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Jin W, Montoya C, Rich BJ, Taswell CS, Noy M, Kwon D, Spieler B, Mahal B, Abramowitz M, Yechieli R, Pollack A, Dal Pra A. A Smart Water Bottle and Companion App (HidrateSpark 3) to Improve Bladder-Filling Compliance in Patients With Prostate Cancer Receiving Radiotherapy: Nonrandomized Trial of Feasibility and Acceptability. JMIR Cancer 2024; 10:e51061. [PMID: 39255484 DOI: 10.2196/51061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 11/06/2023] [Accepted: 03/04/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND Patients with prostate cancer undergoing radiation therapy (RT) need comfortably full bladders to reduce toxicities during treatment. Poor compliance is common with standard of care written or verbal instructions, leading to wasted patient value (PV) and clinic resources via poor throughput efficiency (TE). OBJECTIVE Herein, we assessed the feasibility and acceptability of a smartphone-based behavioral intervention (SBI) to improve bladder-filling compliance and methods for quantifying PV and TE. METHODS In total, 36 patients with prostate cancer were enrolled in a single-institution, closed-access, nonrandomized feasibility trial. The SBI consists of a fully automated smart water bottle and smartphone app. Both pieces alert the patient to empty his bladder and drink a personalized volume goal, based on simulation bladder volume, 1.25 hours before his scheduled RT. Patients were trained to adjust their volume goal and notification times to achieve comfortably full bladders. The primary end point was met if qualitative (QLC) and quantitative compliance (QNC) were >80%. For QLC, patients were asked if they prepared their bladders before daily RT. QNC was met if bladder volumes on daily cone-beam tomography were >75% of the simulation's volume. The Service User Technology Acceptability Questionnaire (SUTAQ) was given in person pre- and post-SBI. Additional acceptability and engagement end points were met if >3 out of 5 across 4 domains on the SUTAQ and >80% (15/18) of patients used the device >50% of the time, respectively. Finally, the impact of SBI on PV and TE was measured by time spent in a clinic and on the linear accelerator (linac), respectively, and contrasted with matched controls. RESULTS QLC was 100% in 375 out of 398 (94.2%) total treatments, while QNC was 88.9% in 341 out of 398 (85.7%) total treatments. Of a total score of 5, patients scored 4.33 on privacy concerns, 4 on belief in benefits, 4.56 on satisfaction, and 4.24 on usability via SUTAQ. Further, 83% (15/18) of patients used the SBI on >50% of treatments. Patients in the intervention arm spent less time in a clinic (53.24, SEM 1.71 minutes) compared to the control (75.01, SEM 2.26 minutes) group (P<.001). Similarly, the intervention arm spent less time on the linac (10.67, SEM 0.40 minutes) compared to the control (14.19, SEM 0.32 minutes) group (P<.001). CONCLUSIONS This digital intervention trial showed high rates of bladder-filling compliance and engagement. High patient value and TE were feasibly quantified by shortened clinic times and linac usage, respectively. Future studies are needed to evaluate clinical outcomes, patient experience, and cost-benefit. TRIAL REGISTRATION ClinicalTrials.gov NCT04946214; https://www.clinicaltrials.gov/study/NCT04946214.
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Affiliation(s)
- William Jin
- Department of Radiation Oncology, Jackson Memorial Hospital, Miami, FL, United States
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
| | - Christopher Montoya
- Department of Radiation Oncology, Jackson Memorial Hospital, Miami, FL, United States
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
| | - Benjamin James Rich
- Department of Radiation Oncology, Jackson Memorial Hospital, Miami, FL, United States
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
| | - Crystal Seldon Taswell
- Department of Radiation Oncology, Jackson Memorial Hospital, Miami, FL, United States
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
| | - Miguel Noy
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
| | - Deukwoo Kwon
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, United States
- Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Benjamin Spieler
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
| | - Brandon Mahal
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
| | - Matthew Abramowitz
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
| | - Raphael Yechieli
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
| | - Alan Pollack
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
| | - Alan Dal Pra
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
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Huang HH, Chang MH, Chen PT, Lin CL, Sung PS, Chen CH, Fan SY. Exploring factors affecting the acceptance of fall detection technology among older adults and their families: a content analysis. BMC Geriatr 2024; 24:694. [PMID: 39164655 PMCID: PMC11334405 DOI: 10.1186/s12877-024-05262-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 07/30/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND This study conducted in-depth interviews to explore the factors that influence the adoption of fall detection technology among older adults and their families, providing a valuable evaluation framework for healthcare providers in the field of fall detection, with the ultimate goal of assisting older adults immediately and effectively when falls occur. METHODS The method employed a qualitative approach, utilizing semi-structured interviews with 30 older adults and 29 families, focusing on their perspectives and expectations of fall detection technology. Purposive sampling ensured representation from older adults with conditions such as Parkinson's, dementia, and stroke. RESULTS The results reveal key considerations influencing the adoption of fall-detection devices, including health factors, reliance on human care, personal comfort, awareness of market alternatives, attitude towards technology, financial concerns, and expectations for fall detection technology. CONCLUSIONS This study identifies seven key factors influencing the adoption of fall detection technology among older adults and their families. The conclusion highlights the need to address these factors to encourage adoption, advocating for user-centered, safe, and affordable technology. This research provides valuable insights for the development of fall detection technology, aiming to enhance the safety of older adults and reduce the caregiving burden.
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Affiliation(s)
- Hsin-Hsiung Huang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Ming-Hao Chang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Peng-Ting Chen
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan, ROC.
- Medical Device Innovation Center, National Cheng Kung University, No.138, Shengli Rd., North District, Tainan City, 704, Taiwan, ROC.
| | - Chih-Lung Lin
- Department of Electrical Engineering, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Pi-Shan Sung
- Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan, ROC
| | - Chien-Hsu Chen
- Department of Industrial Design, National Cheng Kung University, Tainan, Taiwan, ROC
| | - Sheng-Yu Fan
- Institute of Gerontology, National Cheng Kung University, Tainan, Taiwan, ROC
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Wong AKC, Bayuo J, Su JJ, Chow KKS, Wong SM, Wong BP, Lee AYL, Wong FKY. Exploring the Experiences of Community-Dwelling Older Adults on Using Wearable Monitoring Devices With Regular Support From Community Health Workers, Nurses, and Social Workers: Qualitative Descriptive Study. J Med Internet Res 2024; 26:e49403. [PMID: 39110493 PMCID: PMC11339583 DOI: 10.2196/49403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 01/14/2024] [Accepted: 05/24/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND The use of wearable monitoring devices (WMDs), such as smartwatches, is advancing support and care for community-dwelling older adults across the globe. Despite existing evidence of the importance of WMDs in preventing problems and promoting health, significant concerns remain about the decline in use after a period of time, which warrant an understanding of how older adults experience the devices. OBJECTIVE This study aims to explore and describe the experiences of community-dwelling older adults after receiving our interventional program, which included the use of a smartwatch with support from a community health workers, nurses, and social workers, including the challenges that they experienced while using the device, the perceived benefits, and strategies to promote their sustained use of the device. METHODS We used a qualitative descriptive approach in this study. Older adults who had taken part in an interventional study involving the use of smartwatches and who were receiving regular health and social support were invited to participate in focus group discussions at the end of the trial. Purposive sampling was used to recruit potential participants. Older adults who agreed to participate were assigned to focus groups based on their community. The focus group discussions were facilitated and moderated by 2 members of the research team. All discussions were recorded and transcribed verbatim. We used the constant comparison analytical approach to analyze the focus group data. RESULTS A total of 22 participants assigned to 6 focus groups participated in the study. The experiences of community-dwelling older adults emerged as (1) challenges associated with the use of WMDs, (2) the perceived benefits of using the WMDs, and (3) strategies to promote the use of WMDs. In addition, the findings also demonstrate a hierarchical pattern of health-seeking behaviors by older adults: seeking assistance first from older adult volunteers, then from social workers, and finally from nurses. CONCLUSIONS Ongoing use of the WMDs is potentially possible, but it is important to ensure the availability of technical support, maintain active professional follow-ups by nurses and social workers, and include older adult volunteers to support other older adults in such programs.
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Affiliation(s)
| | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
| | - Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, China (Hong Kong)
| | | | - Siu Man Wong
- Hong Kong Lutheran Social Service, Kowloon, China (Hong Kong)
| | - Bonnie Po Wong
- Hong Kong Lutheran Social Service, Kowloon, China (Hong Kong)
| | - Athena Yin Lam Lee
- Department of Health, The Government of the Hong Kong Special Administrative Region, Hong Kong Island, China (Hong Kong)
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Wiegel P, Fotteler ML, Kohn B, Mayer S, Verri FM, Dallmeier D, Denkinger M. Perceived Benefit and Satisfaction With a Tablet Computer and an Emergency Smartwatch by Older Adults and Their Relatives: Prospective Real-World Pilot Study. JMIR Hum Factors 2024; 11:e53811. [PMID: 39104048 PMCID: PMC11310738 DOI: 10.2196/53811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 03/08/2024] [Accepted: 06/07/2024] [Indexed: 08/07/2024] Open
Abstract
Background Assistive technologies (ATs) have the potential to promote the quality of life and independent living of older adults and, further, to relieve the burden of formal and informal caregivers and relatives. Technological developments over the last decades have led to a boost of available ATs. However, evidence on the benefits and satisfaction with ATs in real-world applications remains scarce. Objective This prospective, real-world, pilot study tested the perceived benefit and satisfaction with different ATs in the real-world environment. Methods Community-dwelling adults aged ≥65 and their relatives tested a tablet computer with a simplified interface or a smartwatch with programmable emergency contacts for 8 weeks in their everyday life. Perceived benefits and satisfaction with ATs were assessed by all older adults and their relatives using different assessment tools before and after the intervention. Outcome measures included the Technology Usage Inventory, Quebec User Evaluation of Satisfaction with Assistive Technology 2.0, and Canadian Occupational Performance Measure. Results A total of 17 older adults (tablet computer: n=8, 47% and smartwatch: n=9, 53%) and 16 relatives (tablet computer: n=7, 44% and smartwatch: n=9, 56%) were included in the study. The number of participants that were frail (according to the Clinical Frailty Scale) and received care was higher in the smartwatch group than in the tablet computer group. Older adults of the smartwatch group reported higher technology acceptance (Technology Usage Inventory) and satisfaction (Quebec User Evaluation of Satisfaction with Assistive Technology 2.0) scores than those of the tablet computer group, although the differences were not significant (all P>.05). In the tablet computer group, relatives had significantly higher ratings on the item intention to use than older adults (t12.3=3.3, P=.006). Identified everyday issues with the Canadian Occupational Performance Measure included contact/communication and entertainment/information for the tablet computer, safety and getting help in emergency situations for the smartwatch, and the usability of the AT for both devices. While the performance (t8=3.5, P=.008) and satisfaction (t8=3.2, P=.01) in these domains significantly improved in the smartwatch group, changes in the tablet computer group were inconsistent (all P>.05). Conclusions This study highlights the remaining obstacles for the widespread and effective application of ATs in the everyday life of older adults and their relatives. While the results do not provide evidence for a positive effect regarding communication deficits, perceived benefits could be shown for the area of safety. Future research and technical developments need to consider not only the preferences, problems, and goals of older adults but also their relatives and caregivers to improve the acceptability and effectiveness of ATs.
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Affiliation(s)
- Patrick Wiegel
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Zollernring 26, Ulm, 89073, Germany, 49 731187 ext 191
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
| | - Marina Liselotte Fotteler
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Neu-Ulm, Germany
| | - Brigitte Kohn
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Zollernring 26, Ulm, 89073, Germany, 49 731187 ext 191
- Geriatric Center Ulm, Ulm, Germany
| | - Sarah Mayer
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Zollernring 26, Ulm, 89073, Germany, 49 731187 ext 191
- Geriatric Center Ulm, Ulm, Germany
| | - Filippo Maria Verri
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Zollernring 26, Ulm, 89073, Germany, 49 731187 ext 191
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
| | - Dhayana Dallmeier
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Zollernring 26, Ulm, 89073, Germany, 49 731187 ext 191
- Geriatric Center Ulm, Ulm, Germany
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Michael Denkinger
- Research Unit on Ageing, Agaplesion Bethesda Clinic Ulm, Zollernring 26, Ulm, 89073, Germany, 49 731187 ext 191
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
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Borghare PT, Methwani DA, Pathade AG. A Comprehensive Review on Harnessing Wearable Technology for Enhanced Depression Treatment. Cureus 2024; 16:e66173. [PMID: 39233951 PMCID: PMC11374139 DOI: 10.7759/cureus.66173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Accepted: 08/04/2024] [Indexed: 09/06/2024] Open
Abstract
Depression is a prevalent and debilitating mental health disorder that significantly impacts individuals, families, and societies worldwide. Despite advancements in treatment, challenges remain in effectively managing and monitoring depressive symptoms. Wearable technology, which encompasses devices that can monitor physiological and behavioral parameters in real time, offers promising new avenues for enhancing depression treatment. This comprehensive review explores the potential of wearable technology in managing and treating depression. It examines how wearables can monitor depressive symptoms, improve patient engagement and adherence to treatment plans, and provide valuable data for personalized treatment strategies. The review covers the integration of wearable technology in clinical settings, the role of wearables in remote monitoring and telemedicine, and the ethical and privacy considerations associated with their use. Additionally, it highlights case studies and pilot programs demonstrating the practical applications and outcomes of wearable technology interventions. Future directions and innovations are discussed, identifying potential advancements and challenges in this emerging field. This review aims to inform healthcare professionals, researchers, and policymakers about the opportunities and challenges of integrating wearable technology into depression treatment, ultimately contributing to improved mental healthcare outcomes.
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Affiliation(s)
- Pramod T Borghare
- Otolaryngology, Mahatma Gandhi Ayurved College Hospital and Research, Wardha, IND
| | - Disha A Methwani
- Otolaryngology, NKP Salve Institute Of Medical Sciences & Research Centre And Lata Mangeshkar Hospital, Nagpur, IND
| | - Aniket G Pathade
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Nagappan A, Krasniansky A, Knowles M. Patterns of Ownership and Usage of Wearable Devices in the United States, 2020-2022: Survey Study. J Med Internet Res 2024; 26:e56504. [PMID: 39058548 PMCID: PMC11316147 DOI: 10.2196/56504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/31/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Although wearable technology has become increasingly common, comprehensive studies examining its ownership across different sociodemographic groups are limited. OBJECTIVE The aims of this study were to (1) measure wearable device ownership by sociodemographic characteristics in a cohort of US consumers and (2) investigate how these devices are acquired and used for health-related purposes. METHODS Data from the Rock Health Digital Health Consumer Adoption Survey collected from 2020 to 2022 with 23,974 US participants were analyzed. The sample was US Census-matched for demographics, including age, race/ethnicity, gender, and income. The relationship between sociodemographic factors and wearable ownership was explored using descriptive analysis and multivariate logistic regression. RESULTS Of the 23,974 respondents, 10,679 (44.5%) owned wearables. Ownership was higher among younger individuals, those with higher incomes and education levels, and respondents living in urban areas. Compared to those aged 18-24 years, respondents 65 years and older had significantly lower odds of wearable ownership (odds ratio [OR] 0.18, 95% CI 0.16-0.21). Higher annual income (≥US $200,000; OR 2.27, 95% CI 2.01-2.57) and advanced degrees (OR 2.23, 95% CI 2.01-2.48) were strong predictors of ownership. Living in rural areas reduced ownership odds (OR 0.65, 95% CI 0.60-0.72). There was a notable difference in ownership based on gender and health insurance status. Women had slightly higher ownership odds than men (OR 1.10, 95% CI 1.04-1.17). Private insurance increased ownership odds (OR 1.28, 95% CI 1.17-1.40), whereas being uninsured (OR 0.41, 95% CI 0.36-0.47) or on Medicaid (OR 0.75, 95% CI 0.68-0.82) decreased the odds of ownership. Interestingly, minority groups such as non-Hispanic Black (OR 1.14, 95% CI 1.03-1.25) and Hispanic/Latine (OR 1.20, 95% CI 1.10-1.31) respondents showed slightly higher ownership odds than other racial/ethnic groups. CONCLUSIONS Our findings suggest that despite overall growth in wearable ownership, sociodemographic divides persist. The data indicate a need for equitable access strategies as wearables become integral to clinical and public health domains.
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Affiliation(s)
- Ashwini Nagappan
- Department of Health Policy and Management, University of California, Los Angeles, Los Angeles, CA, United States
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Ahn J, Yang Y, Park G. Advancing elderly diabetes care: exploring the usability and acceptance of continuous glucose monitoring (CGM). Geriatr Nurs 2024; 59:15-25. [PMID: 38981204 DOI: 10.1016/j.gerinurse.2024.06.041] [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: 01/10/2024] [Revised: 06/10/2024] [Accepted: 06/27/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVES This study aimed to evaluate the acceptability, usability, compliance, and satisfaction of Continuous Glucose Monitoring (CGM) among elderly diabetic patients. DESIGN Utilizing a mixed-methods approach, the study involved 30 participants, averaging 74.79 years in age. Participants wore two CGM devices, and their experiences, along with survey data, were comprehensively analyzed to gauge the effectiveness of CGM in managing diabetes. RESULTS The study demonstrated that -CGM- is highly usable and acceptable among elderly diabetic patients. Participants effectively utilized CGM to monitor and predict blood glucose trends, positively influencing their glucose control and lifestyle. The average adherence rate was found to be 81 %, indicating a substantial level of effective self-management and treatment decision-making. CONCLUSION The study recommends developing CGM educational programs tailored for the elderly, educating healthcare professionals, expanding insurance coverage for CGM, and promoting real-time CGM technology to improve usability and acceptance among the elderly.
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Affiliation(s)
- Junhee Ahn
- Department of Nursing, Wonkwang Health Science University, Iksan, South Korea
| | - Youngran Yang
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, South Korea.
| | - Gloria Park
- St. David's School of Nursing, Texas State University, Round Rock, TX, USA
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Adam E, Meiland F, Frielink N, Meinders E, Smits R, Embregts P, Smaling H. User Requirements and Perceptions of a Sensor System for Early Stress Detection in People With Dementia and People With Intellectual Disability: Qualitative Study. JMIR Form Res 2024; 8:e52248. [PMID: 38905626 PMCID: PMC11245304 DOI: 10.2196/52248] [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: 08/29/2023] [Revised: 04/09/2024] [Accepted: 04/24/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Timely detection of stress in people with dementia and people with an intellectual disability (ID) may reduce the occurrence of challenging behavior. However, detecting stress is often challenging as many long-term care (LTC) residents with dementia and residents with ID have communication impairments, limiting their ability to express themselves. Wearables can help detect stress but are not always accepted by users and are uncomfortable to wear for longer periods. Integrating sensors into clothing may be a more acceptable approach for users in LTC. To develop a sensor system for early stress detection that is accepted by LTC residents with dementia and residents with ID, understanding their perceptions and requirements is essential. OBJECTIVE This study aimed to (1) identify user requirements for a garment-integrated sensor system (wearable) for early stress detection in people with dementia and people with ID, (2) explore the perceptions of the users toward the sensor system, and (3) investigate the implementation requirements in LTC settings. METHODS A qualitative design with 18 focus groups and 29 interviews was used. Focus groups and interviews were conducted per setting (dementia, ID) and target group (people with dementia, people with ID, family caregivers, health care professionals). The focus groups were conducted at 3 time points within a 6-month period, where each new focus group built on the findings of previous rounds. The data from each round were used to (further) develop the sensor system. A thematic analysis with an inductive approach was used to analyze the data. RESULTS The study included 44 participants who expressed a positive attitude toward the idea of a garment-integrated sensor system but also identified some potential concerns. In addition to early stress detection, participants recognized other potential purposes or benefits of the sensor system, such as identifying triggers for challenging behavior, evaluating intervention effects, and diagnostic purposes. Participants emphasized the importance of meeting specific system requirements, such as washability and safety, and user requirements, such as customizability and usability, to increase user acceptance. Moreover, some participants were concerned the sensor system could contribute to the replacement of human contact by technology. Important factors for implementation included the cost of the sensor system, added value to resident and health care professionals, and education for all users. CONCLUSIONS The idea of a garment-integrated sensor system for early stress detection in LTC for people with dementia and people with ID is perceived as positive and promising by stakeholders. To increase acceptability and implementation success, it is important to develop an easy-to-use, customizable wearable that has a clear and demonstrable added value for health care professionals and LTC residents. The next step involves pilot-testing the developed wearable with LTC residents with dementia and residents with ID in clinical practice.
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Affiliation(s)
- Esmee Adam
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- University Network for Care sector Zuid-Holland, Leiden University Medical Center, Leiden, Netherlands
| | - Franka Meiland
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- Department of Medicine for Older people, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Noud Frielink
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | | | - Reon Smits
- Mentech Innovation B.V., Eindhoven, Netherlands
| | - Petri Embregts
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Hanneke Smaling
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- University Network for Care sector Zuid-Holland, Leiden University Medical Center, Leiden, Netherlands
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Chan CSW, Kan MMP, Wong AKC. Effects of Peer- or Professional-Led Support in Enhancing Adherence to Wearable Monitoring Devices Among Community-Dwelling Older Adults: Systematic Review of Randomized Controlled Trials. J Med Internet Res 2024; 26:e53607. [PMID: 38900546 PMCID: PMC11224698 DOI: 10.2196/53607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 03/25/2024] [Accepted: 04/23/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Despite the well-documented health benefits associated with wearable monitoring devices (WMDs), adherence among community-dwelling older adults remains low. By providing guidance on the purpose and benefits of using WMDs, facilitating goal-setting aligned with the device's features, promoting comprehension of the health data captured by the device, and assisting in overcoming technological challenges, peers and health care professionals can potentially enhance older adults' adherence to WMDs. However, the effectiveness of such support mechanisms in promoting adherence to WMDs among older adults remains poorly understood. OBJECTIVE The aims of this systematic review were to examine the effects of peer- or professional-led intervention programs designed to improve adherence to WMDs among community-dwelling older adults and to identify the intervention components that may positively influence the effects of the intervention. METHODS We conducted a comprehensive search across 7 electronic databases (Cochrane Central Register of Controlled Trials [CENTRAL], PubMed, EMBASE, PsycINFO, British Nursing Index, Web of Science, and CINAHL) to identify articles published between January 1, 2010, and June 26, 2023. We specifically targeted randomized controlled trials that examined the impact of peer- or professional-led interventions on enhancing adherence to WMDs among individuals aged 60 years and older residing in the community. Two independent reviewers extracted data from the included studies and assessed the potential risk of bias in accordance with the Cochrane Risk of Bias tool for randomized trials, version 2. RESULTS A total of 10,511 studies were identified through the database search. Eventually, we included 3 randomized controlled trials involving 154 community-dwelling older adults. The participants had a mean age of 65 years. Our review revealed that increasing awareness of being monitored and implementing the SystemCHANGE approach, a habit change tool focusing on personal goals and feedback, were effective strategies for enhancing adherence to WMDs among older adults. All of the included studies exhibited a low risk of bias. CONCLUSIONS By collaboratively designing specific goals related to WMDs with health care professionals, including nurses and physicians, older adults exhibited a higher likelihood of adhering to the prescribed use of WMDs. These goal-setting tools provided a framework for structure and motivation, facilitating the seamless integration of WMDs into their daily routines. Researchers should prioritize interventions that target awareness and goal-setting as effective approaches to enhance adherence to WMDs among older adults, thereby maximizing the realization of associated health benefits.
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Affiliation(s)
- Colette Sze Wing Chan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, China (Hong Kong)
| | - Mandy Ming Pui Kan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, China (Hong Kong)
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Goerss D, Köhler S, Rong E, Temp AG, Kilimann I, Bieber G, Teipel S. Smartwatch-Based Interventions for People With Dementia: User-Centered Design Approach. JMIR Aging 2024; 7:e50107. [PMID: 38848116 PMCID: PMC11193079 DOI: 10.2196/50107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 01/30/2024] [Accepted: 02/27/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Assistive technologies can help people living with dementia maintain their everyday activities. Nevertheless, there is a gap between the potential and use of these materials. Involving future users may help close this gap, but the impact on people with dementia is unclear. OBJECTIVE We aimed to determine if user-centered development of smartwatch-based interventions together with people with dementia is feasible. In addition, we evaluated the extent to which user feedback is plausible and therefore helpful for technological improvements. METHODS We examined the interactions between smartwatches and people with dementia or people with mild cognitive impairment. All participants were prompted to complete 2 tasks (drinking water and a specific cognitive task). Prompts were triggered using a smartphone as a remote control and were repeated up to 3 times if participants failed to complete a task. Overall, 50% (20/40) of the participants received regular prompts, and 50% (20/40) received intensive audiovisual prompts to perform everyday tasks. Participants' reactions were observed remotely via cameras. User feedback was captured via questionnaires, which included topics like usability, design, usefulness, and concerns. The internal consistency of the subscales was calculated. Plausibility was also checked using qualitative approaches. RESULTS Participants noted their preferences for particular functions and improvements. Patients struggled with rating using the Likert scale; therefore, we assisted them with completing the questionnaire. Usability (mean 78 out of 100, SD 15.22) and usefulness (mean 9 out of 12) were rated high. The smartwatch design was appealing to most participants (31/40, 76%). Only a few participants (6/40, 15%) were concerned about using the watch. Better usability was associated with better cognition. The observed success and self-rated task comprehension were in agreement for most participants (32/40, 80%). In different qualitative analyses, participants' responses were, in most cases, plausible. Only 8% (3/40) of the participants were completely unaware of their irregular task performance. CONCLUSIONS People with dementia can have positive experiences with smartwatches. Most people with dementia provided valuable information. Developing assistive technologies together with people with dementia can help to prioritize the future development of functional and nonfunctional features.
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Affiliation(s)
- Doreen Goerss
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen Rostock/Greifswald, Rostock, Germany
| | - Stefanie Köhler
- Deutsches Zentrum für Neurodegenerative Erkrankungen Rostock/Greifswald, Rostock, Germany
| | - Eleonora Rong
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Anna Gesine Temp
- Neurozentrum, Berufsgenossenschaftliches Klinikum Hamburg, Hamburg, Germany
| | - Ingo Kilimann
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen Rostock/Greifswald, Rostock, Germany
| | - Gerald Bieber
- Fraunhofer Institut für Graphische Datenverarbeitung, Rostock, Germany
| | - Stefan Teipel
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen Rostock/Greifswald, Rostock, Germany
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11
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Aryal S, Blankenship JM, Bachman SL, Hwang S, Zhai Y, Richards JC, Clay I, Lyden K. Patient-centricity in digital measure development: co-evolution of best practice and regulatory guidance. NPJ Digit Med 2024; 7:128. [PMID: 38755349 PMCID: PMC11099175 DOI: 10.1038/s41746-024-01110-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/15/2024] [Indexed: 05/18/2024] Open
Abstract
Digital health technologies (DHTs) have the potential to modernize drug development and clinical trial operations by remotely, passively, and continuously collecting ecologically valid evidence that is meaningful to patients' lived experiences. Such evidence holds potential for all drug development stakeholders, including regulatory agencies, as it will help create a stronger evidentiary link between approval of new therapeutics and the ultimate aim of improving patient lives. However, only a very small number of novel digital measures have matured from exploratory usage into regulatory qualification or efficacy endpoints. This shows that despite the clear potential, actually gaining regulatory agreement that a new measure is both fit-for-purpose and delivers value remains a serious challenge. One of the key stumbling blocks for developers has been the requirement to demonstrate that a digital measure is meaningful to patients. This viewpoint aims to examine the co-evolution of regulatory guidance in the United States (U.S.) and best practice for integration of DHTs into the development of clinical outcome assessments. Contextualizing guidance on meaningfulness within the larger shift towards a patient-centric drug development approach, this paper reviews the U.S. Food and Drug Administration (FDA) guidance and existing literature surrounding the development of meaningful digital measures and patient engagement, including the recent examples of rejections by the FDA that further emphasize patient-centricity in digital measures. Finally, this paper highlights remaining hurdles and provides insights into the established frameworks for development and adoption of digital measures in clinical research.
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Affiliation(s)
| | | | | | | | - Yaya Zhai
- VivoSense Inc, Newport Coast, CA, USA
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12
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Ramalho A, Paulo R, Duarte-Mendes P, Serrano J, Petrica J. Age Unplugged: A Brief Narrative Review on the Intersection of Digital Tools, Sedentary and Physical Activity Behaviors in Community-Dwelling Older Adults. Healthcare (Basel) 2024; 12:935. [PMID: 38727492 PMCID: PMC11083116 DOI: 10.3390/healthcare12090935] [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: 04/10/2024] [Revised: 04/28/2024] [Accepted: 04/30/2024] [Indexed: 05/13/2024] Open
Abstract
This brief narrative review assesses how digital technologies-such as wearables, mobile health apps, and various digital tools such as computers, game consoles, tablets, smartphones, and extended reality systems-can influence sedentary and physical activity behaviors among community-dwelling older adults. Each section highlights the central role of these technologies in promoting active aging through increased motivation, engagement and customized experiences. It underlines the critical importance of functionality, usability and adaptability of devices and confirms the effectiveness of digital interventions in increasing physical activity and reducing sedentary behavior. The sustainable impact of these technologies needs to be further investigated, with a focus on adapting digital health strategies to the specific needs of older people. The research advocates an interdisciplinary approach and points out that such collaborations are essential for the development of accessible, effective and ethical solutions. This perspective emphasizes the potential of digital tools to improve the health and well-being of the aging population and recommends their strategic integration into health promotion and policy making.
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Affiliation(s)
- André Ramalho
- Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (R.P.); (P.D.-M.); (J.S.); (J.P.)
- SPRINT Sport Physical Activity and Health Research & Innovation Center, 2001-904 Santarém, Portugal
| | - Rui Paulo
- Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (R.P.); (P.D.-M.); (J.S.); (J.P.)
- SPRINT Sport Physical Activity and Health Research & Innovation Center, 2001-904 Santarém, Portugal
| | - Pedro Duarte-Mendes
- Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (R.P.); (P.D.-M.); (J.S.); (J.P.)
- SPRINT Sport Physical Activity and Health Research & Innovation Center, 2001-904 Santarém, Portugal
| | - João Serrano
- Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (R.P.); (P.D.-M.); (J.S.); (J.P.)
- SPRINT Sport Physical Activity and Health Research & Innovation Center, 2001-904 Santarém, Portugal
| | - João Petrica
- Polytechnic Institute of Castelo Branco, 6000-266 Castelo Branco, Portugal; (R.P.); (P.D.-M.); (J.S.); (J.P.)
- SPRINT Sport Physical Activity and Health Research & Innovation Center, 2001-904 Santarém, Portugal
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Ausserhofer D, Piccoliori G, Engl A, Mahlknecht A, Plagg B, Barbieri V, Colletti N, Lombardo S, Gärtner T, Tappeiner W, Wieser H, Wiedermann CJ. Community-Dwelling Older Adults' Readiness for Adopting Digital Health Technologies: Cross-Sectional Survey Study. JMIR Form Res 2024; 8:e54120. [PMID: 38687989 PMCID: PMC11094597 DOI: 10.2196/54120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/06/2024] [Accepted: 02/22/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Digital health technologies offer the potential to improve the daily lives of older adults, maintain their health efficiently, and allow aging in place. Despite increasing evidence of benefits and advantages, readiness for adopting digital interventions among older people remains underexplored. OBJECTIVE This study aims to explore the relationships between sociodemographic-, health-, and lifestyle-related factors and technology use in everyday life and community-dwelling older adults' readiness to adopt telemedicine, smartphones with texting apps, wearables, and robotics. METHODS This was a cross-sectional, population-based survey study with a stratified probabilistic sample of adults aged 75 years or older living in South Tyrol (autonomous province of Bolzano/Bozen, Italy). A random sample of 3600 community-dwelling older adults living at home was invited to complete a questionnaire including single items (older adults' readiness to use health technology) and scales (PRISMA-7; Program of Research on Integration of Services for the Maintenance of Autonomy). Descriptive and logistic regression analyses were performed to analyze the data. RESULTS In total, 1695 community-dwelling older adults completed the survey (for a response rate of 47%). In terms of potential digital health technology adoption, wearable devices were favored by 33.7% (n=571), telemedicine by 30.1% (n=510), smartphones and texting apps by 24.5% (n=416), and assistant robots by 13.7% (n=232). Sociodemographic-, health- and lifestyle-related factors, as well as the use of technology in everyday life, played a significant role in explaining readiness to adopt digital health technologies. For telemedicine, age ≥85 years (odds ratio [OR] 0.74, 95% CI 0.56-0.96), financial constraints (OR 0.68, 95% CI 0.49-0.95), and less than 2 hours of physical activity per week (OR 0.75, 95% CI 0.58-0.98) were associated with nonreadiness, while Italian-speaking participants (OR 1.54, 95% CI 1.16-2.05) and those regularly using computers (OR 1.74, 95% CI 1.16-2.60), smartphones (OR 1.69, 95% CI 1.22-2.35), and the internet (OR 2.26, 95% CI 1.47-3.49) reported readiness for adoption. CONCLUSIONS Community-dwelling older adults display varied readiness toward the adoption of digital health technologies, influenced by age, mother tongue, living situation, financial resources, physical activity, and current use of technology. The findings underscore the need for tailored interventions and educational programs to boost digital health technology adoption among community-dwelling older adults.
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Affiliation(s)
- Dietmar Ausserhofer
- Institute of General Medicine and Public Health, Bolzano, Italy
- Claudiana Research, College of Healthcare Professions Claudiana, Bolzano, Italy
| | | | - Adolf Engl
- Institute of General Medicine and Public Health, Bolzano, Italy
| | | | - Barbara Plagg
- Institute of General Medicine and Public Health, Bolzano, Italy
| | - Verena Barbieri
- Institute of General Medicine and Public Health, Bolzano, Italy
| | | | | | - Timon Gärtner
- Provincial Institute of Statistics (ASTAT), Bolzano, Italy
| | - Waltraud Tappeiner
- Claudiana Research, College of Healthcare Professions Claudiana, Bolzano, Italy
| | - Heike Wieser
- Claudiana Research, College of Healthcare Professions Claudiana, Bolzano, Italy
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Del-Valle-Soto C, López-Pimentel JC, Vázquez-Castillo J, Nolazco-Flores JA, Velázquez R, Varela-Aldás J, Visconti P. A Comprehensive Review of Behavior Change Techniques in Wearables and IoT: Implications for Health and Well-Being. SENSORS (BASEL, SWITZERLAND) 2024; 24:2429. [PMID: 38676044 PMCID: PMC11054424 DOI: 10.3390/s24082429] [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: 03/12/2024] [Revised: 04/01/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
This research paper delves into the effectiveness and impact of behavior change techniques fostered by information technologies, particularly wearables and Internet of Things (IoT) devices, within the realms of engineering and computer science. By conducting a comprehensive review of the relevant literature sourced from the Scopus database, this study aims to elucidate the mechanisms and strategies employed by these technologies to facilitate behavior change and their potential benefits to individuals and society. Through statistical measurements and related works, our work explores the trends over a span of two decades, from 2000 to 2023, to understand the evolving landscape of behavior change techniques in wearable and IoT technologies. A specific focus is placed on a case study examining the application of behavior change techniques (BCTs) for monitoring vital signs using wearables, underscoring the relevance and urgency of further investigation in this critical intersection of technology and human behavior. The findings shed light on the promising role of wearables and IoT devices for promoting positive behavior modifications and improving individuals' overall well-being and highlighting the need for continued research and development in this area to harness the full potential of technology for societal benefit.
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Affiliation(s)
- Carolina Del-Valle-Soto
- Facultad de Ingeniería, Universidad Panamericana, Álvaro del Portillo 49, Zapopan 45010, Mexico;
| | | | - Javier Vázquez-Castillo
- Department of Informatics and Networking, Universidad Autónoma del Estado de Quintana Roo, Chetumal 77019, Mexico;
| | | | - Ramiro Velázquez
- Facultad de Ingeniería, Universidad Panamericana, Aguascalientes 20296, Mexico;
| | - José Varela-Aldás
- Centro de Investigaciones de Ciencias Humanas y de la Educación—CICHE, Universidad Indoamérica, Ambato 180103, Ecuador;
| | - Paolo Visconti
- Department of Innovation Engineering, University of Salento, 73100 Lecce, Italy;
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15
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Moorthy P, Weinert L, Schüttler C, Svensson L, Sedlmayr B, Müller J, Nagel T. Attributes, Methods, and Frameworks Used to Evaluate Wearables and Their Companion mHealth Apps: Scoping Review. JMIR Mhealth Uhealth 2024; 12:e52179. [PMID: 38578671 PMCID: PMC11031706 DOI: 10.2196/52179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 12/15/2023] [Accepted: 02/01/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Wearable devices, mobile technologies, and their combination have been accepted into clinical use to better assess the physical fitness and quality of life of patients and as preventive measures. Usability is pivotal for overcoming constraints and gaining users' acceptance of technology such as wearables and their companion mobile health (mHealth) apps. However, owing to limitations in design and evaluation, interactive wearables and mHealth apps have often been restricted from their full potential. OBJECTIVE This study aims to identify studies that have incorporated wearable devices and determine their frequency of use in conjunction with mHealth apps or their combination. Specifically, this study aims to understand the attributes and evaluation techniques used to evaluate usability in the health care domain for these technologies and their combinations. METHODS We conducted an extensive search across 4 electronic databases, spanning the last 30 years up to December 2021. Studies including the keywords "wearable devices," "mobile apps," "mHealth apps," "physiological data," "usability," "user experience," and "user evaluation" were considered for inclusion. A team of 5 reviewers screened the collected publications and charted the features based on the research questions. Subsequently, we categorized these characteristics following existing usability and wearable taxonomies. We applied a methodological framework for scoping reviews and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist. RESULTS A total of 382 reports were identified from the search strategy, and 68 articles were included. Most of the studies (57/68, 84%) involved the simultaneous use of wearables and connected mobile apps. Wrist-worn commercial consumer devices such as wristbands were the most prevalent, accounting for 66% (45/68) of the wearables identified in our review. Approximately half of the data from the medical domain (32/68, 47%) focused on studies involving participants with chronic illnesses or disorders. Overall, 29 usability attributes were identified, and 5 attributes were frequently used for evaluation: satisfaction (34/68, 50%), ease of use (27/68, 40%), user experience (16/68, 24%), perceived usefulness (18/68, 26%), and effectiveness (15/68, 22%). Only 10% (7/68) of the studies used a user- or human-centered design paradigm for usability evaluation. CONCLUSIONS Our scoping review identified the types and categories of wearable devices and mHealth apps, their frequency of use in studies, and their implementation in the medical context. In addition, we examined the usability evaluation of these technologies: methods, attributes, and frameworks. Within the array of available wearables and mHealth apps, health care providers encounter the challenge of selecting devices and companion apps that are effective, user-friendly, and compatible with user interactions. The current gap in usability and user experience in health care research limits our understanding of the strengths and limitations of wearable technologies and their companion apps. Additional research is necessary to overcome these limitations.
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Affiliation(s)
- Preetha Moorthy
- Department of Biomedical Informatics, Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lina Weinert
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
- Section for Oral Health, Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Christina Schüttler
- Medical Center for Information and Communication Technology, University Hospital Erlangen, Erlangen, Germany
| | - Laura Svensson
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Brita Sedlmayr
- Institute for Medical Informatics and Biometry, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Julia Müller
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Till Nagel
- Human Data Interaction Lab, Mannheim University of Applied Sciences, Mannheim, Germany
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16
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Jiang Y, Gao J, Sun P, Nan J, Zou X, Sun M, Song X. Factors Associated with the e-Health Literacy Among Older Adults with Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study. Telemed J E Health 2024; 30:e1138-e1147. [PMID: 37851981 DOI: 10.1089/tmj.2023.0394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023] Open
Abstract
Background: The telemanagement model in chronic diseases needs older patients to have a certain level of e-Health literacy. According to Electronic Health Literacy model, factors associated with the e-Health literacy among older patients could be comprehensively investigated from individual, situational, and environmental aspects. Objectives: To investigate the e-Health literacy levels among older patients with chronic obstructive pulmonary disease (COPD) and explore associated factors. Methods: A cross-sectional study was conducted among older patients with COPD. The e-Health Literacy Scale was used to measure individuals' e-Health literacy. The multiple linear regression was applied to identify factors associated with e-Health literacy. Results: A total of 230 responses were included in the final analysis. The average score of e-Health literacy for older COPD patients was 24.66 (6.86). After adjusting the model, the results of multiple linear regression demonstrated that aging attitudes (B = 0.067, p < 0.001), technophobia (B = -0.285, p < 0.001), and self-efficacy (B = 0.431, p < 0.001) accounted for 68.3% (p < 0.001) of the total variation in e-Health literacy. Conclusion: This study identifies significant correlations of technophobia, aging attitudes, and self-efficacy, respectively, with e-Health literacy, and self-efficacy and technophobia may be constant predictive factors of e-Health literacy. In the future, intervention research on e-Health literacy should be conducted from a social psychology perspective, with particular emphasis on addressing negative aging attitudes and technophobia. That will promote the tele-management model of chronic diseases. Trial Registration: Chinese Clinical Trial Registry (ChiCTR): ChiCTR1900028563; http://apps.who.int/trialsearch/default.aspx.
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Affiliation(s)
- Yuyu Jiang
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jing Gao
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Pingping Sun
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Jiang Nan
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Xueqiong Zou
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Manyao Sun
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Xianjing Song
- Department of Nursing, Wuxi School of Medicine, Jiangnan University, Wuxi, China
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17
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Pereira NG, Dos Santos AM, Shinjo SK. Association Between Wearable Device Use and Quality of Life in Patients With Idiopathic Inflammatory Myopathies and Primary Systemic Vasculitis. Cureus 2024; 16:e58948. [PMID: 38800225 PMCID: PMC11126351 DOI: 10.7759/cureus.58948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2024] [Indexed: 05/29/2024] Open
Abstract
Background Despite the increasing use of wearable devices worldwide, concise data on these instruments in patients with systemic autoimmune rheumatic diseases, including idiopathic inflammatory myopathies (IIM) and primary systemic vasculitis (PSV), are lacking. Objectives The aim of this study is to investigate the knowledge and use of wearable devices and to assess their impact on the general quality of life of patients with IIM and PSV. Moreover, we compared these characteristics between patients with IIM and PSV users and non-users of wearable devices. Methods This single-center, cross-sectional study was conducted between January 2023 and June 2023. We included adult patients with IIM and PSV and a control group (CTR) and evaluated their use of cell phones and wearables, level of physical activity, and quality of life. Results A total of 132 patients with IIM, 82 with PSV, and 178 in the CTR were evaluated. Overall, 169 patients and 144 in the CTR were aware of wearable devices, of whom 50 (29.6%) and 47 (32.6%), respectively, had already used this technology. In addition, the IPAQ-Mets and EQ-5D scores were lower in the IIM and PSV groups than in the CTR, and the fatigue severity scale (FSS) scores were higher in the IIM and PSV groups than in the CTR. Patients who used the devices showed FSS scores of 29 (18-40) points, with higher levels of IPAQ-Mets among device users, indicating greater physical activity than among nonusers. Conclusion Based on the results, the use of wearable devices is associated with better fatigue and IPAQ scores. Possibly, the use of such devices can have an impact on better lifestyle habits among these patients.
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Affiliation(s)
- Nathalia G Pereira
- Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, BRA
| | - Alexandre M Dos Santos
- Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, BRA
| | - Samuel K Shinjo
- Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Sao Paulo, BRA
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Gerber S, Silver RE, Das SK, Greene SS, Dix SR, Ramirez I, Morcos CL, Dao MC, Ceglia L, Roberts SB. Development and Feasibility of an eHealth Diabetes Prevention Program Adapted for Older Adults-Results from a Randomized Control Pilot Study. Nutrients 2024; 16:930. [PMID: 38612963 PMCID: PMC11154527 DOI: 10.3390/nu16070930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/11/2024] [Accepted: 03/13/2024] [Indexed: 04/14/2024] Open
Abstract
Lifestyle programs that reduce health risks and support weight loss (WL) in older adults face adherence and attendance challenges due to reduced energy requirements, impaired mobility, lack of transportation, and low social support. Tailored lifestyle and weight management programs are needed to better support healthy aging for older adults. Here, we developed and piloted an age-adapted, remotely delivered modification of the Diabetes Prevention Program (DPP). The modification includes age-appropriate goals, visuals, and examples; flexible dietary composition; remote classroom and fitness-monitoring technology; and standardized online classroom materials employing pedagogical and behavior change theory. The modifications were designed to safeguard fidelity and to boost adherence, engagement, and knowledge integration, with the convenience of a fully remote WL program for diverse older adults. Six-month pilot data are presented from older adults (55-85 years, body mass index (BMI) 27-39.9 kg/m2, N = 20) randomly allocated to an online DPP intervention with weight, diet, and activity monitored remotely, or into a waitlisted control. The intervention achieved 100% attendance and adherence to self-monitoring. The intervention group mean (±SD) body weight change was -9.5% (±4.1); 90% lost ≥ 5%. By contrast, the control group gained 2.4% (±1.8). Once thought incompatible with older adults, remote interventions are feasible for older adults and can support fidelity, adherence, engagement, and clinically significant WL. Standardized materials are provided for future implementation.
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Affiliation(s)
- Suzannah Gerber
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA (S.S.G.); (S.R.D.); (C.L.M.)
| | - Rachel E. Silver
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA
| | - Sai Krupa Das
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA (S.S.G.); (S.R.D.); (C.L.M.)
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA
| | - Savana S. Greene
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA (S.S.G.); (S.R.D.); (C.L.M.)
| | - Sadie R. Dix
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA (S.S.G.); (S.R.D.); (C.L.M.)
| | - Isabella Ramirez
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA (S.S.G.); (S.R.D.); (C.L.M.)
| | - Christina L. Morcos
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA 02111, USA (S.S.G.); (S.R.D.); (C.L.M.)
| | - Maria Carlota Dao
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire, Durham, NH 03824, USA;
| | - Lisa Ceglia
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, 711 Washington Street, Boston, MA 02111, USA
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA 02111, USA
| | - Susan B. Roberts
- Geisel School of Medicine, Dartmouth College, 1 Rope Ferry Rd., Hanover, NH 03755, USA;
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Kim M, Kim B, Park S. Social Support, eHealth Literacy, and mHealth Use in Older Adults With Diabetes: Moderated Mediating Effect of the Perceived Importance of App Design. Comput Inform Nurs 2024; 42:136-143. [PMID: 38129323 DOI: 10.1097/cin.0000000000001081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Mobile healthcare has emerged as a prominent technological solution for self-management of health. However, the development and utilization of tailored mobile healthcare applications for older adults with diabetes mellitus remain limited. This study examined the relationship between social support and mobile healthcare use and further explored how this relationship varies with eHealth literacy and application design among older adults with diabetes mellitus. A descriptive cross-sectional trial was conducted with a structured self-report questionnaire, surveying 252 South Korean older adults with diabetes mellitus via offline and online modes. The mediating effect and moderated mediating effect were analyzed with the PROCESS macro of SPSS. eHealth literacy mediated the relationship between social support and mobile healthcare use. High levels of eHealth literacy and social support may increase mobile healthcare use among older adults with diabetes. Application design aesthetics facilitated mobile healthcare use. Future researchers, healthcare providers, and developers can contribute to the development of tailored mobile healthcare applications for older adults with diabetes mellitus by considering application design aspects such as font size, color, and menu configuration.
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Affiliation(s)
- Minjin Kim
- Author Affiliations: Graduate School of Information (Ms Kim) and Graduate School of Information (Dr Kim), Yonsei University; and College of Nursing, Hanyang University (Dr Park), Seoul, South Korea
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Van Wier MF, Urry E, Lissenberg-Witte BI, Kramer SE. User characteristics associated with use of wrist-worn wearables and physical activity apps by adults with and without impaired speech-in-noise recognition: a cross-sectional analysis. Int J Audiol 2024; 63:49-56. [PMID: 36373621 DOI: 10.1080/14992027.2022.2135031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 10/07/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To study weekly use of smartwatches, fitness watches and physical activity apps among adults with and without impaired speech-in-noise (SIN) recognition, to identify subgroups of users. DESIGN Cross-sectional study. STUDY SAMPLE Adults (aged 28-80 years) with impaired (n = 384) and normal SIN recognition (n = 341) as measured with a web-based digits-in-noise test, from the Netherlands Longitudinal Study on Hearing. Multiple logistic regression analyses were used to study differences and to build an association model. RESULTS Employed adults in both groups are more likely to use each type of fitness technology (all ORs >3.4, all p-values < 0.004). Specific to fitness watch use, adults living with others use it more (OR 2.5, 95%CI 1.1;5.8, p = 0.033) whereas those abstaining from alcohol (OR 0.3, 95%CI 0.1;0.6) or consuming >2 glasses/week (OR 0.4, 95%CI 0.2;0.81, overall p = 0.006) and hearing aid users (OR 0.5, 95%CI 0.2;0.9, p = 0.024) make less use. CONCLUSIONS Subgroups of adults more and less likely to use fitness technology exist, but do not differ between adults with and without impaired SIN recognition. More research is needed to confirm these results and to develop interventions to increase physical activity levels among adults with hearing loss.
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Affiliation(s)
- Marieke F Van Wier
- Otolaryngology-Head and Neck Surgery, Section Ear & Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Emily Urry
- Research & Development, Sonova AG, Stäfa, Switzerland
| | - Birgit I Lissenberg-Witte
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sophia E Kramer
- Otolaryngology-Head and Neck Surgery, Section Ear & Hearing, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Quality of Care, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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21
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Shiwani T, Relton S, Evans R, Kale A, Heaven A, Clegg A, Todd O. New Horizons in artificial intelligence in the healthcare of older people. Age Ageing 2023; 52:afad219. [PMID: 38124256 PMCID: PMC10733173 DOI: 10.1093/ageing/afad219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Indexed: 12/23/2023] Open
Abstract
Artificial intelligence (AI) in healthcare describes algorithm-based computational techniques which manage and analyse large datasets to make inferences and predictions. There are many potential applications of AI in the care of older people, from clinical decision support systems that can support identification of delirium from clinical records to wearable devices that can predict the risk of a fall. We held four meetings of older people, clinicians and AI researchers. Three priority areas were identified for AI application in the care of older people. These included: monitoring and early diagnosis of disease, stratified care and care coordination between healthcare providers. However, the meetings also highlighted concerns that AI may exacerbate health inequity for older people through bias within AI models, lack of external validation amongst older people, infringements on privacy and autonomy, insufficient transparency of AI models and lack of safeguarding for errors. Creating effective interventions for older people requires a person-centred approach to account for the needs of older people, as well as sufficient clinical and technological governance to meet standards of generalisability, transparency and effectiveness. Education of clinicians and patients is also needed to ensure appropriate use of AI technologies, with investment in technological infrastructure required to ensure equity of access.
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Affiliation(s)
- Taha Shiwani
- Academic Unit for Ageing & Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, West Yorkshire BD9 6RJ, UK
| | - Samuel Relton
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Ruth Evans
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Aditya Kale
- Academic Unit of Ophthalmology, Institute of Inflammation & Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Anne Heaven
- Academic Unit for Ageing & Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, West Yorkshire BD9 6RJ, UK
| | - Andrew Clegg
- Academic Unit for Ageing & Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, West Yorkshire BD9 6RJ, UK
| | - Oliver Todd
- Academic Unit for Ageing & Stroke Research, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, West Yorkshire BD9 6RJ, UK
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Daniels K, Lemmens R, Knippenberg E, Marinus N, Vonck S, Baerts J, Bergs J, Spooren A, Hansen D, Bonnechère B. Promoting physical activity and a healthy active lifestyle in community-dwelling older adults: a design thinking approach for the development of a mobile health application. Front Public Health 2023; 11:1280941. [PMID: 38106904 PMCID: PMC10724027 DOI: 10.3389/fpubh.2023.1280941] [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: 08/21/2023] [Accepted: 11/14/2023] [Indexed: 12/19/2023] Open
Abstract
Background Physical activity (PA) has wide-ranging, and well documented benefits for older adults, encompassing physical, cognitive, and mental well-being. The World Health Organization advocates for a minimum of 150-300 min of moderate intensity PA per week, supplemented by muscle-strengthening exercises. However, the rates of PA among older adults remain a concern. While portable technologies hold promises in promoting PA, sustaining long-term engagement continues to be a challenge. Objective The aims of this study are to identify barriers and facilitators to PA in older adults, to develop an mHealth app promoting PA and an active healthy lifestyle in collaboration with community-dwelling older adults guided by the design thinking process, and to test it. Methods A co-creative process was used, employing design thinking. Interviews were conducted to understand the needs of the target population and identify the problem of insufficient PA. Two cocreation sessions involving older adults and experts were conducted to generate innovative ideas. Participants were selected based on age (≥65 years), no severe illness, Dutch language proficiency, and active participation ability. Results were qualitatively analyzed and coded. Finally a prototype was developed and tested. Results Interviews with older adults highlighted diverse perceptions of PA but unanimous agreement on its importance. They recognized health benefits such as improved mobility, balance, and reduced fall risk, while emphasizing the social and mental aspects. Barriers included poor health, time constraints, weather conditions and fear of falling. Cocreation sessions identified key topics: perception of a healthy lifestyle, coping strategies, mHealth App features, screen visualization, and tailored notifications, which led to the development of a mobile app promoting PA and an active lifestyle. The app was stepwise prototyped. Conclusion This study emphasizes the importance of promoting PA among older adults through a collaborative design thinking approach. However, the implementation of mHealth apps faces obstacles due to the digital divide, necessitating personalized solutions to bridge the gap. Moreover, it calls for further research to investigate the long-term impact of such interventions and explore behavior change patterns in this population.
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Affiliation(s)
- Kim Daniels
- Department of PXL – Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Belgium
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Ryanne Lemmens
- Department of PXL – Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Belgium
| | - Els Knippenberg
- Department of PXL – Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Belgium
| | - Nastasia Marinus
- Department of PXL – Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Belgium
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Sharona Vonck
- Department of PXL – Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Belgium
| | - Jan Baerts
- Department of Digital, PXL University College of Applied Sciences and Arts, Hasselt, Belgium
| | - Jochen Bergs
- Department of PXL – Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Belgium
- THINK3 Simulation & Innovation Lab, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium
| | - Annemie Spooren
- Department of PXL – Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Belgium
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Dominique Hansen
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Bruno Bonnechère
- Department of PXL – Healthcare, PXL University of Applied Sciences and Arts, Hasselt, Belgium
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, Diepenbeek, Belgium
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23
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Choma EA, Hayes S, Lewis BA, Rothman AJ, Wyman JF, Guan W, McMahon SK. Technical Assistance Received by Older Adults to Use Commercially Available Physical Activity Monitors (Ready Steady 3.0 Trial): Ad-Hoc Descriptive Longitudinal Study. JMIR Mhealth Uhealth 2023; 11:e47891. [PMID: 37997772 PMCID: PMC10690145 DOI: 10.2196/47891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/11/2023] [Accepted: 09/22/2023] [Indexed: 11/25/2023] Open
Abstract
Background Despite evidence that regular physical activity (PA) among older adults confers numerous health and functional benefits, PA participation rates are low. Using commercially available wearable PA monitors (PAMs) is one way to augment PA promotion efforts. However, while expert recommendations exist for the specific information needed at the beginning of PAM ownership and the general ongoing need for structures that support as-needed technical troubleshooting, information is lacking about the type, frequency, and modes of assistance needed during initial and long-term ownership. Objective This paper describes problems reported and technical assistance received by older adults who used PAMs during the 18 months they participated in a community-based PA trial: Ready Steady 3.0 (RS3). Methods This was an ad-hoc longitudinal analysis of process variables representing technical problems reported and assistance received by 113 RS3 study participants in the 18 months after their orientation to PAMs. Variables included date of contact, problem(s) reported, mode of technical assistance, and whether the equipment was replaced. The descriptive analysis included frequencies and incidence rates of distinct contacts, types of problems, and technical assistance modes. Results On average, participants were aged 77 (SD 5.2) years. Most identified as female (n=87, 77%), reported experience using smartphones (n=92, 81.4%), and used the PAM between 2 and 18 months. Eighty-two participants (72.6%) reported between 1 to 9 problems with using PAMs, resulting in a total of 150 technical assistance contacts with a mean of 1.3 (SD 1.3) contacts. The incidence rate of new, distinct contacts for technical assistance was 99 per 100 persons per year from 2018 to 2021. The most common problems were wearing the PAM (n=43, 28.7%), reading its display (n=23, 15.3%), logging into its app (n=20, 13.3%), charging it (n=18, 12%), and synchronizing it to the app (n=16, 10.7%). The modalities of technical assistance were in person (n=53, 35.3%), by telephone (n=51, 34%), by email (n=25, 16.7%), and by postal mail (n=21, 14%). Conclusions In general, the results of this study show that after receiving orientation to PAMs, problems such as uncomfortable wristbands, difficulty using the PAM or its related app, and obtaining or interpreting relevant personal data were occasionally reported by participants in RS3. Trained staff helped participants troubleshoot and solve these technical problems primarily in person or by phone. Results also underscore the importance of involving older adults in the design, usability testing, and supportive material development processes to prevent technical problems for the initial and ongoing use of PAMs. Clinicians and researchers should further assess technical assistance needed by older adults, accounting for variations in PAM models and wear time, while investigating additional assistance strategies, such as proactive support, short GIF videos, and video calls.
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Affiliation(s)
- Elizabeth A Choma
- Department of Physical Therapy, Whitworth University, SpokaneWA, United States
| | - Shannon Hayes
- School of Nursing, University of Minnesota, MinneapolisMN, United States
| | - Beth A Lewis
- School of Kinesiology, University of Minnesota, MinneapolisMN, United States
| | - Alexander J Rothman
- Department of Psychology, University of Minnesota, MinneapolisMN, United States
| | - Jean F Wyman
- School of Nursing, University of Minnesota, MinneapolisMN, United States
| | - Weihua Guan
- Division of Biostatistics, School of Public Health, University of Minnesota, MinneapolisMN, United States
| | - Siobhan K McMahon
- School of Nursing, University of Minnesota, MinneapolisMN, United States
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24
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D'Amore C, Saunders S, Bhatnagar N, Griffith LE, Richardson J, Beauchamp MK. Determinants of physical activity in community-dwelling older adults: an umbrella review. Int J Behav Nutr Phys Act 2023; 20:135. [PMID: 37990225 PMCID: PMC10664504 DOI: 10.1186/s12966-023-01528-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/10/2023] [Indexed: 11/23/2023] Open
Abstract
INTRODUCTION Physical activity (PA) is critical for disease prevention and maintaining functional ability with aging. Despite this, as many as 50% of older adults in populations worldwide are considered insufficiently active. There is a recognized need to mobilize policies targeted toward modifiable determinants of healthy aging like PA. This umbrella review aimed to summarize the evidence for determinants of PA in community-dwelling older adults. METHODS A research librarian searched six databases. Systematic and scoping reviews were included if they investigated community-dwelling people with a mean age of 60 + years and examined a relationship between a determinant and any type of PA. Two independent reviewers screened and extracted data from all reviews. JBI methodology and Critical Appraisal Checklist for Systematic Reviews and Research Syntheses were followed and information on the quality of the evidence was extracted. RESULTS From 17,277 records screened,11 reviews representing > 300 unique primary papers were ultimately included. Only 6% of studies included in all reviews had longitudinal designs. Included studies used a large variety of PA measures, with 76% using only self-report, 15% using only direct measures (e.g., accelerometry), 3% using both types, and 6% with no outcome measure reported. Only four reviews provided a definition of PA and there was substantial inconsistency in the way PA was categorised. Community level influences, which only included the physical environment, were the most commonly assessed (6/11) with more than 70% of the summarized relationships demonstrating null associations. Three out of four reviews reported a positive relationship between walkability and PA in general community-dwelling older adults. There was also evidence supporting relationships between presence of social support for PA, younger age, and men having higher PA from a single systematic review. None of the included reviews assessed the quality of evidence but over 60% performed a risk of bias assessment. CONCLUSIONS Walkability, age, gender, and social support for PA were the most supported PA determinants identified. Further research should focus on interpersonal and intrapersonal influences and incorporate direct measures of PA with clear operational definitions. There is a need for longitudinal study designs to further understand determinants of PA behaviour trajectories.
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Affiliation(s)
- Cassandra D'Amore
- School Rehabilitation Science, McMaster University, 175 Longwood Rd South - Suite 310A, Hamilton, ON, L8P 0A1, Canada
| | - Stephanie Saunders
- School Rehabilitation Science, McMaster University, 175 Longwood Rd South - Suite 310A, Hamilton, ON, L8P 0A1, Canada
| | - Neera Bhatnagar
- Health Science Library, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Lauren E Griffith
- Health Research Methods, Evidence, and Impact, McMaster Univeristy, 175 Longwood Rd South - Suite 309A, Hamilton, ON, L8P 0A1, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON, L8S 1C7, Canada
| | - Marla K Beauchamp
- School Rehabilitation Science, McMaster University, 175 Longwood Rd South - Suite 310A, Hamilton, ON, L8P 0A1, Canada.
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25
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G Ravindran KK, Della Monica C, Atzori G, Lambert D, Hassanin H, Revell V, Dijk DJ. Three Contactless Sleep Technologies Compared With Actigraphy and Polysomnography in a Heterogeneous Group of Older Men and Women in a Model of Mild Sleep Disturbance: Sleep Laboratory Study. JMIR Mhealth Uhealth 2023; 11:e46338. [PMID: 37878360 PMCID: PMC10632916 DOI: 10.2196/46338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/11/2023] [Accepted: 08/25/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Contactless sleep technologies (CSTs) hold promise for longitudinal, unobtrusive sleep monitoring in the community and at scale. They may be particularly useful in older populations wherein sleep disturbance, which may be indicative of the deterioration of physical and mental health, is highly prevalent. However, few CSTs have been evaluated in older people. OBJECTIVE This study evaluated the performance of 3 CSTs compared to polysomnography (PSG) and actigraphy in an older population. METHODS Overall, 35 older men and women (age: mean 70.8, SD 4.9 y; women: n=14, 40%), several of whom had comorbidities, including sleep apnea, participated in the study. Sleep was recorded simultaneously using a bedside radar (Somnofy [Vital Things]: n=17), 2 undermattress devices (Withings sleep analyzer [WSA; Withings Inc]: n=35; Emfit-QS [Emfit; Emfit Ltd]: n=17), PSG (n=35), and actigraphy (Actiwatch Spectrum [Philips Respironics]: n=18) during the first night in a 10-hour time-in-bed protocol conducted in a sleep laboratory. The devices were evaluated through performance metrics for summary measures and epoch-by-epoch classification. PSG served as the gold standard. RESULTS The protocol induced mild sleep disturbance with a mean sleep efficiency (SEFF) of 70.9% (SD 10.4%; range 52.27%-92.60%). All 3 CSTs overestimated the total sleep time (TST; bias: >90 min) and SEFF (bias: >13%) and underestimated wake after sleep onset (bias: >50 min). Sleep onset latency was accurately detected by the bedside radar (bias: <6 min) but overestimated by the undermattress devices (bias: >16 min). CSTs did not perform as well as actigraphy in estimating the all-night sleep summary measures. In an epoch-by-epoch concordance analysis, the bedside radar performed better in discriminating sleep versus wake (Matthew correlation coefficient [MCC]: mean 0.63, SD 0.12, 95% CI 0.57-0.69) than the undermattress devices (MCC of WSA: mean 0.41, SD 0.15, 95% CI 0.36-0.46; MCC of Emfit: mean 0.35, SD 0.16, 95% CI 0.26-0.43). The accuracy of identifying rapid eye movement and light sleep was poor across all CSTs, whereas deep sleep (ie, slow wave sleep) was predicted with moderate accuracy (MCC: >0.45) by both Somnofy and WSA. The deep sleep duration estimates of Somnofy correlated (r2=0.60; P<.01) with electroencephalography slow wave activity (0.75-4.5 Hz) derived from PSG, whereas for the undermattress devices, this correlation was not significant (WSA: r2=0.0096, P=.58; Emfit: r2=0.11, P=.21). CONCLUSIONS These CSTs overestimated the TST, and sleep stage prediction was unsatisfactory in this group of older people in whom SEFF was relatively low. Although it was previously shown that CSTs provide useful information on bed occupancy, which may be useful for particular use cases, the performance of these CSTs with respect to the TST and sleep stage estimation requires improvement before they can serve as an alternative to PSG in estimating most sleep variables in older individuals.
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Affiliation(s)
- Kiran K G Ravindran
- Surrey Sleep Research Centre, School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London and the University of Surrey, Guildford, United Kingdom
| | - Ciro Della Monica
- Surrey Sleep Research Centre, School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London and the University of Surrey, Guildford, United Kingdom
| | - Giuseppe Atzori
- Surrey Sleep Research Centre, School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London and the University of Surrey, Guildford, United Kingdom
| | - Damion Lambert
- Surrey Sleep Research Centre, School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London and the University of Surrey, Guildford, United Kingdom
| | - Hana Hassanin
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London and the University of Surrey, Guildford, United Kingdom
- Surrey Clinical Research Facility, School of Biosciences, Faculty of Health and Medical Sciences, Guildford, United Kingdom
- National Institute for Health Research - Royal Surrey Clinical Research Facility, Guildford, United Kingdom
| | - Victoria Revell
- Surrey Sleep Research Centre, School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London and the University of Surrey, Guildford, United Kingdom
| | - Derk-Jan Dijk
- Surrey Sleep Research Centre, School of Biosciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London and the University of Surrey, Guildford, United Kingdom
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26
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Fotteler ML, Kocar TD, Dallmeier D, Kohn B, Mayer S, Waibel AK, Swoboda W, Denkinger M. Use and benefit of information, communication, and assistive technology among community-dwelling older adults - a cross-sectional study. BMC Public Health 2023; 23:2004. [PMID: 37833689 PMCID: PMC10576310 DOI: 10.1186/s12889-023-16926-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/06/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Technology can support healthy aging and empower older adults to live independently. However, technology adoption by older adults, particularly assistive technology (AT), is limited and little is known about the types of AT used among older adults. This study explored the use of key information and communication technologies (ICT) and AT among community-dwelling adults aged ≥ 65. METHODS A cross-sectional study was conducted among community-dwelling adults aged ≥ 65 in southern Germany using a paper-based questionnaire. The questionnaire included questions on the three domains sociodemographic aspects, health status, and technology use. Technology use was considered separately for key ICT (smartphone, computer/laptop, and tablet) and a range of 31 different AT. Data were analyzed using descriptive statistics, univariate analyses, and Bernoulli Naïve Bayes modelling. RESULTS The questionnaire was answered by 616 participants (response rate: 24.64%). ICT were used by 497 (80.68%) participants and were associated with lower age, higher level of education, living together with someone, availability of internet connection, higher interest in technology, and better health status (p < .05). No association was found with sex and size of the hometown. The most frequently owned AT were a landline phone, a body scale, and a blood pressure monitor. Several AT related to functionality, (instrumental) activities of daily living- (IADL), and morbidity were used more frequently among non-ICT users compared to ICT-users: senior mobile phone (19.33% vs. 3.22%), in-house emergency call (13.45% vs. 1.01%), hearing aid (26.89% vs. 16.7%), personal lift (7.56% vs. 1.61%), electronic stand-up aid (4.2% vs. 0%). Those with higher interest in technology reported higher levels of benefit from technology use. CONCLUSIONS Despite the benefits older adults can gain from technology, its use remains low, especially among those with multimorbidity. Particularly newer, more innovative and (I)ADL-related AT appear underutilized. Considering the potential challenges in providing adequate care in the future, it may be crucial to support the use of these specific AT among older and frailer populations. To focus scientific and societal work, AT with a high impact on autonomy ((I)ADL/disease-related) should be distinguished from devices with a low impact on autonomy (household-/ comfort-related).
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Affiliation(s)
- Marina L Fotteler
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Wileystrasse 1, 89231, Neu-Ulm, Germany.
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany.
| | - Thomas D Kocar
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
- Agaplesion Bethesda Clinic Ulm, Ulm, Germany
| | - Dhayana Dallmeier
- Agaplesion Bethesda Clinic Ulm, Ulm, Germany
- Department of Epidemiology, Boston University School of Public Health, Boston, USA
- Geriatric Center Ulm, Ulm, Germany
| | - Brigitte Kohn
- Agaplesion Bethesda Clinic Ulm, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
| | - Sarah Mayer
- Agaplesion Bethesda Clinic Ulm, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
| | - Ann-Kathrin Waibel
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Wileystrasse 1, 89231, Neu-Ulm, Germany
| | - Walter Swoboda
- DigiHealth Institute, Neu-Ulm University of Applied Sciences, Wileystrasse 1, 89231, Neu-Ulm, Germany
| | - Michael Denkinger
- Institute for Geriatric Research, Ulm University Medical Center, Ulm, Germany
- Agaplesion Bethesda Clinic Ulm, Ulm, Germany
- Geriatric Center Ulm, Ulm, Germany
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27
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Ravindran KKG, della Monica C, Atzori G, Lambert D, Hassanin H, Revell V, Dijk DJ. Contactless and longitudinal monitoring of nocturnal sleep and daytime naps in older men and women: a digital health technology evaluation study. Sleep 2023; 46:zsad194. [PMID: 37471049 PMCID: PMC10566241 DOI: 10.1093/sleep/zsad194] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/16/2023] [Indexed: 07/21/2023] Open
Abstract
STUDY OBJECTIVES To compare the 24-hour sleep assessment capabilities of two contactless sleep technologies (CSTs) to actigraphy in community-dwelling older adults. METHODS We collected 7-14 days of data at home from 35 older adults (age: 65-83), some with medical conditions, using Withings Sleep Analyser (WSA, n = 29), Emfit QS (Emfit, n = 17), a standard actigraphy device (Actiwatch Spectrum [AWS, n = 34]), and a sleep diary (n = 35). We compared nocturnal and daytime sleep measures estimated by the CSTs and actigraphy without sleep diary information (AWS-A) against sleep-diary-assisted actigraphy (AWS|SD). RESULTS Compared to sleep diary, both CSTs accurately determined the timing of nocturnal sleep (intraclass correlation [ICC]: going to bed, getting out of bed, time in bed >0.75), whereas the accuracy of AWS-A was much lower. Compared to AWS|SD, the CSTs overestimated nocturnal total sleep time (WSA: +92.71 ± 81.16 minutes; Emfit: +101.47 ± 75.95 minutes) as did AWS-A (+46.95 ± 67.26 minutes). The CSTs overestimated sleep efficiency (WSA: +9.19% ± 14.26%; Emfit: +9.41% ± 11.05%), whereas AWS-A estimate (-2.38% ± 10.06%) was accurate. About 65% (n = 23) of participants reported daytime naps either in bed or elsewhere. About 90% in-bed nap periods were accurately determined by WSA while Emfit was less accurate. All three devices estimated 24-hour sleep duration with an error of ≈10% compared to the sleep diary. CONCLUSIONS CSTs accurately capture the timing of in-bed nocturnal sleep periods without the need for sleep diary information. However, improvements are needed in assessing parameters such as total sleep time, sleep efficiency, and naps before these CSTs can be fully utilized in field settings.
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Affiliation(s)
- Kiran K G Ravindran
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
| | - Ciro della Monica
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
| | - Giuseppe Atzori
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
| | - Damion Lambert
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
| | - Hana Hassanin
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
- Surrey Clinical Research Facility, Faculty of Health and Medical Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Victoria Revell
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
| | - Derk-Jan Dijk
- Surrey Sleep Research Centre, University of Surrey, Guildford, UK
- UK Dementia Research Institute, Care Research and Technology Centre at Imperial College, London, UK, and University of Surrey, Guildford, UK
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Kokorelias KM, Grigorovich A, Harris MT, Rehman U, Ritchie L, Levy A, Denecke K, McMurray J. Coadaptation Between Smart Technologies and Older Adults Over Time: Protocol for a Scoping Review. JMIR Res Protoc 2023; 12:e51129. [PMID: 37812466 PMCID: PMC10594133 DOI: 10.2196/51129] [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: 07/21/2023] [Revised: 08/18/2023] [Accepted: 08/27/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND The Internet of Things (IoT) has gained significant attention due to advancements in technology and has potential applications in meeting the needs of an aging population. Smart technologies, a subset of IoT, can support older adults in aging in place, promoting independent living and improving their quality of life. However, there is a lack of research on how older adults and smart technologies coadapt over time to maximize their benefits and sustain adoption. OBJECTIVE We will aim to comprehensively review and analyze the existing scientific literature pertaining to the coadaptation between smart technologies and older adults. The primary focus will be to investigate the extent and nature of this coadaptation process and explore how older adults and technology coevolve over time to enhance older adults' experience with technology. METHODS This scoping review will follow the methodology outlined in the Joanna Briggs Institute Reviewer's Manual and adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews) guidelines for reporting. Peer-reviewed articles will be searched in databases like Ovid MEDLINE, OVID Embase, PEDro, OVID PsycINFO, EBSCO CINAHL, the Cochrane Library, Scopus, IEEE Xplore, Web of Science, and Global Index Medicus. The research team will create a data extraction form covering study characteristics, participant characteristics, underlying models and frameworks, research findings, implications for technology coadaptation, and any identified study limitations. A directed content analysis approach will be used, incorporating the Selection, Optimization, and Compensation framework and Sex- and Gender-Based Analysis Plus theoretical framework. RESULTS The results of this study are expected in January 2024. CONCLUSIONS This scoping review endeavors to present a thorough overview of the available evidence concerning how smart technologies interact with older adults over an extended period. The insights gained from this review will lay the groundwork for a research program that explores how older adults adapt to and use smart technologies throughout their lives, ultimately leading to improved user satisfaction and experience and facilitating aging in place with tailored support and user-centered design principles. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/51129.
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Affiliation(s)
- Kristina Marie Kokorelias
- Division of Geriatric Medicine, Department of Medicine, Sinai Health System and University Health Network, Toronto, ON, Canada
- Department of Occupational Science & Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- National Institute on Ageing, Toronto Metropolitan University, Toronto, ON, Canada
- Toronto Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Alisa Grigorovich
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Recreation and Leisure Studies, Brock University, St. Catharines, ON, Canada
| | - Maurita T Harris
- User Experience Design, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Umair Rehman
- Department of Computer Science, University of Western Ontario, London, ON, Canada
| | - Louise Ritchie
- Alzheimer Scotland Centre for Policy and Practice, University of West Scotland, Scotland, United Kingdom
| | - AnneMarie Levy
- Lazaridis School of Business & Economics/Community Health, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Kerstin Denecke
- Institute for Medical Informatics, Bern University of Applied Sciences, Bern, Switzerland
| | - Josephine McMurray
- Lazaridis School of Business & Economics/Community Health, Wilfrid Laurier University, Waterloo, ON, Canada
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Alpert JM, Sharma B, Cenko E, Zapata R, Karnati Y, Fillingim RB, Gill TM, Marsiske M, Ranka S, Manini T. Identifying barriers and facilitators for using a smartwatch to monitor health among older adults. EDUCATIONAL GERONTOLOGY 2023; 50:282-295. [PMID: 38737621 PMCID: PMC11081104 DOI: 10.1080/03601277.2023.2260970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
Smartwatches are a type of wearable device that enable continuous monitoring of an individual's activities and critical health metrics. As the number of older adults age 65+ continues to grow in the U.S., so does their usage of smartwatches, making it necessary to understand the real-world uptake and use of these devices to monitor health. In this study, older adults with a relatively high level of education and digital skills were provided with a smartwatch equipped with a mobile application (ROAMM) that was worn for a median of 14 days. Usability surveys were distributed, and a qualitative analysis was performed about participants' experience using the smartwatch and ROAMM application. Constructs from the Technology Acceptance Model and Consolidated Framework for Implementation Research were incorporated into in-depth interviews, which were recorded and transcribed. Data were analyzed using the constant comparative method. Interviews among 30 older adults revealed the following main themes: 1) familiarization with the device and adoption and acceptance, 2) factors encouraging usage, such as a doctor's endorsement or the appeal of tracking one's health, and 3) barriers to usage, such as insufficient education and training and the desire for additional functionality. Overall, participants found the smartwatch easy to use and were likely to continue using the device in a long-term study. Data generated from smartwatches have the potential to engage individuals about their health and could inspire them to participate more actively during clinical encounters.
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Affiliation(s)
- Jordan M. Alpert
- Internal Medicine and Geriatrics, Cleveland Clinic, Cleveland, OH, USA
| | - Bhakti Sharma
- College of Journalism and Communications, University of Florida, Gainesville, FL, USA
| | - Erta Cenko
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Ruben Zapata
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Yashaswi Karnati
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Roger B. Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, FL, USA
| | - Thomas M. Gill
- Department of Medicine, Yale University, New Haven, CT, USA
| | - Michael Marsiske
- Department of Clinical and Health Psychology in the College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Sanjay Ranka
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Todd Manini
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
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Chang CH, Lien WC, Chiu TP, Yang TH, Wei CC, Kuo YL, Yeh CH, Liu B, Chen PJ, Lin YC. A novel smart somatosensory wearable assistive device for older adults' home rehabilitation during the COVID-19 pandemic. Front Public Health 2023; 11:1026662. [PMID: 37790724 PMCID: PMC10544986 DOI: 10.3389/fpubh.2023.1026662] [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: 09/20/2022] [Accepted: 08/29/2023] [Indexed: 10/05/2023] Open
Abstract
Background Due to the Coronavirus disease 19 (COVID-19) related social distancing measures and health service suspension, physical activity has declined, leading to increased falling risk and disability, and consequently, compromising the older adult health. How to improve the quality of older adult life has become a crucial social issue. Objective In traditional rehabilitation, manual and repetitive muscle training cannot identify the patient's rehabilitation effect, and increasing the willingness to use it is not easy. Therefore, based on the usability perspective, this study aims to develop a novel smart somatosensory wearable assistive device (called SSWAD) combined with wireless surface electromyography (sEMG) and exergame software and hardware technology. The older adult can do knee extension, ankle dorsiflexion, and ankle plantar flexion rehabilitation exercises at home. Meanwhile, sEMG values can be digitally recorded to assist physicians (or professionals) in judgment, treatment, or diagnosis. Methods To explore whether the novel SSWAD could improve the older adult willingness to use and motivation for home rehabilitation, 25 frail older adult (12 males and 13 females with an average age of 69.3) perform the rehabilitation program with the SSWAD, followed by completing the system usability scale (SUS) questionnaire and the semi-structured interview for the quantitative and qualitative analyses. In addition, we further investigate whether the factor of gender or prior rehabilitation experience would affect the home rehabilitation willingness or not. Results According to the overall SUS score, the novel SSWAD has good overall usability performance (77.70), meaning that the SSWAD makes older adult feel interested and improves their willingness for continuous rehabilitation at home. In addition, the individual item scores of SUS are shown that female older adult with prior rehabilitation experience perform better in "Learnability" (t = 2.35, p = 0.03) and "Confidence" (t = -3.24, p = 0.01). On the contrary, male older adult without rehabilitation experience are more willing to adopt new technologies (t = -2.73, p = 0.02), and perform better in "Learnability" (t = 2.18, p = 0.04) and "Confidence" (t = -3.75, p < 0.001) with the SSWAD. In addition, the result of the semi-structured interview shows that the operation of the SSWAD is highly flexible, thus reducing older adult burden during the rehabilitation exercise and using them long-term. Conclusion This novel SSWAD receives consistently positive feedback regardless of the gender or prior rehabilitation experience of elders. The SSWAD could be used as a novel way of home rehabilitation for elders, especially during the COVID-19 pandemic. Older adult can do rehabilitation exercises at home, and physicians could make proper judgments or adjust suitable treatments online according to the sEMG data, which older adult can know their rehabilitation progress at the same time. Most importantly, older adult do not have to go to the hospital every time for rehabilitation, which significantly reduces time and the risk of infection.
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Affiliation(s)
- Chien-Hsiang Chang
- Department of Industrial Design, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Chih Lien
- Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Physical Medicine and Rehabilitation, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tseng-Ping Chiu
- Department of Industrial Design, National Cheng Kung University, Tainan, Taiwan
| | - Tai-Hua Yang
- Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taipei, Taiwan
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Chun Wei
- Department of Digital Multimedia Design, National Taipei University of Business, Taipei, Taiwan
| | - Yu-Liang Kuo
- Department of Industrial Design, National Cheng Kung University, Tainan, Taiwan
| | - Chung-Hsing Yeh
- Faculty of Information Technology, Monash University, Melbourne, VIC, Australia
| | - Bo Liu
- Department of Industrial Design, National Cheng Kung University, Tainan, Taiwan
| | - Pin-Jun Chen
- Department of Industrial Design, National Cheng Kung University, Tainan, Taiwan
| | - Yang-Cheng Lin
- Department of Industrial Design, National Cheng Kung University, Tainan, Taiwan
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Das J, Walker R, Barry G, Vitório R, Stuart S, Morris R. Stroboscopic visual training: The potential for clinical application in neurological populations. PLOS DIGITAL HEALTH 2023; 2:e0000335. [PMID: 37611053 PMCID: PMC10446176 DOI: 10.1371/journal.pdig.0000335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
Visual problems are common in people who have neurological injury or disease, with deficits linked to postural control and gait impairment. Vision therapy could be a useful intervention for visual impairment in various neurological conditions such as stroke, head injury, or Parkinson's disease. Stroboscopic visual training (SVT) has been shown to improve aspects of visuomotor and cognitive performance in healthy populations, but approaches vary with respect to testing protocols, populations, and outcomes. The purpose of this structured review was to examine the use of strobe glasses as a training intervention to inform the development of robust protocols for use in clinical practice. Within this review, any studies using strobe glasses as a training intervention with visual or motor performance-related outcomes was considered. PubMed, Scopus, and ProQuest databases were searched in January 2023. Two independent reviewers (JD and RM) screened articles that used strobe glasses as a training tool. A total of 33 full text articles were screened, and 15 met inclusion/exclusion criteria. Reported outcomes of SVT included improvements in short-term memory, attention, and visual response times, with emerging evidence for training effects translating to balance and physical performance. However, the lack of standardisation across studies for SVT protocols, variation in intervention settings, duration and outcomes, and the limited evidence within clinical populations demonstrates that further work is required to determine optimal strobe dosage and delivery. This review highlights the potential benefits, and existing research gaps regarding the use of SVT in clinical practice, with recommendations for clinicians considering adopting this technology as part of future studies in this emerging field.
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Affiliation(s)
- Julia Das
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom
| | - Richard Walker
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom
| | - Gill Barry
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Rodrigo Vitório
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Samuel Stuart
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom
| | - Rosie Morris
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom
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Schilz C, Sammito S. Physical activity of daily life of Bundeswehr soldiers: a cross-sectional study. BMJ Mil Health 2023; 169:302-306. [PMID: 34266977 DOI: 10.1136/bmjmilitary-2021-001865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/24/2021] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Activity of daily life is an important key to maintaining and improving the health status. This is especially important for people in physically demanding jobs, such as firefighters, military and police. METHODS In order to record the actual state of activity of daily life among soldiers, a step count measurement with a pedometer was carried out on 196 soldiers of the German Armed Forces over 7 days and supplemented by a questionnaire on lifestyle factors. RESULTS The subjects exceeded the recommended 7000-8000 steps per day, with the rank and file moving the least and the commissioned officers the most. It was also striking that the soldiers in the study moved an average of 2600 steps less per day on weekends than on weekdays. CONCLUSIONS Based on these findings, targeted physical activity measures can be established for the identified target groups within the framework of corporate health management in order to ensure the physical fitness of soldiers on routine duty and on deployment.
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Affiliation(s)
- Christin Schilz
- Department of Anesthesiology and Intensive Care Medicine, Bundeswehr Central Hospital Koblenz, Koblenz, Germany
- Department of Occupational Medicine, Medical Faculty, Otto von Guericke Universitat Magdeburg, Magdeburg, Germany
| | - S Sammito
- Department of Occupational Medicine, Medical Faculty, Otto von Guericke Universitat Magdeburg, Magdeburg, Germany
- Section Experimental Aerospace Medicine Research, German Air Force Centre of Aerospace Medicine, Cologne, Germany
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Seifer AK, Dorschky E, Küderle A, Moradi H, Hannemann R, Eskofier BM. EarGait: Estimation of Temporal Gait Parameters from Hearing Aid Integrated Inertial Sensors. SENSORS (BASEL, SWITZERLAND) 2023; 23:6565. [PMID: 37514858 PMCID: PMC10383770 DOI: 10.3390/s23146565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
Wearable sensors are able to monitor physical health in a home environment and detect changes in gait patterns over time. To ensure long-term user engagement, wearable sensors need to be seamlessly integrated into the user's daily life, such as hearing aids or earbuds. Therefore, we present EarGait, an open-source Python toolbox for gait analysis using inertial sensors integrated into hearing aids. This work contributes a validation for gait event detection algorithms and the estimation of temporal parameters using ear-worn sensors. We perform a comparative analysis of two algorithms based on acceleration data and propose a modified version of one of the algorithms. We conducted a study with healthy young and elderly participants to record walking data using the hearing aid's integrated sensors and an optical motion capture system as a reference. All algorithms were able to detect gait events (initial and terminal contacts), and the improved algorithm performed best, detecting 99.8% of initial contacts and obtaining a mean stride time error of 12 ± 32 ms. The existing algorithms faced challenges in determining the laterality of gait events. To address this limitation, we propose modifications that enhance the determination of the step laterality (ipsi- or contralateral), resulting in a 50% reduction in stride time error. Moreover, the improved version is shown to be robust to different study populations and sampling frequencies but is sensitive to walking speed. This work establishes a solid foundation for a comprehensive gait analysis system integrated into hearing aids that will facilitate continuous and long-term home monitoring.
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Affiliation(s)
- Ann-Kristin Seifer
- Machine Learning and Data Analytics Lab (MaD Lab), Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany
| | - Eva Dorschky
- Machine Learning and Data Analytics Lab (MaD Lab), Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany
| | - Arne Küderle
- Machine Learning and Data Analytics Lab (MaD Lab), Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany
| | - Hamid Moradi
- Machine Learning and Data Analytics Lab (MaD Lab), Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany
| | | | - Björn M Eskofier
- Machine Learning and Data Analytics Lab (MaD Lab), Department Artificial Intelligence in Biomedical Engineering (AIBE), Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91052 Erlangen, Germany
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Zhu D, Al Mahmud A, Liu W. Social connections and participation among people with mild cognitive impairment: barriers and recommendations. Front Psychiatry 2023; 14:1188887. [PMID: 37476544 PMCID: PMC10356108 DOI: 10.3389/fpsyt.2023.1188887] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023] Open
Abstract
Objective Social connections and participation are essential for individuals with mild cognitive impairment (MCI) to prevent the progression of cognitive decline and enhance their overall well-being. However, existing research has primarily focused on environmental barriers, overlooking personal factors and the interconnected nature of these barriers. Moreover, there is a lack of understanding regarding social connections and participation challenges specific to people with MCI in low- and middle-income countries. Therefore, this study aimed to explore the barriers that hinder social connections and participation among people with MCI in China and investigate opportunities to design appropriate supportive interventions. Methods Thirty-one people with MCI (13 males and 18 females; mean age = 82.74 years, SD = 7.69; mean MoCA score = 21.26, SD = 2.44) and 13 caregivers were recruited to attend focus groups. In addition, 10 therapists were interviewed using a semi-structured interview guide. Focus groups and interviews were audio-recorded, transcribed, and analyzed using a framework analysis approach. Results We found that the ability to build social connections among people with MCI is affected by mobility challenges, intensive grandparenting responsibilities, availability of suitable activities, and feelings of exclusion in a closed-minded community environment. Personal reasons, such as lower social efficacy, inability to find suitable social activities, and intensive family responsibilities, discourage people with MCI from social participation. The digital literacy of people with MCI depends on their motivation to learn and use digital tools; people with MCI who live in a community have a higher digital literacy than those living in care centers. The motivation to achieve digital literacy is affected by perceived benefits, costs of technology use, and social influence. Conclusion Multidimensional initiatives are needed to address barriers to social connections, participation, and technology adoption among individuals with MCI. This includes organizing and engaging in social activities, promoting awareness and education on the importance of social participation, and exploring technology-based interventions to improve memory and storytelling abilities. These efforts can create a supportive environment and empower individuals with MCI to participate actively in social interactions, enhancing their overall well-being.
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Affiliation(s)
- Di Zhu
- Swinburne University of Technology, Hawthorn, VIC, Australia
- Beijing Normal University, Beijing, China
| | | | - Wei Liu
- Beijing Normal University, Beijing, China
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Goodman A, Mahoney R, Spurling G, Lawler S. Influencing Factors to mHealth Uptake With Indigenous Populations: Qualitative Systematic Review. JMIR Mhealth Uhealth 2023; 11:e45162. [PMID: 37351947 PMCID: PMC10337452 DOI: 10.2196/45162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/07/2023] [Accepted: 04/21/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND The advancements and abundance of mobile phones and portable health devices have created an opportunity to use mobile health (mHealth) for population health systems. There is increasing evidence for the feasibility and acceptance of mHealth with Indigenous populations. Providing a synthesis of qualitative findings of mHealth with Indigenous populations will gain insights into the strengths and challenges to mHealth use in Indigenous populations. OBJECTIVE This review aimed to identify and synthesize qualitative data pertaining to the experiences and perceptions of mHealth from the perspectives of end users (patients and service providers) living in the colonial settler democracies of Canada, Australia, New Zealand, the United States, the Pacific Islands, and the Sápmi region of northern Europe. METHODS In May 2021, systematic searches of peer-reviewed, scientific papers were conducted across the 5 databases of PubMed, CINAHL, Embase, PsycINFO, and Web of Science. Qualitative or mixed method studies were included where a mHealth intervention was the primary focus for responding to health challenges with Indigenous populations. Two authors independently screened papers for eligibility and assessed the risk of bias using a modified version of the Critical Appraisal Skills Programme. A meta-aggregative approach was used to analyze the findings of included studies. RESULTS Seventeen papers met the eligibility criteria, 8 studies with patients, 7 studies with service providers, and 2 studies that included both patients and service providers. Studies were conducted in Australia (n=10), Canada (n=2), New Zealand (n=2), Papua New Guinea (n=1), the United States (n=1), and Samoa (n=1). Our interpretation of these qualitative findings shows commonalities between Indigenous patients' and service providers' perceptions of mHealth. We summarize our findings in six themes: (1) mHealth literacy, (2) mHealth as a facilitator for connection and support, (3) mHealth content needed to be culturally relevant, (4) mHealth security and confidentiality, (5) mHealth supporting rather than replacing service providers, and (6) workplace and organizational capacity. CONCLUSIONS This research suggests that mHealth can meet the needs of both patients and service providers when the mHealth intervention is culturally relevant, accounts for digital and health literacy, incorporates interactive components, is supported by workplaces, fits into health provider workflows, and meets security and confidentiality standards. Future mHealth research with Indigenous populations should partner with key representatives (eg, patients, service providers, and executive leaders) in the mHealth design appropriate to the purpose, people, setting, and delivery.
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Affiliation(s)
- Andrew Goodman
- School of Public Health, The University of Queensland, Turrbal, Jagera Country, Herston, Australia
- Australian eHealth Research Centre (AEHRC), Commonwealth Scientific and Industrial Research Organisation (CSIRO), Turrbal, Jagera Country, Herston, Australia
| | - Ray Mahoney
- College of Medicine and Public Health, Flinders University, Kaurna Country, Adelaide, Australia
| | - Geoffrey Spurling
- General Practice Clinical Unit, The University of Queensland, Turrbal, Jagera Country, Herston, Australia
| | - Sheleigh Lawler
- School of Public Health, The University of Queensland, Turrbal, Jagera Country, Herston, Australia
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Brem AK, Kuruppu S, de Boer C, Muurling M, Diaz-Ponce A, Gove D, Curcic J, Pilotto A, Ng WF, Cummins N, Malzbender K, Nies VJM, Erdemli G, Graeber J, Narayan VA, Rochester L, Maetzler W, Aarsland D. Digital endpoints in clinical trials of Alzheimer's disease and other neurodegenerative diseases: challenges and opportunities. Front Neurol 2023; 14:1210974. [PMID: 37435159 PMCID: PMC10332162 DOI: 10.3389/fneur.2023.1210974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 05/26/2023] [Indexed: 07/13/2023] Open
Abstract
Alzheimer's disease (AD) and other neurodegenerative diseases such as Parkinson's disease (PD) and Huntington's disease (HD) are associated with progressive cognitive, motor, affective and consequently functional decline considerably affecting Activities of Daily Living (ADL) and quality of life. Standard assessments, such as questionnaires and interviews, cognitive testing, and mobility assessments, lack sensitivity, especially in early stages of neurodegenerative diseases and in the disease progression, and have therefore a limited utility as outcome measurements in clinical trials. Major advances in the last decade in digital technologies have opened a window of opportunity to introduce digital endpoints into clinical trials that can reform the assessment and tracking of neurodegenerative symptoms. The Innovative Health Initiative (IMI)-funded projects RADAR-AD (Remote assessment of disease and relapse-Alzheimer's disease), IDEA-FAST (Identifying digital endpoints to assess fatigue, sleep and ADL in neurodegenerative disorders and immune-mediated inflammatory diseases) and Mobilise-D (Connecting digital mobility assessment to clinical outcomes for regulatory and clinical endorsement) aim to identify digital endpoints relevant for neurodegenerative diseases that provide reliable, objective, and sensitive evaluation of disability and health-related quality of life. In this article, we will draw from the findings and experiences of the different IMI projects in discussing (1) the value of remote technologies to assess neurodegenerative diseases; (2) feasibility, acceptability and usability of digital assessments; (3) challenges related to the use of digital tools; (4) public involvement and the implementation of patient advisory boards; (5) regulatory learnings; and (6) the significance of inter-project exchange and data- and algorithm-sharing.
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Affiliation(s)
- Anna-Katharine Brem
- Department of Old Age Psychiatry, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland
| | - Sajini Kuruppu
- Department of Old Age Psychiatry, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Casper de Boer
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | - Marijn Muurling
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | | | | | - Jelena Curcic
- Novartis Institutes for Biomedical Research (NIBR), Basel, Switzerland
| | - Andrea Pilotto
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Laboratory of Digital Neurology and Biosensors, University of Brescia, Brescia, Italy
- Neurology Unit, Department of Continuity of Care and Frailty, ASST Spedali Civili Brescia Hospital, Brescia, Italy
| | - Wan-Fai Ng
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Newcastle Biomedical Research Centre and Clinical Research Facility, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Nicholas Cummins
- Department of Biostats and Health Informatics, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | | | | | - Gul Erdemli
- Novartis Pharmaceuticals Corporations, Cambridge, MA, United States
| | - Johanna Graeber
- Institute of General Practice, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | | | - Lynn Rochester
- Faculty of Medical Sciences, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
- National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Walter Maetzler
- Department of Neurology, University Hospital Schleswig-Holstein and Kiel University, Kiel, Germany
| | - Dag Aarsland
- Department of Old Age Psychiatry, King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
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Avella-Rodríguez E, Gómez L, Ramirez-Scarpetta J, Rosero E. Colombian Stakeholder Perceptions and Recommendations Regarding Fall Detection Systems for Older Adults. Geriatrics (Basel) 2023; 8:geriatrics8030051. [PMID: 37218831 DOI: 10.3390/geriatrics8030051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/14/2023] [Accepted: 04/16/2023] [Indexed: 05/24/2023] Open
Abstract
This study aimed to analyze perceptions and recommendations from stakeholders on the effectiveness of fall detection systems for older adults, aside from any additional technological solutions they may use within their activities of daily living (ADLs). This study performed a mixed-method approach to explore the views and recommendations of stakeholders concerning the implementation of wearable fall detection systems. Semi-structured online interviews and surveys were conducted on 25 Colombian adults classified into four stakeholder groups: older adults, informal caregivers, healthcare professionals, and researchers. A total of 25 individuals were interviewed or surveyed, comprising 12 females (48%) and 13 males (52%). The four groups cited the importance of wearable fall detection systems in ADLs monitoring of older adults. They did not consider them stigmatizing nor discriminatory but some raised potential privacy issues. The groups also communicated that the apparatus could be small, lightweight, and easy to handle with a help message sent to a relative or caregiver. All stakeholders interviewed perceived assistive technology as potentially useful for opportune healthcare, as well as for promoting independent living for the end user and their family members. For this reason, this study assessed the perceptions and recommendations received concerning fall detectors depending on the needs of stakeholders and the settings in which they are used.
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Affiliation(s)
- Edna Avella-Rodríguez
- Escuela de Ingeniería Eléctrica y Electrónica, Universidad del Valle, Calle 13#100-00, Santiago de Cali 760032, Colombia
| | - Lessby Gómez
- Escuela de Rehabilitación Humana, Universidad del Valle, Calle 4b#36-00, Santiago de Cali 760043, Colombia
| | - Jose Ramirez-Scarpetta
- Escuela de Ingeniería Eléctrica y Electrónica, Universidad del Valle, Calle 13#100-00, Santiago de Cali 760032, Colombia
| | - Esteban Rosero
- Escuela de Ingeniería Eléctrica y Electrónica, Universidad del Valle, Calle 13#100-00, Santiago de Cali 760032, Colombia
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Paulauskaite-Taraseviciene A, Siaulys J, Sutiene K, Petravicius T, Navickas S, Oliandra M, Rapalis A, Balciunas J. Geriatric Care Management System Powered by the IoT and Computer Vision Techniques. Healthcare (Basel) 2023; 11:healthcare11081152. [PMID: 37107987 PMCID: PMC10138364 DOI: 10.3390/healthcare11081152] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/03/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
The digitalisation of geriatric care refers to the use of emerging technologies to manage and provide person-centered care to the elderly by collecting patients' data electronically and using them to streamline the care process, which improves the overall quality, accuracy, and efficiency of healthcare. In many countries, healthcare providers still rely on the manual measurement of bioparameters, inconsistent monitoring, and paper-based care plans to manage and deliver care to elderly patients. This can lead to a number of problems, including incomplete and inaccurate record-keeping, errors, and delays in identifying and resolving health problems. The purpose of this study is to develop a geriatric care management system that combines signals from various wearable sensors, noncontact measurement devices, and image recognition techniques to monitor and detect changes in the health status of a person. The system relies on deep learning algorithms and the Internet of Things (IoT) to identify the patient and their six most pertinent poses. In addition, the algorithm has been developed to monitor changes in the patient's position over a longer period of time, which could be important for detecting health problems in a timely manner and taking appropriate measures. Finally, based on expert knowledge and a priori rules integrated in a decision tree-based model, the automated final decision on the status of nursing care plan is generated to support nursing staff.
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Affiliation(s)
| | - Julius Siaulys
- Faculty of Informatics, Kaunas University of Technology, Studentu 50, 51368 Kaunas, Lithuania
| | - Kristina Sutiene
- Department of Mathematical Modeling, Kaunas University of Technology, Studentu 50, 51368 Kaunas, Lithuania
| | - Titas Petravicius
- Faculty of Informatics, Kaunas University of Technology, Studentu 50, 51368 Kaunas, Lithuania
| | - Skirmantas Navickas
- Faculty of Informatics, Kaunas University of Technology, Studentu 50, 51368 Kaunas, Lithuania
| | - Marius Oliandra
- Faculty of Informatics, Kaunas University of Technology, Studentu 50, 51368 Kaunas, Lithuania
| | - Andrius Rapalis
- Biomedical Engineering Institute, Kaunas University of Technology, K. Barsausko 59, 51423 Kaunas, Lithuania
- Faculty of Electrical and Electronics Engineering, Kaunas University of Technology, Studentu 48, 51367 Kaunas, Lithuania
| | - Justinas Balciunas
- Faculty of Medicine, Vilnius University, Universiteto 3, 01513 Vilnius, Lithuania
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Garcia Reyes EP, Kelly R, Buchanan G, Waycott J. Understanding Older Adults' Experiences With Technologies for Health Self-management: Interview Study. JMIR Aging 2023; 6:e43197. [PMID: 36943333 PMCID: PMC10131633 DOI: 10.2196/43197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Many older adults now use technologies such as wearable devices and telehealth services to support their health and well-being while living independently at home. However, older adults vary in how they use these technologies, and there is a lack of knowledge regarding the motivations that influence their acceptance and use of health-related technologies in home environments. OBJECTIVE This study aimed to understand the types of technologies that older adults use to support their health and the factors that motivate them to use their chosen technologies to support their health. In addition, we aimed to understand the factors that enable the effective use of technologies for health self-management and to identify the barriers that can negatively affect the adoption of technologies. METHODS A total of 22 older adults participated in semistructured interviews regarding their experiences of using technologies for health self-management. Interview transcripts were analyzed through an in-depth thematic analysis. RESULTS The interviews revealed that a range of technologies, such as videoconferencing software, fitness trackers, and other devices, were being used by older adults to support their health. Interviews showed that participants were motivated to use technologies to monitor health issues, to stay active and connected, and to record and change their behavior in the light of foreseen risks related to their future health status. Enablers that facilitated the effective use of technologies include social and organizational influence, convenient access to health care and safety provided by the technology, and easy setup and low cost of the technology. Barriers include information overload and a sense of futility about future health decline; telehealth being an inadequate substitute for in-person consultation; concerns about trust related to privacy and accuracy; and technologies being stigmatizing, uncomfortable to use, expensive, and unfamiliar. CONCLUSIONS This study suggested that older adults were using a variety of technologies to prevent or prepare for future health decline, evidencing a resilient attitude toward health and aging. In addition, older adults were willing to continue using the technology when there was a perceived need. The enabler mentioned by most participants was the social and organizational influence that included health care staff, family, friends, and organizations. This analysis provides a better understanding of how older adults use technologies to support their health and can guide the provision of appropriate health technologies for them.
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Affiliation(s)
- Elsy Paola Garcia Reyes
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - Ryan Kelly
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - George Buchanan
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
| | - Jenny Waycott
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia
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Debelle H, Packer E, Beales E, Bailey HGB, Mc Ardle R, Brown P, Hunter H, Ciravegna F, Ireson N, Evers J, Niessen M, Shi JQ, Yarnall AJ, Rochester L, Alcock L, Del Din S. Feasibility and usability of a digital health technology system to monitor mobility and assess medication adherence in mild-to-moderate Parkinson's disease. Front Neurol 2023; 14:1111260. [PMID: 37006505 PMCID: PMC10050691 DOI: 10.3389/fneur.2023.1111260] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/20/2023] [Indexed: 03/17/2023] Open
Abstract
IntroductionParkinson's disease (PD) is a neurodegenerative disorder which requires complex medication regimens to mitigate motor symptoms. The use of digital health technology systems (DHTSs) to collect mobility and medication data provides an opportunity to objectively quantify the effect of medication on motor performance during day-to-day activities. This insight could inform clinical decision-making, personalise care, and aid self-management. This study investigates the feasibility and usability of a multi-component DHTS to remotely assess self-reported medication adherence and monitor mobility in people with Parkinson's (PwP).MethodsThirty participants with PD [Hoehn and Yahr stage I (n = 1) and II (n = 29)] were recruited for this cross-sectional study. Participants were required to wear, and where appropriate, interact with a DHTS (smartwatch, inertial measurement unit, and smartphone) for seven consecutive days to assess medication adherence and monitor digital mobility outcomes and contextual factors. Participants reported their daily motor complications [motor fluctuations and dyskinesias (i.e., involuntary movements)] in a diary. Following the monitoring period, participants completed a questionnaire to gauge the usability of the DHTS. Feasibility was assessed through the percentage of data collected, and usability through analysis of qualitative questionnaire feedback.ResultsAdherence to each device exceeded 70% and ranged from 73 to 97%. Overall, the DHTS was well tolerated with 17/30 participants giving a score > 75% [average score for these participants = 89%, from 0 (worst) to 100 (best)] for its usability. Usability of the DHTS was significantly associated with age (ρ = −0.560, BCa 95% CI [−0.791, −0.207]). This study identified means to improve usability of the DHTS by addressing technical and design issues of the smartwatch. Feasibility, usability and acceptability were identified as key themes from PwP qualitative feedback on the DHTS.ConclusionThis study highlighted the feasibility and usability of our integrated DHTS to remotely assess medication adherence and monitor mobility in people with mild-to-moderate Parkinson's disease. Further work is necessary to determine whether this DHTS can be implemented for clinical decision-making to optimise management of PwP.
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Affiliation(s)
- Héloïse Debelle
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Emma Packer
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Esther Beales
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Harry G. B. Bailey
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Ríona Mc Ardle
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- National Institute for Health and Care Research (NIHR), Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Philip Brown
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Heather Hunter
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Fabio Ciravegna
- Department of Computer Science and INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, United Kingdom
- Dipartimento di Informatica, Università di Torino, Turin, Italy
| | - Neil Ireson
- Department of Computer Science and INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, United Kingdom
| | | | | | - Jian Qing Shi
- Department of Statistics and Data Science, Southern University of Science and Technology, Shenzhen, China
| | - Alison J. Yarnall
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- National Institute for Health and Care Research (NIHR), Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Lynn Rochester
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- National Institute for Health and Care Research (NIHR), Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
- The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Lisa Alcock
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- National Institute for Health and Care Research (NIHR), Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Silvia Del Din
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- National Institute for Health and Care Research (NIHR), Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
- *Correspondence: Silvia Del Din
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Zytnick D, Folta SC, Reid KF, Chomitz VR. Better Understanding Wearable Activity Monitor Use and Non-Use Among Older Adults: A Qualitative Study. J Appl Gerontol 2023; 42:447-455. [PMID: 36314597 DOI: 10.1177/07334648221137057] [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: 02/18/2023] Open
Abstract
We used qualitative methods to better understand wearable activity monitor (WAM) use and its relationship with physical activity (PA) among older adults. Four focus groups, stratified by current/past ("ever") WAM users and "never" WAM users, were conducted with 57 participants aged ≥60 years. Data were coded with deductive and inductive approaches. Among ever WAM users, those with low pre-WAM PA levels reported higher PA related to WAM use while those with high pre-WAM PA levels reported they used WAM for tracking and monitoring their activity. Ever WAM users were motivated to increase PA through rewards and social support. Many never WAM users reported that WAM was unnecessary. WAM may be helpful for some older adults to increase their PA, particularly those who are motivated by setting and achieving PA goals. The results could help develop strategies to overcome barriers to WAM adoption and promote WAM use among older adults.
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Affiliation(s)
- Deena Zytnick
- Department of Public Health and Community Medicine, School of Medicine, 1810Tufts University, Boston, MA, USA
| | - Sara C Folta
- Friedman School of Nutrition Science and Policy, 1810Tufts University, Boston, MA, USA
| | - Kieran F Reid
- Laboratory of Exercise Physiology and Physical Performance, Boston Claude D. Pepper Older Americans Independence Center for Function Promoting Therapies, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Virginia R Chomitz
- Department of Public Health and Community Medicine, School of Medicine, 1810Tufts University, Boston, MA, USA
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Chen J, Li T, You H, Wang J, Peng X, Chen B. Behavioral Interpretation of Willingness to Use Wearable Health Devices in Community Residents: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3247. [PMID: 36833943 PMCID: PMC9960868 DOI: 10.3390/ijerph20043247] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/22/2023] [Accepted: 02/06/2023] [Indexed: 05/30/2023]
Abstract
Wearable health devices (WHDs) have become increasingly advantageous in long-term health monitoring and patient management. However, most people have not yet benefited from such innovative technologies, and the willingness to accept WHDs and their influencing factors are still unclear. Based on two behavioral theories: the theory of planned behavior (TPB) and the diffusion of innovation (DOI), this study aims to explore the influencing factors of willingness to use WHDs in community residents from the perspective of both internal and external factors. A convenience sample of 407 community residents were recruited from three randomly selected Community Health Service Centers (CHSCs) in Nanjing, China, and were investigated with a self-developed questionnaires. The mean score of willingness to use WHDs was 17.00 (range 5-25). In the dimensions of TPB, perceived behavioral control (β = 1.979, p < 0.001) was the strongest influencing factor. Subjective norms (β = 1.457, p < 0.001) and attitudes (β = 0.651, p = 0.016) were also positively associated with willingness. In innovation characteristics of DOI, compatibility (β = 0.889, p < 0.001) and observability (β = 0.576, p = 0.003) had positive association with the willingness to wear a WHD. This study supports the applicability of the two behavioral theories to interpret the willingness to use WHDs in Chinese community residents. Compared with the innovative features of WHDs, individual cognitive factors were more critical predictors of willingness to use.
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Affiliation(s)
- Jiaxin Chen
- School of Nursing, Nanjing Medical University, Nanjing 211166, China
| | - Ting Li
- Geriatric Hospital of Nanjing Medical University, Nanjing 210009, China
| | - Hua You
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Jingyu Wang
- School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Xueqing Peng
- Chengdu Center for Disease Control and Prevention, Chengdu 610041, China
| | - Baoyi Chen
- MaiGaoQiao Community Health Service Center, Nanjing 210028, China
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Félix J, Moreira J, Santos R, Kontio E, Pinheiro AR, Sousa ASP. Health-Related Telemonitoring Parameters/Signals of Older Adults: An Umbrella Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:796. [PMID: 36679588 PMCID: PMC9862356 DOI: 10.3390/s23020796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 06/17/2023]
Abstract
Aging is one of the greatest challenges in modern society. The development of wearable solutions for telemonitoring biological signals has been viewed as a strategy to enhance older adults' healthcare sustainability. This study aims to review the biological signals remotely monitored by technologies in older adults. PubMed, the Cochrane Database of Systematic Reviews, the Web of Science, and the Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports were systematically searched in December 2021. Only systematic reviews and meta-analyses of remote health-related biological and environmental monitoring signals in older adults were considered, with publication dates between 2016 and 2022, written in English, Portuguese, or Spanish. Studies referring to conference proceedings or articles with abstract access only were excluded. The data were extracted independently by two reviewers, using a predefined table form, consulting a third reviewer in case of doubts or concerns. Eighteen studies were included, fourteen systematic reviews and four meta-analyses. Nine of the reviews included older adults from the community, whereas the others also included institutionalized participants. Heart and respiratory rate, physical activity, electrocardiography, body temperature, blood pressure, glucose, and heart rate were the most frequently measured biological variables, with physical activity and heart rate foremost. These were obtained through wearables, with the waist, wrist, and ankle being the most mentioned body regions for the device's placement. Six of the reviews presented the psychometric properties of the systems, most of which were valid and accurate. In relation to environmental signals, only two articles presented data on this topic. Luminosity, temperature, and movement were the most mentioned variables. The need for large-scale long-term health-related telemonitoring implementation of studies with larger sample sizes was pointed out by several reviews in order to define the feasibility levels of wearable devices.
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Affiliation(s)
- José Félix
- Department of Physics, School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal
- Department of Medical Sciences, University of Aveiro, Agras do Crasto, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Juliana Moreira
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal
| | - Rubim Santos
- Department of Physics, School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal
| | - Elina Kontio
- Faculty of Engineering and Business, Turku University of Applied Sciences, Joukahaisenkatu 3, 20520 Turku, Finland
| | - Ana Rita Pinheiro
- School of Health Sciences (ESSUA), University of Aveiro, Agras do Crasto, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
- Institute of Biomedicine (iBiMED), University of Aveiro, Agras do Crasto, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Andreia S. P. Sousa
- Center for Rehabilitation Research (CIR), School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal
- Department of Physiotherapy, School of Health, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida, 400, 4200-072 Porto, Portugal
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Clay I, Peerenboom N, Connors DE, Bourke S, Keogh A, Wac K, Gur-Arie T, Baker J, Bull C, Cereatti A, Cormack F, Eggenspieler D, Foschini L, Ganea R, Groenen PM, Gusset N, Izmailova E, Kanzler CM, Leyens L, Lyden K, Mueller A, Nam J, Ng WF, Nobbs D, Orfaniotou F, Perumal TM, Piwko W, Ries A, Scotland A, Taptiklis N, Torous J, Vereijken B, Xu S, Baltzer L, Vetter T, Goldhahn J, Hoffmann SC. Reverse Engineering of Digital Measures: Inviting Patients to the Conversation. Digit Biomark 2023; 7:28-44. [PMID: 37206894 PMCID: PMC10189241 DOI: 10.1159/000530413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/07/2023] [Indexed: 05/21/2023] Open
Abstract
Background Digital measures offer an unparalleled opportunity to create a more holistic picture of how people who are patients behave in their real-world environments, thereby establishing a better connection between patients, caregivers, and the clinical evidence used to drive drug development and disease management. Reaching this vision will require achieving a new level of co-creation between the stakeholders who design, develop, use, and make decisions using evidence from digital measures. Summary In September 2022, the second in a series of meetings hosted by the Swiss Federal Institute of Technology in Zürich, the Foundation for the National Institutes of Health Biomarkers Consortium, and sponsored by Wellcome Trust, entitled "Reverse Engineering of Digital Measures," was held in Zurich, Switzerland, with a broad range of stakeholders sharing their experience across four case studies to examine how patient centricity is essential in shaping development and validation of digital evidence generation tools. Key Messages In this paper, we discuss progress and the remaining barriers to widespread use of digital measures for evidence generation in clinical development and care delivery. We also present key discussion points and takeaways in order to continue discourse and provide a basis for dissemination and outreach to the wider community and other stakeholders. The work presented here shows us a blueprint for how and why the patient voice can be thoughtfully integrated into digital measure development and that continued multistakeholder engagement is critical for further progress.
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Affiliation(s)
| | | | | | | | - Alison Keogh
- Insight Centre for Data Analytics, UC Dublin, Dublin, Ireland
- Mobilise-D, Newcastle University, Newcastle upon Tyne, UK
| | - Katarzyna Wac
- Quality of Life Lab, University of Geneva, Geneva, Switzerland
| | - Tova Gur-Arie
- Mobilise-D, Newcastle University, Newcastle upon Tyne, UK
| | | | - Christopher Bull
- Newcastle University, Newcastle, UK
- IDEA-FAST, Newcastle University, Newcastle upon Tyne, UK
| | - Andrea Cereatti
- Mobilise-D, Newcastle University, Newcastle upon Tyne, UK
- Polytechnic University of Torino, Torino, Italy
| | - Francesca Cormack
- IDEA-FAST, Newcastle University, Newcastle upon Tyne, UK
- Cambridge Cognition Ltd, Cambridge, UK
| | | | | | | | | | | | | | | | | | | | - Arne Mueller
- Mobilise-D, Newcastle University, Newcastle upon Tyne, UK
- Novartis, Basel, Switzerland
| | - Julian Nam
- F. Hoffmann-La Roche, Basel, Switzerland
| | - Wan-Fai Ng
- Newcastle University, Newcastle, UK
- IDEA-FAST, Newcastle University, Newcastle upon Tyne, UK
| | - David Nobbs
- IDEA-FAST, Newcastle University, Newcastle upon Tyne, UK
- F. Hoffmann-La Roche, Basel, Switzerland
| | | | | | - Wojciech Piwko
- Takeda Pharmaceuticals International, Zurich, Switzerland
| | - Anja Ries
- F. Hoffmann-La Roche, Basel, Switzerland
| | - Alf Scotland
- Biogen Digital Health International GmbH, Baar, Switzerland
| | - Nick Taptiklis
- IDEA-FAST, Newcastle University, Newcastle upon Tyne, UK
- Cambridge Cognition Ltd, Cambridge, UK
| | | | - Beatrix Vereijken
- Mobilise-D, Newcastle University, Newcastle upon Tyne, UK
- Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | | | - Jörg Goldhahn
- Swiss Federal Institute of Technology, Zurich, Switzerland
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45
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Vietzke J, Schenk L, Baer NR. Middle-aged and older adults' acceptance of mobile nutrition and fitness tools: A qualitative typology. Digit Health 2023; 9:20552076231163788. [PMID: 36937695 PMCID: PMC10017948 DOI: 10.1177/20552076231163788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 02/24/2023] [Indexed: 03/16/2023] Open
Abstract
Background The utilization of mobile health (mHealth) devices such as nutrition and fitness tools seems to be promising in facilitating healthy lifestyle behaviors in middle-aged and older adults. As user acceptance plays a decisive role in the successful implementation of mHealth tools, it is vital to examine the target groups' acceptance, particularly their usage behavior and attitudes toward these tools. This qualitative study aimed to explore how far middle-aged as well as older adults accept mobile nutrition and fitness tools and to identify facilitators and barriers shaping their acceptance. Methods Twenty-one qualitative semi-structured interviews were conducted with German adults aged 50 years and older. Data material was analyzed using Qualitative Content Analysis (Kuckartz). Results A comprehensive acceptance typology with three acceptance types could be reconstructed: The Rejection Type, The Selective Acceptance Type, and The Comprehensive Acceptance Type. The target group's acceptance of mobile nutrition and fitness tools appeared to differ considerably across the three acceptance types and between the two different types of mHealth tools - with mobile nutrition tools having been less accepted. Among others, high levels of usability were identified as a key facilitator, while a desire for autonomy and privacy concerns showed to be prominent barriers. Conclusion The resulting typology indicates a pronounced heterogeneity among middle-aged and older adults regarding their acceptance of mobile nutrition and fitness tools. The findings highlight a need for more individualized mHealth tools along with respective promotion strategies that are specifically tailored to the needs and expectations of middle-aged and older adults.
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Affiliation(s)
- Julia Vietzke
- Julia Vietzke, Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany.
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Tuominen M, Koski P, Axelin A, Stenholm S, Leskinen T. Acceptable, useful, and ineffective? Recent retirees’ experiences of a 12-month activity tracker-based physical activity intervention. Digit Health 2023. [DOI: 10.1177/20552076221147419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objective Activity trackers appear cost-effective and acceptable intervention tools for promoting physical activity among older adults, particularly in the short-term. However, long-term studies focused on participants’ experiences continue to be scarce. This study evaluated participants’ experiences of a 12-month activity tracker-driven physical activity intervention. Methods Participants’ experiences were assessed qualitatively using open-ended questionnaire items ( n = 113) and semi-structured interviews conducted after the 12-month intervention ( n = 27). Quantitative items assessed the perceived ease-of-use and usefulness of the activity tracker during the intervention. Qualitative data was analyzed using thematic analysis and Wilcoxon signed-rank tests were used to examine changes in the perceived ease-of-use and usefulness over time. Results The 113 participants completing the 12-month intervention were on average 65.2 ( SD 1.0) years old and 81.4% women with 92.3% providing activity tracker data on at least 2 weeks per each intervention month. In the qualitative analysis, four main themes with 20 subthemes were identified: (a) burdens of participation, (b) affective attitudes of using the activity tracker, (c) perceived effects of using the activity tracker, and (d) no perceived behavioral effects. At 12 months, the participants found activity trackers mainly easy to use (mean 4.6, SD 0.6), reliable (mean 3.6, SD 1.2), motivating (mean 3.9, SD 1.0), and helpful in reducing sitting (mean 3.7, SD 1.0) with no changes observed during the intervention. Conclusions The participants’ experiences were highly varied suggesting that tailored intervention designs are likely to be required for effectively using activity trackers to promote long-term changes in daily activity among older adults.
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Affiliation(s)
- Miika Tuominen
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Pasi Koski
- Department of Teacher Education, University of Turku, Turku, Finland
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Tuija Leskinen
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
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Kari T, Makkonen M, Carlsson C. Physical Activity Tracker Application in Promoting Physical Activity Behavior among Older Adults: A 24-month Follow-Up Study. J Aging Health 2022:8982643221135812. [DOI: 10.1177/08982643221135812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objectives To investigate whether and how PA tracker application use supports PA behavior among older adults during the first 24 months of use. Methods: The changes in PA levels (i.e., time spent in different PA intensities) and between PA categories (i.e., low, moderate, or high based on total PA) were examined between three different time points: before taking the application into use (t0), after 12 months of use (t1), and after 24 months of use (t2). The data was collected by using the International Physical Activity Questionnaire modified for the elderly (IPAQ-E). Results: A statistically significant increase was observed in walking (χ2 (2) = 29.741, p < .001), moderate PA (χ2 (2) = 6.327, p = .042), and total PA levels (χ2 (2) = 11.489, p = .003). The increase was observed between t0 and t1 as well as between t0 and t2. The overall changes between PA categories were statistically significant between t0 and t1 (χ2 (3) = 15.789, p = .001) as well as between t0 and t2 (χ2 (3) = 14.745, p = .002). There were more increasingly active (moved to a higher PA category) than decreasingly active (moved to a lower PA category) participants. Discussion: Overall, the results indicate that PA tracker application use can promote PA behavior among older adults. Stakeholders that work with PA programs and PA promotion, as well as individual users, can utilize digital wellness technologies in supporting PA promotion, especially in exceptional times, like the COVID-19 pandemic, when health care restrictions prevent general gatherings.
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Affiliation(s)
- Tuomas Kari
- Institute for Advanced Management Systems Research, Turku, Finland
- Natural Resources Institute Finland (Luke), Helsinki, Finland
| | - Markus Makkonen
- Institute for Advanced Management Systems Research, Turku, Finland
- University of Jyvaskyla, Faculty of Information Technology, Jyvaskyla, Finland
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48
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Hofbauer LM, Rodriguez FS. How is the usability of commercial activity monitors perceived by older adults and by researchers? A cross-sectional evaluation of community-living individuals. BMJ Open 2022; 12:e063135. [PMID: 36323474 PMCID: PMC9639094 DOI: 10.1136/bmjopen-2022-063135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVES Using commercial activity monitors may advance research with older adults. However, usability for the older population is not sufficiently established. This study aims at evaluating the usability of three wrist-worn monitors for older adults. In addition, we report on usability (including data management) for research. DESIGN Data were collected cross-sectionally. Between-person of three activity monitor type (Apple Watch 3, Fitbit Charge 4, Polar A370) were made. SETTING The activity monitors were worn in normal daily life in an urban community in Germany. The period of wear was 2 weeks. PARTICIPANTS Using convenience sampling, we recruited N=27 healthy older adults (≥60 years old) who were not already habitual users of activity monitors. OUTCOMES To evaluate usability from the participant perspective, we used the System Usability Scale (SUS) as well as a study-specific qualitative checklist. Assessment further comprised age, highest academic degree, computer proficiency and affinity for technology interaction. Usability from the researchers' perspective was assessed using quantitative data management markers and a study-specific qualitative check-list. RESULTS There was no significant difference between monitors in the SUS. Female gender was associated with higher SUS usability ratings. Qualitative participant-usability reports revealed distinctive shortcomings, for example, in terms of battery life and display readability. Usability for researchers came with problems in data management, such as completeness of the data download. CONCLUSION The usability of the monitors compared in this work differed qualitatively. Yet, the overall usability ratings by participants were comparable. Conversely, from the researchers' perspective, there were crucial differences in data management and usability that should be considered when making monitor choices for future studies.
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Affiliation(s)
- Lena M Hofbauer
- Research Group Psychosocial Epidemiology & Public Health, German Center for Neurodegenerative Diseases Site Rostock/Greifswald, Greifswald, Germany
| | - Francisca S Rodriguez
- Research Group Psychosocial Epidemiology & Public Health, German Center for Neurodegenerative Diseases Site Rostock/Greifswald, Greifswald, Germany
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Wearables in Cardiovascular Disease. J Cardiovasc Transl Res 2022:10.1007/s12265-022-10314-0. [PMID: 36085432 DOI: 10.1007/s12265-022-10314-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 08/29/2022] [Indexed: 10/14/2022]
Abstract
Wearable devices stand to revolutionize the way healthcare is delivered. From consumer devices that provide general health information and screen for medical conditions to medical-grade devices that allow collection of larger datasets that include multiple modalities, wearables have a myriad of potential uses, especially in cardiovascular disorders. In this review, we summarize the underlying technologies employed in these devices and discuss the regulatory and economic aspects of such devices as well as the future implications of their use.
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50
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Hechinger M, Hentschel D, Aumer C, Rester C. A Conceptual Model of Experiences With Digital Technologies in Aging in Place: Qualitative Systematic Review and Meta-synthesis. JMIR Aging 2022; 5:e34872. [PMID: 36083625 PMCID: PMC9508672 DOI: 10.2196/34872] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/25/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Older adults with chronic illnesses or dependency on care who strive to age in place need support and care depending on their illness. Digital technology has enabled the possibility of supporting older adults in their wishes to age in place. However, current studies have mainly focused on the solitary evaluation of individual technologies or on evaluating technologies for specific illnesses. OBJECTIVE This study aimed to synthesize research on the experiences of older people from the Western culture with chronic illnesses or care needs and their families with digital technology for aging in place. From the meta-synthesis, a model was derived that can be useful for the development of assistive devices in old age and that can support health care providers and professionals in their work with affected individuals. METHODS A systematic review and qualitative meta-synthesis was performed using an inductive approach, as proposed by Sandelowski and Barroso. We performed a systematic literature search in 6 databases from 2000 to 2019, with an update in 2021 and, in addition, conducted a hand search in 2 databases, relevant journals, and reference lists. The results of each study were analyzed using initial and axial coding, followed by theoretical coding. A conceptual model was derived. RESULTS A total of 7776 articles were identified. Articles were screened independently by 2 authors based on the eligibility criteria. Finally, of the 7776 studies, 18 (0.23%) were included in the meta-synthesis. The derived conceptual model describes older adults with chronic illnesses or dependency on care and their family members in an individual process of reflection and decision-making, starting with the use of a digital device. Older adults live in times of change. They experience stable and unstable times of illness as they are part of a changing digital world. Hence, older adults and their families consider digital technology a solution to their current situation. As they become familiar with a specific digital technology, they refine their needs and demands, gain confidence in its use, and note its advantages and disadvantages. They weigh hopes, needs, demands, and experiences in a process of reflection to decide on convenience and inconvenience. Independent of their decision, they achieve peace of mind either with or without digital technology. This process can restart repeatedly during the illness trajectory of older adults. CONCLUSIONS This study promotes a differentiated understanding of older adults' experiences with digital technology. The conceptual model can be useful for the development of assistive technology in old age. Moreover, it can guide health care professionals in their work with older adults and their families to provide individual counseling to find the appropriate digital technology for their respective situations.
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Affiliation(s)
- Mareike Hechinger
- Deggendorf Institute of Technology, Faculty of Applied Healthcare Science, Deggendorf, Germany
| | - Diana Hentschel
- Deggendorf Institute of Technology, Faculty of Applied Healthcare Science, Deggendorf, Germany
| | - Christine Aumer
- Deggendorf Institute of Technology, Faculty of Applied Healthcare Science, Deggendorf, Germany
| | - Christian Rester
- Deggendorf Institute of Technology, Faculty of Applied Healthcare Science, Deggendorf, Germany
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