scholarly journals Digital Literacy: A Barrier to Adoption of Connected Health Technologies in Older Adults (Preprint)

2018 ◽  
Author(s):  
Lisa Gualtieri ◽  
Jeffrey Phillips ◽  
Sandra Rosenbluth ◽  
Steph Synoracki
Keyword(s):  
Older Adults ◽  
Digital Literacy ◽  
Digital Health ◽  
Age Groups ◽  
Literacy Skills ◽  
Barriers To Adoption ◽  
Health Technologies ◽  
Hands On ◽  
Smartphone Use ◽  
Effective Use

BACKGROUND Adoption and effective use of digital health technologies is especially important for older adults, who bear the greatest burden of chronic disease. However, some older adults lack the digital literacy skills needed to reap the benefits of these tools. Despite the greater infiltration of smartphones in all age groups, including older adults, smartphone ownership does not equate to adept smartphone use. Impediments to smartphone use can impede adoption and use of digital health technologies that rely on apps. OBJECTIVE Our objectives were to 1) determine the barriers to adoption and use of digital health technologies, specifically wearable activity trackers, by older adults; and 2) identify and test facilitators to adoption and use. METHODS We recruited more than 100 older adults aged 50-75 who owned a smartphone for our tracker studies. We provided each participant with a tracker and hands-on support for its setup and use. Support was tailored to each participant’s level of comfort and adeptness with his or her smartphone and new tracker, with the goal of having participants leave with a working tracker and an app they could engage with. RESULTS While all participants owned a smartphone, we identified several barriers to successful engagement with their own smartphones as well as with their new trackers. Some older model or pay-as-you-go phones could not download apps. Many participants required assistance to download and setup an app, as well as sync their tracker to the app. In several cases, the use of jargon such as “sync with Bluetooth” required an explanation. Some app features required guidance, such as changing the default of 10,000 steps to one that was more achievable and realistic for older adults. Furthermore, the design of some tracker faces and bands were preferred or more comfortable for participants. We found that once participants were able to overcome barriers to setup through hands-on training, other facilitators, such as a visual reminder of their commitment to physical activity and the immediate gratification of seeing their activity reflected in the tracker and the app, kept them engaged with the tracker. CONCLUSIONS The digital health market is growing rapidly and has great potential to improve health outcomes, yet it is failing to reach and meet the needs of older adults. Poor digital literacy skills impede adoption of digital health technologies, and their effective use once adopted. While a high-touch approach to helping older adults overcome barriers to adoption and use of digital health technologies has proven to be a successful facilitator in our studies, the challenge is in bringing this approach to scale and applying it to both consumer- and medical-grade technologies. In future studies, we hope to build on this knowledge and further identify design and training solutions that can be scaled to increase successful engagement of digital health technologies by older adults.

scholarly journals Digital Health Interventions for Healthy Aging: A Qualitative User Evaluation and Ethical Assessment

2020 ◽  
Author(s):  
Marcello Ienca ◽  
Christophe Schneble ◽  
Reto Kressig ◽  
Tenzin Wangmo
Keyword(s):  
Older Adults ◽  
Older People ◽  
Healthy Aging ◽  
Ethical Issues ◽  
Digital Health ◽  
Functional Independence ◽  
Community Dwelling ◽  
Healthy Ageing ◽  
Health Technologies ◽  
Community Dwelling Older Adults

Abstract BackgroundDigital health technologies are being increasingly developed with the aim of allowing older adults to maintain functional independence throughout the old age, a process known as healthy ageing. Such digital health technologies for healthy ageing are expected to mitigate the socio-economic effects of population ageing and improve the quality of life of older people. However, little is known regarding the views and needs of older people regarding these technologies. AimThe aim of this study is to explore the views, needs and perceptions of community-dwelling older adults regarding the use of digital health technologies for healthy ageing. MethodFace-to-face, in-depth qualitative interviews were conducted with community-dwelling older adults (median age 79.6 years). The interview process involved both abstract reflections and practical demonstrations. The interviews were transcribed verbatim and analyzed according to inductive content analysis. ResultsThree main themes and twelve sub-themes emerged. The three main themes revolved around the following thematic areas: favorable views and perceptions on technology-assisted living, usability evaluations and ethical considerations. ConclusionsOur study reveals a generally positive attitude towards digital health technologies as participants believed digital tools could positively contribute to improving their overall wellbeing, especially if designed in a patient-centered manner. Safety concerns and ethical issues related to privacy, empowerment and lack of human contact also emerged as key considerations.

scholarly journals Exploring the barriers and facilitators for the use of digital health technologies for the management of COPD: a qualitative study of clinician perceptions

QJM ◽  
2019 ◽  
Author(s):  
P Slevin ◽  
T Kessie ◽  
J Cullen ◽  
M W Butler ◽  
S C Donnelly ◽  
...  
Keyword(s):  
Digital Literacy ◽  
Resource Constraints ◽  
Digital Health ◽  
User Involvement ◽  
Structured Interview ◽  
Barriers And Facilitators ◽  
Chronic Obstructive ◽  
Snowball Sampling ◽  
University Hospitals ◽  
Health Technologies

Abstract Background Digital health technology (DHT) promises to support patients and healthcare professionals (HCPs) to optimize the management of chronic obstructive pulmonary disease (COPD). However, there is a lack of evidence demonstrating the effectiveness of DHT for the management of COPD. One reason for this is the lack of user-involvement in the development of DHT interventions in COPD meaning their needs and preferences are rarely accounted for in the design phase. Although HCP adoption issues have been identified in relation to DHT, little is known about the challenges perceived by HCPs providing care to COPD patients. Therefore, this study aims to qualitatively explore the barriers and facilitators HCPs perceive for the use of DHT in the management of COPD. Methods Participants (n = 32) were recruited using snowball sampling from two university hospitals and several general practitioner clinics. A semi-structured interview was conducted with each participant. NVivo 12 software was used to complete thematic analysis on the data. Results Themes identified include: data quality; evidence-based care; resource constraints; and digital literacy presented as barriers; and facilitators include the following themes: digital health training and education; improving HCP digital literacy; and Personalized prescribing. Patient-centered approaches, such as pulmonary rehabilitation and shared decision-making were suggested as implementation strategies to ease the adoption of digital health for the management of COPD. Conclusion These findings contribute new insights about the needs and preferences of HCPs working in COPD regarding DHT. The findings can be used to help mitigate user-experience issues by informing the design of person-centered implementation and adoption strategies for future digital health interventions in COPD.

scholarly journals Determinants of and barriers to adoption of digital therapeutics for mental health at scale in the NHS

2020 ◽  
Vol 6 (3) ◽  
pp. 92-98
Author(s):  
Matt G Williams ◽  
Richard Stott ◽  
Nicki Bromwich ◽  
Susie K Oblak ◽  
Colin A Espie ◽  
...  
Keyword(s):  
Mental Health ◽  
Digital Literacy ◽  
Market Access ◽  
Qualitative Content Analysis ◽  
Digital Health ◽  
Decision Makers ◽  
Structured Interviews ◽  
Barriers To Adoption ◽  
Information Governance ◽  
Further Development

ObjectivesAlthough it is widely acknowledged that digital therapeutics will play a significant role in the future delivery of healthcare, the method by which these innovations may be commissioned by the National Health Service, at scale, remains unclear. This study explores English health commissioners’ experiences of, and attitudes towards, adopting digital healthcare innovations.Methods37 commissioners and decision-makers from a range of sectors within the health profession were invited to participate in structured interviews to gather relevant examples of experience and opinions. 14 commissioners participated and the notes from the resulting interviews were interpreted using qualitative content analysis. Controlled interpretation was applied to the categorised responses, paraphrasing and classifying into themes.ResultsCommon determinants and barriers to adoption of digital mental health expressed during the interview process included commissioners’ lack of familiarity with technology, information governance, digital literacy of users and decision-makers.ConclusionsRecognition of identified barriers may be helpful for innovators when developing engagement and market access strategies and suggest areas for focus and further development within the commissioning process to accommodate digital health solutions.

scholarly journals Digital Predictors of Morbidity, Hospitalization, and Mortality Among Older Adults: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2 ◽  
Author(s):  
Sofia Daniolou ◽  
Andreas Rapp ◽  
Celina Haase ◽  
Alfred Ruppert ◽  
Marlene Wittwer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Health Outcomes ◽  
Digital Health ◽  
Meta Analysis ◽  
Design Development ◽  
Clinical Implementation ◽  
Care Needs ◽  
Health Technologies ◽  
Improve Health

The widespread adoption of digital health technologies such as smartphone-based mobile applications, wearable activity trackers and Internet of Things systems has rapidly enabled new opportunities for predictive health monitoring. Leveraging digital health tools to track parameters relevant to human health is particularly important for the older segments of the population as old age is associated with multimorbidity and higher care needs. In order to assess the potential of these digital health technologies to improve health outcomes, it is paramount to investigate which digitally measurable parameters can effectively improve health outcomes among the elderly population. Currently, there is a lack of systematic evidence on this topic due to the inherent heterogeneity of the digital health domain and the lack of clinical validation of both novel prototypes and marketed devices. For this reason, the aim of the current study is to synthesize and systematically analyse which digitally measurable data may be effectively collected through digital health devices to improve health outcomes for older people. Using a modified PICO process and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework, we provide the results of a systematic review and subsequent meta-analysis of digitally measurable predictors of morbidity, hospitalization, and mortality among older adults aged 65 or older. These findings can inform both technology developers and clinicians involved in the design, development and clinical implementation of digital health technologies for elderly citizens.

scholarly journals ProACT - A Digital Platform to Support Self-Management of Multiple Chronic Conditions: Findings in Relation to Engagement during a one-year Proof-of-Concept Trial (Preprint)

2020 ◽  
Author(s):  
Julie Doyle ◽  
Emma Murphy ◽  
Shane Gavin ◽  
Alessandra Pascale ◽  
Stephane Deparis ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Conditions ◽  
Digital Health ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
User Engagement ◽  
Proof Of Concept ◽  
Structured Interviews ◽  
Health Technologies ◽  
Care Approach

BACKGROUND Self-management, a core activity for older adults living with multiple chronic conditions (multimorbidity), is challenging, requiring the person to engage in multiple tasks such as symptom monitoring, recognition of exacerbations, medication adherence and inter-stakeholder communication. A digital, integrated care approach is a critical part of the solution, however, there is a dearth of literature on this topic. Furthermore, there is little research on older adults’ acceptability, usage and experiences of engaging with digital health technologies, particularly over long periods of time. OBJECTIVE The objectives were to (1) co-design and develop a digital health platform, called ProACT, to facilitate older adults self-managing multimorbidity, with support from their care network (CN); (2) evaluate end user engagement and experiences with the platform through a 12-month trial. METHODS The ProACT digital health platfrom is presented. The platform was evaluated in a year-long proof-of-concept (PoC) action research trial with 120 older persons with multimorbidity (PwMs) in Ireland and Belgium. Alongside the technology, participants had access to a clinical triage service responding to symptom alerts, and a technical helpdesk. Interactions with the platform during the PoC trial were logged to determine engagement, semi-structured interviews were conducted with participants and analysed using inductive thematic analysis methods, while usability and user burden were examined using validated questionnaires. RESULTS This article presents the ProACT platform and its components, along with findings on engagement with the platform and its usability. Of the 120 participants who took part, 24 withdrew before the end of the study while three passed away. The remaining 93 participants actively used the platform until the end of the trial, on average taking two or three health readings daily over the course of the trial, in Ireland and Belgium respectively. Participants reported ProACT to be usable and of low burden. Findings from interviews outline that participants experienced multiple benefits as a result of using ProACT, including improved self-management, improved health and wellbeing and support from the triage service. For those who withdrew, barriers to engagement were poor health and frustration when technology didn’t work as expected. CONCLUSIONS This is the first study to present findings from a longitudinal study of older adults using digital health technology to self-manage multiple chronic conditions. Our findings show that older adults sustained engagement with the technology and found it usable. Potential reasons for this include a strong focus on user-centred design and engagement throughout the project lifecycle, resulting in a platform that met user needs, as well as the integration of behavior change techniques and personal analytics into the platform. The provision of triage and technical support services alongside the platform during the trial were also important facilitators of engagement. INTERNATIONAL REGISTERED REPORT RR2-10.2196/preprints.22125

Remote Monitoring of Patient- and Family-Generated Health Data in Pediatrics

PEDIATRICS ◽  
2022 ◽  
Author(s):  
Carolyn Foster ◽  
Dana Schinasi ◽  
Kristin Kan ◽  
Michelle Macy ◽  
Derek Wheeler ◽  
...  
Keyword(s):  
Health Care ◽  
Digital Literacy ◽  
Care Delivery ◽  
Digital Health ◽  
Health Care Team ◽  
Models Of Care ◽  
Health Data ◽  
Care Needs ◽  
Case Examples ◽  
Health Technologies

Remote patient monitoring (RPM) is a form of telemedicine that involves the collection and transmission of health data from a patient to their health care team by using digital health technologies. RPM can be leveraged to aggregate and visualize longitudinal patient-generated health data for proactive clinical management and engagement of the patient and family in a child’s health care. Collection of remote data has been considered standard of care for years in some chronic pediatric conditions. However, software limitations, gaps in access to the Internet and technology devices, digital literacy, insufficient reimbursement, and other challenges have prevented expansion of RPM in pediatric medicine on a wide scale. Recent technological advances in remote devices and software, coupled with a shift toward virtual models of care, have created a need to better understand how RPM can be leveraged in pediatrics to improve the health of more children, especially for children with special health care needs who are reliant on high-quality chronic disease management. In this article, we define RPM for the general pediatric health care provider audience, provide case examples of existing RPM models, discuss advantages of and limitations to RPM (including how data are collected, evaluated, and managed), and provide a list of current RPM resources for clinical practitioners. Finally, we propose considerations for expansion of this health care delivery approach for children, including clinical infrastructure, equitable access to digital health care, and necessary reimbursement. The overarching goal is to advance health for children by adapting RPM technologies as appropriate and beneficial for patients, families, and providers alike.

Breaking barriers, building understanding

2021 ◽  
Vol 49 (1) ◽  
pp. 23-24
Author(s):  
Kelly Steelman ◽  
Charles Wallace
Keyword(s):  
Older Adults ◽  
Digital Literacy ◽  
Social Cognitive ◽  
Local Community ◽  
Literacy Skills ◽  
University Student ◽  
Cognitive Approach ◽  
Digital Community ◽  
Way Finding

In entering the digital realm, older adults face obstacles beyond the physical and cognitive barriers traditionally associated with accessibility. One of these obstacles, technology related anxiety, is particularly problematic because it discourages exploration and way finding, two behaviors critical to the development of digital literacy. We see opportunities to address this issue and bring isolated older adults into a larger digital community, while simultaneously offering our students with valuable first-hand experience learning about and addressing the challenges faced by capable people struggling with unfamiliar technology. Here, we describe our social-cognitive approach to training digital literacy skills, pairing university student tutors with learners from the local community.

scholarly journals Older Adults Engage With Personalized Digital Coaching Programs at Rates That Exceed Those of Younger Adults

2021 ◽  
Vol 3 ◽  
Author(s):  
Sarah A. Graham ◽  
Natalie Stein ◽  
Fjori Shemaj ◽  
OraLee H. Branch ◽  
Jason Paruthi ◽  
...  
Keyword(s):  
Older Adults ◽  
Technology Use ◽  
Chronic Conditions ◽  
Digital Health ◽  
Cost Effective ◽  
Health Programs ◽  
Care Providers ◽  
Younger Adults ◽  
Health Technologies ◽  
Healthcare Needs

Background: The US population is aging and has an expanding set of healthcare needs for the prevention and management of chronic conditions. Older adults contribute disproportionately to US healthcare costs, accounting for 34% of total healthcare expenditures in 2014 but only 15% of the population. Fully automated, digital health programs offer a scalable and cost-effective option to help manage chronic conditions. However, the literature on technology use suggests that older adults face barriers to the use of digital technologies that could limit their engagement with digital health programs. The objective of this study was to characterize the engagement of adults 65 years and older with a fully automated digital health platform called Lark Health and compare their engagement to that of adults aged 35–64 years.Methods: We analyzed data from 2,169 Lark platform users across four different coaching programs (diabetes prevention, diabetes care, hypertension care, and prevention) over a 12-month period. We characterized user engagement as participation in digital coaching conversations, meals logged, and device measurements. We compared engagement metrics between older and younger adults using nonparametric bivariate analyses.Main Results: Aggregate engagement across all users during the 12-month period included 1,623,178 coaching conversations, 588,436 meals logged, and 203,693 device measurements. We found that older adults were significantly more engaged with the digital platform than younger adults, evidenced by older adults participating in a larger median number of coaching conversations (514 vs. 428) and logging more meals (174 vs. 89) and device measurements (39 vs. 28) all p ≤ 0.01.Conclusions: Older adult users of a commercially available, fully digital health platform exhibited greater engagement than younger adults. These findings suggest that despite potential barriers, older adults readily adopted digital health technologies. Fully digital health programs may present a widely scalable and cost-effective alternative to traditional telehealth models that still require costly touchpoints with human care providers.

Digital Health for Geriatric Oncology

2018 ◽  
pp. 1-12 ◽  
Author(s):  
Ramin Fallahzadeh ◽  
Seyed Ali Rokni ◽  
Hassan Ghasemzadeh ◽  
Enrique Soto-Perez-de-Celis ◽  
Armin Shahrokni
Keyword(s):  
Older Adults ◽  
State Of The Art ◽  
Digital Health ◽  
Unmet Need ◽  
Geriatric Oncology ◽  
Symptom Assessment ◽  
Health Technologies ◽  
Cancer Management ◽  
Study Protocols ◽  
Health Related

In this review, we describe state-of-the-art digital health solutions for geriatric oncology and explore the potential application of emerging remote health-monitoring technologies in the context of cancer care. We also discuss the benefits and motivations behind adopting technology for symptom monitoring of older adults with cancer. We provide an overview of common symptoms and of the digital solutions–designed remote symptom assessment. We describe state-of-the-art systems for this purpose and highlight the limitations and challenges for the full-scale adoption of such solutions in geriatric oncology. With rapid advances in Internet-of-things technologies, many remote assessment systems have been developed in recent years. Despite showing potential in several health care domains and reliable functionality, few of these solutions have been designed for or tested in older patients with cancer. As a result, the geriatric oncology community lacks a consensus understanding of a possible correlation between remote digital assessments and health-related outcomes. Although the recent development of digital health solutions has been shown to be reliable and effective in many health-related applications, there exists an unmet need for development of systems and clinical trials specifically designed for remote cancer management of older adults with cancer, including developing advanced remote technologies for cancer-related symptom assessment and psychological behavior monitoring at home and developing outcome-oriented study protocols for accurate evaluation of existing or emerging systems. We conclude that perhaps the clearest path to future large-scale use of remote digital health technologies in cancer research is designing and conducting collaborative studies involving computer scientists, oncologists, and patient advocates.

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