Exploring Perceptions of Technology Use to Support Self-Management Among Older Adults with Cancer and Multimorbidities

Mobility and technology can facilitate in-person and virtual social participation to help reduce social isolation, but issues exist regarding older adults’ access, feasibility, and motivation to use various forms of mobility and technology. This qualitative study explores how a diverse group of low-income, urban-living older adults use mobility and technology for social participation. We conducted six focus groups ( N = 48), two each in English, Spanish, and Korean at a Los Angeles senior center. Three major themes emerged from thematic analysis: using technology for mobility; links between mobility and social participation; and technology-mediated social participation. Cost, perceived safety, (dis)ability, and support from family and friends were related to mobility and technology use. This study demonstrates the range of mobility and technology uses among older adults and associated barriers. The findings can help establish a pre-COVID-19 baseline on how to make mobility and technology more accessible for older adults at risk of isolation.

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Effectiveness of an eHealth self-management tool for older adults with multimorbidity (KeepWell): protocol for a hybrid effectiveness–implementation randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2020-048350 ◽

2021 ◽

Vol 11 (2) ◽

pp. e048350

Author(s):

Monika Kastner ◽

Julie Makarski ◽

Leigh Hayden ◽

Jemila S Hamid ◽

Jayna Holroyd-Leduc ◽

...

Keyword(s):

Older Adults ◽

Chronic Disease ◽

Randomised Controlled Trial ◽

Disease Management ◽

Chronic Conditions ◽

Controlled Trial ◽

Management Tool ◽

Self Management ◽

Plain Language ◽

Randomised Controlled

IntroductionIn response to the burden of chronic disease among older adults, different chronic disease self-management tools have been created to optimise disease management. However, these seldom consider all aspects of disease management are not usually developed specifically for seniors or created for sustained use and are primarily focused on a single disease. We created an eHealth self-management application called ‘KeepWell’ that supports seniors with complex care needs in their homes. It incorporates the care for two or more chronic conditions from among the most prevalent high-burden chronic diseases.Methods and analysisWe will evaluate the effectiveness, cost and uptake of KeepWell in a 6-month, pragmatic, hybrid effectiveness–implementation randomised controlled trial. Older adults age ≥65 years with one or more chronic conditions who are English speaking are able to consent and have access to a computer or tablet device, internet and an email address will be eligible. All consenting participants will be randomly assigned to KeepWell or control. The allocation sequence will be determined using a random number generator.Primary outcome is perceived self-efficacy at 6 months. Secondary outcomes include quality of life, health background/status, lifestyle (nutrition, physical activity, caffeine, alcohol, smoking and bladder health), social engagement and connections, eHealth literacy; all collected via a Health Risk Questionnaire embedded within KeepWell (intervention) or a survey platform (control). Implementation outcomes will include reach, effectiveness, adoption, fidelity, implementation cost and sustainability.Ethics and disseminationEthics approval has been received from the North York General Hospital Research and Ethics Board. The study is funded by the Canadian Institutes of Health Research and the Ontario Ministry of Health. We will work with our team to develop a dissemination strategy which will include publications, presentations, plain language summaries and an end-of-grant meeting.Trial registration numberNCT04437238.

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Developing a Healthcare Technology Acceptance Model (H-TAM) for Older Adults with Hypertension

Ageing and Society ◽

10.1017/s0144686x21001069 ◽

2021 ◽

pp. 1-21

Author(s):

Maurita T. Harris ◽

Wendy A. Rogers

Keyword(s):

Older Adults ◽

Technology Acceptance ◽

Technology Acceptance Model ◽

Perceived Usefulness ◽

Relative Advantage ◽

Self Management ◽

Healthcare Technology ◽

Perceived Need ◽

Healthcare Technologies ◽

Acceptance Model

Abstract Older adults with a chronic health condition (e.g. hypertension) use various self-management methods. Healthcare technologies have the potential to support health self-management. However, it is necessary to understand the acceptance of these technologies as a precursor to older adults’ adoption and integration into their health plan. Our focus was on the factors older adults with hypertension initially consider when introduced to three new healthcare technologies that might support their health self-management. We compared their considerations for a blood pressure monitor, an electronic pillbox and a multifunction robot to simulate incrementally more complex technologies. Twenty-three participants (aged 65–84) completed four questionnaires and a semi-structured interview. The interview transcripts were analysed using a thematic analysis approach. We identified the factors that were frequently mentioned among the participants for each of the three healthcare technologies. The factors that older adults initially considered were familiarity, perceived benefits, perceived ease of use, perceived need for oneself, relative advantage, complexity and perceived need for others. Upon further reflection, participants considered advice acceptance, compatibility, convenience, facilitating conditions, perceived usefulness, privacy, subjective norm, and trust. We integrated the factors that older adults considered into the Healthcare Technology Acceptance Model (H-TAM), which elucidates the complexity of healthcare technology acceptance and provides guidance for future explorations.

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Older Adults and Technology Use: A Systematic Literature Review

Innovation in Aging ◽

10.1093/geroni/igaa057.3004 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 823-823

Author(s):

Hyung Wook Choi ◽

Rose Ann DiMaria-Ghalili ◽

Mat Kelly ◽

Alexander Poole ◽

Erjia Yan ◽

...

Keyword(s):

Older Adults ◽

Technology Use ◽

Age Groups ◽

Well Being ◽

Sample Population ◽

Age Cohorts ◽

Fine Grained ◽

Nuanced Understanding ◽

Smart Technologies ◽

Age Range

Abstract Researchers are increasingly interested in leveraging technology to support the physical and mental well-being of older adults. We systematically reviewed previous scholars’ criteria for sampling older adult populations, focusing on age cohorts (namely adults over 65) and their use of internet and smart technologies. We iteratively developed keyword combinations that represent older adults and technology from the retrieved literature. Between 2011 and 2020, 70 systematic reviews were identified, 26 of which met our inclusion criteria for full review. Most important, not one of the 26 papers used a sample population classification more fine-grained than “65 and older.” A knowledge gap thus exists; researchers lack a nuanced understanding of differences within this extraordinarily broad age-range. Demographics that we propose to analyze empirically include not only finer measures of age (e.g., 65-70 or 71-75, as opposed to “65 and older”), but also those age groups’ attitudes toward and capacity for technology use.

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Older Adult Peer Specialists’ Role in Reducing Loneliness Among People With Mental Health Conditions

Innovation in Aging ◽

10.1093/geroni/igaa057.2288 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 662-662

Author(s):

Karen Fortuna ◽

George Mois ◽

Jessica Brooks ◽

Amanda Myers ◽

Cynthia Bianco

Keyword(s):

Mental Health ◽

Older Adults ◽

Real World ◽

Smartphone Application ◽

Interactive Effects ◽

Health Conditions ◽

Self Management ◽

Potential Effectiveness ◽

Mental Health Conditions ◽

Management Intervention

Abstract PeerTECH is a peer-delivered and technology-support integrated medical and psychiatric self-management intervention developed by peers. A pre/post trial by our group has shown PeerTECH is associated with statistically significant improvements in self-efficacy for managing chronic disease and psychiatric self-management skills. This presentation will discuss the feasibility and potential effectiveness of using ecological momentary assessments (EMA) with older adults with mental health conditions to allow us to recognize early signs of loneliness and intervene as early as possible in real-world settings. EMA involves repeated sampling of an individual’s behaviors and experiences in real time, real-world environments on the smartphone application. Then, we will discuss the main and interactive effects of loneliness and factors linked to mortality. In conclusion, we will discuss potential effectiveness of PeerTECH with older adults with SMI.

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Predictors for Confidence in Self-Management of Falls and the Role of Fear of Falls

Innovation in Aging ◽

10.1093/geroni/igaa057.964 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 301-301

Author(s):

Qiwei Li ◽

Becky Knight

Keyword(s):

Older Adults ◽

Fall Prevention ◽

Predictor Variable ◽

Path Model ◽

Self Management ◽

Hierarchical Regression ◽

Mediating Role ◽

Self Protection ◽

Fear Of Falls

Abstract Falls have been a crucial threat for older adults to stay independent. Once they have fallen, older adults are more likely to receive injuries and become people with disabilities. Conventionally, the measurement of fall efficacy focused on the capacity of performing certain activities such as walking or bathing without a fall. However, given the fact that one out of five older adults fall every year, self-efficacy in self-protection when falls do happen calls for a better understanding of confidence in self-management of a fall. Among predictors for fall prevention outcomes, “fear of falls” has received attention. However, “fear of falls” was largely missing in studies exploring self-management of falls in scenarios where falls do happen. This study explores the predictors for CSMoF including “fear of falls”. A series of simultaneous and hierarchical regression analyses with related interaction analyses and a path model were applied to determine the contribution of each predictor variable and the mediating role of “fear of falls”. The findings of the study reported that demographic characteristics, chronic conditions, and perceptions of falls were associated with CSMoF. The path analysis confirmed the mediating role of “fear of falls” as the indirect effects were occupying substantial percentages in the total identified effects. “Fear of falls” should continue to be a core of fall prevention programs and is particularly important for programs that aim to teach older adults what to do when they fall, whom to call for help, and how to avoid injuries upon falling.

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Technology Use and Preferences for Minority Diabetes Self-Management Application

Journal of Health Care for the Poor and Underserved ◽

10.1353/hpu.2021.0002 ◽

2021 ◽

Vol 32 (1) ◽

pp. 1-7

Author(s):

Lila L. Carden ◽

Jennifer Garza ◽

Samuel S. Sampson

Keyword(s):

Technology Use ◽

Self Management ◽

Management Application

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Older Adults’ Adaptations to the Call for Social Distancing and Use of Technology: Insights From Socioemotional Selectivity Theory and Lived Experiences

Journal of Applied Gerontology ◽

10.1177/0733464821996864 ◽

2021 ◽

pp. 073346482199686

Author(s):

Shoshana H. Bardach ◽

Elizabeth K. Rhodus ◽

Kelly Parsons ◽

Allison K. Gibson

Keyword(s):

Older Adults ◽

Technology Use ◽

Technology Training ◽

Well Being ◽

Socioemotional Selectivity Theory ◽

Structured Interviews ◽

Socioemotional Selectivity ◽

Social Distancing ◽

Use Of Technology ◽

Comparison Approach

Social distancing guidelines during COVID can be isolating, especially for older adults, with potential for poor health outcomes. Technology offers opportunities for remote connection, yet, older adults’ use of and perspectives on technology during this time remain largely unknown. The purpose of this study was to gain insight into older adults’ technology use and preferences to inform the development of a technology training intervention to support older adult well-being. Semi-structured interviews were conducted with 30 older adults. Interviews were analyzed using an iterative, constant comparison approach. Findings were consistent with Socioemotional Selectivity Theory; respondents were primarily interested in technology to support emotionally meaningful goals. Participants indicated limited interest in technology training, referencing diminished future time perspectives to explain disinterest. Findings suggest that efforts to encourage older adults’ expanded technology adoption should highlight how use supports emotionally meaningful goals and provide low-effort, timely training, tied to specific and clear applications.

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