Ageism in the use and design of digital technology

Background and research objectives: Technological innovation is often described as a solution for or considered to have the potential of meeting the challenges of the ageing society, improving older persons' quality of life, well-being, and healthcare, and supporting ageing in place in a safe and independent environment. At the same time, older persons often experience ageism, defined as stereotypes, prejudice, and discrimination, in the context of digital technology. Such stereotypes are omnipresent in various contexts (e.g., workforce, healthcare, and media) and can hinder active and successful ageing in a highly digitalizing reality. The main goal of this dissertation is to understand what are the manifestations of ageism in the context of digital technology and the potential role of ageism as an underlying factor that may affect the design, acceptance, and use of digital technology. Methods: A mixed-methods approach was utilized to initiate and present a coherent and holistic outcome intending to discover paradoxes, contradictions, and new perspectives on the design, acceptance, and use of digital technology. Six studies were conducted, triangulating data from 1) different methodologies, 2) various stakeholders' perspectives (older persons, designers, researchers, and healthcare professionals) 3) and different contexts of use and design of digital technology.Main results: The triangulation of this dissertation's qualitative and quantitative findings are synthesized in a theoretical model of Ageism in the Use and Design of Digital Technology (see figure). Manifestations of ageism in the use and design of digital technology are identified throughout the different dimensions of ageism: (1) Social-psychological level of stereotypes, prejudice, and discrimination, (2) Negative-positive valance, (3) Explicit-implicit representations, (4) and three levels of individual-micro level (self-ageism), a social-organizational meso level of inter-generational interaction, and policy and design macro level. Importantly, ageism may influence the acceptance and use of digital technology in a dynamic and iterative process of interaction between different levels and interchanging between individuals, design processes, and technological devices and services.Recommendations for future research and policy: Ageism in the use and design of digital technology is a developing field for future research, entrepreneurship, and policy. The main recommendations are to:1.Develop interventions to mitigate self-ageism, empower older persons, and reduce ageism in the design process of digital technology and intergenerational tension.2.Raise awareness and training to change the discourse on ageing and technology. 3.Promote inclusion and aim for partnership and meaningful involvement of older persons throughout the development of digital technology-related products, services, and policy. 4.Design digital technologies for versatile social, leisure, and communication needs.5.Develop methodological innovations to measure the influence of ageism on the use and design of digital technology. In particular concerning discrimination; intersectionality of digital technology, ageism, and other characteristics; and the use of data and artificial intelligence (AI).6.Ensure access to digital technology to eliminate the access divide influenced by age, education, and other characteristics

Ageism in the use and design of digital technology

Background and research objectives: Technological innovation is often described as a solution for or considered to have the potential of meeting the challenges of the ageing society, improving older persons' quality of life, well-being, and healthcare, and supporting ageing in place in a safe and independent environment. At the same time, older persons often experience ageism, defined as stereotypes, prejudice, and discrimination, in the context of digital technology. Such stereotypes are omnipresent in various contexts (e.g., workforce, healthcare, and media) and can hinder active and successful ageing in a highly digitalizing reality. The main goal of this dissertation is to understand what are the manifestations of ageism in the context of digital technology and the potential role of ageism as an underlying factor that may affect the design, acceptance, and use of digital technology. Methods: A mixed-methods approach was utilized to initiate and present a coherent and holistic outcome intending to discover paradoxes, contradictions, and new perspectives on the design, acceptance, and use of digital technology. Six studies were conducted, triangulating data from 1) different methodologies, 2) various stakeholders' perspectives (older persons, designers, researchers, and healthcare professionals) 3) and different contexts of use and design of digital technology.Main results: The triangulation of this dissertation's qualitative and quantitative findings are synthesized in a theoretical model of Ageism in the Use and Design of Digital Technology (see figure). Manifestations of ageism in the use and design of digital technology are identified throughout the different dimensions of ageism: (1) Social-psychological level of stereotypes, prejudice, and discrimination, (2) Negative-positive valance, (3) Explicit-implicit representations, (4) and three levels of individual-micro level (self-ageism), a social-organizational meso level of inter-generational interaction, and policy and design macro level. Importantly, ageism may influence the acceptance and use of digital technology in a dynamic and iterative process of interaction between different levels and interchanging between individuals, design processes, and technological devices and services.Recommendations for future research and policy: Ageism in the use and design of digital technology is a developing field for future research, entrepreneurship, and policy. The main recommendations are to:1.Develop interventions to mitigate self-ageism, empower older persons, and reduce ageism in the design process of digital technology and intergenerational tension.2.Raise awareness and training to change the discourse on ageing and technology. 3.Promote inclusion and aim for partnership and meaningful involvement of older persons throughout the development of digital technology-related products, services, and policy. 4.Design digital technologies for versatile social, leisure, and communication needs.5.Develop methodological innovations to measure the influence of ageism on the use and design of digital technology. In particular concerning discrimination; intersectionality of digital technology, ageism, and other characteristics; and the use of data and artificial intelligence (AI).6.Ensure access to digital technology to eliminate the access divide influenced by age, education, and other characteristics

An “ultimate partnership”:Older persons’ perspectives on age-stereotypes and intergenerational interaction in co-designing digital technologies

AimThere is often a gap between the ideal of involving older persons iteratively throughout the design process of digital technology, and actual practice. Until now, the lens of ageism has not been applied to address this gap. The goals of this study were: to voice the perspectives and experiences of older persons who participated in co-designing regarding the design process; their perceived role in co-designing and intergenerational interaction with the designers; and apparent manifestations of ageism that potentially influence the design of digital technology.MethodsTwenty-one older persons participated in three focus groups. Five themes were identified using thematic analysis which combined a critical ageism ‘lens’ deductive approach and an inductive approach.ResultsAgeism was experienced by participants in their daily lives and interactions with the designers during the design process. Negative images of ageing were pointed out as a potential influencing factor on design decisions. Nevertheless, positive experiences of inclusive design pointed out the importance of “partnership” in the design process. Participants defined the “ultimate partnership” in co-designing as processes in which they were involved from the beginning, iteratively, in a participatory approach. Such processes were perceived as leading to successful design outcomes, which they would like to use, and reduced intergenerational tension.ConclusionsThis study highlights the potential role of ageism as a detrimental factor in how digital technologies are designed. Viewing older persons as partners in co-designing and aspiring to more inclusive design processes may promote designing technologies that are needed, wanted and used

Ageism: an old concept from new perspectives.

This article is an introduction to the special issue "New horizons in ageism research: innovation in study design, methodology and applications to research, policy and practice". This special issue aims to offer a broad and innovative perspective on ageism. The first section addresses new developments in the conceptualization of ageism. This section focuses not only on the negative side of ageism, but also on benevolent ageism, which is manifested in protective attitudes and behaviors towards older persons because of their age, following the stereotype of older persons as a vulnerable group that needs protection. The second section concerns the manifestation of ageism: between traditional and underexplored arenas. The third section concerns innovative methods to explore the concept of ageism. This section relies on innovations in qualitative and quantitative methods to explore nuances in the manifestations of ageism. The next section addresses interventions to reduce or prevent ageism

Wearables measuring electrodermal activity to assess perceived stress in care:A scoping review

Background:Chronic stress responses can lead to physical and behavioural health problems, often experienced and observed in the care of people with intellectual disabilities or people with dementia. Electrodermal activity (EDA) is a bio-signal for stress, which can be measured by wearables and thereby support stress management. However, the how, when and to what extent patients and healthcare providers can benefit is unclear. This study aims to create an overview of available wearables enabling the detection of perceived stress by using EDA.Methods:Following the PRISMA-SCR protocol for scoping reviews, four databases were included in the search of peer-reviewed studies published between 2012 and 2022, reporting detection of EDA in relation to self-reported stress or stress-related behaviours. Type of wearable, bodily location, research population, context, stressor type and the reported relationship between EDA and perceived stress were extracted.Results:Of the 74 included studies, the majority included healthy subjects in laboratory situations. Field studies and studies using machine learning (ML) to predict stress have increased in the last years. EDA is most often measured on the wrist, with offline data processing. Studies predicting perceived stress or stress-related behaviour using EDA features, reported accuracies between 42% and 100% with an average of 82.6%. Of these studies, the majority used ML.Conclusion:Wearable EDA sensors are promising in detecting perceived stress. Field studies with relevant populations in a health or care context are lacking. Future studies should focus on the application of EDA-measuring wearables in real-life situations to support stress management

Ageism in the discourse and practice of designing digital technology for older persons:A scoping review

Background and Objectives Involving older persons in the design process of digital technology (DT) promotes the development of technologies that are appealing, beneficial, and used. However, negative discourse on aging and ageism are potential underlying factors that could influence which and how DTs are designed and how older persons are involved in the design process. This scoping review investigates the explicit and implicit manifestations of ageism in the design process of DT. Research Design and Methods Seven databases were screened for studies reporting on the design of DT with older persons between January 2015 and January 2020. Data regarding study and DT characteristics, discourse about older persons, and their involvement in the design process were extracted, coded, and analyzed using critical discourse analysis. Results Sixty articles met the inclusion criteria and were included in the analysis. Various forms of exclusion of older persons from the design process were identified, such as no or low involvement, upper-age limits, and sample biases toward relatively “active,” healthy and “tech-savvy” older persons. Critical discourse analysis revealed the use of outdated language, stereotypical categorizations, and/or design decisions based on ageism in 71.7% of the studies. Discussion and Implications A discrepancy was found between an “ideal” discourse regarding the involvement of older persons throughout the design process and actual practice. Manifestations of ageism, errors, and biases of designing DT with older persons are discussed. This article calls for more authentic inclusion of older persons and higher awareness toward the implications of ageism in the design process of DT

Ageism in the use and design of digital technology

Background and research objectives: Technological innovation is often described as a solution for or considered to have the potential of meeting the challenges of the ageing society, improving older persons' quality of life, well-being, and healthcare, and supporting ageing in place in a safe and independent environment. At the same time, older persons often experience ageism, defined as stereotypes, prejudice, and discrimination, in the context of digital technology. Such stereotypes are omnipresent in various contexts (e.g., workforce, healthcare, and media) and can hinder active and successful ageing in a highly digitalizing reality. The main goal of this dissertation is to understand what are the manifestations of ageism in the context of digital technology and the potential role of ageism as an underlying factor that may affect the design, acceptance, and use of digital technology. Methods: A mixed-methods approach was utilized to initiate and present a coherent and holistic outcome intending to discover paradoxes, contradictions, and new perspectives on the design, acceptance, and use of digital technology. Six studies were conducted, triangulating data from 1) different methodologies, 2) various stakeholders' perspectives (older persons, designers, researchers, and healthcare professionals) 3) and different contexts of use and design of digital technology. Main results: The triangulation of this dissertation's qualitative and quantitative findings are synthesized in a theoretical model of Ageism in the Use and Design of Digital Technology (see figure). Manifestations of ageism in the use and design of digital technology are identified throughout the different dimensions of ageism: (1) Social-psychological level of stereotypes, prejudice, and discrimination, (2) Negative-positive valance, (3) Explicit-implicit representations, (4) and three levels of individual-micro level (self-ageism), a social-organizational meso level of inter-generational interaction, and policy and design macro level. Importantly, ageism may influence the acceptance and use of digital technology in a dynamic and iterative process of interaction between different levels and interchanging between individuals, design processes, and technological devices and services. Recommendations for future research and policy: Ageism in the use and design of digital technology is a developing field for future research, entrepreneurship, and policy. The main recommendations are to: 1.Develop interventions to mitigate self-ageism, empower older persons, and reduce ageism in the design process of digital technology and intergenerational tension. 2.Raise awareness and training to change the discourse on ageing and technology. 3.Promote inclusion and aim for partnership and meaningful involvement of older persons throughout the development of digital technology-related products, services, and policy. 4.Design digital technologies for versatile social, leisure, and communication needs. 5.Develop methodological innovations to measure the influence of ageism on the use and design of digital technology. In particular concerning discrimination; intersectionality of digital technology, ageism, and other characteristics; and the use of data and artificial intelligence (AI). 6.Ensure access to digital technology to eliminate the access divide influenced by age, education, and other characteristics

Ageism in applying digitial technology in healthcare:Implications for adoption and actual use

Many discussions, studies, and policy reports regarding ageing and digital technology (DT) begin by addressing the following logic: the population is rapidly ageing, leading to an increase in chronic diseases and increasing costs and burden on the healthcare system (Neven, 2010). DT is often presented as an answer or a solution to this ‘problem’ in what Peine and Neven (2019) described as ‘interventionist logic’. However, older adults are often categorised and discoursed as a homogeneous group of ‘non-users’ in the context of designing DTs (Quan-Haase et al., 2018), associated with illness, frailty, cognitive decline, and dependency (Neven, 2010). These conceptions, together with the notion that as people age they consume’ as much as three times more healthcare resources than others (Alemayehu and Warner, 2004), leads to a fixation on DTs developed primarily for care and healthcare for older adults (Schulz et al., 2015). This is often policy-driven due to the idea that DT has the potential to reduce healthcare costs. This fixation has led to a rapidly growing age-tech market of healthcare DT, as can be seen in a visualised mapping of age-tech companies currently operating in the market (see Etkin, 2021). Consequently, healthcare professionals and caregivers are positioned at the forefront of using DT with older adults. For the purpose of this chapter, we describe DT as technological devices, ser vices, or platforms that use, collect, and often process data, and are connected to the Internet, other devices, or apps. Examples of such DTs are eHealth apps, smart watches, sensors and systems that can detect and predict falls, and social robots, among others

Associations between everyday ICT usage and (self-)ageism: A systematic literature review

Background and Objectives Both rapid technological changes and (self-)ageism are pervasive challenges of the 21st century, potentially affecting older adults’ everyday functioning, health, and well-being. This systematic literature review aimed to synthesize scholarly evidence to determine the associations between everyday information and communication technology (EICT) usage and (self-)ageism as well as potential moderators. Research Design and Methods A systematic search was performed in 8 academic databases, covering the time frame from January 1995 to January 2021. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a total of 15 articles met the inclusion criteria and were involved in the analysis. The standardized National Heart, Lung, and Blood Institute’s quality assessment tools were used for risk bias. Results Several studies demonstrated significant associations between EICT usage and stereotype embodiment (n = 8), stereotype threat (n = 2), and age discrimination (n = 3). Age (group), gender, and motivation were examined as potential moderators. Discussion and Implications This review provides initial evidence on the associations between (self-)ageism and EICT usage. It highlights the importance of positive subjective aging perceptions for active EICT usage in older adults, but also emphasizes the detrimental consequences of ageism in EICT learning settings and technology design on older persons’ willingness and ability to use EICT. Further ecologically valid and methodologically sound research is needed to better understand both the nature and direction of the association between EICT usage and (self-)ageism

Associations between everyday ICT usage and (self-)ageism:A systematic literature review

Background and Objectives Both rapid technological changes and (self-)ageism are pervasive challenges of the 21st century, potentially affecting older adults’ everyday functioning, health, and well-being. This systematic literature review aimed to synthesize scholarly evidence to determine the associations between everyday information and communication technology (EICT) usage and (self-)ageism as well as potential moderators. Research Design and Methods A systematic search was performed in 8 academic databases, covering the time frame from January 1995 to January 2021. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a total of 15 articles met the inclusion criteria and were involved in the analysis. The standardized National Heart, Lung, and Blood Institute’s quality assessment tools were used for risk bias. Results Several studies demonstrated significant associations between EICT usage and stereotype embodiment (n = 8), stereotype threat (n = 2), and age discrimination (n = 3). Age (group), gender, and motivation were examined as potential moderators. Discussion and Implications This review provides initial evidence on the associations between (self-)ageism and EICT usage. It highlights the importance of positive subjective aging perceptions for active EICT usage in older adults, but also emphasizes the detrimental consequences of ageism in EICT learning settings and technology design on older persons’ willingness and ability to use EICT. Further ecologically valid and methodologically sound research is needed to better understand both the nature and direction of the association between EICT usage and (self-)ageism