
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Kim JC, Saguna S, Åhlund C. Acceptability of a Health Care App With 3 User Interfaces for Older Adults and Their Caregivers: Design and Evaluation Study. JMIR Hum Factors 2023; 10:e42145. [PMID: 36884275 PMCID: PMC10034616 DOI: 10.2196/42145] [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: 09/06/2022] [Revised: 12/19/2022] [Accepted: 01/24/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND The older population needs solutions for independent living and reducing the burden on caregivers while maintaining the quality and dignity of life. OBJECTIVE The aim of this study was to design, develop, and evaluate an older adult health care app that supports trained caregivers (ie, formal caregivers) and relatives (ie, informal caregivers). We aimed to identify the factors that affect user acceptance of interfaces depending on the user's role. METHODS We designed and developed an app with 3 user interfaces that enable remote sensing of an older adult's daily activities and behaviors. We conducted user evaluations (N=25) with older adults and their formal and informal caregivers to obtain an overall impression of the health care monitoring app in terms of user experience and usability. In our design study, the participants had firsthand experience with our app, followed by a questionnaire and individual interview to express their opinions on the app. Through the interview, we also identified their views on each user interface and interaction modality to identify the relationship between the user's role and their acceptance of a particular interface. The questionnaire answers were statistically analyzed, and we coded the interview answers based on keywords related to a participant's experience, for example, ease of use and usefulness. RESULTS We obtained overall positive results in the user evaluation of our app regarding key aspects such as efficiency, perspicuity, dependability, stimulation, and novelty, with an average between 1.74 (SD 1.02) and 2.18 (SD 0.93) on a scale of -3.0 to 3.0. The overall impression of our app was favorable, and we identified that "simple" and "intuitive" were the main factors affecting older adults' and caregivers' preference for the user interface and interaction modality. We also identified a positive user acceptance of the use of augmented reality by 91% (10/11) of the older adults to share information with their formal and informal caregivers. CONCLUSIONS To address the need for a study to evaluate the user experience and user acceptance by older adults as well as both formal and informal caregivers regarding the user interfaces with multimodal interaction in the context of health monitoring, we designed, developed, and conducted user evaluations with the target user groups. Our results through this design study show important implications for designing future health monitoring apps with multiple interaction modalities and intuitive user interfaces in the older adult health care domain.
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Affiliation(s)
- Joo Chan Kim
- Division of Computer Science, Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Skellefteå, Sweden
| | - Saguna Saguna
- Division of Computer Science, Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Skellefteå, Sweden
| | - Christer Åhlund
- Division of Computer Science, Department of Computer Science, Electrical and Space Engineering, Luleå University of Technology, Skellefteå, Sweden
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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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Han Y, Han CB, Chen C, Lee PW, Hogarth M, Moore AA, Weibel N, Farcas E. Towards Visualization of Time-Series Ecological Momentary Assessment (EMA) Data on Standalone Voice-First Virtual Assistants. ASSETS. ANNUAL ACM CONFERENCE ON ASSISTIVE TECHNOLOGIES 2022; 2022:60. [PMID: 39076843 PMCID: PMC11286321 DOI: 10.1145/3517428.3550398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/31/2024]
Abstract
Population aging is an increasingly important consideration for health care in the 21th century, and continuing to have access and interact with digital health information is a key challenge for aging populations. Voice-based Intelligent Virtual Assistants (IVAs) are promising to improve the Quality of Life (QoL) of older adults, and coupled with Ecological Momentary Assessments (EMA) they can be effective to collect important health information from older adults, especially when it comes to repeated time-based events. However, this same EMA data is hard to access for the older adult: although the newest IVAs are equipped with a display, the effectiveness of visualizing time-series based EMA data on standalone IVAs has not been explored. To investigate the potential opportunities for visualizing time-series based EMA data on standalone IVAs, we designed a prototype system, where older adults are able to query and examine the time-series EMA data on Amazon Echo Show - a widely used commercially available standalone screen-based IVA. We conducted a preliminary semi-structured interview with a geriatrician and an older adult, and identified three findings that should be carefully considered when designing such visualizations.
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Affiliation(s)
- Yichen Han
- Computer Science and Engineering, University of California San Diego, La Jolla, California, United States
| | - Christopher Bo Han
- Department of Mathematics, University of California San Diego, La Jolla, California, United States
| | - Chen Chen
- Computer Science and Engineering, University of California San Diego, La Jolla, California, United States
| | - Peng Wei Lee
- Electrical and Computer Engineering, University of California San Diego, La Jolla, California, United States
| | - Michael Hogarth
- School of Medicine, University of California San Diego, La Jolla, California, United States
| | - Alison A Moore
- School of Medicine, University of California San Diego, La Jolla, California, United States
| | - Nadir Weibel
- Computer Science and Engineering, University of California San Diego, La Jolla, California, United States
| | - Emilia Farcas
- Qualcomm Institute, University of California San Diego, La Jolla, California, United States
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11
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Benefits and challenges of conversational agents in older adults. Z Gerontol Geriatr 2022; 55:381-387. [DOI: 10.1007/s00391-022-02085-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2022] [Indexed: 11/26/2022]
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Mohlman J, Tsang W, Magee SA, Dalokay L, Basch C. Which Variant of Anxiety Is Associated with Smartphone Expertise in Community Dwelling Older Adults? Clin Gerontol 2022; 45:403-413. [PMID: 34928188 DOI: 10.1080/07317115.2021.2013382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Older adults vary greatly in their mastery of state-of-the-art smartphones. Anxiety may function as a barrier to technological expertise. This study characterizes an older community-dwelling sample (n = 71) in terms of their levels of demonstrated smartphone expertise relative to variants of anxiety (e.g., trait, social, tech-related). METHODS A 20-step behavioral smartphone challenge task, the Smartphone Task for Older Adults (STOA), was used to evaluate older adults' knowledge of a range of smartphone functions. Self-report measures of anxiety symptoms and perceived digital proficiency were also administered. RESULTS STOA scores were relatively low (x = 8.26, s.d. = 5.65) and showed negative relations with tech-anxiety and in-vivo frustration, but not social or trait anxiety. A hierarchical regression model indicated that tech-related anxiety and in-vivo frustration contributed significantly to STOA scores, above and beyond established predictors such as education. CONCLUSIONS Tech-anxiety and frustration while learning new smartphone functions may characterize the next cohort of older adults who have not effectively mastered the use of smartphones. CLINICAL IMPLICATIONS Anxiety management skills derived from cognitive behavior therapy and other self-regulation tools could help those who experience tech-anxiety or frustration during smartphone training, facilitating the development of expertise.
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Affiliation(s)
- Jan Mohlman
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
| | - William Tsang
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
| | - Sofia Alba Magee
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
| | - Lauren Dalokay
- Department of Psychology, William Paterson University, Wayne, New Jersey, USA
| | - Corey Basch
- Department of Public Health,William Paterson University, Wayne, New Jersey, USA
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Desai S, McGrath C, McNeil H, Sveistrup H, McMurray J, Astell A. Experiential Value of Technologies: A Qualitative Study with Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042235. [PMID: 35206435 PMCID: PMC8872025 DOI: 10.3390/ijerph19042235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/04/2022] [Accepted: 02/12/2022] [Indexed: 11/26/2022]
Abstract
This study investigated the experiences of older adults with technologies they own and determined how they value them. Thirty-seven older adults participated in a Show and Tell co-creation session at a one-day workshop. Participants described why they loved or abandoned technologies they own. Their responses were recorded and analysed using Atlas.ti 22.0.0. Seven main themes representing experiential value in older adults emerged from the analysis: Convenience, Economy, Learning and Support, Currency of Technology, Privacy and Security, Emotions and Identity aspects of their experiences. This qualitative study has resulted in implications to design that recommends (a) Design for product ecosystems with technologies and services well-coordinated and synchronized to facilitate use of the technology (b) Create awareness and information on privacy and security issues and technical language associated with it (c) Make anti-virus and anti-phishing software accessible to older population (d) Design technologies as tools that allow older adults to identify themselves in the community and family (e) Create services that make technologies and services in the ecosystem affordable for the older adults. The outcomes of this study are significant as they provide recommendations that target systemic issues which present barriers in the use of technology.
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Affiliation(s)
- Shital Desai
- Social and Technological Systems Lab, School of Arts Media Performance and Design, York University, Toronto, ON M3J 1P3, Canada
- Correspondence: ; Tel.: +1-416-736-5885
| | - Colleen McGrath
- School of Occupational Therapy, Western University, London, ON N6A 3K7, Canada;
| | - Heather McNeil
- SE Research Centre, SE Health, Markham, ON L3R 6H3, Canada;
| | - Heidi Sveistrup
- School of Rehabilitation Services, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Josephine McMurray
- Lazaridis School of Business & Economics, Wilfrid Laurier University, Waterloo, ON N2L 3C7, Canada;
| | - Arlene Astell
- Department of Occupational Sciences & Occupational Therapy, University of Toronto, Toronto, ON M5G 1V7, Canada;
- Department of Psychiatry, University of Toronto, Toronto, ON M5G 1V7, Canada
- KITE, Toronto Rehabilitation Institute, Toronto, ON M5G 2A2, Canada
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Schlomann A, Even C, Hammann T. How Older Adults Learn ICT—Guided and Self-Regulated Learning in Individuals With and Without Disabilities. FRONTIERS IN COMPUTER SCIENCE 2022. [DOI: 10.3389/fcomp.2021.803740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Learning to use information and communication technologies (ICT) may be more difficult for older people due to decreases in fluid intelligence, generational effects, and other age-related effects. Especially older people with intellectual disabilities (ID) are at a high risk of digital exclusion. To enable all older adults to use ICT, individualized technology training may be provided. However, little is known about the ICT learning preferences among older people with ID. Based on semi-structured interviews with older adults (n = 7, mean age = 76.6 years) and older adults with ID (n = 14, mean age = 62.4 years), this paper analyzes learning strategies, preferences, and learning settings. The results from content analysis show that guided learning with personal explanations in a one-to-one setting is the most preferred learning format in both groups of older adults. While many older adults without ID additionally favor self-regulated learning (i.e., learning with manuals or videos), older adults with ID mostly rely on guided learning with personal assistance. The differences can be explained by different abilities (e.g., reading skills) and social networks (e.g., living situation, having children). Not all older adults have a family or an institutional support network to help them learn ICT and community organizations may provide additional support. Researchers and practitioners should be aware of the diverse knowledge backgrounds and competencies in the group of older adults. ICT training in old age should be ideally composed in a modular way embedding self-regulated learning formats into guided learning modules.
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Kim S, Yao W, Du X. Exploring older adults' adoption and use of a tablet computer during COVID-19: Longitudinal qualitative study (Preprint). JMIR Aging 2021; 5:e32957. [PMID: 35134747 PMCID: PMC8906838 DOI: 10.2196/32957] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 01/21/2022] [Accepted: 02/06/2022] [Indexed: 01/08/2023] Open
Abstract
Background As mobile computing technology evolves, such as smartphones and tablet computers, it increasingly offers features that may be particularly beneficial to older adults. However, the digital divide exists, and many older adults have been shown to have difficulty using these devices. The COVID-19 pandemic has magnified how much older adults need but are excluded from having access to technologies to meet essential daily needs and overcome physical distancing restrictions. Objective This study sought to understand how older adults who had never used a tablet computer learn to use it, what they want to use it for, and what barriers they experience as they continue to use it during social isolation caused by the COVID-19 pandemic. Methods We conducted a series of semistructured interviews with eight people aged 65 years and older for 16 weeks, investigating older novice users’ adoption and use of a tablet computer during the nationwide lockdown due to COVID-19. Results Participants were gradually yet successfully accustomed to using a tablet computer to serve various daily needs, including entertainment, social connectedness, and information-seeking. However, this success was not achieved through developing sufficient digital skills but rather by applying the methods they were already familiar with in its operation, such as taking and referring to instruction notes. Conclusions Our findings imply that older adults without digital literacy can still benefit from a digital device for quality of later life if proper traditional methods they are already familiar with are offered in its use.
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Affiliation(s)
- Sunyoung Kim
- School of Communication and Information, Rutgers University, New Brunswick, NJ, United States
| | - Willow Yao
- School of Communication and Information, Rutgers University, New Brunswick, NJ, United States
| | - Xiaotong Du
- School of Communication and Information, Rutgers University, New Brunswick, NJ, United States
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Klimova B, Sanda L. A Novel Educational Smartphone Application for Cognitively Healthy Seniors: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6601. [PMID: 34205284 PMCID: PMC8296486 DOI: 10.3390/ijerph18126601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/14/2021] [Accepted: 06/17/2021] [Indexed: 11/17/2022]
Abstract
Modern technologies surround people every day, including seniors. The aim of this pilot study was to create a maximally user-friendly mobile application in order to meet older users' individual needs. The research sample consisted of 13 older individuals at the age of 55+ years with a mean age of 67 years, living in the Czech Republic. The key assessment tools of this pilot study were the developed application and usability testing. The findings confirmed that the newly developed mobile application for teaching English met the needs of cognitively healthy seniors, and was acceptable and feasible. In addition, it indicated what technical (e.g., visual interface or easy navigation) and pedagogical (e.g., an instructional manual or adjusting to seniors' learning pace or clear instructions) aspects should be strictly followed when designing such an educational smartphone application. In addition, the authors of this pilot study provide several implications for pedagogical practice. Further research should include more empirical studies aimed at the exploration of educational mobile applications for older generation groups with respect to meeting their individual needs in order to enhance their overall well-being. However, such studies are, nowadays, very rare.
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Affiliation(s)
- Blanka Klimova
- Department of Applied Linguistics, Faculty of Informatics and Management, University of Hradec Kralove, Rokitanskeho 62, 500 03 Hradec Králové, Czech Republic;
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Information resource orchestration during the COVID-19 pandemic: A study of community lockdowns in China. INTERNATIONAL JOURNAL OF INFORMATION MANAGEMENT 2020; 54:102143. [PMID: 32394997 PMCID: PMC7211621 DOI: 10.1016/j.ijinfomgt.2020.102143] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/05/2020] [Accepted: 05/05/2020] [Indexed: 11/29/2022]
Abstract
The outbreak of the COVID-19 pandemic has created significant challenges for people worldwide. To combat the virus, one of the most dramatic measures was the lockdown of 4 billion people in what is believed to be the largest quasi-quarantine in human history. As a response to the call to study information behavior during a global health crisis, we adopted a resource orchestration perspective to investigate six Chinese families who survived the lockdown. We explored how elderly, young and middle-aged individuals and children resourced information and how they adapted their information behavior to emerging online technologies. Two information resource orchestration practices (information resourcing activities and information behavior adaptation activities) and three mechanisms (online emergence and convergence in community resilience, the overcoming of information flow impediments, and the application of absorptive capacity) were identified in the study.
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Redfern J. Can Older Adults Benefit from Smart Devices, Wearables, and Other Digital Health Options to Enhance Cardiac Rehabilitation? Clin Geriatr Med 2019; 35:489-497. [PMID: 31543180 DOI: 10.1016/j.cger.2019.07.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Cardiovascular disease (CVD) is the leading cause of death and disease burden globally. Improving reach, access, and effectiveness of postdischarge care through cardiac rehabilitation and secondary prevention strategies is an international priority. The current proliferation of mobile technology has resulted in widespread development and availability of digital health interventions that can reduce cardiovascular risk. Text-messaging programs and apps have been shown to improve health outcomes. Other areas of research investigating the use of wearable devices are still emerging but lack robust data. Mobile and smartphone ownership is increasing among older populations, and digital health is not limited by age.
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Affiliation(s)
- Julie Redfern
- University of Sydney, Westmead Applied Research Centre, Faculty of Medicine and Health; The George Institute for Global Health, UNSW Medicine, Sydney, Australia.
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Jarvis MA, Sartorius B, Chipps J. Technology acceptance of older persons living in residential care. INFORMATION DEVELOPMENT 2019. [DOI: 10.1177/0266666919854164] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The social, psychological, physical, and financial benefits of digital inclusion are of increasing importance for older persons. However, older persons are often less inclined to utilise technological communication with reports of perceived poor technology acceptance. In this context, a study was conducted to investigate communication technology acceptance in older persons living in residential care. A cross sectional survey of residents (≥60 yrs) of four inner city residences in Durban, South Africa was conducted to assess communication technology access and technology acceptance defined as Usage Behaviour. A researcher-administered questionnaire was based on the Senior Technology Acceptance Model (STAM). Descriptive statistics of STAM factors and structural equation model (SEM) were conducted to test this model, to quantify the importance of various technology acceptance factors on Usage Behaviour among older persons living in residential care. The survey had a 72.1% response rate (n=277). Most of the respondents owned mobile phones (87.6%), although there was low smartphone ownership. Family desire to communicate and ease of use motivated mobile phone acquisition. Behaviour Intention, Facilitating Conditions, Attitude to Life and Satisfaction and education level were significantly associated with Usage Behaviour. Gerontechnology Anxiety and Age showed significant negative associations with Usage Behaviour. The acceptance of communication technology in this setting was low and predominantly influenced by Attitudinal and Technological Context factors together with age and education.
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Jarvis MA, Chipps J, Padmanabhanunni A. “This phone saved my life”: Older persons’ experiences and appraisals of an mHealth intervention aimed at addressing loneliness. JOURNAL OF PSYCHOLOGY IN AFRICA 2019. [DOI: 10.1080/14330237.2019.1594650] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Mary Ann Jarvis
- School of Nursing and Public Health, College of Health Science, University of KwaZulu-Natal, Durban, South Africa
| | - Jennifer Chipps
- School of Nursing, Faculty of Community and Health, University of the Western Cape, Cape Town, South Africa
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Jarvis MA, Padmanabhanunni A, Chipps J. An Evaluation of a Low-Intensity Cognitive Behavioral Therapy mHealth-Supported Intervention to Reduce Loneliness in Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1305. [PMID: 30979042 PMCID: PMC6480633 DOI: 10.3390/ijerph16071305] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 11/16/2022]
Abstract
There is a high prevalence of loneliness among older people, especially in residential care settings. Loneliness is often accompanied by maladaptive cognitions which can affect the maintenance and establishment of meaningful social connections. This study implemented and evaluated a low-intensity Cognitive Behavior Therapy (LI-CBT) mHealth-supported intervention which targeted maladaptive cognitions in older people (≥60 years) experiencing loneliness. The three-month intervention using WhatsApp was implemented with older people in four inner-city residential care facilities. The intervention included three components: technology acceptance, psycho-education, and individualized positively worded messages addressing maladaptive cognitions. The intervention was evaluated using a randomized control design. Key outcomes were measured pre-, post-, and one month after the intervention. There were significant changes in social cognition (YSQ-SF T₀-T₁-T₂, X² = 9.69, p = 0.008) and loneliness levels (total loneliness T₀-T₁-T₂, X² = 14.62, p = 0.001), and an increase in WhatsApp usage (T₀ = 26% vs. T₁ = 60%, X²=15.22, p = 0.019). At 1-month follow-up, even with a significant reduction in WhatsApp usage, a significant reduction in loneliness was maintained. LI-CBT delivered via instant messaging may be effective in reducing loneliness experienced by older people.
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Affiliation(s)
- Mary Ann Jarvis
- School of Nursing and Public Health, Desmond Clarence Bldg. Howard College Campus, University of KwaZulu-Natal, Durban 4001, South Africa.
| | - Anita Padmanabhanunni
- Department of Psychology, University of the Western Cape, Robert Sobukwe Avenue, Belville 7535, South Africa.
| | - Jennifer Chipps
- School of Nursing, Faculty of Community Health, University of the Western Cape, 14 Blanckenberg Road, Belville 7535, South Africa.
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Emas S, Montoya L, Chen A, Tran C, Tran P, Dharni A. Empowering Older Adults: Incorporating Technology for Retirement Adjustment. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2018. [DOI: 10.1080/02703181.2018.1497747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Shari Emas
- Department of Occupational Therapy, Stanbridge University, Irvine, CA, USA
| | - Lia Montoya
- Department of Occupational Therapy, Stanbridge University, Irvine, CA, USA
| | - Annie Chen
- Department of Occupational Therapy, Stanbridge University, Irvine, CA, USA
| | - Calvin Tran
- Department of Occupational Therapy, Stanbridge University, Irvine, CA, USA
| | - Peter Tran
- Department of Occupational Therapy, Stanbridge University, Irvine, CA, USA
| | - Anu Dharni
- Department of Occupational Therapy, Stanbridge University, Irvine, CA, USA
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Fan M, Truong KN. Guidelines for Creating Senior-Friendly Product Instructions. ACM TRANSACTIONS ON ACCESSIBLE COMPUTING 2018. [DOI: 10.1145/3209882] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Although older adults feel generally positive about technologies, many face difficulties when using them and need support during the process. One common form of support is the product instructions that come with devices. Unfortunately, when using them, older adults often feel confused, overwhelmed, or frustrated. In this work, we sought to address the issues that affect older adults’ ability to successfully complete tasks using product instructions. By observing how older adults used the product instructions of various devices and how they made modifications to simplify the use of the instructions, we identified 11 guidelines for creating senior-friendly product instructions. We validated the usability and effectiveness of the guidelines by evaluating how older adults used instruction manuals that were modified to adhere to these guidelines against the originals and those that were modified by interaction design researchers. Results show that, overall, participants had the highest task success rate and lowest task completion time when using guideline-modified user instructions. Participants also perceived these instructions to be the most helpful, the easiest to follow, the most complete, and the most concise among the three. We also compared the guidelines derived from this research to existing documentation guidelines and discussed potential challenges of applying them.
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Affiliation(s)
- Mingming Fan
- Department of Computer Science, University of Toronto, Toronto, ON Canada
| | - Khai N. Truong
- Department of Computer Science, University of Toronto, Toronto, ON Canada
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Petrovčič A, Rogelj A, Dolničar V. Smart but not adapted enough: Heuristic evaluation of smartphone launchers with an adapted interface and assistive technologies for older adults. COMPUTERS IN HUMAN BEHAVIOR 2018. [DOI: 10.1016/j.chb.2017.10.021] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Sengpiel M. Teach or Design? How Older Adults’ Use of Ticket Vending Machines Could Be More Effective. ACM TRANSACTIONS ON ACCESSIBLE COMPUTING 2016. [DOI: 10.1145/2935619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The dominance of computer technology in work and leisure poses challenges for older people. Their lack of computer experience and computer literacy impedes their ability to explore and use new interactive systems. This is particularly challenging for the design of public access systems, such as ticket vending machines (TVM). This article describes a conflict relevant for many designers considering age-related differences in technology use: should the user be taught to use the existing design or should the design be changed to accommodate older users? An experiment was conducted to directly compare these alternative approaches with each other and with a simulation of an existing TVM. It compares three TVM designs regarding the usability criteria of effectiveness, efficiency and satisfaction, controlling for age, and cognitive and motivational characteristics. 62 older (M = 68 years) and 62 younger (M = 25 years) participants were split into three groups: The control group solved 11 tasks using a simulation of the TVM, the video group watched a brief instructional video before solving the same tasks with the same TVM, and the wizard group used a redesigned wizard interface instead. Results indicate that young and old participants’ performance improved after watching the video, but older participants improved more, reaching the effectiveness of the young control group. In the wizard condition, age differences in effectiveness and satisfaction were eliminated; however, speed differences remained in all conditions. The results suggest that the simple integration of minimal video instruction or a task-oriented wizard design can make public access systems truly universally usable, and that the wizard TVM was a true “walk-up-and-use system.”
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Affiliation(s)
- Michael Sengpiel
- Department of Psychology, Humboldt-Universität zu Berlin, Germany
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Chen YX, Hung YP, Chen HC. Mobile Application–Assisted Cognitive Behavioral Therapy for Insomnia in an Older Adult. Telemed J E Health 2016; 22:332-4. [DOI: 10.1089/tmj.2015.0064] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Yong-Xiang Chen
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Yi-Ping Hung
- Graduate Institute of Networking and Multimedia, National Taiwan University, Taipei, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
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New Strategy to Reduce the Global Burden of Stroke. Stroke 2015; 46:1740-7. [DOI: 10.1161/strokeaha.115.008222] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 03/27/2015] [Indexed: 11/16/2022]
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Parmar P, Krishnamurthi R, Ikram MA, Hofman A, Mirza SS, Varakin Y, Kravchenko M, Piradov M, Thrift AG, Norrving B, Wang W, Mandal DK, Barker-Collo S, Sahathevan R, Davis S, Saposnik G, Kivipelto M, Sindi S, Bornstein NM, Giroud M, Béjot Y, Brainin M, Poulton R, Narayan KMV, Correia M, Freire A, Kokubo Y, Wiebers D, Mensah G, BinDhim NF, Barber PA, Pandian JD, Hankey GJ, Mehndiratta MM, Azhagammal S, Ibrahim NM, Abbott M, Rush E, Hume P, Hussein T, Bhattacharjee R, Purohit M, Feigin VL. The Stroke Riskometer(TM) App: validation of a data collection tool and stroke risk predictor. Int J Stroke 2014; 10:231-44. [PMID: 25491651 PMCID: PMC4335600 DOI: 10.1111/ijs.12411] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 10/28/2014] [Indexed: 11/26/2022]
Abstract
Background The greatest potential to reduce the burden of stroke is by primary prevention of first-ever stroke, which constitutes three quarters of all stroke. In addition to population-wide prevention strategies (the ‘mass’ approach), the ‘high risk’ approach aims to identify individuals at risk of stroke and to modify their risk factors, and risk, accordingly. Current methods of assessing and modifying stroke risk are difficult to access and implement by the general population, amongst whom most future strokes will arise. To help reduce the burden of stroke on individuals and the population a new app, the Stroke Riskometer™, has been developed. We aim to explore the validity of the app for predicting the risk of stroke compared with current best methods. Methods 752 stroke outcomes from a sample of 9501 individuals across three countries (New Zealand, Russia and the Netherlands) were utilized to investigate the performance of a novel stroke risk prediction tool algorithm (Stroke Riskometer™) compared with two established stroke risk score prediction algorithms (Framingham Stroke Risk Score [FSRS] and QStroke). We calculated the receiver operating characteristics (ROC) curves and area under the ROC curve (AUROC) with 95% confidence intervals, Harrels C-statistic and D-statistics for measure of discrimination, R2 statistics to indicate level of variability accounted for by each prediction algorithm, the Hosmer-Lemeshow statistic for calibration, and the sensitivity and specificity of each algorithm. Results The Stroke Riskometer™ performed well against the FSRS five-year AUROC for both males (FSRS = 75·0% (95% CI 72·3%–77·6%), Stroke Riskometer™ = 74·0(95% CI 71·3%–76·7%) and females [FSRS = 70·3% (95% CI 67·9%–72·8%, Stroke Riskometer™ = 71·5% (95% CI 69·0%–73·9%)], and better than QStroke [males – 59·7% (95% CI 57·3%–62·0%) and comparable to females = 71·1% (95% CI 69·0%–73·1%)]. Discriminative ability of all algorithms was low (C-statistic ranging from 0·51–0·56, D-statistic ranging from 0·01–0·12). Hosmer-Lemeshow illustrated that all of the predicted risk scores were not well calibrated with the observed event data (P < 0·006). Conclusions The Stroke Riskometer™ is comparable in performance for stroke prediction with FSRS and QStroke. All three algorithms performed equally poorly in predicting stroke events. The Stroke Riskometer™ will be continually developed and validated to address the need to improve the current stroke risk scoring systems to more accurately predict stroke, particularly by identifying robust ethnic/race ethnicity group and country specific risk factors.
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Characteristics of Elderly User Behavior on Mobile Multi-touch Devices. HUMAN-COMPUTER INTERACTION – INTERACT 2013 2013. [DOI: 10.1007/978-3-642-40498-6_25] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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