scholarly journals EDUCATION AND TRAINING ELECTRONIC NAVIGATION SYSTEMS’ IMPACT ON OLDER DRIVER PERFORMANCE AND TRAINING TO OVERCOME UNFAMILIARITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S665-S665
Author(s):  
Anne E Dickerson ◽  
F Dennis Thomas ◽  
Lindsay Graham ◽  
M Chandler Coleman ◽  
Richard Blomberg ◽  
...  
Keyword(s):  
Older Adults ◽  
Phase 1 ◽  
Driving Performance ◽  
Older Drivers ◽  
Driving Safety ◽  
Navigation Systems ◽  
Phase 2 ◽  
Driver Performance ◽  
Hands On ◽  
And Training

Abstract Technology may assist older adults in improving their driving performance and therefore driving safety. However, it is sometimes a distraction and some older adults avoid its use due to the complexity of learning the systems. This study examined how older drivers interacted with an electronic navigation system (e.g., GPS) and the extent to which it impacted driving performance on unfamiliar routes. It also examined three approaches to training older adults how to program the devices. In Phase 1, 80 older drivers navigated unfamiliar routes using a GPS or paper directions and completed destination entry tasks. In Phase 2, 60 older drivers completed one of three training conditions (video, video with hands-on, placebo) to examine the impacts of training on destination entry performance. Driving performance was improved with GPS over paper directions (p = .025), as evaluated by a driver rehabilitation specialized on counterbalanced standardized routes. Analyses also showed significant effects for familiarity for use of GPS (p=.035) and age group (60’s versus 70’s) (p<.001), but many drivers had difficulty entering destinations. In Phase 2, a main effect of training was found (p=.02) with using video and one-on-one training showing the best performance. This study demonstrates older drivers could benefit from the use of such devices when driving to unfamiliar destinations, but training is needed with hands-on training with a live instructor being the best.

scholarly journals Acceptance of Transportation Technologies by Aging Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 555-555
Author(s):  
Neil Charness ◽  
Dustin Souders ◽  
Ryan Best ◽  
Nelson Roque ◽  
JongSung Yoon ◽  
...  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Detection System ◽  
Blind Spot ◽  
Driving Performance ◽  
Older Drivers ◽  
Crash Risk ◽  
Warning Systems ◽  
Risk Of Death ◽  
Spot Detection

Abstract Older adults are at greater risk of death and serious injury in transportation crashes which have been increasing in older adult cohorts relative to younger cohorts. Can technology provide a safer road environment? Even if technology can mitigate crash risk, is it acceptable to older road users? We outline the results from several studies that tested 1) whether advanced driver assistance systems (ADAS) can improve older adult driving performance, 2) older adults’ acceptance of ADAS and Autonomous Vehicle (AV) systems, and 3) perceptions of value for ADAS systems, particularly for blind-spot detection systems. We found that collision avoidance warning systems improved older adult simulator driving performance, but not lane departure warning systems. In a young to middle-aged sample the factor “concern with AV” showed age effects with older drivers less favorable. Older drivers, however, valued an active blind spot detection system more than younger drivers.

scholarly journals Building a Digital Bridge to Support Patient-Centered Care Transitions From Hospital to Home for Older Adults With Complex Care Needs: Protocol for a Co-Design, Implementation, and Evaluation Study (Preprint)

2020 ◽  
Author(s):  
Carolyn Steele Gray ◽  
Terence Tang ◽  
Alana Armas ◽  
Mira Backo-Shannon ◽  
Sarah Harvey ◽  
...  
Keyword(s):  
Older Adults ◽  
Phase 1 ◽  
Care Transitions ◽  
Self Management ◽  
Complex Care ◽  
Phase 2 ◽  
Care Needs ◽  
Centered Care ◽  
Hospital To Home ◽  
Complex Care Needs

BACKGROUND Older adults with multimorbidity and complex care needs (CCN) are among those most likely to experience frequent care transitions between settings, particularly from hospital to home. Transition periods mark vulnerable moments in care for individuals with CCN. Poor communication and incomplete information transfer between clinicians and organizations involved in the transition from hospital to home can impede access to needed support and resources. Establishing digitally supported communication that enables person-centered care and supported self-management may offer significant advantages as we support older adults with CCN transitioning from hospital to home. OBJECTIVE This protocol outlines the plan for the development, implementation, and evaluation of a Digital Bridge co-designed to support person-centered health care transitions for older adults with CCN. The Digital Bridge builds on the foundation of two validated technologies: Care Connector, designed to improve interprofessional communication in hospital, and the electronic Patient-Reported Outcomes (ePRO) tool, designed to support goal-oriented care planning and self-management in primary care settings. This project poses three overarching research questions that focus on adapting the technology to local contexts, evaluating the impact of the Digital Bridge in relation to the quadruple aim, and exploring the potential to scale and spread the technology. METHODS The study includes two phases: workflow co-design (phase 1), followed by implementation and evaluation (phase 2). Phase 1 will include iterative co-design working groups with patients, caregivers, hospital providers, and primary care providers to develop a transition workflow that will leverage the use of Care Connector and ePRO to support communication through the transition process. Phase 2 will include implementation and evaluation of the Digital Bridge within two hospital systems in Ontario in acute and rehab settings (600 patients: 300 baseline and 300 implementation). The primary outcome measure for this study is the Care Transitions Measure–3 to assess transition quality. An embedded ethnography will be included to capture context and process data to inform the implementation assessment and development of a scale and spread strategy. An Integrated Knowledge Translation approach is taken to inform the study. An advisory group will be established to provide insight and feedback regarding the project design and implementation, leading the development of the project knowledge translation strategy and associated outputs. RESULTS This project is underway and expected to be complete by Spring 2024. CONCLUSIONS Given the real-world implementation of Digital Bridge, practice changes in the research sites and variable adherence to the implementation protocols are likely. Capturing and understanding these considerations through a mixed-methods approach will help identify the range of factors that may influence study results. Should a favorable evaluation suggest wide adoption of the proposed intervention, this project could lead to positive impact at patient, clinician, organizational, and health system levels. CLINICALTRIAL ClinicalTrials.gov NCT04287192; https://clinicaltrials.gov/ct2/show/NCT04287192 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/20220

scholarly journals Older Adults’ Utilization of Community Resources Targeting Fall Prevention and Physical Activity

2018 ◽  
Vol 59 (3) ◽  
pp. 436-446 ◽  
Author(s):  
Siobhan K McMahon ◽  
Young Shin Park ◽  
Beth Lewis ◽  
Weihua Guan ◽  
J Michael Oakes ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Fall Prevention ◽  
Local Community ◽  
Phase 1 ◽  
Implementation Strategies ◽  
Community Resources ◽  
Phase 2 ◽  
Internal Resources ◽  
Diagnosis Of Dementia

Abstract Background and Objectives Despite the availability of community resources, fall and inactivity rates remain high among older adults. Thus, in this article, we describe older adults’ self-reported awareness and use of community resources targeting fall prevention and physical activity. Research Design and Methods In-depth, semistructured interviews were conducted in Phase 1 with community center leaders (n = 5) and adults (n = 16) ≥70 years old whose experience with community programs varied. In Phase 2, surveys were administered to intervention study participants (n = 102) who were ≥70 years old, did not have a diagnosis of dementia, and reported low levels of physical activity. Results Four themes emerged from Phase 1 data: (a) identifying a broad range of local community resources; (b) learning from trusted sources; (c) the dynamic gap between awareness and use of community resources; and (d) using internal resources to avoid falls. Phase 2 data confirmed these themes; enabled the categorization of similar participant-identified resources (10); and showed that participants who received encouragement to increase community resource use, compared to those who did not, had significantly greater odds of using ≥1 resource immediately postintervention, but not 6 months’ postintervention. Discussion and Implications Although participants in this study were aware of a broad range of local community resources for physical activity, they used resources that support walking most frequently. Additionally, receiving encouragement to use community resources had short-term effects only. Findings improve our understanding of resources that need bolstering or better dissemination and suggest researchers identify best promotion, dissemination, implementation strategies.

Personal and Clinical Factors Associated with Older Drivers’ Self-Awareness of Driving Performance

2020 ◽  
pp. 1-15 ◽  
Author(s):  
Yu-Ting Chen ◽  
Isabelle Gélinas ◽  
Barbara Mazer ◽  
Anita Myers ◽  
Brenda Vrkljan ◽  
...  
Keyword(s):  
Processing Speed ◽  
Driving Performance ◽  
Older Drivers ◽  
Driving Safety ◽  
Driving Ability ◽  
Accurate Estimation ◽  
Self Awareness ◽  
Motor Processing ◽  
Two Factors ◽  
Trail Making

ABSTRACT Most older adults perceive themselves as good drivers; however, their perception may not be accurate, and could negatively affect their driving safety. This study examined the accuracy of older drivers’ self-awareness of driving ability in their everyday driving environment by determining the concordance between the perceived (assessed by the Perceived Driving Ability [PDA] questionnaire) and actual (assessed by electronic Driving Observation Schedule [eDOS]) driving performance. One hundred and eight older drivers (male: 67.6%; age: mean = 80.6 years, standard deviation [SD] = 4.9 years) who participated in the study were classified into three groups: underestimation (19%), accurate estimation (29%), and overestimation (53%). Using the demographic and clinical functioning information collected in the Candrive annual assessments, an ordinal regression showed that two factors were related to the accuracy of self-awareness: older drivers with better visuo-motor processing speed measured by the Trail Making Test (TMT)-A and fewer self-reported comorbid conditions tended to overestimate their driving ability, and vice versa.

Development and Testing of the Resourcefulness Scale for Older Adults

2006 ◽  
Vol 14 (1) ◽  
pp. 57-68 ◽  
Author(s):  
Jaclene A. Zauszniewski ◽  
Chien-Yu Lai ◽  
Sukuma Tithiphontumrong
Keyword(s):  
Older Adults ◽  
Internal Consistency ◽  
Phase 1 ◽  
Chronically Ill ◽  
Potential Usefulness ◽  
Phase 2 ◽  
Middle Aged ◽  
Phase Study ◽  
Middle Aged Adults ◽  
Acceptable Internal Consistency

Resourcefulness is the ability to independently perform daily tasks (personal resourcefulness) and to seek help from others when unable to function independently (social resourcefulness). The 2 forms of resourcefulness are theoretically related, yet no current measure captures both simultaneously. This 2-phase study involved development and testing of a Resourcefulness Scale for elders from existing measures of personal and social resourcefulness. Data from 2 studies of 451 chronically ill elders were randomly split: the measure was developed in phase 1 and validated in phase 2. The new Resourcefulness Scale has acceptable internal consistency (α= .85). Two correlated subscales reflecting personal and social resourcefulness (r= .41) were confirmed. The Resourcefulness Scale has potential usefulness for older adults as well as younger and middle-aged adults.

Beyond ADA Accessibility Requirements: Meeting Seniors’ Needs for Toilet Transfers

2017 ◽  
Vol 11 (2) ◽  
pp. 32-44 ◽  
Author(s):  
Su Jin Lee ◽  
Jon Sanford ◽  
Margaret Calkins ◽  
Sarah Melgen ◽  
Sarah Endicott ◽  
...  
Keyword(s):  
Older Adults ◽  
Americans With Disabilities Act ◽  
Phase 1 ◽  
Ease Of Use ◽  
Nursing Facilities ◽  
Phase 2 ◽  
Care Providers ◽  
Substantial Evidence ◽  
Skilled Nursing ◽  
Matched Samples

Purpose: To identify the optimal spatial and dimensional requirements of grab bars that support independent and assisted transfers by older adults and their care providers. Background: Although research has demonstrated that toilet grab bars based on the Americans with Disabilities Act (ADA) Accessibility Standards do not meet the needs of older adults, the specific dimensional requirements for alternative configurations are unknown. Methods: A two-phased study with older adults and care providers in residential facilities was conducted to determine the optimal requirements for grab bars. Seniors and caregivers in skilled nursing facilities performed transfers using a mock-up toilet. In Phase 1, participants evaluated three grab bar configurations to identify optimal characteristics for safety, ease of use, comfort, and helpfulness. These characteristics were then validated for using ability-matched samples in Phase 2. Results: The optimal configuration derived in Phase 1 included fold-down grab bars on both sides of the toilet (14" from centerline [CL] of toilet, 32" above the floor, and extended a minimum of 6" in front of the toilet) with one side open and a sidewall 24" from CL of toilet on the other. Phase 2 feedback was significantly positive for independent and one-person transfers and somewhat lower, albeit still positive, for two-person transfers. Conclusion: The study provides substantial evidence that bilateral grab bars are significantly more effective than those that comply with current ADA Accessibility Standards. Findings provide specific spatial and dimensional attributes for grab bar configurations that would be most effective in senior facilities.

scholarly journals A Mobile App Directory of Occupational Therapists Who Provide Home Modifications: Development and Preliminary Usability Evaluation

10.2196/14465 ◽  
2020 ◽  
Vol 7 (1) ◽  
pp. e14465
Author(s):  
An Thi Nguyen ◽  
Emily Kling Somerville ◽  
Sandra Martina Espín-Tello ◽  
Marian Keglovits ◽  
Susan Lynn Stark
Keyword(s):  
Older Adults ◽  
Phase 1 ◽  
Occupational Therapists ◽  
The United States ◽  
Mobile App ◽  
Community Dwelling ◽  
Phase 2 ◽  
Home Modifications ◽  
The Mean ◽  
Community Dwelling Older Adults

Background Home modifications provided by occupational therapists (OTs) are effective in improving daily activity performance and reducing fall risk among community-dwelling older adults. However, the prevalence of home modification is low. One reason is the lack of a centralized database of OTs who provide home modifications. Objective This study aimed to develop and test the usability of a mobile app directory of OTs who provide home modifications in the United States. Methods In phase 1, a prototype was developed by identifying OTs who provide home modifications through keyword Web searches. Referral information was confirmed by phone or email. In phase 2, community-dwelling older adults aged older than 65 years and OTs currently working in the United States were purposefully recruited to participate in a single usability test of the mobile app, Home Modifications for Aging and Disability Directory of Referrals (Home Maddirs). Participants completed the System Usability Scale (SUS) and semistructured interview questions. Interview data were coded, and themes were derived using a grounded theory approach. Results In phase 1, referral information for 101 OTs across 49 states was confirmed. In phase 2, 6 OTs (mean clinical experience 4.3 years, SD 1.6 years) and 6 older adults (mean age 72.8 years, SD 5.0 years) participated. The mean SUS score for OTs was 91.7 (SD 8.0; out of 100), indicating good usability. The mean SUS score for older adults was 71.7 (SD 27.1), indicating considerable variability in usability. In addition, the SUS scores indicated that the app is acceptable to OTs and may be acceptable to some older adults. For OTs, self-reported barriers to acceptability and usability included the need for more information on the scope of referral services. For older adults, barriers included high cognitive load, lack of operational skills, and the need to accommodate sensory changes. For both groups, facilitators of acceptability and usability included perceived usefulness, social support, and multiple options to access information. Conclusions Home Maddirs demonstrates good preliminary acceptability and usability to OTs. Older adults’ perceptions regarding acceptability and usability varied considerably, partly based on prior experience using mobile apps. Results will be used to make improvements to this promising new tool for increasing older adults’ access to home modifications.

scholarly journals A Mobile App Directory of Occupational Therapists Who Provide Home Modifications: Development and Preliminary Usability Evaluation (Preprint)

2019 ◽  
Author(s):  
An Thi Nguyen ◽  
Emily Kling Somerville ◽  
Sandra Martina Espín-Tello ◽  
Marian Keglovits ◽  
Susan Lynn Stark
Keyword(s):  
Older Adults ◽  
Phase 1 ◽  
Occupational Therapists ◽  
The United States ◽  
Mobile App ◽  
Community Dwelling ◽  
Phase 2 ◽  
Home Modifications ◽  
The Mean ◽  
Community Dwelling Older Adults

BACKGROUND Home modifications provided by occupational therapists (OTs) are effective in improving daily activity performance and reducing fall risk among community-dwelling older adults. However, the prevalence of home modification is low. One reason is the lack of a centralized database of OTs who provide home modifications. OBJECTIVE This study aimed to develop and test the usability of a mobile app directory of OTs who provide home modifications in the United States. METHODS In phase 1, a prototype was developed by identifying OTs who provide home modifications through keyword Web searches. Referral information was confirmed by phone or email. In phase 2, community-dwelling older adults aged older than 65 years and OTs currently working in the United States were purposefully recruited to participate in a single usability test of the mobile app, Home Modifications for Aging and Disability Directory of Referrals (Home Maddirs). Participants completed the System Usability Scale (SUS) and semistructured interview questions. Interview data were coded, and themes were derived using a grounded theory approach. RESULTS In phase 1, referral information for 101 OTs across 49 states was confirmed. In phase 2, 6 OTs (mean clinical experience 4.3 years, SD 1.6 years) and 6 older adults (mean age 72.8 years, SD 5.0 years) participated. The mean SUS score for OTs was 91.7 (SD 8.0; out of 100), indicating good usability. The mean SUS score for older adults was 71.7 (SD 27.1), indicating considerable variability in usability. In addition, the SUS scores indicated that the app is acceptable to OTs and may be acceptable to some older adults. For OTs, self-reported barriers to acceptability and usability included the need for more information on the scope of referral services. For older adults, barriers included high cognitive load, lack of operational skills, and the need to accommodate sensory changes. For both groups, facilitators of acceptability and usability included perceived usefulness, social support, and multiple options to access information. CONCLUSIONS Home Maddirs demonstrates good preliminary acceptability and usability to OTs. Older adults’ perceptions regarding acceptability and usability varied considerably, partly based on prior experience using mobile apps. Results will be used to make improvements to this promising new tool for increasing older adults’ access to home modifications.

scholarly journals Development and Feasibility of A Tailored Habit-based Dietary Intervention Coupled With Natural Tooth Replacement On The Nutritional Status Of Older Patients

2020 ◽  
Author(s):  
Leigh-Ann McCrum ◽  
Sinead Watson ◽  
Laura McGowan ◽  
Bernadette Mcguinness ◽  
Chris Cardwell ◽  
...  
Keyword(s):  
Older Adults ◽  
Nutritional Status ◽  
Dietary Intervention ◽  
Phase 1 ◽  
Study Phase ◽  
Recruitment Strategies ◽  
Phase 2 ◽  
Tooth Replacement ◽  
Screening Procedures ◽  
Natural Tooth

Abstract Background: Older adults suffering partial tooth loss may need additional intervention strategies other than natural tooth replacement alone to improve their nutritional status. This study aimed to design and develop a habit-based tailored dietary intervention and to assess the feasibility and acceptability of the intervention, in conjunction with natural tooth replacement, amongst partially dentate older adults. Methods: The design and development of the dietary intervention (Phase 1) consisted of analysis of the target population’s dietary intake and qualitative research through focus groups with community-dwelling older adults (aged 65 years and over). The dietary intervention consisted of forming three healthy dietary habits around fruits and vegetables, wholegrains and healthy proteins. Feasibility of the intervention was then tested among older adults receiving natural tooth replacement in a small non-randomised single arm study (Phase 2). The principal feasibility outcome was the usability and acceptability of the intervention which was measured using evaluation questionnaires and by conducting post-intervention semi-structured interviews. Supporting outcomes consisted of feasibility of screening procedures; recruitment strategies; and retention/ attrition rates as well as the participant’s compliance to the intervention assessed through self-monitoring tracking sheets. Results: Twenty-one older adults (mean [SD] age 72.1 [10.4].) took part in one of four focus group discussions (Phase 1). Twelve themes related to barriers (e.g oral health, appetite) and facilitators (e.g nutritional knowledge, retirement) of healthy eating guided intervention development, as did a further five themes when asked for direct intervention feedback. Nine older adult participants (mean [SD] age 72.5[9.7]) were recruited into the feasibility study (Phase 2) where eight themes were identified from feedback interview discussions. The principal outcome measures identified intervention feasibility as participants considered the intervention acceptable and useable as both the evaluation questionnaire and qualitative interview results were overwhelmingly positive. As a supporting outcome measure, strong intervention compliance was also achieved. Screening procedures were accepted but additional recruitment strategies (e.g incorporation of home study visits or recruitment via posters advertisement) may benefit future study enrolment and retention. Conclusion: Phase 1 and Phase 2 findings have allowed for an iterative, user-driven intervention to be developed and refined for a randomised control study to evaluate the intervention’s effectiveness. Trial registration: ISRCTN66118345

scholarly journals Development and Feasibility of A Tailored Habit-based Dietary Intervention Coupled With Oral Rehabilitation On The Nutritional Status Of Older Patients

2020 ◽  
Author(s):  
Leigh-Ann McCrum ◽  
Sinead Watson ◽  
Laura McGowan ◽  
Bernadette Mcguinness ◽  
Chris Cardwell ◽  
...  
Keyword(s):  
Older Adults ◽  
Nutritional Status ◽  
Dietary Intervention ◽  
Phase 1 ◽  
Community Dwelling ◽  
Study Phase ◽  
Recruitment Strategies ◽  
Phase 2 ◽  
Oral Rehabilitation ◽  
Screening Procedures

Abstract BackgroundOlder adults suffering partial tooth loss may need additional intervention strategies other than oral rehabilitation alone to improve their nutritional status. This study aimed to design and develop a habit-based tailored dietary intervention and to assess the feasibility and acceptability of the intervention, in conjunction with oral rehabilitation, amongst partially dentate older adults.MethodsThe design and development of the dietary intervention (Phase 1) consisted of analysis of the target population’s dietary intake and qualitative research through focus groups with community-dwelling older adults (aged 65 years and over). Feasibility of the intervention was then tested among older adults receiving oral rehabilitation in a small non-randomised single arm study (Phase 2). The primary feasibility outcome was the usability and acceptability of the intervention which was measured using evaluation questionnaires and by conducting post-intervention semi-structured interviews. Secondary outcomes consisted of feasibility of screening procedures; recruitment strategies; and retention/ attrition rates as well as the participant’s compliance to the intervention assessed through self-monitoring tracking sheets.ResultsTwenty-one older adults (mean [SD] age 72.1 [10.4].) took part in one of four focus group discussions (Phase 1). Twelve themes related to barriers (e.g oral health, appetite) and facilitators (e.g nutritional knowledge, retirement) of healthy eating guided intervention development, as did a further five themes when asked for direct intervention feedback. Nine older adult participants (mean [SD] age 72.5[9.7]) were recruited into the feasibility study (Phase 2) where eight themes were identified from feedback interview discussions. Primary outcome measures identified intervention feasibility as participants considered the intervention acceptable and useable as both the evaluation questionnaire and qualitative interview results were overwhelmingly positive. As a secondary outcome measure, strong intervention compliance was also achieved. Screening procedures were accepted but additional recruitment strategies (e.g incorporation of home study visits or recruitment via posters advertisement) may benefit future study enrolment and retention.ConclusionPhase 1 and Phase 2 findings have allowed for an iterative, user-driven intervention to be developed and refined for a randomised control study to evaluate the intervention’s effectiveness.Trial registration: ISRCTN66118345

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