Abstract

Ambient assisted living (AAL) technologies present one approach to counter the challenges of demographic change in terms of an aging population, rising care needs, and lacking care personnel by supporting (older) people in need of care and enabling a longer and more independent staying at own home. Although the number of studies focusing on AAL users' acceptance and perception has increased in the last years, trade-off decisions—the weighing of perceived benefits and barriers of technology usage—have not been studied so far. Nevertheless, this is of high relevance: A realistic evaluation of adoption behaviors in different stakeholders (patients, care personnel) requires an understanding of exactly the weighing process of benefits against the barriers in line with the decision of the final willingness to use AAL technology. The current study applied a conjoint analysis approach and investigates people's decision behavior to use an AAL system for a family member in need of care. Study participants (n = 140) had to decide between realistic care scenarios consisting of different options of two benefits (increase in safety, relief of caring burden of relatives) and two barriers (access to personal data and data handling) of technology usage. Results revealed data access and privacy to be most relevant for the decision to use AAL technology at home. However, care experience essentially influenced the decision patterns. For the care experienced group, data access should be limited to most trusted persons and close relatives, rather than to medical professionals. The most important reasons to use AAL are the emotional relief and the felt safety for the person in care. For care novices, in contrast, data access should be in the exclusive responsibility of medical professionals. The reasons that militate in favor of using AAL technology are the increase in process efficiency and medical safety. The results are useful to develop user-tailored technology concepts and derive user-specific communication guidelines within and across clinical and home care contexts.

Highlights

  • Almost all over the world, demographic change presents major challenges for societies and health care systems: an increased longevity, lower fertility rates, and lacking care personnel lead to aging societies facing shortages in the care sector resulting in more and more older people in need of care, who have to be supported either in their home environment or in professional care institutions [1, 2]

  • The present study aimed for a holistic investigation of laypeople’s decisions between selected perceived benefits and barriers of ambient assisted living (AAL) technology usage taking the perspective of a caring relative into account

  • Answering RQ1, privacy operationalized as data access represented the most important criterion for the decisions between perceived benefits and barriers of the AAL system’s usage (27.5%, SD = 12.1)

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Summary

Introduction

Almost all over the world, demographic change presents major challenges for societies and health care systems: an increased longevity, lower fertility rates, and lacking care personnel lead to aging societies facing shortages in the care sector resulting in more and more older people in need of care, who have to be supported either in their home environment or in professional care institutions [1, 2]. Reasons for the hampered rollout and the prevention of a broad adoption are related to concerns about the technical complexity, economic burdens, lack of support by health insurances [11,12,13,14], and potential fears of care persons to be controlled by supervisors and colleagues [15] Beyond these practical reasons, one major source of the reluctance lies in the missing public acceptance of the systems and a deeply grained uncertainty whether those systems might bring more positive than negative changes [16] [for an overview, see Blackman et al [3]]. To pave the way for future users’ acceptance and technology adoption in real life, it is necessary to understand future users’ perspectives and perception of assisting technologies and systems

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