Application for Older Adults to Ask for Help from Volunteers Through Television: Design and Evaluation of a High Visual-Fidelity Prototype

In the last years, voice has been used as an interaction mode in several devices such as smart speakers, mobile devices or television (TV). However, there seems to be a lack of practical recommendations about how visual interfaces can be designed to support the use of voice input in TV applications in certain tasks in a way to take advantage of the full potential of this interaction mode. This paper aims to present the design strategies adopted in a TV application targeting older adults which allows them to request help from a group of volunteers in daily life tasks and where voice is used in certain tasks such as to make the request instead of using the TV remote control. These strategies are discussed around three dimensions considered especially important when using voice-based input: information for voice usage, keeping the user informed and prompts to clarify system's doubts. The paper also presents the results of usability tests with potential users, in order to identify usability problems regarding the use of voice-based input to make the request and to gather information about how improve the usability of this feature. Study results indicate positive attitudes towards the use of voice input method and that older adults considered the use of voice easier than if they had to use a TV remote control to make a request. In a context where voice interaction appears as relevant for older adults, this study can contribute to more informed design strategies in multimodal interaction targeting this group.

BackgroundEvidence of the harmful health effects of sedentary behavior is emerging; however, little is known about domain-specific sedentary behavior correlates. Thus, in this study, the personal and behavioral correlates of total and domain-specific sedentary behavior in older Taiwanese adults were identified.MethodThe sample comprised 1046 older adults (aged ≥65 years). Cross-sectional data on self-administered personal behavioral variables and time spent engaging in domain-specific sedentary behavior were obtained using computer-assisted telephone-based interviews. Binary logistic regression analyses were performed.ResultsThose aged older than 75 years were less likely to have longer total sedentary, computer use, and transportation times. Compared to women, older men were more likely to have longer total sedentary and transportation times. Older adults with low educational levels were less likely to have longer total sedentary and computer use times but were more likely to have an excessive television (TV) viewing time (≥2 h/day). Older adults who lived alone and were overweight had a longer TV viewing time. Furthermore, unemployment was associated with an excessive TV viewing time and shorter transportation time. Older adults residing in nonmetropolitan areas had lower total sedentary, TV viewing, and computer use times. Older adults who engaged in insufficient leisure time physical activity were more likely to have longer total sedentary and transportation times.ConclusionsBoth common and distinct personal and behavioral factors were associated with total and domain-specific sedentary behavior. Interventions for reducing total and domain-specific sedentary behavior should focus on both common and distinct subgroups of the Taiwanese older population.

The effects of volunteering on loneliness among lonely older adults: the HEAL-HOA dual randomised controlled trial.

Intensive glucose lowering in older adults with diabetes leads to increased risks with minimal benefits. Surveys indicate that clinician confidence for individualizing glycemic goals and regimens remains low. We created an interactive workshop and clinical tool kit to improve clinician knowledge of safe diabetes management in older adults. Finding the Sweet Spot was a 1-hour workshop taught by pharmacists to medical and pharmacy learners that introduced a five-step framework for diabetes management in older adults. The interactive presentation included cases and a clinical tool kit based on current recommendations from the American Diabetes Association and American Geriatrics Society. Pilot workshops were held for 6 months, allowing for real-time revisions based on feedback; final implementation occurred for 6 months thereafter. We evaluated learner self-efficacy (via a 5-point Likert scale) and knowledge (via multiple-choice questions) of diabetes management in older adults before and after the workshop. Thirty learners participated in Finding the Sweet Spot (70% medicine, 30% pharmacy). The percentage of confident learners increased from 55% to 97% (p < .05) after the workshop. All learners demonstrated improvements in knowledge, with the mean score on the knowledge assessment increasing from 61% to 80% (p < .05). Via open-ended feedback, learners expressed satisfaction and found the clinical tool kit especially helpful. Our Finding the Sweet Spot workshop demonstrated statistically significant changes in self-efficacy and knowledge among learners, indicating that this interactive workshop improves medical and pharmacy provider confidence and skills in caring for older adults with diabetes.

Age-friendly smartphone launchers are tools designed to enhance smartphone handling among older adults with cognitive and functional limitations. Although evidence exists about the positive effects of age-friendly smartphone launchers on older adults' usability performance in general, little is known about how the design and interface complexity of these launchers affect their interface usability effectiveness and efficiency compared with standard Android smartphone interfaces. Thus, in this study, a randomized crossover experiment involving 50 older smartphone users, aged 60 years and above, was guided by the principles of summative usability testing to assess whether an age-friendly launcher performs better than a standard Android launcher performs and to investigate the relationship between the user interface complexity and usability performance of launchers. The results of usability tests in which each participant solved 10 tasks on both launchers indicate that the two tested launchers had comparable effectiveness (i.e. completeness with which participants achieved the test tasks' goals), whereas the age-friendly launcher marginally outperformed its standard Android counterpart in terms of efficiency (i.e. the amount of time used by participants to solve the test tasks). The results also demonstrate that lower user interface complexity is associated with higher effectiveness and efficiency, suggesting that age-friendly smartphone launchers might lead to higher adoption rates of smartphones among older adults if interface designers could reduce their cognitive complexity by limiting the number of steps and alternative paths for task completion.

The growing aging population globally requires accessible digital healthcare services to maintain a healthy lifestyle. Smartphones have the potential to connect individuals with digital healthcare services. However, whether older adults perceive smartphones as a convenient means of accessing these services remains uncertain. This study aimed to investigate the perspectives of older Indian adults regarding smartphone adoption and its usage in healthcare services. For this, a mixed-methods approach combining quantitative and qualitative methods was employed. A total of 59 older adults participated in the study, of whom 54 completed survey questionnaires, 15 engaged in semi-structured interviews, and 10 participated in both studies. The findings reveal that older adults have adopted smartphones for various purposes after initially facing hindrances, often with assistance from family members. However, the use of smartphone-based healthcare applications remains minimal. These findings suggest that addressing the challenges older adults face with user interface design will enhance their use of healthcare applications. Thus, healthcare applications must feature a user-friendly interface specifically tailored for older adults. Additionally, familiar and popular application-inspired interfaces, social and family support, co-designing, digital health awareness, and training programmes can further promote the adoption of smartphone-based healthcare applications among older adults.

The purpose of this study was to examine differences between older and younger listeners in the ability to sequentially attend to and ignore words. Participants (n = 13 older adults and 13 younger adults) completed a temporally interleaved word recognition task. On each trial, 10 words were presented, and participants were instructed to repeat back every other word while ignoring the intervening words. Three variables were examined: (1) whether the word strings that were to be attended and to be ignored created syntactically correct sentences; (2) whether the to-be-attended and to-be-ignored words were presented from the same or from different spatial locations; and (3) whether the five target words in each trial (and the five distractor words in each trial) were spoken by a single talker or by five different talkers. In addition, digit-span forward and digit-span backward were measured and used as variables in correlation analyses. As a group, the younger participants outperformed the older listeners, particularly when the to-be-attended and to-be-ignored words were presented from the same spatial location (versus when they were presented with spatial separation). Compared with the younger participants, older listeners also made more error responses that were to-be-ignored words, although the proportion of errors that were not responses involving masking words did not significantly differ between groups. Scores on the digit-span-forward test (but not digit-span-backward scores or the degree of hearing loss) were associated with older individuals' performance on this temporally interleaved speech-recognition task. The overall pattern of results suggests that factors other than threshold elevation contribute to speech-understanding problems experienced by older listeners. However, although younger adults outperformed older listeners on this interleaved sentence task, older and younger adults benefited, to a similar extent, from spatial separation of the to-be-attended and to-be-ignored words, and from having a consistent target talker within a trial.

The aim of this study was to investigate the television (TV) consumption patterns (viewing behavior and motivation) of older adults in Wuhan, China, during the COVID-19 pandemic and its impact on older adults' mental health, particularly in relation to COVID-19-induced fear. A questionnaire survey was conducted with 405 older adults in Wuhan, China. The data were analyzed using a structural equation model to understand the relationship between TV viewing behavior, motivation, and fear related to COVID-19. The findings indicate that the motivation to watch TV has a positive influence on viewing behavior among older adults during the pandemic. However, this motivation negatively impacts their COVID-19-related fear. Furthermore, a negative correlation was observed between viewing behavior and fear. The primary motivations for TV viewing among older adults during the pandemic were identified as social interaction and emotion management, followed by information seeking and value expression. The findings suggest that TV viewing plays a significant role in the mental well-being of older adults during the COVID-19 pandemic. By addressing the motivations of social interaction, emotion management, information seeking, and value expression, public health organizations and TV stations can contribute to the mental health of this vulnerable population.

Having a meaningful life is one of the most important goals among older adults. This paper provided an overview of a programme of research and practice on meaningful aging among older Chinese adults. It firstly describes the process of developing and validating a relational conceptualization of a meaningful life (i.e., spiritual well-being) among older Chinese adults from its conceptual roots, development, and validation process since 2009 through an academic–community collaboration. In brief, a meaningful life was attributed to five relationships centered on older adults: the relationship with self, relationship with family, relationship with friends, relationship with people other than family and friends, and relationship with the environment. Secondly, the paper explains a validated assessment tool (e.g., the Spirituality Scale for Chinese Elders, (SSCE)) that was developed accordingly. Evidence-based stratified interventions derived from the conceptualization and operationalization were then introduced including a professionally led group intervention protocol, a volunteer-partner intervention protocol, and a self-help-oriented intervention, which shared eight-session core contents. Good practices in applying various interventions among older adults with diversified backgrounds (e.g., health status, age, and gender) and various service settings (e.g., community, long-term care facilities, and home visits) were then synthesized. Thirdly, feedback from stakeholders is illustrated, and good practices are discussed. In conclusion, a culturally sensitive and meaningful aging framework is timely and impactful for the globally aging world.

This paper discusses the topic of evaluating systems for health and entertainment when specifically targeting the older adult population. Building upon and extending on two previous studies that used a well-known discount usability evaluation method, heuristic evaluation, as well as a list of heuristics specifically created to evaluate smartphone apps that keep older adults' needs and characteristics in mind, this paper presents the assessment of the previous aggregated list of heuristics by ten experts after using it. Results show that the list of heuristics used in our previous studies does receive a positive assessment by the ten evaluators in terms of their appropriateness, completeness, usefulness, and clarity. Moreover, this paper reinforces that despite being a conventional and mature method, heuristic evaluation does offers valuable feedback regarding user interface flaws.

The age group of 65 years has been described as the fastest growing demographic in the world. As life expectancy increases, older adults prefer to remain independent at home. Smart Home systems and Assistive Technologies have been developed to enable older adults to live in their own homes as they age, enhancing safety, independence and quality of life. Although considerable Smart Home mobile applications exist focused on older adult’s wellbeing, they still face considerable challenges in usability, feasibility and accessibility regarding design of interfaces. There is a gap in recent research on evaluation of User Interface (UI) designed or adapted to address older adults needs and abilities. The paper takes part of an ongoing project evaluation stage, for a smart home and health monitoring system, applied in two stages: (i) heuristic evaluation and (ii) remote user testing. The main objective of the paper is to focus on the second evaluation stage, that took place with end users, applying unmoderated remote usability testing, due to Covid-19 pandemic. According to the System Usability Scale (SUS) and Net Promoter Score (NPS) techniques it could be able to quantify the users experience and measure the level of satisfaction related to the smart home and health monitoring system. The SUS results identified that the system’s usability was considered acceptable with a final score of 65,6. It was concluded that the unmoderated test with a SUS post-questionnaire can be a complex method to apply with older adults. The SUS questionnaire could lead to mistakes and misinterpretation, some contradictory results could be related to this complexity among older adults, and this could lead to a major impact on overall SUS scores. In addition, the NPS metric was identified as not the appropriate to measure user satisfaction with a small sample of users as SUS technique. It is concluded that findings should be supported by applying individual moderated tests with more end users to provide insights to designers and developers to create more usable interfaces to address the needs and abilities of the older adults.KeywordsSmart homeAge-friendly designUser interface designRemote user testing

Respiratory viral infections are typically more severe in older adults. Older adults are more vulnerable to infection and do not respond effectively to vaccines due to a combination of immunosenescence, so-called inflamm-ageing, and accumulation of comorbidities. Although age-related changes in immune responses have been described, the causes of this enhanced respiratory disease in older adults remain poorly understood. We therefore performed volunteer challenge with respiratory syncytial virus (RSV) in groups of younger and older adult volunteers. The aim of this study was to establish the safety and tolerability of this model and define age-related clinical, virological, and immunological outcomes. In this human infection challenge pilot study, adults aged 18-55 years and 60-75 years were assessed for enrolment using protocol-defined inclusion and exclusion criteria. Symptoms were documented by self-completed diaries and viral load determined by quantitative PCR of nasal lavage. Peripheral blood B cell frequencies were measured by enzyme-linked immunospot and antibodies against pre-fusion and post-fusion, NP, and G proteins in the blood and upper respiratory tract were measured. The study was registered with ClinicalTrials.gov, NCT03728413. 381 adults aged 60-75 years (older cohort) and 19 adults aged 18-55 years (young cohort) were assessed for enrolment using protocol-defined inclusion and exclusion criteria between Nov 12, 2018, and Feb 26, 2020. 12 healthy volunteers aged 60-75 years and 21 aged 18-55 years were inoculated intranasally with RSV Memphis-37. Nine (67%) of the 12 older volunteers became infected, developing mild-to-moderate upper respiratory tract symptoms that resolved without serious adverse events or sequelae. Viral load peaked on day 6 post-inoculation and symptoms peaked between days 6 and 8. Increases in circulating IgG-positive and IgA-positive antigen-specific plasmablasts, serum neutralising antibodies, and pre-F specific IgG were similar younger and older adults. However, in contrast to young participants, secretory IgA titres in older volunteers failed to increase during infection and, unlike serum IgG, did not correlate with protection. Better understanding of age-related differences in clinical outcomes and immune correlates of protection can overcome reduction in vaccine efficacy with advancing age. We identify correlates of protection in older adults, revealing previously unrecognised factors which might have implications for targeted vaccine discovery and drug development in this vulnerable group. Medical Research Council and GlaxoSmithKline EMINENT Consortium.

As the number of older adults who are using the internet increases, there is a need to consider accessibility in mobile application design. Web accessibility means that users of all groups should be able to access information easily. Telemedicine systems are now widely available, including in Indonesia. Older adults are among the user groups for which a telemedicine system is targeted. The question is whether and how far has the current telemedicine system has addressed accessibility in its application design. Halodoc is a well-known telemedicine system in Indonesia. In this research, we tested Halodoc mobile application's accessibility using two methods: scanner test using Accessibility Scanner tool and user test. From the scanner test, many accessibility issues are found, such as small touch targets, insufficient text, and poor image contrasts. From the user tests, we observed that users needed more than two minutes to finish a task. We also found that the accessibility issues were caused not only by non-compliance with WCAG 2.0 guidelines but also by the user interface design.

Chronic cytomegalovirus (CMV) infection may favor the development of immunosenescence and inflammation that impair vaccine responses, including COVID-19. In addition, the polymorphism of the interferon-lambda gene (IFNλ) affects COVID-19 immune responses in older adults. We aimed to investigate the impact of IFNλ polymorphism (IL28B gene-rs12979860) on the immune/inflammatory response to vaccination with CoronaVac for COVID-19 in older adults who were CMV-seropositive. Blood samples from 42 CMV-seropositive older adults (73.7 ± 4.5 years) were collected before and 30 days after immunization with a second dose of the CoronaVac vaccine to evaluate the immune/inflammatory response. At genotyping, 20 subjects were homozygous for the C/C alleles (Allele-1 group), 5 were homozygous for the T/T Alleles (Allele-2 group), and 17 were heterozygous (C/T, Alleles-1/2 group). The Allele-1 group showed higher IgG levels for COVID-19 (p = 0.0269) and intermediate monocyte percentage (p = 0.017), in contrast to a lower non-classical monocyte percentage (p = 0.0141) post-vaccination than pre-vaccination. Also, this group showed that IgG levels for CMV were positively associated with a systemic pro-inflammatory state and senescent T cells (CD4+ and CD8+). The Allele-2 group presented higher IFN-β levels at pre- (p = 0.0248) and post-vaccination (p = 0.0206) than the values in the Allele-1 and Alleles-1/2 groups, respectively. In addition, the Allele-2 and Alleles-1/2 groups showed that IgG levels for COVID-19 were positively associated with a balanced systemic inflammatory state. CMV-seropositivity in older adults who had Allele-1 could lead to an unbalanced systemic inflammatory state, which may impair their antibody response to COVID-19 vaccination compared to other volunteer groups.

ObjectiveStudies have suggested that frequent participation in social groups contributes to the well-being of older people. The primary aim of this study was to identify the number of days older adults should participate in the activities of social groups to maintain their health for 4 years. This study also aimed to examine whether the effective frequency differs by the type of social group activity.MethodWe examined a prospective cohort of 1,320 community-dwelling older adults over 65 years of age, who responded to both a baseline and a follow-up mail survey, in a suburban city of Tokyo, Japan. The dependent variable was the change in functional competence during 4 years. Logistic regression analyses were conducted to examine the effects of participation in the activities of the 5 most common social groups among older Japanese on maintaining functional competence.ResultsNine hundred and ninety-four participants (76.5%) maintained their functional competence for 4 years. The results of the logistic regression analyses showed that participating in alumni groups less than once a month and being an inactive member were associated with higher odds of maintaining functional competence, after controlling for socioeconomic, demographic and baseline health status. Additionally, the odds of maintaining functional competence for 4 years increased upon participating in volunteer groups once a month or more. These results were also confirmed using logistic regression analysis, even after adjustment for the effects of participation in other social groups.DiscussionThe results indicated the effectiveness of volunteer activities that fulfill a social role in maintaining health. Therefore, older adults should be encouraged to participate in activities of volunteer groups at least once a month. Additionally, older adults can obtain positive health outcomes through less frequent participation in alumni groups, compared with the activities of volunteer groups.