Critical Reflections on Technology to Support Physical Activity among Older Adults

Navigating Challenges and Opportunities in Community-Based Interventions for Promoting Active Aging: A Systematic Review of the Roles of Technology

Background and Objectives

Researchers from different fields are increasingly interested in incorporating technology into community-based interventions that promote active aging. Yet, there lacks a comprehensive understanding of technology roles, posing challenges for designers seeking to maximize the intended impacts of such interventions. This systematic review aims to fill the gap by examining existing community-based interventions that integrate digital technologies to promote active aging.

Research Design and Methods

Thirteen studies were screened, with a total of 14 interventions examined, following the PRISMA Guideline.

Results

The challenges in designing and operating community-based interventions, the roles of technology in the interventions, and the caveats of utilizing technology during the process were identified. The review emphasizes the importance of overcoming challenges in community-based interventions and leveraging technology to enhance the intended impacts.

Discussion and Implications

The findings underscore the need to understand technology's nuanced roles in community-based interventions for active aging. The article provides a starting point for accumulating knowledge and practice in utilizing technology to navigate the challenges and opportunities encountered in such interventions. It also sheds light on a notable gap: the lack of innovative and strategic approaches that harness digital interventions appropriately in community-based interventions. This emphasizes a crucial requirement for guidelines to assist designers, policymakers, and community staff in integrating technology appropriately into community-based interventions or implementing interventions that incorporate digital technologies at the community level.

Designing Tangible as an Orchestration Tool for Collaborative Activities

Orchestrating collaborative learning activities is a challenge, even with the support of technology. Tangibles as orchestration tools represent an ambient and embodied approach to sharing information about the learning content and flow of the activity, thus facilitating both collaboration and its orchestration. Therefore, we propose tangibles as a solution to orchestrate productive collaborative learning. Concretely, this paper makes three contributions toward this end: First, we analyze the design space for tangibles as an orchestration tool to support collaborative learning and identify twelve essential dimensions. Second, we present five tangible tools for collaborative learning activities in face-to-face and online classrooms. Third, we present principles and challenges to designing tangibles for orchestrating collaborative learning based on our findings from the evaluation of ten educational experts who evaluated these tools using a usability scale and open questions. The key findings were: (1) they had good usability; (2) their main advantages are ease of use and support for collaborative learning; (3) their main disadvantages are limited functions and the difficulty to scale them to more users. We conclude by providing reflections and recommendations for the future design of tangibles for orchestration.

Home-based digital health technologies for older adults to self-manage multiple chronic conditions: A data-informed analysis of user engagement from a longitudinal trial

Background

Ageing populations are resulting in higher prevalence of people with multiple chronic conditions (multimorbidity). Digital health platforms have great potential to support self-management of multimorbidity, increasing a person's awareness of their health and well-being, supporting a better understanding of diseases and encouraging behaviour change. However, little research has explored the long-term engagement of older adults with such digital interventions.

Methods

The aim of this study is to analyse how 60 older adults with multimorbidity engaged with digital symptom and well-being monitoring through a digital health platform over a period of approximately 12 months. Data analysis focused on user retention, frequency of monitoring, intervals in monitoring and patterns of daily engagement.

Results

Our findings show that the overall engagement with the digital health platform was high, with more than 80% of participants using the technology devices for over 200 days. The submission frequency for symptom parameters (e.g. blood glucose (BG), blood pressure (BP), etc.) was between three and four times per week which was higher than that of self-report (2.24) and weight (2.84). Submissions of exercise (6.12) and sleep (5.67) were more frequent. The majority of interactions happened in the morning time. The most common time of submission for symptom parameters was 10 am, whereas 8 am was the most common time for weight measurements.

Conclusions

The findings indicate the patterns of engagement of older adults with complex chronic diseases with digital home-based self-management systems.

Immersive Virtual Reality for Older Adults

Despite the proliferation of research on immersive virtual reality (IVR) technologies for older adults, comprehensive guidelines on designing immersive and engaging VR for older adults remain sparse. Therefore, we first compounded 67 guidelines based on published literature. Next, to empirically ground these design recommendations, we provided 37 older adults of diverse ages, education levels, and cognitive abilities with a first VR experience. Analyzing interviews with the 37 older adults via the Laddering method, we found that they generally reported positive experiences with their first VR exposure. With these deepened insights, we reflect on, nuance, and contextualize existing design guidelines, and formulate points to bear in mind when designing accessible and engaging VR experiences for older persons.

Irrelevant Gadgets or a Source of Worry

Wearable activity trackers are routinely applied in physical activity (PA) interventions in late life, but there is little research that focuses on older adults' perspectives on the technology. We conducted a qualitative study with 24 older persons to explore their perspective on wearables and PA. First, we discussed their relationship with PA and wearable trackers during focus groups. Next, nine participants crafted prototypes for wearables during co-design sessions. Through Thematic Analysis, we identified two main themes: (1) PA is personal in terms of preferred activities and reasons for PA, and (2) wearables are an emotional technology, causing negative emotions when resembling medical trackers or pressurizing to perform. We followed upon these results through a survey with 41 participants, which further highlighted individual differences in the perception of wearables. We conclude with questions to guide the design of wearables and reflect on their role to support PA in late life.

Adopting Diffractive Reading to Advance HCI Research: A Case Study on Technology for Aging

Researchers in Human-Computer Interaction (HCI) have long developed technologies for older adults. Recently, researchers are engaging in critical reflections of these approaches. IoT for aging in place is one area around which these conflicting discourses have converged, likely in part driven by government and industry interest. This article introduces diffractive analysis as an approach that examines difference to yield new empirical understandings about our methods and the topics we study. We constructed three analyses of a dataset collected at an IoT design workshop and then conducted a diffractive analysis. We present themes from this analysis regarding the ways that participants are inscribed in our research, considerations related to transferability and novelty between work centered on older adults and other work, and insights about methodologies. Our discussion contributes implications for researchers to form teams and account for their roles in research, as well as recommendations how diffractive analysis can support other research agendas.

Development of the Digital Assessment of Precise Physical Activity (DAPPA) Tool for Older Adults

Physical activity (PA) is central to maintaining health and wellbeing as we age. Valid, reliable measurement tools are vital for understanding, and evaluating PA. There are limited options for comprehensively, accurately and affordably measuring older adults’ PA at scale at present. We aimed to develop a digital PA measurement tool specifically for adults aged 65+ using a person-based approach. We collated evidence from target users, field experts and the relevant literature to learn how older adults comprehend PA and would accept a digital tool. Findings suggest that older adults’ PA is often integrated into their daily life activities and that commonly applied terminology (e.g., moderate and vigorous) can be difficult to interpret. We also found that there is increasing familiarity with digital platforms amongst older adults, and that technological simplicity is valued. These findings informed the development of a digital tool that asks users to report their activities across key PA domains and dimensions from the previous 7-days. Users found the tool easy to navigate and comprehensive in terms of activity reporting. However, real-world usability testing revealed that users struggled with seven-day recall. Further work will address the identified issues, including creating a single-day reporting option, before commencing work to validate this new tool.