Needing smart home technologies: the perspectives of older adults in continuing care retirement communities

Background At present, the vast majority of older adults reside in the community. Though many older adults live in their own homes, increasing numbers are choosing continuing care retirement communities (CCRCs),which range from independent apartments to assisted living and skilled-nursing facilities. With predictions of a large increase in the segment of the population aged 65 and older, a subsequent increase in demand on CCRCs can be anticipated. With these expectations, researchers have begun exploring the use of smart home information-based technologies in these care facilities to enhance resident quality of life and safety, but little evaluation research exists on older adults' acceptance and use of these technologies. Objective This study investigated the factors that influence the willingness of older adults living in independent and assisted living CCRCs to adopt smart home technology. Subjects and setting Participants (n = 14) were recruited from community-dwelling older adults, aged 65 or older, living in one of two mid-western US CCRC facilities (independent living and assisted living type facilities). Methods This study used a qualitative, descriptive approach, guided by principles of grounded theory research. Data saturation (or when no new themes or issues emerged from group sessions) occurred after four focus groups (n = 11 unique respondents) and was confirmed through additional individual interviews (n = 3). Results The findings from this study indicate that although privacy can be a barrier for older adults' adoption of smart home technology their own perception of their need for the technology can override their privacy concerns. Conclusions Factors influencing self-perception of need for smart home technology, including the influence of primary care providers, are presented. Further exploration of the factors influencing older adults' perceptions of smart home technology need and the development of appropriate interventions is necessary

Exploring the potential facilitators and barriers of using personal data collected by sensor-based technologies to promote health and well-being.

The growth of the ageing population worldwide raises concerns about human health and well-being. In this context, sensor-based technologies have the potential to support health monitoring activities. This thesis, developed in two studies, presents a detailed understanding of the facilitators of and barriers to acceptability and potential further adoption of sensor-based technologies by older adults. The first study, with twenty-six participants (middle-aged and elderly) from Brazil and England, investigates the acceptability of three sensor-based devices in different contexts. A survey and semi-structured interview were conducted using the vignette technique to explore different devices in three specific scenarios, to monitor mental and physical health and well-being. Using thematic analysis, twenty-eight sub-themes of barriers, facilitators or moderators emerged from the first study. These factors were categorised as data-related factors, user-related factors and technology-related factors. The second study explored the factors influencing participants’ willingness to share personal data collected through sensor-based devices. In this second study, thirty-five participants of sixty-five years and upwards were divided into six focus groups. A mobile App of a sensor-based wearable device, in the format of wireframes, was used to explore aspects specifically related to data sharing and use. As a result of the thematic analysis of focus group data, facilitators and barriers were categorised as data-related factors, user-related factors, technology-related factors and the new theme: third-party-related factors. A total of thirty-five sub-themes of barriers, facilitators or moderators emerged. From these findings, a list of seven main facilitators and three barriers were identified that affect the acceptability of sensor-based technologies, and a further six main facilitators and eight barriers that affect willingness to share personal data. A set of thirteen guidelines based on the findings is presented that address the requirements of older adults to inform designers seeking to design better sensor-based health-related technologies. Overall, the conclusions of this research indicate that older adults see the potential in using wearable devices in their daily life. Many factors investigated in this research can contribute to an understanding of future technology adoption, considering that by exploring acceptability, useful insights for potential adoption can be gained; the adoption of some technologies can critically maximise independence for older adults and consequently improve quality of life. The material collected during these studies can be drawn upon to support the enhanced design of sensor-based technologies that addresses people’s needs and overcomes concerns regarding data privacy and security. A key academic field that this thesis contributed to is the Human-Centered Design (HCD) field by exploring the factors influencing the acceptability and potential adoption of sensor-based technologies among older adults by providing a valuable understanding of older adults’ views on technology. The study helped identify areas for improvement in the design and usability of sensor-based systems to accommodate older adults’ needs better. While this research represents a step towards understanding the relationship between ageing populations and technology adoption, it offers a foundation for further investigation and refinement of sensor-based solutions in the context of HCD. This thesis also contributes to Health and Personal Informatics by promoting the development of more effective and user-friendly health technologies that address users’ unique needs and preferences while focusing on individuals’ tracking and ethical and privacy concerns

Privacy and senior adoption of assistive technology in residential care

The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file.Vita."May 2006"Thesis (Ph. D.) University of Missouri-Columbia 2006.Within the next twenty years, there is a large increase anticipated in the segment of the population ages sixty five and older and a subsequent increase in demand on residential care facilities. With this expectation, researchers have been exploring the use of assistive information-based technologies in residential care facilities to enhance resident quality of life and safety. Assistive technologies in this context are information based technologies that collect and share resident information to health care providers such as nurses or physicians. Little evaluation research exists on user acceptance and effectiveness of assistive technologies in RC facilities (Demiris et al., 2004). Older adults' perceptions of privacy can inhibit their adoption of assistive technologies. This qualitative study used descriptive content analysis of focus group sessions and individual interviews to explore the relationship between privacy, living environment and willingness to adopt assistive technology with older adults living in residential care facilities. The findings from this study indicate that privacy can be a barrier for older adults' adoption of assistive technologies; however their perception of their need for the technology may override their own privacy concerns. Privacy concerns, as a barrier to technology adoption, can be influenced by both individual-level and community-level factors. Further exploration of the factors influencing older adults' perceptions of assistive technology need is necessary.Includes bibliographical references

Exploring the potential facilitators and barriers of using personal data collected by sensor-based technologies to promote health and well-being.

The growth of the ageing population worldwide raises concerns about human health and well-being. In this context, sensor-based technologies have the potential to support health monitoring activities. This thesis, developed in two studies, presents a detailed understanding of the facilitators of and barriers to acceptability and potential further adoption of sensor-based technologies by older adults. The first study, with twenty-six participants (middle-aged and elderly) from Brazil and England, investigates the acceptability of three sensor-based devices in different contexts. A survey and semi-structured interview were conducted using the vignette technique to explore different devices in three specific scenarios, to monitor mental and physical health and well-being. Using thematic analysis, twenty-eight sub-themes of barriers, facilitators or moderators emerged from the first study. These factors were categorised as data-related factors, user-related factors and technology-related factors. The second study explored the factors influencing participants’ willingness to share personal data collected through sensor-based devices. In this second study, thirty-five participants of sixty-five years and upwards were divided into six focus groups. A mobile App of a sensor-based wearable device, in the format of wireframes, was used to explore aspects specifically related to data sharing and use. As a result of the thematic analysis of focus group data, facilitators and barriers were categorised as data-related factors, user-related factors, technology-related factors and the new theme: third-party-related factors. A total of thirty-five sub-themes of barriers, facilitators or moderators emerged. From these findings, a list of seven main facilitators and three barriers were identified that affect the acceptability of sensor-based technologies, and a further six main facilitators and eight barriers that affect willingness to share personal data. A set of thirteen guidelines based on the findings is presented that address the requirements of older adults to inform designers seeking to design better sensor-based health-related technologies. Overall, the conclusions of this research indicate that older adults see the potential in using wearable devices in their daily life. Many factors investigated in this research can contribute to an understanding of future technology adoption, considering that by exploring acceptability, useful insights for potential adoption can be gained; the adoption of some technologies can critically maximise independence for older adults and consequently improve quality of life. The material collected during these studies can be drawn upon to support the enhanced design of sensor-based technologies that addresses people’s needs and overcomes concerns regarding data privacy and security. A key academic field that this thesis contributed to is the Human-Centered Design (HCD) field by exploring the factors influencing the acceptability and potential adoption of sensor-based technologies among older adults by providing a valuable understanding of older adults’ views on technology. The study helped identify areas for improvement in the design and usability of sensor-based systems to accommodate older adults’ needs better. While this research represents a step towards understanding the relationship between ageing populations and technology adoption, it offers a foundation for further investigation and refinement of sensor-based solutions in the context of HCD. This thesis also contributes to Health and Personal Informatics by promoting the development of more effective and user-friendly health technologies that address users’ unique needs and preferences while focusing on individuals’ tracking and ethical and privacy concerns

A Theoretical Domains Framework (TDF) approach to the qualitative analysis of older adults’ intentions to adopt assistive smart home technology

Background: There is a need for a broader understanding of the psychological influences impacting healthy older adults’ intentions to use assistive smart home technologies if these technologies are to succeed in helping older adults to continue to live independently in their own homes. Objective: This qualitative paper aimed to analyse healthy older adults’ intentions to adopt and use assistive smart home technologies using the Theoretical Domains Framework (TDF), which synthesises a large number of theories of psychology and behaviour change. Method: Using a focus group methodology, an in-person workshop presented fictitious personas representing end-user cases to participants, soliciting potential problems that may arise while living independently and solutions that might help. Online Zoom workshops facilitated discussions centred on participant opinions about how various forms of technology could support independent living for older adults. Comments were analysed using a TDF approach. Results: Key domains identified as influencing intention to adopt and use assistive smart home technologies included Knowledge, Skills, Beliefs about Capabilities, Goals, Beliefs about Consequences, Social Influences, Emotions, and Environmental Context and Resources. Conclusion: This paper has identified the eight most relevant TDF domains and mapped these to some of the theories and associated behaviour change strategies most suited to investigating and shaping intentions to use assistive smart home technology. The TDF-based analysis successfully elucidated a broad range of psychological influences driving intentions to adopt and use such technology. Knowledge of these influences can assist those involved in technology design, development, and marketing to ultimately increase the uptake of smart technology by older adults. Key advantages of the TDF include its comprehensive theoretical coverage contained within domains comprising mediators of behaviour change, and its capacity to elicit a wide range of influences with the potential to drive acceptance and adoption of smart technology among community-dwelling older adults

Smartphones Adoption and Usage of 50+ Adults in the United Kingdom

This is an Accepted Manuscript of a book chapter published by Routledge in Jyoti Choudrie, Sherah Kurnia, and Panayiota Tsatsou, eds., Social Inclusion and Usability of ICT-enabled Services, on October 2017, available online at: https://www.routledge.com/Social-Inclusion-and-Usability-of-ICT-enabled-Services/Choudrie-Kurnia-Tsatsou/p/book/9781138935556. Under embargo until 30 April 2019.Peer reviewedFinal Accepted Versio

"Call a Teenager… That's What I Do!" - Grandchildren Help Older Adults Use New Technologies: Qualitative Study.

BackgroundAlthough family technical support seems intuitive, there is very little research exploring this topic.ObjectiveThe objective of this study was to conduct a subanalysis of data collected from a large-scale qualitative project regarding older adults' experiences in using health information technology. Specifically, the subanalysis explored older adults' experiences with technology support from family members to inform strategies for promoting older adults' engagement with new health technologies. Although the primary analysis of the original study was theoretically driven, this paper reports results from an inductive, open-coding analysis.MethodsThis is a subanalysis of a major code identified unexpectedly from a qualitative study investigating older adults' use experience of a widespread health technology, the patient portal. A total of 24 older patients (≥65 years) with multiple chronic conditions (Charlson Comorbidity Index >2) participated in focus groups conducted at the patients' primary clinic. While conducting the primary theoretically driven analysis, coders utilized an open-coding approach to ensure important ideas not reflected in the theoretical code book were captured. Open coding resulted in 1 code: family support. This subanalysis further categorized family support by who provided tech support, how tech support was offered, and the opinions of older participants about receiving family tech support.ResultsThe participants were not specifically asked about family support, yet themes around family assistance and encouragement for technology emerged from every focus group. Participants repeatedly mentioned that they called their grandchildren and adult children if they needed help with technology. Participants also reported that family members experienced difficulty when teaching technology use. Family members struggled to explain simple technology tasks and were frustrated by the slow teaching process.ConclusionsThe results suggest that older adults ask their family members, particularly grandchildren, to support them in the use of new technologies. However, family may experience difficulties in providing this support. Older adults will be increasingly expected to use health technologies, and family members may help with tech support. Providers and health systems should consider potential family support and engagement strategies to foster adoption and use among older patients

A protocol paper on the preservation of identity: understanding the technology adoption patterns of older adults with age-related vision loss (ARVL)

There are a growing number of older adults with age-related vision loss (ARVL) for whom technology holds promise in supporting their engagement in daily activities. Despite the growing presence of technologies intended to support older adults with ARVL, there remains high rates of abandonment. This phenomenon of technology abandonment may be partly explained by the concept of self-image, meaning that older adults with ARVL avoid the use of particular technologies due to an underlying fear that use of such technologies may mark them as objects of pity, ridicule, and/or stigmatization. In response to this, the proposed study aims to understand how the decision-making processes of older adults with ARVL, as it relates to technology adoption, is influenced by the negotiation of identity. The study protocol will justify the need for this critical ethnographic study, unpack the theoretical underpinnings of this work, detail the sampling/recruitment strategy, describe the methods which included a home tour, go-along, and semi-structured in-depth interview, as well as the collective approach taken to analyze the data. The protocol concludes by examining the ethical tensions associated with this study, including a focus on the methods adopted as well as the ethical challenges inherent when working with an older adult population experiencing vision loss

Technology use in everyday life: Implications for designing for older users

This study examines the experience and attitudes of older adults towards technology and how they compare with younger age groups. Two hundred and thirty seven participants completed an extensive questionnaire exploring their daily lifestyle, use of technology, attitudes towards technology, and perceived difficulty of household devices. The main findings from the study were; (1) there was a strong motivation to learn or to continue learning to use computers by the older group; (2) social connectedness influenced how the older group used or would like to use technology and also why some preferred not to use it; and finally (3) there was an age-related increase in perceived difficulty for many household devices, however some devices maintained intergenerational usability. These finding can be used to inform the design of future intergenerational household technologies

Investigating the adoption and use of smartphones in the UK : a silver-surfers perspective

Copyright and all rights therein are retained by the authors. All persons copying this information are expected to adhere to the terms and conditions invoked by each author's copyright. These works may not be re-posted without the explicit permission of the copyright holdersSmart phones are innovations that currently provide immense benefits and convenience to users in society. However, not all members of society are accepting and using smart phones; more specifically, for this research study silver-surfers or older adults (50+) are a demographic group displaying such an attitude. Currently, there is minimal knowledge of the reasons for older adults adopting and using smartphones. Bearing this in mind, this research study aims to investigate the adoption and usage behaviours of silver-surfers. For this purpose, the conceptual framework applied to this research draws factors from the following theories: Unified Theory of Acceptance and Use of Technology (UTAUT), the Diffusion of Innovations theory (DoI), and TAM3 (Technology Acceptance Model). From the online survey of 204 completed replies it was found that observability, compatibility, social influence, facilitating conditions, effort expectancy and enjoyment are important to the adoption and use of smartphones within silver-surfers. The contributions of this research are an identification and understanding of the factors that encourage or inhibit smartphone use within the older adult population. Second, this research can inform the design of computing devices and applications used for silver-surfers. Finally, this research can enlighten policy makers when forming decisions that encourage adoption and use of smartphones among silver surfersFinal Published versio