Older Users Research Articles

Mobile App for Patients With Chronic Obstructive Pulmonary Diseases During Home-Based Exercise Care: Usability Study.

Digital health tools have demonstrated promise in the treatment and self-management of chronic diseases while also serving as an important means for reducing the workload of health care professionals (HCPs) and enhancing the quality of care. However, these tools often merely undergo large-scale testing or enter the market without undergoing rigorous user experience analysis in the early stages of their development, leading to frequent instances of low use or failure. This study aims to assess the usability of and satisfaction with a mobile app designed for the clinical monitoring of patients with chronic obstructive pulmonary disease undergoing pulmonary rehabilitation at home. This study used a mixed methods approach involving two key stakeholders-patients with chronic obstructive pulmonary disease and HCPs-across three phases: (1) mobile app mock-up design, (2) usability testing, and (3) satisfaction evaluation. Using convenience sampling, participants were grouped as HCPs (n=12) and patients (n=18). Each received a tablet with mock-ups for usability testing through interviews, with audio recordings transcribed and analyzed anonymously in NVivo12.0, focusing on mock-up features and usability insights. Task difficulty was rated from 1 (very easy) to 5 (very difficult), with noncompletion deemed a critical error. Usability satisfaction was measured on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). The research indicated a notable difference in app usability perceptions: 66% (8/12) of HCPs found tasks "very easy," compared to only 22% (4/18) of patients. Despite this, no participant made critical errors or withdrew, and satisfaction was high. HCPs completed tasks in about 20 minutes, while patients took 30. Older adults faced challenges with touch screens and scroll menus, suggesting the need for intuitive design aids like auditory support and visual health progress indicators, such as graphs. HCPs noted potential data delays affecting service, while non-native-speaking caregivers faced interpretation challenges. A secure pairing system for privacy in teleconsultations proved difficult for older users; a simpler icon-based system is recommended. This study highlights the need to consider stakeholder abilities in medical app design to enhance function implementation. Most HCPs (11/12, 91%) found the app intuitive, though they recommended adding icons to show patient progress to support clinical decisions. In contrast, 62% (11/18) of patients struggled with tablet navigation, especially with connectivity features. To ensure equitable access, the design should accommodate older users with diverse abilities. Despite challenges, both groups reported high satisfaction, with patients expressing a willingness to learn and recommending the app. These positive usability evaluations suggest that, with design improvements, such apps could see increased use in home-based care.

EXPRESS: Individual control of input rate improves recall of spoken discourse by adult users of cochlear implants: An exploratory study.

Although cochlear implants (CI) successfully replace the sense of hearing, they do not restore natural hearing. Still, CI users adapt to this novel signal, reaching meaningful levels of speech recognition in clinical tests that focus on repetition of words and short sentences. However, many patients who score above average in clinical speech perception tests complain that everyday speech interactions are both difficult and cognitively draining. In part this difficulty may be due to the naturally rapid pace of everyday discourse. We report a study in which 12 CI users aged 23 to 77, recalled multi-sentence discourse presented without interruption, or in the condition of interest, when passages were paused at major linguistic boundaries, with participants given control of when to initiate the next segment. Comprehension of the discourse structure was based on a formalized representational system that organizes discourse elements hierarchically to index the relative importance of different elements to the overall understanding of the discourse. Results showed (a) better recall when CI users were allowed to control the discourse pace, (b) an overall effect of aging, with older CI users recalling discourse less accurately, (c) better recall for passages with higher average inter-word predictability, (d) a "semantic hierarchy effect" reflected by better recall of main ideas versus minor details, (e) an attenuation of the semantic hierarchy effect for low predictability passages. Results underscore the benefits of extra processing time in addressing CI listening challenges and highlight the limited ecological validity of single-word or single-sentence speech recognition tests.

Older Migrant Patients and Health Care Professionals' Experiences With Digital Translation Tools in Care Interactions: A Qualitative Literature Review.

Finding solutions to communicate difficulties in care interactions between health care professionals and older migrant patients may be facilitated by the use of digital translation tools. The aim was to explore older migrant patients' and health professionals' experiences using digital translation tools in transcultural care. A systematic qualitative literature review, based on nine quality assessed articles published 2009 to 2024 from five databases, and analyzed using thematic analysis. Three themes and eight subthemes emerged: advantages of using translation tools describes the benefits experienced using such tools; limitations and challenges highlights the problems identified in their use; and improvement suggestions for the functions of the translation apps describes adjustments and developments of the translation tools. Digital translation used in basic care, may enhance relationships and equity of care, but should not substitute human interpreters in complex care conversations. Translation tools need to be developed according to older users' abilities.

The Cross-sectional Relationship Between Use of Automatic Insulin Delivery Systems and Eating Styles Among Older Adults With Type 1 Diabetes: An Exploratory Analysis.

The number of older adults with type 1 diabetes (T1D) is increasing. Use of automated insulin delivery (AID) may influence nutrition and eating behaviors. We explored how three eating styles (restrained, external, emotional) differ between older adults with T1D who use and do not use AID. We administered a one-time electronic survey from September to November 2023 to adults ≥65 years with T1D receiving care through a university-affiliated hospital system. Clinical and demographic information was collected from medical records. Eating styles were characterized with the Dutch Eating Behavior Questionnaire. Our sample (n = 77, 95% non-Hispanic white) had mean (SD) age: 71.8 (4.1) years, diabetes duration: 33 (18) years, hemoglobin A1c (HbA1c): 6.83 (1.12%), and body mass index (BMI): 27.3 (4.7) kg/m2. Respondents reported variable eating styles, with the highest median scores for external and restrained eating and lower scores for emotional eating. Older adults using AID systems had higher median scores for emotional and external eating, and more varied restrained eating scores compared to those not using AID systems. Weak correlations were found between eating styles and HbA1c (restrained: r = -0.14; external: r = 0.08; emotional: r = 0.15), as well as between restrained (r = 0.09) and external (r = 0.04) eating with BMI, with a small correlation between emotional eating and BMI (r = 0.27). Eating styles may vary between older adult AID users and non-users. To our knowledge, this is the first study to characterize eating styles in this population, though generalizability is limited by a non-diverse and small sample with high technology use overall (eg, continuous glucose monitoring, insulin pumps).

Gaining Technological Autonomy and Soci-emotional Support: A Case Study of How and Why Chinese Older Adults Engage with a Semi-acquaintance Online Community

Older adults are often underserved and marginalized in technology engagement due to their reluctance and the barriers they face in adopting and engaging with mainstream technology. However, Pinxiaoquan, a social feature of an e-commerce platform in China, has gained a large number of older users. This work investigates how and why Chinese older adults use Pinxiaoquan, aiming to unveil the underlying logic and inspire technology-inclusive design for older adults. To this end, we conducted a mixed-methods qualitative study over two years, which included online observation, and semi-interview. We found that Pinxiaoquan's success among Chinese older adults is mainly due to its ability to inspire technological autonomy and provide social-emotional support. Rather than simply lowering technical barriers or asking them to seek assistance outside the platform, Pinxiaoquan builds a semi-acquaintance online community based on location and social ties that allows older adults to realize technical support mutually. Pinxiaoquan also fulfills their social-emotional needs, such as free online expression, memory creation and preservation, relationship expansion and maintenance, and a sense of value. Our research contributes to the HCI community by highlighting the importance of improving older adults' technology autonomy following their specific social and cultural background and social-emotional needs. This work also provides unique insights and implications for building inclusive technology for the growing aging population.

A Study on Consumer Preference of UPI With Reference to Ahmedabad City

This study investigates the associations between age and preferences for various payment methods, particularly focusing on Unified Payments Interface (UPI). Utilizing a quantitative approach, we tested multiple alternative hypotheses to explore how age influences payment preferences and perceptions. Results indicate that younger consumers tend to favor UPI due to its convenience, while older adults exhibit a preference for traditional payment methods such as debit and credit cards. Concerns about security and usability are notably more pronounced among older users, suggesting the need for tailored educational initiatives and user-friendly designs. The findings contribute to existing consumer behavior theories by integrating age as a critical factor in technology adoption. Practical implications emphasize the importance of targeted marketing strategies, enhanced user experiences, and effective communication regarding security features to foster greater acceptance of digital payment systems across all demographics. Recommendations for future research include longitudinal studies, cross-cultural comparisons, and an exploration of emerging technologies in the payment landscape. Understanding these dynamics is crucial for stakeholders aiming to enhance digital payment adoption and ensure inclusivity in the financial ecosystem

Comfort of Wrist-Worn Devices: Development of an Assessment Tool and Measurement of Comfort-Discomfort Pressure for Older and Younger Users

Wrist-worn devices hold significant potential for health monitoring, particularly for older people. However, the adoption and continuous usage of these devices are heavily affected by wearing comfort. Currently, there is still a lack of validated assessment tools specifically developed to evaluate the comfort of such devices. Additionally, while pressure is critical for both proper device placement and maintaining comfort, quantitative references for suitbale pressure levels are scarce. Moreover, the impact of age difference on comfort perceptions have been largely overlooked. To address these gaps, we conducted two experiments involving 18 older and 18 younger participants. In Experiment 1, we gathered comfort evaluations from participants while wearing the devices in both home/office and exercise scenarios. In Experiment 2, we focused on pressure, measuring the pressure on participants’ wrists under three strap material conditions and collecting their corresponding comfort evaluations. The results established three dimensions of comfort: movement comfort, thermophysiological comfort, and contact comfort, with their relative importance varying by age and use scenario. Also, we identified comfort-discomfort pressure ranges for both age groups, highlighting the influence of strap material and age on comfort perceptions. These findings offer valuable design guidance for manufacturers and enhance understanding of wrist-mounted device comfort.

Youth activism and (de)personalized remix on TikTok

ABSTRACT Social media has provided everyday actors with a platform to share their personal stories and ideas. This has had a profound effect on activism, as movements are increasingly built up and amplified through the circulation of participants’ individualized motivations, experiences, and sentiments. TikTok has emerged as a salient site for studying this turn: it has proven to be a highly successful tool in activist campaigns, strongly affords personalized communication, and supports a main user base of young people known for emphasizing self-expression in their online participation. Since remix is the core form of sharing on TikTok, users are encouraged to insert and articulate themselves not only in the process of content creation, but in the process of circulation as well. Here, we focus on the way remix is exploited as a mode of personalizing activist content on TikTok, particularly among young users. We do so by qualitatively coding and analyzing remixed content associated with the digital activist organization Gen-Z for Change. We find that, despite expectations based on prior research and the observed behavior of older users, young users tended to resist personalization in their remix strategies. Yet, they simultaneously managed to assert their presence in ways that are meaningful on the app. Our results elaborate on digital activist strategies and the role of platform affordances therein, and add important nuance to common conceptions of youth political participation styles.

A Roadmap for the Design of a Public-participation Geographic-Information System to Support Urban Ageing

Geospatial technologies have the potential to transform the lives of older adults by providing them with necessary tools to navigate their local communities, access services, connect with others, and access valuable information. However, the usability and accessibility of such technologies often fall short of the needs of older adults. Many existing geospatial tools are not designed with the needs and preferences of older adults in mind; this can lead to usability challenges and limit their usage. This paper explores a participatory approach in developing an inclusive geodata-collection tool that is specifically tailored to older users’ needs. The paper also highlights the importance of incorporating user-centered design principles, participatory design methods, and accessibility guidelines throughout the entire geodata-tool-development process. It also emphasizes the need for ongoing user engagement and feedback in order to ensure that the tool remains relevant and usable in the evolving digital landscape. This participatory approach has resulted in a tool that is easy to use and accessible for older adults; it is available in various languages, thus ensuring that the elderly can actively participate in the prototype’s creation and contribute to the collection of the geospatial information that reflects their lived experiences and needs.

Ecommerce and Public Health: Managing the Digital Transformation of Healthcare Services

The study investigates the impact of demographic factors, usage frequency, and professional roles on user satisfaction with digital health platforms. A sample of 300 participants, including healthcare professionals, platform operators, and patients, was analyzed to assess the role of age, gender, professional role, and frequency of platform use on satisfaction levels. The results show that the gender did not significantly influence satisfaction, suggesting that platforms may cater equally to both male and female users. Multivariate Analysis of Variance (MANOVA) revealed that professional role also significantly influenced perceptions of digital healthcare transformation and willingness to adopt new services, with platform operators displaying the most positive views. Patients, however, showed more reluctance to adopt new services, suggesting that additional trust-building measures are needed for wider adoption. The study concludes that digital health platforms must prioritize user experience across demographics, particularly focusing on older users and patients, to increase satisfaction and engagement. Collaborating with healthcare professionals in platform development and enhancing communication about the benefits of digital health services can drive greater adoption and satisfaction.

A Bibliometric Analysis Exploring the Acceptance of Virtual Reality among Older Adults: A Review

In recent years, there has been a widespread integration of virtual reality (VR) technology across various sectors including healthcare, education, and entertainment, marking a significant rise in its societal importance. However, with the ongoing trend of population ageing, understanding the elderly’s acceptance of such new technologies has become a focal point in both academic and industrial discourse. Despite the attention it garners, there exists a gap in understanding the attitudes of older adults towards VR adoption, along with evident needs and barriers within this demographic. Hence, gaining an in-depth comprehension of the factors influencing the acceptance of VR technology among older adults becomes imperative to enhance its utility and efficacy within this group. This study employs renowned databases such as WoS and Scopus to scrutinize and analyze the utilization of VR among the elderly population. Utilizing VOSviewer software (version 1.6.20), statistical analysis is conducted on the pertinent literature to delve into research lacunae, obstacles, and recommendations in this domain. The findings unveil a notable surge in literature studies concerning VR usage among older adults, particularly evident since 2019. This study documents significant journals, authors, citations, countries, and research domains contributing to this area. Furthermore, it highlights pertinent issues and challenges surrounding the adoption of VR by older users, aiming to identify prevailing constraints, research voids, and future technological trajectories. Simultaneously, this study furnishes guidelines and suggestions tailored towards enhancing VR acceptance among the elderly, thereby fostering a more inclusive technological milieu. Ultimately, this research aspires to establish an encompassing technological ecosystem empowering older adults to harness VR technology for enriched engagement, learning, and social interactions.

Effectiveness of the active communication education program in improving the general quality of life of older adults who use hearing aids: a randomized clinical trial

BackgroundHearing loss in older adults affects general, generic health-related and disease-specific quality of life (QoL). The conventional strategy to address it is through hearing aids, which have been shown to improve disease-specific QoL. However, the long-term results regarding general quality of life are unknown, and communication problems and stigma associated with hearing loss may persist. An effective intervention strategy to address these problems is group communication programs, most notably Active Communication Education (ACE). This program has been shown to increase communication strategies and reduce communication activity limitations and participation restrictions. These precedents allow us to hypothesize that this program could improve general QoL.MethodsA randomized clinical trial was conducted on 114 older adult hearing aid users. Fifty-four subjects composed the intervention group that received the ACE program, while 60 subjects composed the control group that received an informational-lectures type intervention. The WHOQOL-BREF questionnaire was used to measure general QoL. Measurements were taken before and right after the intervention, with follow-ups at 6 and 12 months. Multilevel linear mixed models were estimated, considering the WHOQOL-BREF dimension scores and total score as the outcomes, and an interaction term between time since intervention and group as the predictor. Within- and between-group comparisons were made.ResultsCompared to the baseline time-point, the ACE group showed significant improvements right after the intervention, and at the 6-month and 12-month follow-ups for the dimensions of psychological health, social relationships, environment, and total score. Compared to the control group, the ACE group exhibited significantly greater improvements in the social dimension at all postintervention assessments, as well as in the environment dimension and total score at the 12-month follow-up.ConclusionsThe ACE program improved general QoL in terms of social relationships and environment dimensions, which lasted up to 12 months after the intervention. Therefore, ACE is positioned as an effective complement for HA users, enhancing and delivering new benefits related to broader aspects of QoL not necessarily tied to health.Trial registrationISRCTN54021189 (retrospectively registered on 18/07/2023).

Effects of Frequency-Composition Algorithm and Phoneme-Based Auditory Training in Older Hearing Aid Users.

Frequency-lowering (FL) algorithms improve the audibility of high-frequency sounds by shifting inaudible high-frequency components to audible low-frequency regions. However, the FL algorithm has yielded mixed findings. This study involved two experiments. The first experiment investigated whether objective and subjective auditory outcomes would be enhanced by activating frequency composition (Fcomp), which is a type of FL technique. The second experiment determined whether auditory training with Fcomp activation would provide perceptual benefits to older hearing aid users. Twelve older hearing aid users with moderate to profound high-frequency sensorineural hearing loss participated in this study. In Experiment I, all participants received a 4-week adaptation period to Fcomp before the measurement, and then the influence of Fcomp was evaluated. In Experiment II, among the 12 participants in Experiment I, five received 8-week phoneme-based auditory training while activating Fcomp, whereas the remaining seven did not receive training but continued to use Fcomp as non-trained controls. In Experiment I, 4-week passive accli-matization period to Fcomp did not improve speech-in-quiet recognition or self-perceived sound quality. In Experiment II, active pho-neme-based training enhanced recognition of consonants and words as well as better speech-quality ratings for trained participants. The consecutive use of Fcomp did not lead to any differences for non-trained participants. Overall, phoneme-based auditory training would allow older hearing aid users to relearn frequency-lowered speech sounds and reduce phonetic confusion. However, the analytical training approach did not lead to transfer to sentence recognition or overall satisfaction with the hearing aids.

Deprescribing of proton pump inhibitors in older patients: A cost-effectiveness analysis.

Over-prescribing of proton-pump inhibitors (PPIs) is widely observed in older patients. Clinical findings have showed that deprescribing service significantly decreased inappropriate PPIs utilization. We aimed to examine the cost-effectiveness of PPI deprescribing service from the perspective of Hong Kong public healthcare provider. A decision-analytic model was constructed to examine the clinical and economic outcomes of PPI deprescribing service (deprescribing group) and usual care (UC group) in a hypothetical cohort of older PPI-users aged ≥65 years in the ambulatory care setting. The model inputs were retrieved from literature and public data. The model time-frame was one-year. Base-case analysis and sensitivity analysis were performed. Primary model outcomes were direct medical cost and quality-adjusted life-years (QALYs) loss. In base-case analysis, the deprescribing service (versus UC) reduced total direct medical cost by USD235 and saved 0.0249 QALY per PPI user evaluated. The base-case results were robust to variation of all model inputs in one-way sensitivity analysis. In probabilistic sensitivity analysis, the deprescribing group was accepted as cost-effective (versus the UC group) in 100% of the 10,000 Monte Carlo simulations. In conclusion, the PPI deprescribing service saved QALYs and reduced total direct medical cost in older PPIs users, and showed a high probability to be accepted as the cost-effective option from the perspective of public healthcare provider in Hong Kong.

Trust Assessment Skills Among Close Friends in a Ubiquitous Social Media Environment

For ages, individuals have relied on trust assessment skills to evaluate spoken words and accompanying body language social signals (BLSS) in friendships. This interactive process seeks to avoid harmful associations and unreliable information. However, with widespread social media use, assessment of BLSS is difficult, and users commonly report harm from defective estimations of interactions. This study evaluates how individuals adjust their trust assessment skills for close social media friendships, given the importance they place on BLSS in its role as a moderator. The research utilizes PLS-SEM, ANOVA, and cluster analysis to evaluate 247 U.S. online survey participants aged 18 to 67. The study adapts Mayer et al.’s trust model using social learning and cognitive dissonance theories. The independent variables, ability, benevolence, and integrity, strongly predict the dependent trust belief. In line with cognitive dissonance theory, BLSS has a negative and significant moderating effect on ability. BLSS reflects a small effect and widely insignificant moderating relationship with benevolence; analysis shows that a moderating relationship should not apply to benevolence. Counter to the hypothesized direction, BLSS produced a positive moderating effect on integrity, which was insignificant by a narrow margin. The analysis explains the basis for the positive relationship. Lastly, statistical analysis reveals an age-based shift in the relevancy of BLSS; younger users place less importance on BLSS, whereas older users place more importance on BLSS. This position for younger users aligns with their exposure and acclimation to social environments with widespread mobile communication and social media use since childhood.

Analisis Penerapan JKN Mobile bagi Pengguna Lansia di Rumah Sakit Harapan dan Doa (RSHD) Kota Bengkulu

The JKN Mobile application has purposed to facilitate BPJS Health participants in employing JKN-KIS services without the need to come directly to the BPJS office. The aim of this research is to determine how JKN Mobile is employed by senior citizens at Bengkulu City's Harapan and Doa Hospitals, as well as to outline the services provided to JKN Mobile senior citizens at RSHD Bengkulu City.The research method employed in this study is the qualitative research method. Data collections were carried out through observation, interviews, and documentation. Informant selection technique using accidental sampling. The stages of data analysis used are data reduction, data presentation, and conclusion drawing. The results of this study indicate the application of JKN Mobile for older people users at Harapan and Doa Hospital, Bengkulu City, found problems with older people users who claimed to be quite difficult in using the JKN Mobile application to get services at the hospital such as not having a smartphone that supports it, not understanding how to use the JKN Mobile application, to difficulties due to not having a family companion as a source of information supporting the older people.

Enhancing quality of life measurement: adapting the ASCOT easy read for older adults accessing social care.

This study aimed to adapt and assess the content validity of the ASCOT Easy Read (ASCOT-ER) for older people accessing social care. A co-production working group of 8 older social care users and their supporters was established to evaluate the comprehensibilityand relevanceof the ASCOT-ER images, wording and layout. Changes made by the working group were iteratively tested using cognitive interviewing techniques (think aloud) with 25 older social care users not able to self-complete the original ASCOT. Co-research with people with dementia and their supporters was critical to the development of an effective and accessible tool. Issues identified with comprehension, recall, judgement and response were addressed through iterative adjustments to design, layout and wording. An unexpected finding was that illustrations were disliked or disregarded by the majority of people, and, in particular, those living with dementia. This result contrasts with the typical assumption of easy read approaches, where illustrations are expected to enhance comprehension. The ASCOT-ER measure for older people is suitable for older people using social care services with mild to moderate dementia, mild cognitive impairment and other age-related needs. The revisions applied were designed to improve comprehension, judgement and response for this group and even those who were most cognitively impaired experienced fewer issues by the final round of testing. Nonetheless, some prompting was still required, particularly for those with higher levels of cognitive impairment and it is likely that some respondents will require the questionnaire to be administered in an interview format.

Investigating older adults users' willingness to adopt wearable devices by integrating the technology acceptance model (UTAUT2) and the Technology Readiness Index theory.

With the continuous advancement of wearable technology, smart wearable devices are increasingly recognized for their value in health monitoring, assessment, and intervention for the older adults, thus promoting intelligent older adults care. This study, based on the theoretical framework of the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) and the Technology Readiness Index (TRI) model, aims to identify and explore the key factors influencing older adults consumers' willingness to adopt smart wearable devices and their impact mechanisms. A questionnaire survey was conducted to collect valid data from 389 older adults respondents. Empirical analysis validated the model's applicability and explored the key factors influencing acceptance. Factors influencing the use of smart wearable devices by the older adults include performance expectancy (β = 0.152, p < 0.001), effort expectancy (β = 0.154, p < 0.001), social influence (β = 0.135, p < 0.05), facilitating conditions (β = 0.126, p < 0.05), hedonic motivation (β = 0.166, p < 0.001), price value (β = 0.182, p < 0.001), and digital health literacy (β = 0.189, p < 0.001). Additionally, optimism (β = 0.208, p < 0.001), innovativeness (β = 0.218, p < 0.001), and discomfort (β = -0.245, p < 0.001) significantly positively influenced performance expectancy, while optimism (β = 0.282, p < 0.001), innovativeness (β = 0.144, p < 0.01), discomfort (β = -0.239, p < 0.001), and insecurity (β = -0.117, p < 0.05) significantly positively influenced effort expectancy. Insecurity did not significantly influence performance expectancy. Performance expectancy and effort expectancy partially mediated the relationship between personality traits (optimism, innovativeness, discomfort, and insecurity) and behavioral intention. Digital health literacy significantly negatively moderated the relationship between performance expectancy and behavioral intention, as well as between effort expectancy and behavioral intention. The study confirms that integrating the UTAUT2 model and TRI theory effectively explains the acceptance of smart wearable devices among older adults consumers, emphasizing the importance of enhancing digital health literacy in the design and promotion of smart health devices. The findings provide guidance for developers, increasing the acceptance and usage rate of these devices among the older adults.

Effect of older adults willingness on telemedicine usage: an integrated approach based on technology acceptance and decomposed theory of planned behavior model

BackgroundTelemedicine, as a novel method of health management system, has demonstrated to have a significant impact on health levels. However, a challenge persists in the form of low usage rates and acceptance among older adults in China. There are accumulating evidence that willingness will affect the telemedicine usage among older adults. This study investigates factors influencing older users’ trust in adopting telemedicine technology, thereby promoting actual use.MethodsA questionnaire survey was conducted with 400 urban seniors aged 60 and above. Drawing from the Technology Acceptance Model (TAM) and the Decomposed Theory of Planned Behavior (DTPB), the author combines elements such as Perceived Usefulness, Perceived Ease of Use, Subjective Norms, Service Environment, Self-Efficacy, Behavioral Intention to Use, and Usage Behavior. The aim is to explore the interrelationships between these factors.ResultsPerceived Usefulness (PU) and Service Environment (SE) significantly and positively impact Behavioral Intention (BI) to use telemedicine, with Trust (TR) identified as a crucial mediating variable. Enhancing trust can substantially increase older adults’ intention to use telemedicine services. Furthermore, the study reveals a significant relationship between older adults’ trust in telemedicine and factors such as Perceived Usefulness (PU), Service Environment (SE), Subjective Norms (SR), as well as Emotional Risk (ER) and Cost Risk (CR), the latter two tending to decrease Trust(TR).ConclusionsThis paper constructs and validates a combined model based on TAM and DTPB, comprehensively exploring the potential factors influencing the older adults’ intention to use telemedicine. The findings suggest that telemedicine services for older adults should prioritize improving user perception and enhancing trust throughout the service process to effectively increase their willingness to use these services.

Factors related to the intention of choosing shared E-scooters for metro transfer: A survey study integrating weather perception into satisfaction evaluation from Changsha.

Shared E-scooter (SE) travel is a low-carbon transportation method that can be further enhanced by integrating with metro systems. This study aims to quantify the impact of the built environment, attitude preferences, weather perception, and other factors on the evaluation and intention to use the "SE-metro transfer" travel mode, as well as how to efficiently and concisely measure and model these effects. Empirical analysis was conducted using questionnaire data from Changsha, China, with 683 participants surveyed. Three satisfaction models were established and compared based on the Technology Acceptance Model (TAM), and an optimal M2 model was expanded to incorporate users' subjective perceptions of weather, proposing a method to simplify questionnaire length. The study found that well-designed vehicles and infrastructure, along with necessary supporting facilities, play important roles in enhancing SE usage. However, there are still many areas for optimization in Changsha's SE policies. Despite the advantages of SE in terrain and physical fitness, which have significantly expanded and changed their user base compared to traditional shared bicycles, there is still much potential to adapt to the middle-aged and older user groups. The results of this study can provide valuable insights for professionals and government officials in designing systems, constructing infrastructure, and formulating policies.