1
|
Dino MJS, Dion KW, Abadir PM, Budhathoki C, Huang CM, Padula WV, Himmelfarb CRD, Davidson PM. The impact of a mixed reality technology-driven health enhancing physical activity program among community-dwelling older adults: a study protocol. Front Public Health 2024; 12:1383407. [PMID: 38807990 PMCID: PMC11130374 DOI: 10.3389/fpubh.2024.1383407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 04/25/2024] [Indexed: 05/30/2024] Open
Abstract
Background Physical inactivity and a sedentary lifestyle among community-dwelling older adults poses a greater risk for progressive physical and cognitive decline. Mixed reality technology-driven health enhancing physical activities such as the use of virtual coaches provide an emerging and promising solution to support healthy lifestyle, but the impact has not been clearly understood. Methods and analysis An observational explanatory sequential mixed-method research design was conceptualized to examine the potential impact of a user-preferred mixed reality technology-driven health enhancing physical activity program directed toward purposively selected community-dwelling older adults in two senior centers in the Philippines. Quantitative components of the study will be done through a discreet choice experiment and a quasi-experimental study. A total of 128, or 64 older adults in each center, will be recruited via posters at community senior centers who will undergo additional screening or health records review by a certified gerontologist to ensure safety and proper fit. Treatments (live coaching with video-based exercise and mixed reality technology-driven exercise) will be assigned to each of the two senior center sites for the quasi-experiment. The participants from the experimental group shall be involved in the discreet choice experiment, modeling, and usability evaluations. Finally, a qualitative sample of participants (n = 6) as key informants shall be obtained from the experimental group using purposive selection. Discussion This study protocol will examine the health impact of a promising mixed reality program in health promotion among older adults. The study utilizes a human-centered mixed method research design in technology development and evaluation in the context of developing nations.Clinical trial registration: ClinicalTrials.gov, identifier NCT06136468.
Collapse
Affiliation(s)
- Michael Joseph S. Dino
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
- Research, Development, and Innovation Center, Our Lady of Fatima University, Valenzuela, Philippines
- Sigma Theta Tau, International Honor Society in Nursing, Indianapolis, IN, United States
| | - Kenneth W. Dion
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
- Sigma Theta Tau, International Honor Society in Nursing, Indianapolis, IN, United States
| | - Peter M. Abadir
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Chakra Budhathoki
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
- Sigma Theta Tau, International Honor Society in Nursing, Indianapolis, IN, United States
| | - Chien-Ming Huang
- Department of Computer Science, Johns Hopkins University, Baltimore, MD, United States
| | - William V. Padula
- Department of Pharmaceutical and Health Economics, University of Southern California School of Pharmacy, Los Angeles, CA, United States
| | - Cheryl R. Dennison Himmelfarb
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
- Sigma Theta Tau, International Honor Society in Nursing, Indianapolis, IN, United States
| | - Patricia M. Davidson
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
- Sigma Theta Tau, International Honor Society in Nursing, Indianapolis, IN, United States
- Office of the Vice Chancellor and President, University of Wollongong, Wollongong, NSW, Australia
| |
Collapse
|
2
|
Uemura JI, Uno K, Hoshino A, Tanikaga M, Tanaka M, Chishima M. Identification of Subgroups of Activity Participation in Group of Community-Dwelling Older Adults. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:676-682. [PMID: 36604780 DOI: 10.1177/15394492221144433] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Occupational therapy in public health is advancing for groups of older adults, but few studies have focused on measuring population-based activity engagement. This study aimed to identify subgroups based on the daily activity pattern of community-dwelling older adults. Japanese older adults aged ≥65 years responded to a 128-activity-item questionnaire. Sparse principal component analysis was applied to summarize the activities, and k-means clustering was used to identify subgroups. Respondents were divided into three subgroups (subgroup 1: n = 39, high instrumental/leisure and social/cognitive activity; subgroup 2: n = 51, high instrumental/leisure and low social/cognitive activity; subgroup 3: n = 44, low instrumental/leisure and social/cognitive activity). The three subgroups were associated with sociodemographics (sex, area, education, and activity level) (p < .05). This study highlighted the activity-based subgroups of older adults and provided a novel viewpoint regarding occupation-based community assessments in addition to previous community occupational therapy practice.
Collapse
Affiliation(s)
- Jun-Ichi Uemura
- Department of Integrated Health Sciences, Nagoya University, Japan
| | - Kohei Uno
- Department of Biomedical and Health Informatics Unit, Integrated Health Science, Nagoya University, Japan
| | - Aiko Hoshino
- Department of Integrated Health Sciences, Nagoya University, Japan
| | - Miki Tanikaga
- Department of Occupational Therapy, Chubu University, Kasugai, Japan
| | - Masahiro Tanaka
- Department of Rehabilitation, Nihon Fukushi University, Handa, Japan
| | - Makoto Chishima
- Department of Integrated Health Sciences, Nagoya University, Japan
| |
Collapse
|
3
|
Agyemang-Duah W, Asante D, Oduro Appiah J, Morgan AK, Mensah IV, Peprah P, Mensah AA. System, institutional, and client-level factors associated with formal healthcare utilisation among older adults with low income under a social protection scheme in Ghana. Arch Public Health 2023; 81:68. [PMID: 37088819 PMCID: PMC10123979 DOI: 10.1186/s13690-023-01063-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/15/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND In sub-Saharan African context, effect of system, institutional and client-level factors on formal healthcare utilisation among older adults with low income, especially those under a social protection scheme (called Livelihood Empowerment against Poverty [LEAP] programme) is least explored in the literature. However, an adequate understanding of how these factors contribute to formal healthcare utilisation among older adults who are classified as poor (in terms of low income) is important to inform health policy decisions. The aim of this study, therefore, was to examine the contributions of system, institutional and client-level factors in formal healthcare utilisation among older adults with low income under the LEAP programme in Ghana. METHODS Data associated with this study were obtained from an Ageing, Health, Lifestyle and Health Services survey conducted between 1 and 20 June 2018 (N = 200) in the Atwima Nwabiagya Municipal and Atwima Nwabiagya North District of Ghana. Multivariable logistic regressions were used to determine system, institutional and client-level factors associated with formal healthcare utilisation among older adults with low income under the LEAP programme in Ghana. The significance of the test was set at a probability value of 0.05 or below. RESULTS The study revealed that participants who relied on the LEAP programme and/or health insurance subscription to cater for their healthcare expenses (AOR: 11.934, CI: 1.151-123.777), those whose family/caregivers decided on when and where to use formal healthcare (AOR:12.409; CI: 2.198-70.076) and those who did not encounter communication problem with healthcare providers (AOR: 1.358; CI: 1.074-3.737) were significantly more likely to utilise formal healthcare services compared with their counterparts. The study further found that participants who perceived the attitude of healthcare providers as poor (AOR: 0.889; CI: 0.24-0.931) and those who spent 20-40 minutes at the healthcare facility were significantly less likely to utilise formal healthcare services compared with their counterparts (AOR: 0.070; CI: 0.006-0.195). CONCLUSION Our findings suggest that reducing waiting time at healthcare facilities, improving social protection and/or health insurance schemes, improving patient-doctor communication and promoting attitudinal change programmes (such as orientations and supportive supervision) for healthcare providers may help to facilitate the use of needed formal healthcare services by older adults with low income in Ghana.
Collapse
Affiliation(s)
| | - Dennis Asante
- College of Medicine & Public Health, Rural and Remote Health, Flinders University, Adelaide, South Australia, Australia
| | - Joseph Oduro Appiah
- Department of Geography, Environment & Spatial Analysis, Cal Poly Humboldt, Arcata, California, United States
| | - Anthony Kwame Morgan
- Department of Planning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Isaac Verberk Mensah
- Department of Social Sciences, St. Ambrose College of Education, Wamfie, Bono Region, Ghana
| | - Prince Peprah
- Social Policy Research Centre, Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Anthony Acquah Mensah
- Department of Planning, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| |
Collapse
|
4
|
Okpalauwaekwe U, Li CY, Tzeng HM. Social Determinants and Self-Care for Making Good Treatment Decisions and Treatment Participation in Older Adults: A Cross-Sectional Survey Study. NURSING REPORTS 2022; 12:198-209. [PMID: 35324566 PMCID: PMC8948722 DOI: 10.3390/nursrep12010020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/02/2022] [Accepted: 03/08/2022] [Indexed: 01/07/2023] Open
Abstract
Background: Community-dwelling adults who can perform self-care behaviors related to making treatment decisions and participating in treatment have been found to use less emergency care. In this exploratory study, we examined the relationships in older adults between five social determinants (urban/rural residence, sex, age, marital status, and education) and the perceived importance, desirability, and ability to perform 11 self-care behaviors related to making good treatment decisions and participating in treatment. Methods: This cross-sectional study surveyed 123 community-dwelling older adults living in the southern United States in 2015-2016. All participants were 65 years or older. Data were collected using the Patient Action Inventory for Self-Care and analyzed using descriptive, univariate, and multivariate logistic regression analyses. Results: The social determinants (identified as barriers) of self-care behaviors related to making good treatment decisions and participating in treatment were: having less than a high school education, being 75 years or older, and being separated from a spouse. Sex and residence were found to be neither barriers nor facilitators. Conclusions: Our findings suggest that, in older adults, attending to the needs related to health literacy education and improving social support might increase self-care behaviors related to making good treatment decisions and participating in treatment. Future research will compare the differences across diverse populations to validate our study findings.
Collapse
Affiliation(s)
- Udoka Okpalauwaekwe
- College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 2Z4, Canada;
| | - Chih-Ying Li
- Department of Occupational Therapy, School of Health Professions, The University of Texas Medical Branch, Galveston, TX 77555, USA;
| | - Huey-Ming Tzeng
- School of Nursing, The University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555, USA
| |
Collapse
|
5
|
Demand analysis of an intelligent medication administration system for older adults with chronic diseases based on the Kano model. Int J Nurs Sci 2022; 9:63-70. [PMID: 35079606 PMCID: PMC8766777 DOI: 10.1016/j.ijnss.2021.12.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/26/2021] [Accepted: 12/17/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives Gerontechnology has great potential in promoting older adults’ well-being. With the accelerated aging process, gerontechnology has a promising market prospect. However, most technological developers and healthcare professionals attached importance to products’ effectiveness, and ignored older adults’ demands and user experience, which reduced older adults' adoption intention of gerontechnology use. The inclusion of older adults in the design process of technologies is essential to maximize the effect. This study explored older adults’ demands for a self-developed intelligent medication administration system and proposed optimization schemes, thus providing reference to developing geriatric-friendly technologies and products. Methods A cross-sectional survey was conducted to explore older adults’ technological demands for the self-developed intelligent medication administration system, and data were analyzed based on the Kano model. A self-made questionnaire was administered from July 2020 to October 2020 after participants used this system for two weeks. The study was registered with the Chinese Clinical Trial Registry (ChiCTR2000040644). Results A total of 354 older adults participated in the survey. Four items, namely larger font size, simpler operation process, scheduled medication reminders and reliable hardware, were classified as must-be attributes; three items, namely searching drug instructions through WeChat, more sensitive system and longer battery life, as attractive attributes; one item, viewing disease-related information through WeChat, as the one-dimensional attribute; and the rest were indifferent attributes, including simple and beautiful displays, blocking advertisements automatically, providing user privacy protection protocol, viewing personal medical information only by logged-in users, recording all the medications, ordering medications through WeChat. The satisfaction values were between 0.24 and 0.69, and dissatisfaction values were between 0.06 and 0.94. Conclusion This study suggested that older adults had personalized technology demands. Including their technological demands and desire may assist in decreasing the digital divide and promoting the satisfaction of e-health and/or m-health. Based on older adults’ demands, our study proposed optimization schemes of the intelligent medication administration system, which may help developers design geriatric-friendly intelligent products and nurses to perform older adults-centered and efficient medication management.
Collapse
|
6
|
Okpalauwaekwe U, Tzeng HM. Adverse Events and Their Contributors Among Older Adults During Skilled Nursing Stays for Rehabilitation: A Scoping Review. Patient Relat Outcome Meas 2021; 12:323-337. [PMID: 34803416 PMCID: PMC8599876 DOI: 10.2147/prom.s336784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/30/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To identify factors that contribute to adverse events among older adults during short stays at skilled nursing facilities (SNFs) for rehabilitation (ie, up to 100 resident days). Adults aged 65 years and older are at serious risk for adverse events throughout their continuum of care. Over 33% of older adults admitted to SNFs experienced an adverse event (eg, falls) within the first 35 days of their stay. Design A scoping review. Setting and Participants Older adults admitted for short stays in SNFs. Methods Eligibility criteria were peer-reviewed original articles published between 1 January 2015 and 30 May 2021, written in English, and containing any of the following key terms and synonyms: “skilled nursing facilities”, “adverse events”, and “older adults”. These terms were searched in PubMed, MEDLINE, CINAHL, EBSCOHost, and the ProQuest Nursing and Allied Health Database. We summarized the findings using the Joanna Briggs Institute and PRISMA-ScR reporting guidelines. We also used the Capability-Opportunity-Motivation-Behavior (COM-B) model of health behavioral change as a framework to guide the content, thematic, and descriptive analyses of the results. Results Eleven articles were included in this scoping review. Intrinsic and extrinsic contributors to adverse events (ie, falls, medication errors, pressure ulcers, and acute infections) varied for each COM-B domain. The most frequently mentioned capacity-related intrinsic contributors to adverse events were frailty and reduced muscle strength due to advancing age. Inappropriate medication usage and polypharmacy were the most common capacity-related extrinsic factors. Opportunity-related extrinsic factors contributing to adverse events included environmental hazards, poor communication among SNF staff, lack of individualized resident safety plans, and overall poor care quality owing to racial bias and organizational and administrative issues. Conclusion These findings shed light on areas that warrant further research and may aid in developing interventional strategies for adverse events during short SNF stays.
Collapse
Affiliation(s)
- Udoka Okpalauwaekwe
- University of Saskatchewan, College of Medicine, Saskatoon, Saskatchewan, Canada
| | - Huey-Ming Tzeng
- The University of Texas Medical Branch at Galveston, School of Nursing, Galveston, TX, USA
| |
Collapse
|
7
|
Ramírez-Hurtado JM, Hernández-Díaz AG, López-Sánchez AD, Pérez-León VE. Measuring Online Teaching Service Quality in Higher Education in the COVID-19 Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2403. [PMID: 33804546 PMCID: PMC7967760 DOI: 10.3390/ijerph18052403] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/18/2021] [Accepted: 02/24/2021] [Indexed: 01/01/2023]
Abstract
The use of the Internet to develop new technologies has generated a considerable change in teaching and student learning in higher education. The pandemic caused by COVID-19 has forced universities to switch from face-to-face to online instruction. Furthermore, this transfer process was planned and executed quickly, with urgent redesigns of courses originally conceived for live teaching. The aim of this work is to measure the service quality of online teaching delivered during the COVID-19 period. The methodology was based on an importance-performance analysis using a structural equations model. The data were obtained from a sample of 467 students attending a university in southern Spain. The results reveal five priority attributes of online teaching that need to be improved in order to enhance the service quality of the virtual instruction provided to students. Universities need to redefine their online format by integrating methodological and technological decisions and involving collaboration between teachers, students and administration staff and services. The results do not apply to educational institutions that exclusively teach courses online, but to those institutions that had to rapidly adapt, and shift course material originally designed for face-to-face training.
Collapse
Affiliation(s)
- José M. Ramírez-Hurtado
- Department of Economics, Quantitative Methods and Economy History, Faculty of Business, Pablo de Olavide University, Ctra. de Utrera, Km. 1, 41013 Seville, Spain; (A.G.H.-D.); (A.D.L.-S.)
| | - Alfredo G. Hernández-Díaz
- Department of Economics, Quantitative Methods and Economy History, Faculty of Business, Pablo de Olavide University, Ctra. de Utrera, Km. 1, 41013 Seville, Spain; (A.G.H.-D.); (A.D.L.-S.)
| | - Ana D. López-Sánchez
- Department of Economics, Quantitative Methods and Economy History, Faculty of Business, Pablo de Olavide University, Ctra. de Utrera, Km. 1, 41013 Seville, Spain; (A.G.H.-D.); (A.D.L.-S.)
| | - Víctor E. Pérez-León
- Department of Applied Economics II, Faculty of Economics and Business, University of Seville, Avenida Ramón y Cajal, 1, 41018 Seville, Spain;
| |
Collapse
|