Tablet computers for older people in Thailand and the UK: usability and effects of different text presentations

As there is a sharp increase in the older population in Thailand, the UK and worldwide and the older population will continue to grow worldwide in the next two decades. The use of personal technologies such as tablet computers has also rapidly increased in both Thailand and the UK. Although the number of older people using tablet computers has increased, some older people still have issues in using tablet computers. Thus the usability and acceptability of tablet computers for older people is still an issue and there is little research about how to best present text on tablet computers on tablets for older people in English and none for the Thai language. Therefore this programme of research investigated usability issues in using tablet computers and attitudes toward tablet computers for older people in Thailand and the United Kingdom. In addition, it investigated a number of aspects of text presentation for tablet computers in Thai and English with both younger and older people. Study 1 focused on older people’s attitudes to and use of the tablet computers and another three studies focused on the effects of text presentation on tablets. Study 2 investigated font types and font sizes, Study 3 investigated text and background colours, and Study 4 investigated column format and text justification. Key findings included that Thai and UK older people had positive attitudes toward tablets, although some encountered usability problems such as text which was too small and not resizable. In addition, tapping and zooming on the tablet were generally easy for older people, but tapping is still a problem for some of them. On text presentation, on the basis of the findings in these studies, 18 point text in a Sans Serif typeface for English and a Serif typeface for Thai are recommended for text presentation on tablets. Black text on a white background is the best for readers in both countries. Finally, a format of two columns with left justification is recommended for both English and Thai, when tablets are used in landscape orientation

Moving Together: Developing and Testing the Impact of a Technology-Driven Intergenerational Intervention. A Pragmatic Evaluation

The phenomenon of intergenerational contact and the ability it may have to facilitate benefits for both older adults and children, often attracts attention. However, it is an underexplored concept, primarily underpinned by anecdotal evidence. This thesis aimed to develop and investigate the potential impact of a familial intergenerational technology-driven intervention on physical activity levels, sedentary behaviour, health-related quality of life, and stereotypes of ageing in older adults, aged ≥ 60 years old, in a real-world setting. Through the rigorous application of the stages of an individualised, iterative, multi-stage process model, justification of approach was confirmed, a unique intervention designed and refined, the incorporated behaviour change techniques mapped out, and, the feasibility, acceptability, functionality, and useability of the intervention and approach established. The developed intervention interlinked several discrete elements to allow intergenerational dyads, comprised of older adults (aged ≥ 60 years), and children (aged 7-11 years), to work collaboratively, using activity trackers (Mi Band 2) to complete virtual walk route challenges via the World Walking platform. Despite the limitations imposed by the COVID-19 pandemic, it was clearly established that: i) Age stereotype-based interventions provide an encouraging approach to challenging the health-related behaviour of older adults; ii) Through the components of Contact Theory (Allport, 1954), intergenerational contact and technology already available within the public domain, can be innovatively entwined to formulate health behaviour change intervention strategies; iii) Intergenerational contact provides mutual benefits for older adults and children, and, iv) The intervention developed was acceptable, useable, and potentially a highly feasible way of empirically exploring the impact of intergenerational contact, challenging age stereotypes, and positively affecting physical activity levels, sedentary behaviour, and health-related quality of life. Indeed, where depictions of later life have historically been negative, intergenerational contact provides an avenue to challenge such beliefs and behaviours

Using Technology to Address the Problems of Malnutrition and Dehydration in Older Adults

Malnutrition and dehydration of important problems for older adults even in developed countries such as the UK and both have many serious health consequences. This programme of research developed an app, MyHealthyLiving, to support older adults in monitoring their intake of liquids and fruit and vegetables. I followed a user-centred design lifecycle and conducted six studies, starting with focus groups to understand the older users’ needs and wishes, through expert and user evaluations, to a two week field study of the use of the app by 15 older people. Using the data from the user evaluations, a new set of evidence-based heuristics for the development and evaluation of tablet apps for older people was also produced

The feasibility and potential effectiveness of a conventional and exergame intervention to alter balance-related outcomes including fall risk: a mixed methods study

Introduction: Fall risk, occurrence and injury is increasing as the world ages, and Africa and other emerging regions will not be spared. Similarly, the rise of noncommunicable diseases, compressed morbidity and lack of physical activity present major challenges. This novel feasibility study explored the use of an exergaming technology compared with a conventional, evidence-based exercise programme (Otago Exercise Programme) to reduce fall risk by improving balance, and to inform a large-scale randomised control trial. Methodology: Mixed methods study in independent older adults with established fall risk. The quantitative component employed feasibility RCT methodology. Cluster randomisation assigned interventions to sites. Single blinding was used. Both interventions were offered for six months. A variety of balance-related endpoints (e.g., Timed Up and Go, Dynamic Gait Index, Mini-BESTest) were used to find the most applicable. Patient-centred variables included questionnaires regarding depression, physical activity levels, quality of life and estimates of self-efficacy for exercise. Qualitative focus groups explored participants' experiences of falls and the exergaming intervention using a phenomenology lens. Results: Site and participant recruitment was simple and readily achievable, with low numbers need to screen required. Eligibility criteria were confirmed and more added. Adherence and attrition were major challenges. Cluster randomisation appeared to exacerbate between-group differences at baseline. The exergaming intervention produced preliminary evidence in its favour, with results approaching Minimal Clinically Important Difference compared with the evidence-based intervention. The experience of the exergaming intervention was regarded as positive by focus group participants. Barriers and facilitators are reported. Discussion: Methodological issues in the literature have prevented firm consensus on the use of exergaming in falls prevention, although studies are abundant. The current study used rigorous methodology in the novel context of a developing region, which offers numerous challenges for older adults. Implications for a large-scale, fully funded RCT are discussed. Lessons learned can be used to scale up service delivery for an under-served population; and promote the aim of well-being for all at all ages