Preferences Of Older Adults Research Articles

Increasing Adoption and Utility of Smartwatches in Older Adults

Older adults (55+) represent one of the fastest growing groups adopting wearable devices (e.g. smartwatches). However, questions remain as to how older adults, healthcare providers and researchers can maximize the ability of these devices to maintain and improve health. The objective of this study was to understand the needs and preferences of older adults in wearable devices, as part of a Florida High Tech Corridor Matching Grant between The Villages Health, Aviv/Xtend Scientific, and The University of South Florida. Six focus groups were conducted with older adults (n=36) living in The Villages, Florida, and were stratified by gender. Topics such as adoption, benefits/concerns, usability, and potential gender differences were explored. Heart rate monitoring, calories burned, and step counting features were most often utilized by current wearable users (43%). Participants reported that the most important benefits of wearables were atrial fibrillation identification, fitness tracking and fall detection. Concerns included privacy, the “learning curve” and too frequent of notifications by the device. Across both genders, choice resonated strongly as a theme. Male and female participants desired personalized, easy to understand outcomes and control over data sharing preferences. Men were interested in continual access to wearable health data, whereas females were interested in daily or weekly summaries. Further, men reported higher on-going use and comfort with smartwatches as compared to females. Participants suggested “low, medium, and high-tech savvy” user profiles and supporting resources (e.g. 1-1 training, paper manuals) to enhance adoption. Recommendations for policy and practice are shared, in light of the findings.

Patterns of preference importance ratings among African-American and White nursing home residents

Background: The Preferences for Everyday Living Inventory (PELI) was developed to assess the psychosocial preferences of older adults receiving home care (PELI-HC) and then revised for nursing home residents (PELI-NH). While the PELI-HC has been tested to identify patterns in preference ratings by race, the PELI-NH has not. We sought to explore whether the PELI-NH tool captures differences in preference ratings of African-American and White NH residents. Methods: Preference assessment interviews were conducted with NH residents (n = 317). Analysis via a Mann-Whitney U test, results show that 46 of 72 (63.88%) a preference importance items were not statistically different between African-American and White NH residents. Additionally, African-Americans reported greater importance than White older adult NH residents in 26 of 72 (36%) preference importance items. Conclusion/Implications: It appears that the PELI-NH can test group differences in preference importance among African-American and White NH residents; implications for practice will be discussed. Part of a symposium sponsored by the Research in Quality of Care Interest Group.

Longitudinal Relationships Between Favorite Activities and Homebound Status in Older Adults

Favorite activities are usually meaningful to older adults and may influence their homebound status and vice versa. Using Round 1 (R1, in 2011) and Round 5 (R5, in 2015) data from the National Health and Aging Trends Study, we examined the patterns of favorite activity by homebound status and investigated their relationship among community-dwelling older adults (N=3,332). Homebound status (non-homebound, semi-homebound, and homebound) was determined by the frequency, difficulty, and needing help of outdoor mobility. Favorite activities were named by participants verbatim and then were classified into two categories (active and non-active) based on the estimated energy needed to perform the activity. Logistic regression models were used to determine whether homebound status at R1 predicted the types of favorite activity in R5, and ordinal logistic regression models for predictions from the types of favorite activity at R1 to homebound status at R5, adjusting for demographics and health conditions. The sample was, on average, 76±7.23 years old, non-Hispanic White (72.9%), and female (59.7%). Regardless of the homebound status, reading and walking are the top two favorite activities. Homebound older adults enjoyed “non-active” activities (e.g., watching TV), while non-homebound counterparts preferred “active” outdoor maintenance. Being homebound at R1 predicted non-active favorite activity in R5 (OR=.257, p<0.001), and R1 non-active favorite activity also predicted homebound status in R5 (OR=1.219, p =0.039). These findings provide new information on the activity preferences of older adults with different homebound status and how their preferences may influence their future homebound status.

Risky Preferences: Nursing Staff Perceptions of Risks May Impede Delivery of Person-Centered Care

Nursing home (NH) staff perceptions of risks to residents’ health and safety is a major barrier to honoring resident preferences, the cornerstone of person-centered care delivery. This study examined direct-care nursing staff perceptions of risk (possibilities for harm or loss) associated with honoring residents’ preferences for everyday living and care activities. Participants (N=27) were mostly female (85%), had more than 3 years of experience (74%), and worked in NHs experiencing 6-12 health citations. Content analysis of 12 focus groups indicated nursing staff perceptions of risks may impede delivery of PCC. This is supported by the overarching theme: pervasive risk avoidance; and sub-themes of: staff values, supports for risk-taking, and challenges to honoring preferences. Findings will be discussed considering a newly modified risk engagement framework meant to understand and inform the clinical management of older adult preferences perceived to carry risks. Opportunities for future research will be discussed (e.g. measurement development). Part of a symposium sponsored by the Research in Quality of Care Interest Group.

Human factors and aging: A 20-year retrospective and prospective from CREATE researchers

The Center for Research and Education on Aging and Technology Enhancement (CREATE) was founded in 1999 and is funded by the National Institute on Aging (National Institutes of Health; PO1 AG017211). This interdisciplinary team of psychologists and engineers focuses on design and deployment of technology with aging adults. In this panel session, we will provide an overview of CREATE research in the domains of health, leisure, work, and social engagement. We will discuss current and emerging technologies. CREATE research has provided insights about the needs and preferences of older adults; design requirements for successful technology support; the necessity of proper instruction and training; and the value of technology tools for all facets of life. This interdisciplinary collaboration has generated evidence-based guidelines for designing, training, and deploying technology to enhance quality of life. Time will be provided for general audience discussion regarding future directions and challenges for design of emerging technologies.

Digital engagement preferences of individuals aged 65 and older with cancer.

289 Background: Recent reviews suggest that digital solutions play a prominent role in the context of geriatric oncology. While interventions ranging from remote monitoring to nutrition and physical activity support have demonstrated feasibility in older adults (aged 65 and older), little is known about facilitators and barriers to eHealth uptake in older adults diagnosed with cancer. Insights into the digital engagement preferences of older adults with cancer may help to inform which platforms may be best aligned to optimal engagement and outcomes. Methods: A retrospective analysis was conducted to examine patient engagement preferences (phone, text and/or email) among older adults with cancer enrolled in a digital health coaching program. Descriptive statistics were used to summarize patient characteristics. Chi-square tests were used to evaluate differences in patient engagement preferences by race. Results: Of 513 individuals, the majority (n = 308; 60%) preferred information be provided by phone, email and text, while 20% (n = 105) requested content by phone and text only. Less than 10% of the sample requested content via phone only (n = 45; 8%), phone and email, (n = 31; 6%), email only (n = 11, 2%), or by email and text (n = 9; 2%). Interestingly, adults aged 65 and older had a significant predisposition to phone only communication (8.77%) compared to 2.25% in the general oncology population (p &lt; 0.001). Among adults aged 65 and older with a phone preference, there were on average 8.39 calls over the course of the program with an average of 9.51 minutes per call over the course of 12-weeks. For those with text message preference, there were an average of 14.17 outbound and 8.30 inbound texts over the 12-week engagement, and for those with email preference a 62.38% open rate was observed. Retention over a three month coaching period was highest among those engaged via phone, text and email (56.17%), and email only (54.55%). Race was significantly related to engagement preference, with black members twice as likely (p &lt; 0.001) to choose phone and text, and three times as likely (p &lt; 0.001) to choose phone only compared with white members. However, no differences emerged between race and retention. Conclusions: Engagement preference was associated with differences in retention and race. Our results highlight the importance of offering different mechanisms for patient engagement and the need for attention to specific demographic differences such as race, which may impact access to and preference for engagement types when employing digital health solutions for older adults with cancer.

S0328 Older Adult Preferences for FIT vs Colonoscopy for Colorectal Cancer Screening and Polyp Surveillance

S0328 Older Adult Preferences for FIT vs Colonoscopy for Colorectal Cancer Screening and Polyp Surveillance

From skeuomorphism to flat design: age-related differences in performance and aesthetic perceptions

ABSTRACT The design of graphical user interfaces has been evolving from skeuomorph interfaces – which use elements that mimic the aesthetics and functionality of their real-world counterparts – to minimalist and flat designs. Despite the growing popularity of these new design approaches, they can be challenging for older adults who experience a decline in visual and cognitive abilities. Still, little is known about user performance, aesthetic perception, and preference of older adults, particularly in comparison to younger users and traditional skeuomorph interfaces. In this paper, we examine the performance and aesthetic perception of older (65–77 years old) and younger (20–40) adults with three design approaches: skeuomorph, skeuominimalist, and flat design. Results show flat design is either slower or less accurate than traditional skeuomorph interfaces for older adults across three tasks: visual search, identifying clickable objects, and multiple page navigation. Younger adults were less susceptible to performance differences between design approaches, but still subject to ‘click uncertainty’ with flat interfaces. Skeuominimalism did not show clear performance benefits over flat design or skeuomorphism, while the latter reduced the performance gap between age groups. Finally, younger adults preferred the simplicity of skeuominimalism, while older adults preferred skeuomorph interfaces because of the perceived usability, beauty, and trustiness.

Connecting to Nature: Outdoor Recreation Preferences and Constraints of Older Adults in the Intermountain West, United States

Drawing on household survey data collected in 2018 and 2019, this research identifies key barriers to older adults’ involvement in outdoor recreation, and also highlights management actions that are most likely to bolster and/or impact their participation. With such information, managers can better understand outdoor recreation preferences of older adults and also craft effective strategies to facilitate participation. Survey data illustrated that older adults were most likely to benefit from walking trails and increased law enforcement presence. In addition, males and those in the highest income bracket were most likely to benefit from increase in motorized trail recreational opportunities (e.g., for all-terrain vehicles), not older adults. The research findings provide federal recreation professionals and newly formed state outdoor recreation offices with useful guidance on how to meet the outdoor recreation needs of older adults in the Intermountain West, United States. Subscribe to JPRA

Pervasive Risk Avoidance: Nursing Staff Perceptions of Risk in Person-Centered Care Delivery.

Nursing home (NH) staff perceptions of risks to residents' health and safety are a major barrier to honoring resident preferences, the cornerstone of person-centered care (PCC) delivery. This study explored direct-care nursing staff perceptions of risk (possibilities for harm or loss) associated with honoring residents' preferences for everyday living and care activities. Qualitative, descriptive design using sequential focus group (FG) methodology. Participants (N = 27) were mostly female (85%), had more than 3 years of experience (74%), and worked in NHs recently experiencing 6-12 health citations. Content analysis of 12 sequential FGs indicated nursing staff perceptions of risks may impede delivery of person-centered care. This is supported by the overarching theme: pervasive risk avoidance; and subthemes of: staff values, supports for risk-taking, and challenges to honoring preferences. Development of a multidimensional framework with specific risk engagement measures that account for the unique risk perspectives of nursing staff will contribute significantly to the clinical management of older adult preferences and research on the effectiveness of preference-based PCC delivery in the NH setting.

Location Choice in the Context of Older Adults' Leisure-Time Walking.

Leisure-time walking is the most prevalent and preferred form of physical activity of older adults. In order to promote leisure-time walking and enhance the efficiency of using outdoor open spaces, the supply of different types of walking locations should match the needs, interests and preferences of older adults. However, there is limited knowledge on which location types are chosen by which groups of individuals under which conditions. This study therefore examines the effects of socio-demographics, episode participation attributes and neighborhood characteristics on the location choice of older adults for leisure-time walking. A multinomial logit model is estimated based on data collected among 316 respondents aged 60 or older in Dalian, China. The results indicate that older people’s location choices for walking are associated with their socio-demographics, episode participation attributes and neighborhood characteristics. Finally, implications of the results for the planning, design and management of open spaces are identified.

Personal preferences of participation in fall prevention programmes: a descriptive study

BackgroundParticipation in fall prevention programmes is associated with lower risk of injurious falls among older adults. However participation rates in fall prevention interventions are low. The limited participation in fall prevention might increase with a preference based approach. Therefore, the aims of this study are to a) determine the personal preferences of older adults regarding fall prevention and b) explore the association between personal preferences and participation.MethodsWe assessed the personal preferences of older adults and the association between their preferences, chosen programme and participation level. Nine different programmes, with a focus on those best matching their personal preferences, were offered to participants. Twelve weeks after the start of the programme, participation was assessed by questionnaire. Logistic regression was performed to test the association between preferences and participation and an ANOVA was performed to assess differences between the number of preferences included in the chosen programme and participation level.ResultsOf the 134 participants, 49% preferred to exercise at home versus 43% elsewhere, 46% preferred to exercise alone versus 44% in a group and 41% indicated a programme must be free of charge while 51% were willing to pay. The combination of an external location, in a group and for a fee was preferred by 27%, whereas 26% preferred at home, alone and only for free. The presence of preferences or the extent to which the programme matched earlier preferences was not associated with participation.ConclusionDespite the fact that preferences can vary greatly among older adults, local programmes should be available for at least the two largest subgroups. This includes a programme at home, offered individually and for free. In addition, local healthcare providers should cooperate to increase the accessibility of currently available group programmes.

Perception of Older Adults about Health-Related Functionality of Foods Compared with Other Age Groups

The proportion of older adults in the population is significantly growing in the EU, therefore, wellbeing of the older population has become a social challenge. Functional foodstuffs are food products with nutritional composition that may reduce the risk of diet-related diseases or enhance physiological functions. Therefore, they could play an important role in prevention and mitigation of health-related problems, and in promotion of healthy ageing. The aim of this study is to present the impact of age on consumer preferences about functionality of foods, covering attitude aspects, nutrition claims, possible carriers, some particular health problems and expectations about sustainable production. The results are based on a representative quantitative survey. Findings highlight statistically significant (p &lt; 0.05) differences in preferences of older adults compared to other age segments. They generally accept functional foods, especially when functionality is attached to increased vitamin, protein, and fiber content. Older adults also prefer products with lower salt and sugar content, which were less relevant for other age groups. Products of fruit and vegetable origin are distinguished as carriers of functional traits. Compared to other segments, older adults accept products of animal origin (especially milk products) and even breakfast products on a higher level. The paper provides details about particular health issues that could be addressed by functional foods based on actual consumer concerns.

Investigating the preferences of older adults concerning the design elements of a companion robot

AbstractResearchers have reported that companion robots have had positive effects on older adults with depression. However, there has been little quantitative analysis on the relationship between robot design and depression. To address this, we surveyed 191 older adults and investigated the impact of age, gender and depression level on design preferences for companion robots. We focused on toy-sized companion robots and evaluated three design elements: type, weight and material. The findings show that baby-type robots were the most preferred by older adults. They favoured the lightest weights and microfibre materials, regardless of the independent variables. Moreover, robot weight preferences varied significantly with the level of depression. Highly depressed older adults disliked heavy robots. These preliminary findings suggest that companion robots need to be designed with careful consideration of their physical characteristics and potential psychological effects.

TECHNOLOGY DESIGN TO SUPPORT SOCIAL ENGAGEMENT FOR OLDER ADULTS

Evidence that loneliness and isolation are precursors to myriad negative health issues is accumulating. For older adults, social engagement may be particularly important due to life-changing events that can accompany older adulthood, including retirement, disease, or mobility limitations. Individuals vary in their levels of social engagement, and these differences may have consequential effects on quality of life. Technology has the potential to create and enhance social engagement opportunities for older adults at risk for social isolation. For such technology innovations to be effective and widely adopted, designers must consider the unique needs, capabilities, limitations, and preferences of older adults. I will describe technologies that currently exist (e.g., apps, mobile devices, social networking) or are being developed (e.g., robotics, telepresence, virtual reality) to support social engagement, connectedness, and community participation. I will discuss the potential of these technologies as well as the design and training challenges unique to older adults.

INNOVATIONS IN HOME MODIFICATION RESEARCH: THE STATE OF THE ART

The overwhelming preference of older adults is to stay in their homes for as long as possible (AARP). However, most housing lacks supportive features and presents barriers that jeopardize residents’ ability to successfully age in place. Only 1% of houses have five key features to ensure accessibility: no-step entry, single-floor living, lever door handles, accessible electrical controls, and extra-wide doors and hallways (Harvard Joint Center for Housing Studies), making the vast majority unsuitable for persons who use wheelchairs and problematic for the growing number of people with activity limitations. Persons least likely to have such features in their homes need them the most: old-old, low income, frail, and residents in older housing stock. Although home modification can support people as their needs change and preclude the need to move, often to institutional settings, the majority of older adults lack these supports. Recent studies have demonstrated the role of home modification in health, safety, and cost effectiveness. This symposium will convene a panel of researchers to share evidence-base in home modification, recent cost-saving innovations including the CAPABLE Program, and policy change to improve service delivery.

HARNESSING VOICE-ASSISTED TECHNOLOGY AND IN-HOME SENSORS TO MANAGE OLDER ADULT HEALTH: A USER PREFERENCE STUDY

In recent years voice-assisted technologies, such as the Amazon Echo Show and Google Home, have been harnessed to help older adults manage their health. However, little is known about the use of such technologies in combination with in-home sensor systems to help older adults age in place. Therefore, this research explored user preferences of older adults and a designated family member/friend in using voice-assisted technologies to retrieve in-home sensor-generated health information, such as fall risk and other early indicators of health changes. Seventeen dyad interviews were conducted with known pairs of older adults (Mean age=75; 56% female) and a family member/friend (Mean age=64; 89% female). Participants were given a description of the technology and its capabilities, and then were instructed to interact with each device using a prepared scenario. Participants asked each device health-related questions to elicit pre-programmed information for the respective scenarios and provided user experience feedback for each device. At the end of the interview, participants completed a speech recognition test for each device and a technology acceptance survey. Overall acceptance of the technology was high, and participants believed that using voice-assisted technologies to retrieve sensor-generated health information would be beneficial in managing their health or providing care to a family member/friend. However, advantages and disadvantages exist with each device and the Google Home generally performed better on the speech recognition test for each dyad pair. These findings provide valuable insight about older adults’ preferences (as well as family members’/friends) in using voice-assisted technologies to manage their health.

Effect of walking surface, late-cueing, physiological characteristics of aging, and gait parameters on turn style preference in healthy, older adults

Turning while walking is a crucial component of locomotion, often performed on irregular surfaces with little planning time. Turns can be difficult for some older adults due to physiological age-related changes. Two different turning strategies have been identified in the literature. During step turns, which are biomechanically stable, the body rotates about the outside limb, while for spin turns, generally performed with closer foot-to-foot distance, the inside limb is the main pivot point. Turning strategy preferences of older adults under challenging conditions remains unclear. The aim of this study was to determine how turning strategy preference in healthy older adults is modulated by surface features, cueing time, physiological characteristics of aging, and gait parameters. Seventeen healthy older adults (71.5 ± 4.2 years) performed 90° turns for two surfaces (flat, uneven) and two cue conditions (pre-planned, late-cue). Gait parameters were identified from kinematic data. Measures of lower-limb strength, balance, and reaction-time were also recorded. Generalized linear (logistic) regression mixed-effects models examined the effect of (1) surface and cuing, (2) physiological characteristics of ageing, and (3) gait parameters on turn strategy preference. Step turns were preferred when the condition was pre-planned (p < 0.001) (model 1) and when the gait parameters of stride regularity and maximum acceleration decreased (p = 0.010 and p = 0.039, respectively) (model 3). Differences in turn strategy selection under dynamic conditions ought to be evaluated in future fall-risk research and rehabilitation utilizing real-world activity monitoring.

Mobile and Connected Health Technology Needs for Older Adults Aging in Place: Cross-Sectional Survey Study.

BackgroundAn increasing number of mobile and wearable devices are available in the market. However, the extent to which these devices can be used to assist older adults to age in place remains unclear.ObjectiveThis study aimed to assess older adults’ perceptions of using mobile and connected health technologies.MethodsUsing a cross-sectional design, a total of 51 participants were recruited from a senior community center. Demographics and usage of mobile or wearable devices and online health communities were collected using a survey questionnaire. Descriptive statistics assessed usage of devices and online health communities. The Fisher exact test was used to examine the relationship between technology usage and having access to a smartphone.ResultsThe sample was primarily comprised non-Hispanic white (35/51, 69%), educated (39/51, 76% any college), and female (36/51, 71%) participants, with an average age of 70 (SD 8) years. All participants were insured and nearly all lived at home (49/51, 94%). A total of 86% (44/51) of the participants had heard of wearable health devices, but only 18 out of 51 (35%) had ever used them. Over 80% (42/51) expressed interest in using such devices and were interested in tracking exercise and physical activity (46/51, 90%), sleep (38/51, 75%), blood pressure (34/51, 67%), diet (31/51, 61%), blood sugar (28/51, 55%), weight (26/51, 51%), and fall risk (23/51, 45%). The greatest concerns about using wearable devices were cost (31/51, 61%), safety (14/51, 28%), and privacy (13/51, 26%); one-fourth (12/51) reported having no concerns. They were mostly interested in sharing data from mobile and connected devices with their health care providers followed by family, online communities, friends, and no one. About 41% (21/51) of the older adults surveyed reported having ever heard of an online health community, and roughly 40% (20/51) of the participants reported being interested in joining such a community. Most participants reported having access to a smartphone (38/51, 74%), and those with such access were significantly more likely to show interest in using a wearable health device (P<.001) and joining an online health community (P=.05).ConclusionsOur findings suggest that, although few older adults are currently using mobile and wearable devices and connected health technologies for managing health, they are open to this idea and are mostly interested in sharing such data with their health care providers. Further studies are warranted to explore strategies to balance the data sharing preference of older adults and how to best integrate mobile and wearable device data with clinical workflow for health care providers to promote healthy aging in place.

Using the Technology Acceptance Model to Explore User Experience, Intent to Use, and Use Behavior of a Patient Portal Among Older Adults With Multiple Chronic Conditions: Descriptive Qualitative Study.

BackgroundPatient portals offer modern digital tools for older adults with multiple chronic conditions (MCC) to engage in their health management. However, there are barriers to portal adoption among older adults. Understanding portal user interface and user experience (UI and UX) preferences of older adults with MCC may improve the accessibility, acceptability, and adoption of patient portals.ObjectiveThe aim of this study was to use the Technology Acceptance Model (TAM) as a framework for qualitatively describing the UI and UX, intent to use, and use behaviors among older patients with MCC.MethodsWe carried out a qualitative descriptive study of Kaiser Permanente Colorado’s established patient portal, My Health Manager. Older patients (N=24; mean 78.41 (SD 5.4) years) with MCC participated in focus groups. Stratified random sampling was used to maximize age and experience with the portal among participants. The semistructured focus groups used a combination of discussion and think-aloud strategies. A total of 2 coders led the theoretically driven analysis based on the TAM to determine themes related to use behavior, portal usefulness and ease of use, and intent to use.ResultsPortal users commonly used email, pharmacy, and lab results sections of the portal. Although, generally, the portal was seen to be easy to use, simple, and quick, challenges related to log-ins, UI design (color and font), and specific features were identified. Such challenges inhibited participants’ intent to use the portal entirely or specific features. Participants indicated that the portal improved patient-provider communication, saved time and money, and provided relevant health information. Participants intended to use features that were beneficial to their health management and easy to use.ConclusionsOlder adults are interested in using patient portals and are already taking advantage of the features available to them. We have the opportunity to better engage older adults in portal use but need to pay close attention to key considerations promoting usefulness and ease of use.