Factors Affecting the Acceptability of Technology in Health Care Among Older Korean Adults with Multiple Chronic Conditions: A Cross-Sectional Study Adopting the Senior Technology Acceptance Model

Perceptions of Telehealth Services Among Rural Lung Cancer Patients in China: A Qualitative Study Using the Technology Acceptance Model

OBJECTIVES

To describe the perceptions of telehealth services among lung cancer patients in rural areas of China, as well as to explore the potential of telemedicine to improve long-term health recovery at home for rural lung cancer patients.

METHODS

A qualitative descriptive study design was used in this study and we conducted semi-structured interviews with 14 rural Chinese lung cancer patients between December 2022 and March 2023. Interview content was analyzed using Nvivo software and a framework analysis was performed using the Technology Acceptance Model to identify meaningful themes.

RESULTS

Participants identified perceptual and technical factors related to perceived ease of use, benefits and drawbacks related to perceived usefulness, and facilitators and barriers related to intention to use. However, regional and disease features including literacy barriers, medical insurance condition, symptom burden, and rural cultural health seeking behavior conduct must be taken into account.

CONCLUSIONS

Lung cancer patients in rural China believe that telehealth services could be an alternative solution for addressing health and care needs, but various aspects, such as user interface design, cost-effectiveness, and technological anxiety, need to be optimized.

IMPLICATIONS FOR NURSING PRACTICE

More highly specialized nursing team, friendly telecare lung function modules, and media technology training courses should be developed for rural lung cancer patients to enhance the quality of their home care, meet their information needs and better control their disease progression.

Understanding Factors Influencing Diabetic Patients' Intention to Use Digital Health Services in Saudi Arabia Using the Technology Acceptance Model

This study employs the Technology Acceptance Model to investigate the factors influencing Saudi Arabian diabetic patients' intention to use digital health services. There is an urgent need to investigate the possibilities of digital health services in managing diabetes given the startlingly rapidly increasing prevalence rate of diabetes in KSA. The study examines the variables affecting patients' acceptance and desire to use digital health tools to manage their diabetes. The study employs the Technology Acceptance Model to ascertain the crucial factors that impact patients' opinions regarding the usefulness and ease of use of digital healthcare technologies. The proposed model extends the traditional Technology Acceptance Model by adding two new constructs, perceived privacy and trust. These constructs were examined by analyzing the intentions of 600 respondents through online surveys. The study's conclusions showed that attitudes toward using digital health services for KSA diabetic patients are greatly influenced by every component of the extended Technology Acceptance Model. The study's conclusions add to the body of knowledge already in existence and offer insightful information to decision-makers hoping to improve digital health services.

Home-monitoring for neovascular age-related macular degeneration in older adults within the UK: the MONARCH diagnostic accuracy study

Background

Most neovascular age-related macular degeneration treatments involve long-term follow-up of disease activity. Home monitoring would reduce the burden on patients and those they depend on for transport, and release clinic appointments for other patients. The study aimed to evaluate three home-monitoring tests for patients to use to detect active neovascular age-related macular degeneration compared with diagnosing active neovascular age-related macular degeneration by hospital follow-up.

Objectives

There were five objectives: Estimate the accuracy of three home-monitoring tests to detect active neovascular age-related macular degeneration. Determine the acceptability of home monitoring to patients and carers and adherence to home monitoring. Explore whether inequalities exist in recruitment, participants' ability to self-test and their adherence to weekly testing during follow-up. Provide pilot data about the accuracy of home monitoring to detect conversion to neovascular age-related macular degeneration in fellow eyes of patients with unilateral neovascular age-related macular degeneration. Describe challenges experienced when implementing home-monitoring tests.

Design

Diagnostic test accuracy cohort study, stratified by time since starting treatment.

Setting

Six United Kingdom Hospital Eye Service macular clinics (Belfast, Liverpool, Moorfields, James Paget, Southampton, Gloucester).

Participants

Patients with at least one study eye being monitored by hospital follow-up.

Reference standard

Detection of active neovascular age-related macular degeneration by an ophthalmologist at hospital follow-up.

Index tests

KeepSight Journal: paper-based near-vision tests presented as word puzzles. MyVisionTrack®: electronic test, viewed on a tablet device. MultiBit: electronic test, viewed on a tablet device. Participants provided test scores weekly. Raw scores between hospital follow-ups were summarised as averages.

Results

Two hundred and ninety-seven patients (mean age 74.9 years) took part. At least one hospital follow-up was available for 317 study eyes, including 9 second eyes that became eligible during follow-up, in 261 participants (1549 complete visits). Median testing frequency was three times/month. Estimated areas under receiver operating curves were < 0.6 for all index tests, and only KeepSight Journal summary score was significantly associated with the lesion activity (odds ratio = 3.48, 95% confidence interval 1.09 to 11.13, p = 0.036). Older age and worse deprivation for home address were associated with lower participation (χ2 = 50.5 and 24.3, respectively, p < 0.001) but not ability or adherence to self-testing. Areas under receiver operating curves appeared higher for conversion of fellow eyes to neovascular age-related macular degeneration (0.85 for KeepSight Journal) but were estimated with less precision. Almost half of participants called a study helpline, most often due to inability to test electronically.

Limitations

Pre-specified sample size not met; participants' difficulties using the devices; electronic tests not always available.

Conclusions

No index test provided adequate test accuracy to identify lesion diagnosed as active in follow-up clinics. If used to detect conversion, patients would still need to be monitored at hospital. Associations of older age and worse deprivation with study participation highlight the potential for inequities with such interventions. Provision of reliable electronic testing was challenging.

Future work

Future studies evaluating similar technologies should consider: Independent monitoring with clear stopping rules based on test performance. Deployment of apps on patients' own devices since providing devices did not reduce inequalities in participation and complicated home testing. Alternative methods to summarise multiple scores over the period preceding a follow-up.

Trial registration

This trial is registered as ISRCTN79058224.

Funding

This award was funded by the National Institute of Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 15/97/02) and is published in full in Health Technology Assessment; Vol. 28, No. 32. See the NIHR Funding and Awards website for further award information.

Development of the intelligent knee osteoarthritis lifestyle app: a person-based approach

BACKGROUND

Knee osteoarthritis is one of the most prevalent long term health conditions globally. Exercise and physical activity are now widely recognised to significantly reduce joint pain, improve physical function and quality of life in patients with knee osteoarthritis. However, prescribed exercise without regular contact with a healthcare professional often results in lower adherence and poorer health outcomes. Digital mobile health (mHealth) technologies offer great potential to support people with long-term conditions such as knee osteoarthritis more efficiently and effectively and with relatively lower cost than existing interventions. However, there are currently very few mHealth interventions for the self-management of knee osteoarthritis. The aim of the present study was to describe the development process of a mHealth app to extend the support for physical activity and musculoskeletal health beyond short-term, structured rehabilitation through self-management, personalised physical activity, education, and social support.

METHODS

The development of the intelligent knee osteoarthritis lifestyle application intervention involved an iterative and interconnected process comprising intervention 'planning' and 'optimisation' informed by the person-based approach framework for the development of digital health interventions. The planning phase involved a literature review and collection of qualitative data obtained from focus groups with individuals with knee osteoarthritis (n = 26) and interviews with relevant physiotherapists (n = 5) to generate 'guiding principles' for the intervention. The optimisation phase involved usability testing (n = 7) and qualitative 'think aloud' sessions (n = 6) with potential beneficiaries to refine the development of the intervention.

RESULTS

Key themes that emerged from the qualitative data included the need for educational material, modifying activities to suit individual abilities and preferences as well as the inclusion of key features such as rehabilitation exercises. Following a user-trial further changes were made to improve the usability of the application.

CONCLUSIONS

Using a systematic person-based, development approach, we have developed the intelligent knee osteoarthritis lifestyle application to help people maintain physical activity behaviour. The app extends the support for physical activity and musculoskeletal health beyond short-term, structured rehabilitation through personalised physical activity guidance, education, and social support.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Home-based exercise interventions delivered by technology in older adults: A scoping review of technological tools usage

BACKGROUND

Despite technology-based systems being considered promising tools to stimulate and increase physical function at home, most older adults are unfamiliar with technology, which may pose some difficulties. Technology-related parameters, such as adherence, acceptance, and acceptability, are crucial to achieving higher efficacy levels of home-based exercise interventions delivered by technology. In this scoping review, we aimed to revise the use of home-based technological tools to improve physical function in the older population, focusing on the user's experience and perspective. Methods This scoping review was conducted following PRISMA guidelines. The search was conducted in April 2022 and updated in April 2023. A total of 45 studies were included in the review. Results Most studies (95.5%) met the technology usage levels defined by the research team or reported satisfactory technology usage levels. Positive health-related outcomes were reported in 80% of studies. Although the existence of guidelines to correctly define and use measures associated with technology use, including adherence, acceptance and acceptability, some terms are still being used interchangeably. Some concerns related to the lack of an international consensus regarding technology usage measures and the exclusion of older adults who did not own or have previous experience with technology in a large percentage of the included studies may have limited the results obtained. Conclusions Altogether, home-based exercise interventions delivered through technology were associated with positive health-related outcomes in older adults, and technology usage levels are considered satisfactory. Older adults are willing and able to use technology autonomously if adequate support is provided.

Demand and influencing factors of "Internet + Traditional Chinese Medicine" home nursing service for older adult patients with chronic diseases: a mixed research perspective

Background

In the context of global aging, the characteristics of chronic diseases seriously affect the quality of life of older adults. It is urgent to carry out continuous nursing basis for older adult patients with chronic diseases. In view of the remarkable efficacy of Chinese medicine in the treatment of chronic diseases, this study may help to understand the demand for "Internet + Chinese medicine" home care service and its influencing factors of older adult chronic disease patients, and to provide a reference basis for improving the quality of life of the older adult chronic disease population.

Methods

This is a mixed study. The quantitative study adopted the convenience sampling method, and a total of 308 patients in a third-grade hospital in Shaanxi Province were investigated by general data questionnaire, traditional Chinese medicine service demand questionnaire, traditional Chinese medicine knowledge questionnaire, older adult Chinese medicine attitude questionnaire, and home care demand questionnaire from March to April 2022. In the qualitative study, semi-structured interviews were adopted, and patients were interviewed until the content was saturated. Colaizzi analysis method was used to analyze and summarize the topic of the interview data.

Results

308 valid questionnaires were collected, and the patients scored (58.42 ± 17.16) on the demand for TCM nursing services, (59.86 ± 11.54) on the knowledge of TCM, (73.03 ± 9.11) on the attitude toward TCM, and (136.84 ± 46.39) on the demand for home care. The results of multiple linear regression showed that learning about the nursing service pathway, knowledge of general knowledge of Chinese medicine, and attitude toward Chinese medicine among the older adult and home care demand were the influencing factors of the demand for Chinese medicine nursing services for older adult patients with chronic diseases (p < 0.05). The results of the in-depth interviews were summarized into three themes: facilitating factor, hindering factor, and the "Internet + Chinese medicine" multiple needs of home care.

Conclusion

Older adult patients with chronic diseases have a high intention of home care demand and they are affected by multiple factors. Consequently, the actual demand situation of older adult patients with chronic diseases should be used as a guide to provide directed and diversified Chinese medicine home care services to meet the individualized needs of the older adult.

Acceptance of communication technology, emotional support and subjective well-being for Chinese older adults living alone during COVID-19: A moderated mediation model

Stringent social distancing measures implemented to control the spread of COVID-19 affected older adults living alone by limiting their social interaction beyond their households. During these restrictions, interactions beyond the household could be facilitated by communication technology (CT) such as voice calls, instant messages. Our study provides evidence on how CT acceptance could influence the emotional support and in turn, subjective well-being (SWB) of older adults living alone. We did a cross-sectional survey with 293 community-dwelling Chinese older adults. Participants were surveyed from September to November 2020 and had completed measures on CT acceptance (competency), emotional support, and SWB. PROCESS Model 1 was used to estimate the conditional effects of CT acceptance (competency) on emotional support for those living alone versus with others. Following which, PROCESS Model 7 was used to estimate the conditional indirect effects of CT acceptance (competency) on SWB through emotional support. Our results suggested that living arrangement moderated the indirect effect of CT acceptance (competency) on SWB. For older adults living alone, CT acceptance (competency) was significantly associated with perceived emotional support and, in turn, their SWB. For older adults living with others, CT acceptance was not associated with emotional support and SWB. Our findings call for more research and support to increase older adults' acceptance of CT as an option for communication to increase emotional support for older adults living alone, even during non-pandemic times.

Examining Engagement and Usability in an Online Discussion Platform for Older Adults: Findings From Pilot Studies

Social media may facilitate older adults' ability to engage socially and explore health information, but it can present difficulties for older adults. Therefore, it is important to explore older adults' experience of usability and user engagement. We conducted two rounds of pilot studies where we used Facebook to engage older adults. We performed a mixed-methods evaluation of user engagement and usability. A directed content analysis of qualitative data from the pilot studies was used to explore engagement and perceived usability, and the Mann-Whitney U test was used to examine differences in feature usage and engagement. We analyzed qualitative data from 13 participants. Qualitative data analysis yielded themes pertaining to three main domains: user engagement , usability , and usability related to aging-related changes . In terms of user engagement and usability, participants in both pilot studies reported positive feedback on felt involvement and endurability, and the second pilot group reported more positive comments regarding perceived usefulness compared with the first pilot group. There was no statistically significant difference in usage over the two studies. The findings of this study suggest opportunities to improve older adults' experience of online discussion platforms. Considering changes that improve perceived aesthetic appeal and focused attention will be helpful.

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

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

Physicians' perceptions of electronic prescribing of controlled medications in the West Bank, Palestine: A pre-implementation assessment

BACKGROUND

In Palestine, prescribing controlled medications is still done on paper. Despite valuable regulatory efforts, there is a high risk of undetected abuse and "doctor shopping". These problems can be addressed with electronic prescribing of controlled medicines (EPCM). User adoption is essential to the successful implementation of any technology. Therefore, it is crucial to determine the perception of end users at an early stage. This topic has never been addressed in Palestine. Our study aims to investigate the perception of Palestinian physicians towards the introduction of EPCM.

METHODS

This cross-sectional study was conducted among Palestinian physicians in the West Bank who are familiar with controlled medications prescribing. Data were collected using a self-administered questionnaire based on the Unified Theory of User Acceptance and Use of Technology (UTAUT) from a convenience sample of 300 physicians. Data were analyzed using SPSS version 26. Bivariate analysis and binary and multivariate logistic regression were performed to identify factors associated with physicians' perceptions of ECPM.

RESULTS

Most physicians expressed their willingness to use EPCM, with an acceptance rate of 85%. This perception was significantly affected by performance expectancy, effort expectancy and trust. None was moderated by age, gender, or experience with electronic prescribing. Age and specialization level were independent factors significantly influencing the intention to use EPCM. The level of current workflow challenges did not correlate with the intent to use EPCM.

CONCLUSION

Palestinian physicians will accept EPCM. Based on the results of this study, it is recommended that the following be considered: ensuring maximum efficiency of the system, selecting user-friendly interfaces and high-security measures to prevent system breaches.

A Study on Technology Acceptance of Digital Healthcare among Older Korean Adults Using Extended Tam (Extended Technology Acceptance Model)

The use of digital health and wrist-worn wearable technologies have been increasingly utilized, especially during COVID-19 surge, to help monitor patients and vulnerable groups such as elderly people. As one of the countries with highest aging population, South Korean older adults are expected to be familiarized with these healthcare technologies. However, there have been a few studies on the investigation of Korean older adults’ attitude towards the acceptance of wearable technologies, such as a smart health watch after the COVID-19 curve flattened in South Korea. Thus, the purpose of this study is to investigate the acceptability of digital health wearable technology in healthcare by the Korean older adults and their attitude towards the use of smart health watches by using an extended Technology Acceptance Model while considering the context of the COVID-19 pandemic. We performed a cross-sectional survey of Korean adults aged 56 years and older who are living in Busan, and a total of 170 respondents were received. Results reveal that perceived usefulness, perceived ease of use, and facilitating conditions have a significant impact on older Korean’s attitudes towards the use of a smart health watch, while the relationship between social influence and attitude towards its use was found to not be statistically significant. The attitude towards the use of smart health watches had an effect on their intention to use the smartwatch. By using the findings from the study, the digital wearables providers, manufacturers, and promotors can enhance their strategy to elevate the use of digital healthcare wearables among Korean elderly people while ensuring these products are of good quality and affordable, as well as ensuring necessary assistance is provided to the elderly people when utilizing and adopting these wearables in their everyday lives. Moreover, the results of this study can be utilized to accommodate the needs of Korean elderly people regarding their use of smart health watches and help promote the benefits of healthcare wearable technologies after the pandemic subsides.

The relationship between older adults' technology use, in-person engagement, and pandemic-related mental health

OBJECTIVE

The objectives of this study are to 1) describe changes in in-person communication/activity and changes in older adult technology use during the COVID-19 pandemic and 2) examine whether less in-person communication/activity mediates the relationship between pandemic-related mental health and technology use.

METHOD

Linear regressions (stratified by age and financial strain) and structural equation modeling were employed using a nationally representative, cross-sectional survey of 3,188 older adults from the 2020 National Health and Aging Trends Study's COVID-19 Questionairre.

RESULTS

Older adults engaged in more technology-based activity (b = 0.24; p<.001), more technology-based health care communication (b = 0.22; p<.001), and more technology-based food acquisition (b = 0.21; p<.001) during the COVID-19 pandemic, as compared to before the pandemic. Results indicate that adults <80 years old demonstrated greater increases in technology-based activity, technology-based health communication, and technology-based food acquisition, compared to adults ≥80 years old. Change in in-person communication significantly mediated the relationship between pandemic-related mental health and technology-based communication (standardized coefficient= -0.012; p=.005), and change in in-person activity significantly mediated the relationship between pandemic-related mental health and technology-based activity (standardized coefficient= -0.017; p=.020).

CONCLUSIONS

This study suggests that older adults are utilizing technology more, and therefore should be considered in technology design and dissemination. Technology use could be an important positive response to help those with pandemic related worries stay safely engaged with friends and family. Technologies should be produced that are modifiable for older adults with disabilities and affordable for older adults with fixed incomes.

Patient Acceptability of Home Monitoring for Neovascular Age-Related Macular Degeneration Reactivation: A Qualitative Study

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.

Staying connected: smartphone acceptance and use level differences of older adults in China

In recent years, an increasing number of studies have addressed the older adults' Information and Communication Technology acceptance, the majority of which concentrate on the use of computers and the internet. As smartphone use becomes further integrated into older adults' daily lives, it is important to investigate how perceptions about and use of smartphones intersect. This study (1) proposes an extended Technology Acceptance Model and tests the relationships between Perceived Usefulness, Perceived Ease of Use, Attitude, Behavioural Intention, Self-efficacy, Technology Anxiety, and Social Support in older adults' smartphone use by confirmatory factor analysis (CFA); and (2) analyses the specific differences between primary, medium, and advanced use level groups in each construct by Q-cluster and ANOVAs. We conduct a community-based survey with a sample of 1,006 older adults in East China. The data demonstrate that the extended model offered a good explanation of smartphone acceptance among the older adults, and the groups belong to different use levels show significant difference in all constructs. The findings indicate that digital divide is objectively inevitable in smartphone use, but the older adults are extremely diverse groups that do not uniformly conform to technology averse stereotypes.

Factors influencing the intention to use assistive technologies by older adults

Society is ageing at an unprecedented pace worldwide creating implications for the health and social care. Gerontechnology has been recognized as a solution that increases and supports the independency and well-being of older adults at home. This article aims to identify the most critical success factors effecting the adoption of an assistive gerontechnology by older adults in Poland. The object of the authors' interest was Rudy robot, an AI-enabled mobile solution helping users remain physically healthy, mentally sharp, and socially connected. The data was collected among Polish citizens using the CATI technique between November and December 2020. The number of returned questionnaires amounted to 824. The authors used Generalized Least Squares (GLS) of Structural Equation Modelling (GLS-SEM) to verify the hypotheses. The obtained results confirmed statistically significant relationships between the variables of perceived usefulness of Rudy robot and attitude reflecting the willingness to use this technology, as well as between perceived ease of use and perceived usefulness of robot. However, relationship between perceived ease of use and inclination to use this technology in the future was not statistically significant. The conducted research confirmed that the functionality of the analysed Rudy robot for older-adult care positively influences their intension to use it in the future for their own needs or family members. The obtained results confirmed usefulness of robots as assistive technology helping older adults.

New Technology and Loss of Paid Employment among Older Workers: Prospective Cohort Study

BACKGROUND

This study investigates the association between the implementation of new technology in the workplace and the subsequent loss of paid employment among older workers.

METHODS

We estimated the prospective risk of loss of paid employment (register-based) from questions on new technology among 10,320 older workers (≥50 years). To investigate potential differences between work types, analyses were stratified by job function: (1) work with symbols (office, administration, analysis, IT), (2) work with people (people, service, care), (3) work in the field of production (processing, producing or moving things).

RESULTS

The introduction of new technology at the workplace reduced the risk of losing paid employment among older workers working with symbols (risk ratio [RR] 0.74, 95% CI 0.72-0.76) and in the field of production (RR 0.83, 95% CI 0.80-0.85), whereas new technology increased this risk among those working with people (RR 1.22, 95% CI 1.19-1.26). Being involved in the introduction of new technology and receiving adequate training in its use decreased the risk of loss of paid employment.

CONCLUSIONS

Depending on the context, the introduction of new technology at work associates positively as well as negatively with future labour market participation among older workers. Worker involvement and adequate training in the use of new technology seem to be important for retaining workers in the labour market.

Smartphone Use, Technology Affordance for Healthcare and Elders' Life Satisfaction

Previous studies have examined how smartphones influence the life satisfaction of the elderly, but the existence of conflicting conclusions suggests the existence of a “black box”. In this study, using a survey from 941 elders, we examine whether smartphone use can improve life satisfaction of the elders by inducing emotional affordance offered by social networking Apps and functional affordance offered by healthcare system Apps. It is found that both emotional affordance and functional affordance acted as intermediating variables between the use of smartphone and elders' life satisfaction. In addition, it is founded that living arrangement with adult children moderates the positive impact of smartphone use on functional affordance, but there was no such moderating effect on emotional affordance. This study offers insights about how digital healthcare innovation will be applied to increase well-being of elders by applying framework of selective optimization with compensation.

Factors Influencing Intention to Technological Use in Older Adults. The TAM Model Aplication

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.

Association of Visual Display Terminal Usage with Self-Rated Health and Psychological Distress among Japanese Office Workers during the COVID-19 Pandemic

The aim of this study was to examine the association of the duration of visual display terminal (VDT) usage for work and non-work activities with self-rated health (SRH) and psychological distress among office workers during the COVID-19 pandemic in Japan. A cross-sectional data of 7088 office workers from a web-based, self-administered survey conducted from 25 August 2020, to 30 September 2020, was used. Multiple logistic regression analysis was applied. Compared to those who used a VDT for 4–9 h for work, office workers who used a VDT for ≥10 h for work had poor SRH (odds ratio (OR): 1.65; 95% confidence interval (CI): 1.13, 2.41) and severe psychological distress (OR: 2.23; 95% CI: 1.52, 3.28). VDT usage for less than 1 h (OR: 1.37, 95% CI: 1.12, 1.67) and 1–3 h (OR: 1.42, 95% CI: 1.12, 1.80) for work were also associated with severe psychological distress. Stratification analysis by age showed a significant association of VDT usage for work with poor SRH among 30–64-year-olds, while a U-shape association was found between VDT usage for work and psychological distress with the younger age group (15–29 years old). During the COVID-19 pandemic in Japan, the prolonged usage of VDT for work can deteriorate both general and psychological health, while moderate usage of VDT for work can reduce psychological distress.

Assessing private provider perceptions and the acceptability of video observed treatment technology for tuberculosis treatment adherence in three cities across Viet Nam

BACKGROUND

The World Health Organization recently recommended Video Observed Therapy (VOT) as one option for monitoring tuberculosis (TB) treatment adherence. There is evidence that private sector TB treatment has substandard treatment follow-up, which could be improved using VOT. However, acceptability of VOT in the private sector has not yet been evaluated.

METHODS

We conducted a cross-sectional survey employing a theoretical framework for healthcare intervention acceptability to measure private provider perceptions of VOT across seven constructs in three cities of Viet Nam: Ha Noi, Ho Chi Minh City, and Hai Phong. We investigated the differences in private providers' attitudes and perceptions of VOT using mixed ordinal models to test for significant differences in responses between groups of providers stratified by their willingness to use VOT.

RESULTS

A total of 79 private providers completed the survey. Sixty-two providers (75%) indicated they would use VOT if given the opportunity. Between private providers who would and would not use VOT, there were statistically significant differences (p≤0.001) in the providers' beliefs that VOT would help identify side effects faster and in their confidence to monitor treatment and provide differentiated care with VOT. There were also significant differences in providers' beliefs that VOT would save them time and money, address problems faced by their patients, benefit their practice and patients, and be relevant for all their patients.

CONCLUSION

Private providers who completed the survey have positive views towards using VOT and specific subpopulations acknowledge the value of integrating VOT into their practice. Future VOT implementation in the private sector should focus on emphasizing the benefits and relevance of VOT during recruitment and provide programmatic support for implementing differentiated care with the technology.