Word-processing training and retraining: effects of adult age, experience, and interface

A Tablet-Based Application to Enhance Social Connectedness for Individuals With a Cognitive Impairment: Results From the PRISM-CI Pilot Study

Social engagement is fundamental to successful aging and linked to better emotional, physical, and cognitive health. Maintaining social engagement is challenging for many older adults but especially for those with a cognitive impairment (CI). Information and communication technologies (ICT) can provide enhanced opportunities for social and cognitive engagement for older adults with a CI via increased information, education, and social connectivity access. This study used a pre-test post-test design to evaluate the feasibility, acceptability, and preliminary efficacy of the PRISM-CI software system, a tablet-based application designed to enhance access to resources, information, and social engagement, in 52 individuals with a CI between the ages of 65-88 years who had access to PRISM-CI for five months. Findings show that social isolation, loneliness, and depressive symptoms significantly decreased, and mobile device proficiency significantly increased, from baseline to follow-up. Results highlight ICTs potential to foster social engagement among older adults with a CI.

Influence of age, training, intraoral scanner, and software version on the scan accuracy of inexperienced operators

PURPOSE

To evaluate the effect of operator age on the scan accuracy (trueness and precision) of inexperienced operators when compared with experienced operators, and how training, intraoral scanner (IOS), and software version affect scan accuracy.

MATERIAL AND METHODS

Thirty-four operators were sorted into groups: G1 (operators <25 years old, no experience), G2 (operators >40 years old, no experience), and G3 (experienced IOS operators). They conducted partial-arch scans before and after a 4-session training with two IOSs (Trios 3 and True Definition) and two software versions. These scans were compared with the reference scans obtained from conventional impressions and a laboratory scanner (IScan D103i) to evaluate trueness (mean root mean square values) and precision (standard deviation of root mean square values) with a software program (Geomagic Control X). Kruskal-Wallis and post-hoc Dunn's tests were used to evaluate the effect of age on the scan accuracy of inexperienced groups when compared with experienced operators, while the effect of training, IOS, and software version on scan accuracy was evaluated with Wilcoxon or Mann-Whitney U tests (α = 0.05).

RESULTS

Before training, G1 and G2 scans had similar accuracy (p ≥ 0.065). After training, G1 scans had higher accuracy when IOS data was pooled and had higher precision with TD (p ≤ 0.004). Training increased the scan accuracy (p < 0.001), while newer software increased the trueness of inexperienced operator scans (p = 0.015).

CONCLUSIONS

Age affected the scan accuracy of inexperienced operators after training, indicating that extended training may be required for older operators. Training increased the scan accuracy, and newer software increased the trueness of inexperienced operator scans.

In person versus remote cognitive rehabilitation in patients with subjective cognitive decline or neurocognitive disorders: what factors drive patient's preference?

Background

To date, there is still a lack of consensus for identifying the ideal candidate for cognitive telerehabilitation (TR). The main goal of the present study is to identify the factors associated to the preference for either TR or in-person cognitive training (CT) programs in older adults at risk of dementia or with early cognitive impairment.

Methods

A sample of 56 participants with subjective cognitive decline or neurocognitive disorders eligible for CT were enrolled at the Dementia Research Center and Neurorehabilitation Unit of IRCCS Mondino Foundation. All individuals underwent a baseline assessment to capture their complete profile, including cognitive reserve and lifestyle habits, sociodemographic characteristics, cognitive functioning, and mental health. Patients were then asked their preference for TR or in-person CT, before being randomized to either treatment as per protocol procedures. Statistical analyses included explorative descriptive approach, logistic regression, and non-parametric models to explore the overall contribution of each variable.

Results

The two (TR and in-person) preference groups were similar for cognitive functioning and mental health status. Socio-demographic and lifestyle profiles seem to be the most important factors to influence the preference in terms of the area under the curve (AUC) of the models. The two preference groups differed in terms of socio-demographic characteristics (e.g., level of technological skills, age, and distance from the clinic). Furthermore, participants who selected the TR modality of CT had significantly higher levels of cognitive reserve and adopted more protective lifestyle habits (e.g., regular physical activity, Mediterranean diet) when compared to those who preferred in-person CT.

Discussion

These findings highlight that the preference to receive CT delivered by TR or in person is a complex issue and is influenced by a variety of factors, mostly related to lifestyle habits and sociodemographic characteristics. Availability of profiles of patients that may be more attracted to one or the other modality of TR may help promote shared decision-making to enhance patient experience and outcomes.

Individualistic Versus Collaborative Learning in an eHealth Literacy Intervention for Older Adults: Quasi-Experimental Study

BACKGROUND

Older adults tend to have insufficient health literacy, which includes eHealth literacy-the ability to access, assess, and use digital health information. Interventions using methods such as collaborative learning (CL) and individualistic learning (IL) may be effective in addressing older adults' low eHealth literacy, but little is known about the short- and long-term effects of CL versus IL on older adults' eHealth literacy.

OBJECTIVE

The objective of this study was to use a 3 × 2 × 3 mixed factorial design to examine older adults' learning with CL versus IL for eHealth literacy.

METHODS

Older adults (N=466; mean age 70.5, SD 7.2; range 60-96 years) from diverse racial and ethnic groups were randomly assigned to either the CL or IL group (233/466, 50% in each). The intervention consisted of 4 weeks of training in 2-hour sessions held twice a week. Using ANOVA and multiple regression, we focused on the main effects of learning condition and interaction between learning condition and previous computer experience. Learning method (CL or IL) and previous computer experience (experienced, new, or mixed) were between-subject variables, and time of measurement (pretest measurement, posttest measurement, and 6-month follow-up) was the within-subject variable. Primary outcome variables were eHealth literacy efficacy, computer and web knowledge, basic computer and web operation skills, information-seeking skills, and website evaluation skills. Control variables were age, sex, education, health status, race and ethnicity, income, primary language, and previous health literacy.

RESULTS

eHealth literacy efficacy, computer and web knowledge, basic computer and web operation skills, information-seeking skills, and website evaluation skills improved significantly (P<.001 in all cases) from before to after the intervention. From postintervention measurement to 6-month follow-up, there was a significant interaction between learning condition and previous computer experience based on 1 outcome measure, computer and web operation skills (F2,55=3.69; P=.03). To maintain computer and web operation skills 6 months after the intervention, it was more effective for people with little to no previous computer experience to learn individually, whereas for people with more previous computer experience, it was more effective to learn collaboratively. From postintervention measurement to 6-month follow-up, statistically significant decreases were found in 3 of the 5 outcome measures: eHealth literacy efficacy, computer and web knowledge, and basic computer and web operation skills (P<.001 for all 3 cases).

CONCLUSIONS

Older adults' eHealth literacy can be improved through effective intervention, and the IL or CL condition may have little effect on short-term outcomes. However, to maintain long-term benefits, it may be best to learn collaboratively with others who have similar previous computer experience. eHealth literacy is multidimensional, with some components retained better over time. Findings suggest a need for resources to provide continuous training or periodic boosting to maintain intervention gains.

Technology obsolescence across the adult lifespan in a USA internet sample

We know that older adults are less likely to own certain technological devices, such as smartphones, a technology now integral to telehealth. However, for those older adults who do own devices, we know very little about how their devices may differ from those of younger adults. The age of a device can determine the types of programs it can run, as well as the level of protection it has against malicious code. The following study is an attempt to understand the ages of devices owned by different demographic groups. An electronic survey was sent to American adults from ages 19-97, querying the types of devices they own, how old those devices are, when they plan on replacing them, and demographic information. Regression models were employed to determine the factors that predict device ownership and the age of the devices owned. We replicate the finding that older adults are less likely to own certain devices, like smartphones and laptops. However, they may be more likely to own more dated devices, such as non-smart mobile phones. Models of device age showed that older adults are more likely to own older smartphones, as well as older desktop and laptop computers. Thus, older adults may be more susceptible to hacking, due to obsolete technology. In some cases, they also may not have devices modern enough for technology-based health interventions. Thus, obsolete devices may present an additional barrier for adoption of technology-based interventions by older adults.

Information assistance systems as preventive mediators between increasing customization and mental workload

BACKGROUND: The future of work in Germany is shaped by megatrends like globalization, automatization, digitization, and the demographic change. Furthermore, mass customization and the increasing usage of AI even in manual assembly offers new opportunities as well as it creates new challenges. OBJECTIVE: The trend towards mass customization in turn leads to increased complexity in production, which results in additional mental workload. This effect will continue in the foreseeable future. METHOD: Especially for small and medium sized companies, the backbone of Germany’s economy, automatization and Human-Robot-Collaboration will take time to develop. Information assistance systems are and will be a bridging technology to help organizations to manage increasing complexity and the mental workload of their employees to not only boost productivity but also keep their workforce healthy. The ongoing demographic change further underlines the need to use information assistance systems to compensate possible age-associated deficits, but also keep older employees committed to their work and avoid effects of disengagement or disenfranchisement through participatory ergonomics. RESULTS: Information assistance systems can only develop their inherent potential if they are designed to support employees of varying age, competence levels, and affinity for technology. Participatory development and early engagement are key factors for an increased acceptance and usage of the systems as well as the individualization to make it suitable for each individual employee. CONCLUSION: Expanding the functionalities to an adaptive assistance system, using physiological correlates of mental workload as an input, is conceivable in the future.

Intuitive, Efficient and Ergonomic Tele-Nursing Robot Interfaces: Design Evaluation and Evolution

Tele-nursing robots provide a safe approach for patient-caring in quarantine areas. For effective nurse-robot collaboration, ergonomic teleoperation and intuitive interfaces with low physical and cognitive workload must be developed. We propose a framework to evaluate the control interfaces to iteratively develop an intuitive, efficient, and ergonomic teleoperation interface. The framework is a hierarchical procedure that incorporates general to specific assessment and its role in design evolution. We first present pre-defined objective and subjective metrics used to evaluate three representative contemporary teleoperation interfaces. The results indicate that teleoperation via human motion mapping outperforms the gamepad and stylus interfaces. The trade-off with using motion mapping as a teleoperation interface is the non-trivial physical fatigue. To understand the impact of heavy physical demand during motion mapping teleoperation, we propose an objective assessment of physical workload in teleoperation using electromyography (EMG). We find that physical fatigue happens in the actions that involve precise manipulation and steady posture maintenance. We further implemented teleoperation assistance in the form of shared autonomy to eliminate the fatigue-causing component in robot teleoperation via motion mapping. The experimental results show that the autonomous feature effectively reduces the physical effort while improving the efficiency and accuracy of the teleoperation interface.

Investigating Older Adults' Willingness to Invest Time to Acquire Technology Skills Using a Discounting Approach

Background and Objectives

Delay discounting is a common behavioral phenomenon that can influence decision making. A person with a higher discounting rate (DR) will have a stronger preference for smaller, more immediate rewards over larger, delayed rewards than will a person with a lower DR. This study used a novel approach to investigate, among a diverse sample of older adults, discounting of the time people were willing to invest to acquire technology skills across various technologies.

Research Design and Methods

One hundred and eighty-seven male and female adults 65-92 years of age participated in the study and were given presentations on 5 different technologies spanning domains that included transportation, leisure, health, and new learning. A measure of discounting was computed based on participants' assessments of how much additional time they would be willing to spend to acquire increased skill levels on each of the technologies and their ratings of importance of attaining those skill levels. Measures of participants' perceived value of the technologies, technology readiness, and self-assessed cognitive abilities were also collected.

Results

The findings indicated a significant and robust effect of lower DRs with increasing age. Higher perceived value of the technologies and higher levels of positive technology readiness predicted willingness to invest more time to learn the technologies, whereas self-assessments of cognitive abilities predicted the levels of technology skills that participants desired on the 5 technologies.

Discussion and Implications

Our findings demonstrate that for realistic decision-making scenarios related to the acquisition of technology skills, DRs decrease with increasing age, even within an older adult cohort, and that discounting is related to the perceived value of the technology. The findings also have important implications for the design and marketing of technology products for older consumers.

A Framework for Choosing Technology Interventions to Promote Successful Longevity: Prevent, Rehabilitate, Augment, Substitute (PRAS)

Successful longevity is achieved when individuals can continue to plan, pursue, and reach their goals across the life-span. However, normative age-related impairments can make goal attainment more difficult, unless there are interventions to mitigate such changes. Behavioral interventions that use technology are increasing in frequency. I outline a hierarchy of approaches to mitigating impairments. The first strategy to promote successful longevity is prevention of normative age-related decline. When impairments develop, they can be addressed by rehabilitation, augmentation, and substitution approaches.

Older Adults and Digital Society: Scientific Coverage

While there is a progressive ageing of the population, we are witnessing a rapid development of new information and communication technologies (ICTs). Although for most of society this technology is within reach, there are population segments for whom access is limited, especially adults who are considered of old age. Due to the relevance that the relationship between ICTs and older adults acquires in today’s society, it is necessary to carry out an analysis of the scientific literature in order to understand the knowledge structure of this field. In this research, a comparative bibliometric analysis of 172 documents published in the Web of Science (WoS) and Scopus databases was carried out until 2018 and is complemented by a co-citation analysis. The results show that this subject is incipient and is in its exponential growth stage, with two thirds of the production concentrated in the 2012–2018 period. Four out of five authors are transient with a single authorship and the collaboration level is high. The most productive country is Germany followed by the United States and Australia.

Predictors of Performance in Everyday Technology Tasks in Older Adults With and Without Mild Cognitive Impairment

Background and Objectives

The ability to use everyday technology has become a key competence for conducting activities of daily living, maintaining an autonomous life, as well as participating in society. However, studying this issue in older adults needs more attention, particularly among those with mild cognitive impairment (MCI).

Research Design and Methods

We assessed the performance of N = 80 older adults (M = 73 years) in a range of tasks representing important life domains, i.e., using a blood pressure monitor, a mobile phone, and an eBook reader. Thirty-nine participants had been diagnosed with MCI by experienced geropsychiatrists and 41 healthy controls were matched for age, sex, and education. Standardized observation based on video-recording and coding was combined with cognitive testing and assessment of social-cognitive variables (self-efficacy, perceived obsolescence, attitudes towards technology).

Results

Cognitively healthy participants outperformed those with MCI regarding completion time and errors. An interaction effect of device and study group indicated larger differences in completion time for tasks with multilayered interfaces. In hierarchical regression models, aggregated cognitive factors (fluid and memory component) predicted performance and interactions with education level emerged. Obsolescence, addressing a perceived lack of competence to cope with modern society, mediated the effect of cognitive status on performance, both regarding time (partial mediation, adj.R2 = 28%) and errors (full mediation, adj.R2 = 23%).

Discussion and Implications

Findings show that social-cognitive factors contribute to differences in performance on everyday technology tasks in addition to cognitive abilities. Training programs may profit from considering respective individual resources or limitations in the cognitive, personality-related or emotional-motivational domain.

Non-invasive neurophysiological measures of learning: A meta-analysis

In a meta-analysis of 113 experiments we examined neurophysiological outcomes of learning, and the relationship between neurophysiological and behavioral outcomes of learning. Findings showed neurophysiology yielding large effect sizes, with the majority of studies examining electroencephalography and eye-related outcome measures. Effect sizes on neurophysiological outcomes were smaller than effect sizes on behavioral outcomes, however. Neurophysiological outcomes were, but behavioral outcomes were not, influenced by several modulating factors. These factors included the sensory system in which learning took place, number of learning days, whether feedback on performance was provided, and age of participants. Controlling for these factors resulted in the effect size differences between behavior and neurophysiology to disappear. The findings of the current meta-analysis demonstrate that neurophysiology is an appropriate measure in assessing learning, particularly when taking into account factors that could have an influence on neurophysiology. We propose a first model to aid further studies that are needed to examine the exact interplay between learning, neurophysiology, behavior, individual differences, and task-related aspects.

Improving Social Support for Older Adults Through Technology: Findings From the PRISM Randomized Controlled Trial

Objectives

Information and communication technology holds promise in terms of providing support and reducing isolation among older adults. We evaluated the impact of a specially designed computer system for older adults, the Personal Reminder Information and Social Management (PRISM) system.

Design, Setting, and Participants

The trial was a multisite randomized field trial conducted at 3 sites. PRISM was compared to a Binder condition wherein participants received a notebook that contained paper content similar to that contained in PRISM. The sample included 300 older adults at risk for social isolation who lived independently in the community (Mage = 76.15 years). Primary outcome measures included indices of social isolation, social support, loneliness, and well-being. Secondary outcome measures included indices of computer proficiency and attitudes toward technology. Data were collected at baseline and at 6 and 12 months post-randomization.

Results

The PRISM group reported significantly less loneliness and increased perceived social support and well-being at 6 months. There was a trend indicating a decline in social isolation. Group differences were not maintained at 12 months, but those in the PRISM condition still showed improvements from baseline. There was also an increase in computer self-efficacy, proficiency, and comfort with computers for PRISM participants at 6 and 12 months.

Discussion

The findings suggest that access to technology applications such as PRISM may enhance social connectivity and reduce loneliness among older adults and has the potential to change attitudes toward technology and increase technology self-efficacy.

Usability evaluation of a library website with different end user groups

To ensure a certain degree of usability, a library website should be carefully designed, especially since end users constitute a multitude of people with different needs and demands. The focal objective of this research was to investigate how different types of end users (i.e. pupils, students, the working population, seniors and researchers) respond to a library website in terms of its effectiveness, efficiency and satisfaction, which together represent its usability. The answers were obtained by performing formal usability testing, including think-aloud protocol, log analysis and questionnaires. The results of the statistical analysis show that different groups of end users achieve different levels of effectiveness and efficiency, while there is no significant difference between groups in satisfaction level. The results also indicate that participants did not achieve the threshold for a usable website. Based on the identified weaknesses, researchers present recommendations for improving a website’s usefulness, especially for non-experienced users. This research has two main contributions: (1) the connection between the theoretical definition and practical use of ISO 9241-11 attributes and (2) a usability testing procedure with a measurement framework applicable for different types of users in a specific domain, which could be applied to other domains.

The status value of age

A controlled experiment and three replications examined the relationship between a person's age as a status characteristic and the value placed on that person as a potential group member. The experiments used computer-generated avatars to isolate the effects of age on the status value of partners being chosen for a work-related task. The design allowed us to compare the effect of age on status for members of three distinct groups: younger adults, middle-aged adults, and much older adults. Results showed that undergraduate participants rated middle-aged adult avatars higher on status indicators and chose to work with middle-aged adult avatars significantly more often than younger adult or much older adult avatars. The participants rated the much older avatar higher on most indicators of status than the younger adult avatar. They also chose to work with a much older adult more often than a person closer to their own age. This sample of undergraduate students placed the most value on the potential contributions of a middle-aged adult compared to a younger adult and also to a much older adult, suggesting that age as a status characteristic has more than two relevant categories, younger versus older. Further research is needed to determine whether the status value of age rises to a peak in middle age and declines thereafter.

Visual Acuity does not Moderate Effect Sizes of Higher-Level Cognitive Tasks

BACKGROUND/STUDY CONTEXT

Declining visual capacities in older adults have been posited as a driving force behind adult age differences in higher-order cognitive functions (e.g., the "common cause" hypothesis of Lindenberger & Baltes, 1994, Psychology and Aging, 9, 339-355). McGowan, Patterson, and Jordan (2013, Experimental Aging Research, 39, 70-79) also found that a surprisingly large number of published cognitive aging studies failed to include adequate measures of visual acuity. However, a recent meta-analysis of three studies (La Fleur and Salthouse, 2014, Psychonomic Bulletin & Review, 21, 1202-1208) failed to find evidence that visual acuity moderated or mediated age differences in higher-level cognitive processes. In order to provide a more extensive test of whether visual acuity moderates age differences in higher-level cognitive processes, we conducted a more extensive meta-analysis of topic.

METHODS

Using results from 456 studies, we calculated effect sizes for the main effect of age across four cognitive domains (attention, executive function, memory, and perception/language) separately for five levels of visual acuity criteria (no criteria, undisclosed criteria, self-reported acuity, 20/80-20/31, and 20/30 or better).

RESULTS

As expected, age had a significant effect on each cognitive domain. However, these age effects did not further differ as a function of visual acuity criteria.

CONCLUSION

The current meta-analytic, cross-sectional results suggest that visual acuity is not significantly related to age group differences in higher-level cognitive performance-thereby replicating La Fleur and Salthouse (2014). Further efforts are needed to determine whether other measures of visual functioning (e.g., contrast sensitivity, luminance) affect age differences in cognitive functioning.

Age-Related Effects of Training on Developing a System Representation

Technology varies in complexity and requires different types of training for proper use. The present study focuses on the design of training materials to facilitate the development of a system representation of a complex task which may improve product usage. Previous research suggests that understanding the structure, or representation, of a complex system may help in performing infrequent tasks and troubleshooting system failures. The type of training participants receive may facilitate the development of task components necessary to enhance the skills needed for navigation which includes understanding the system representation. The current study examines two questions 1) does the type of training received affect the development of a system representation? and 2) are there age-related differences in the training effects? The discussion of the results will focus on training and age differences on the assessment measures which assess different aspects of learning.

Technology and Aging

Technological advancements have become widespread, and their implementation into products of everyday use is accelerating. Technology has the potential to improve the lives of older adults by increasing their safety, security, and independence in daily life. However, too often older adults' capabilities and limitations are not considered in the design of current and future technologies. In 1990, the National Research Council identified the importance of human factors in the design of technology for an aging population. The goal of this chapter is to review research on aging and technology since that report to determine the contributions of human factors research to issues of aging and technology design. In this chapter we address the extent to which older adults use new technologies, factors to consider in the adoption of technology (e.g., attitudes), the influence of technology design on older adults' performance (e.g., design of input devices), and ways to optimize training for older adults in using new technologies (e.g., age-specific instructional designs). We then review emerging areas of research that may direct the focus of human factors research in the next decade. These areas of research include ubiquitous computing (e.g., home monitoring systems), health care technologies (e.g., telehealth), robotics (e.g., Nursebot), and automated systems (e.g., cruise control). Finally, we consider opportunities and challenges to human factors research as the field continues to address the questions of optimizing technology for older adult users.

Writing in a Digital World: Self-Correction While Typing in Younger and Older Adults

This study examined how younger and older adults approach simple and complex computerized writing tasks. Nineteen younger adults (age range 21–31, mean age 26.1) and 19 older adults (age range 65–83, mean age 72.1) participated in the study. Typing speed, quantitative measures of outcome and process, and self-corrections were recorded. Younger adults spent a lower share of their time on actual typing, and demonstrated more prevalent use of delete keys than did older adults. Within the older group, there was no correlation between the total time spent on the entire task and the number of corrections, but increased typing speed was related to more errors. The results suggest that the approach to the task was different across age groups, either because of age or because of cohort effects. We discuss the interplay of speed and accuracy with regard to digital writing, and its implications for the design of human-computer interactions.

Factors affecting usage of a personal health record (PHR) to manage health

As the health care industry shifts into the digital age, patients are increasingly being provided with access to electronic personal health records (PHRs) that are tethered to their provider-maintained electronic health records. This unprecedented access to personal health information can enable patients to more effectively manage their health, but little is actually known about patients' ability to successfully use a PHR to perform health management tasks or the individual factors that influence task performance. This study evaluated the ability of 56 middle-aged adults (40-59 years) and 51 older adults (60-85 years) to use a simulated PHR to perform 15 common health management tasks encompassing medication management, review/interpretation of lab/test results, and health maintenance activities. Results indicated that participants in both age groups experienced significant difficulties in using the PHR to complete routine health management tasks. Data also showed that older adults, particularly those with lower numeracy and technology experience, encountered greater problems using the system. Furthermore, data revealed that the cognitive abilities predicting one's task performance varied according to the complexity of the task. Results from this study identify important factors to consider in the design of PHRs so that they meet the needs of middle-aged and older adults. As deployment of PHRs is on the rise, knowledge of the individual factors that impact effective PHR use is critical to preventing an increase in health care disparities between those who are able to use a PHR and those who are not.

Usability of therapy controllers in elderly patients with deep brain stimulation

Background

Technical devices are becoming more prevalent in society and also in medical care. Older adults need more support to learn new technologies than younger subjects. So far, no research has been done on the usability of patient controllers in deep brain stimulation in an elderly population. The aim of the study was to investigate the factors influencing the performance of elderly DBS patients with respect to usability aspects of Medtronic Access therapy controllers.

Methods

Time, mistakes and frequency of use of the controller were compared in 41 elderly DBS patients who prior to the study had already owned a therapy controller for more than six years. One group (n = 20, mean age = 66.4 years) was watching an instructional video and then completed practical assignments on a model implantable pulse generator (IPG). The other group (n = 21, mean age = 65.9 years) completed the tasks without having seen the video before. Any errors that patients made were documented and also corrected so that all of them received hands-on training. After six months all patients were re-evaluated on the dummy IPG in order to compare the effects of hands-on alone vs. video-based training combined with hands-on.

Results

The group that had seen the video before significantly outperformed the control group at both assessments with respect to number of errors. Both groups performed faster after six months compared to baseline and tend to use the controller more often than at baseline.

Conclusion

Our results indicate that elderly DBS patients who have been using the controller for several years still have various difficulties in operating the device. However, we also showed that age-specific training may improve the performance in older adults. In general, the design of DBS patient controllers should focus on the specific needs of the end-users. But as changes to medical devices take a long time to be implemented, video instructions with age-specific content plus hands-on training may improve learning for older adults.

A Household Internet Adoption Model Based on Integration of Technology Acceptance Model, Theory of Planned Behavior, and Uses and Gratifications Theory

Existing theories in the technology acceptance and Internet adoption fields have examined the adoption among users, which can be classified into two categories: technological and behavioral perspectives. In this paper, the authors propose an integrated household Internet adoption model combining both perspectives to provide a holistic view on the subject. For this purpose, the three primal models of technology acceptance and usage behavior, the technology acceptance model (TAM), theory of planned behavior (TPB), and uses and gratifications theory (U&G), are selected to construct the integrated model. In this way, based on the dimensions of the studied theories, specific constructs are defined to integrate these dimensions according to their similarities and appropriateness. The relationship between the proposed model’s constructs are then hypothesized based on the literature findings, and examined in a case study of household Internet adoption among Iranian households. Also, structural equation modeling (SEM) is used to illustrate the relationships’ coefficients between proposed model constructs, and derived implications for the Internet adoption among Iranian households are discussed based on the research findings.

Effects of an eHealth literacy intervention for older adults

Background

Older adults generally have low health and computer literacies, making it challenging for them to function well in the eHealth era where technology is increasingly being used in health care. Little is known about effective interventions and strategies for improving the eHealth literacy of the older population.

Objective

The objective of this study was to examine the effects of a theory-driven eHealth literacy intervention for older adults.

Methods

The experimental design was a 2 × 2 mixed factorial design with learning method (collaborative; individualistic) as the between-participants variable and time of measurement (pre; post) as the within-participants variable. A total of 146 older adults aged 56–91 (mean 69.99, SD 8.12) participated in this study during February to May 2011. The intervention involved 2 weeks of learning about using the National Institutes of Health’s SeniorHealth.gov website to access reliable health information. The intervention took place at public libraries. Participants were randomly assigned to either experimental condition (collaborative: n = 72; individualistic: n = 74).

Results

Overall, participants’ knowledge, skills, and eHealth literacy efficacy all improved significantly from pre to post intervention (P < .001 in all cases; effect sizes were >0.8 with statistical power of 1.00 even at the .01 level in all cases). When controlling for baseline differences, no significant main effect of the learning method was found on computer/Web knowledge, skills, or eHealth literacy efficacy. Thus, collaborative learning did not differ from individualistic learning in affecting the learning outcomes. No significant interaction effect of learning method and time of measurement was found. Group composition based on gender, familiarity with peers, or prior computer experience had no significant main or interaction effect on the learning outcomes. Regardless of the specific learning method used, participants had overwhelmingly positive attitudes toward the intervention and reported positive changes in participation in their own health care as a result of the intervention.

Conclusions

The findings provide strong evidence that the eHealth literacy intervention tested in this study, regardless of the specific learning method used, significantly improved knowledge, skills, and eHealth literacy efficacy from pre to post intervention, was positively perceived by participants, and led to positive changes in their own health care. Collaborative learning did not differ from individualistic learning in affecting the learning outcomes, suggesting the previously widely reported advantages of collaborative over individualistic learning may not be easily applied to the older population in informal settings, though several confounding factors might have contributed to this finding (ie, the largely inexperienced computer user composition of the study sample, potential instructor effect, and ceiling effect). Further research is necessary before a more firm conclusion can be drawn. These findings contribute to the literatures on adult learning, social interdependence theory, and health literacy.

Toward a psychological science of advanced technology design for older adults

OBJECTIVES

Technology represents advances in knowledge that change the way humans perform tasks. Ideally, technology will make the task easier, more efficient, safer, or perhaps more pleasurable. Unfortunately, new technologies can sometimes make a task more difficult, slower, dangerous, or perhaps more frustrating. Older adults interact with a variety of technologies in the course of their daily activities and thus products should be designed to be used by people of varying ages.

METHODS

In this article, we provide an overview of what psychology has to offer to the design of technology-from understanding what people need, to identifying their preferences for design characteristics, and to defining their capabilities and limitations that will influence technology interactions.

RESULTS

We identify how research in the field of psychology and aging has advanced understanding of technology interactions and how research on technology interactions can inform theories of aging.

DISCUSSION

Design for aging involves understanding the unique capabilities and limitations of older adults; identifying their needs, preferences, and desires for technology in their lives; and involving them in the design process.

Aging and Information Technology Use

Why are older adults reluctant to adopt new technology, such as the Internet, given its potential to improve the quality of their lives? We review evidence indicating that attitudes and abilities are among the most powerful predictors of technology use. We conclude that normative age-related changes in ability must be taken into account when designing products and training programs for aging adults, and we discuss new tools to support designers. The most promising emerging technologies likely lie in training cognitive abilities and augmenting or substituting for impaired abilities. We discuss reasons to expect that the lag in technology adoption between younger and older adults may lessen but will not disappear in future generations.

Public library computer training for older adults to access high-quality Internet health information

An innovative experiment to develop and evaluate a public library computer training program to teach older adults to access and use high-quality Internet health information involved a productive collaboration among public libraries, the National Institute on Aging and the National Library of Medicine of the National Institutes of Health (NIH), and a Library and Information Science (LIS) academic program at a state university. One hundred and thirty-one older adults aged 54-89 participated in the study between September 2007 and July 2008. Key findings include: a) participants had overwhelmingly positive perceptions of the training program; b) after learning about two NIH websites (http://nihseniorhealth.gov and http://medlineplus.gov) from the training, many participants started using these online resources to find high quality health and medical information and, further, to guide their decision-making regarding a health- or medically-related matter; and c) computer anxiety significantly decreased (p < .001) while computer interest and efficacy significantly increased (p = .001 and p < .001, respectively) from pre- to post-training, suggesting statistically significant improvements in computer attitudes between pre- and post-training. The findings have implications for public libraries, LIS academic programs, and other organizations interested in providing similar programs in their communities.

Video Modeling for Training Older Adults to Use New Technologies

The increasing permeation of technology in our society leads to the challenge that everybody needs to interact with technology systems. Older adults often meet difficulties while trying to interact with complex, demanding systems in their daily life. One approach to enable older adults to use new technologies in a safe and efficient way is the provision of training programs. In this article we report about a promising training strategy using video modeling in conjunction with other instructional methods to enhance learning. Cognitive as well as socio-motivational aspects will be addressed. We assessed if guided error training in video modeling will improve learning outcomes for a Ticket Vending Machine (TVM). To investigate if the training method might be beneficial for younger adults as well, we compared 40 younger and 40 older adult learners in a guided error training course with error-free training. Younger and older participants made fewer mistakes in guided error training, but no differences occurred in task completion times. Moreover, self-efficacy increased with training for both age groups, but no significant differences were found for the training condition. Analysis of knowledge gains showed a significant benefit of guided error training in structural knowledge. Overall, the results showed that guided error training may enhance learning for younger and older adults who are learning to use technology.

Environmental support: an integrative framework

OBJECTIVE

In this qualitative review, we develop an integrative framework to bring coherence to the concept of environmental support (ES) in the fields of human factors and cognitive aging.

BACKGROUND

The ES hypothesis, originally formulated to explain effects of retrieval support on age-related differences in memory by reducing need for self-initiated processing, has been applied to many domains, such that the concept now encompasses many manipulations and measures. We developed a framework in which different types of ES share a common function (external support of performance) but differ in how this function is accomplished. ES improves performance by reducing task demands on mental resources or promoting effective use of resources. Previous reviews show that ES can decrease age-related differences in performance (more benefit for older adults), provide equal benefit, or increase differences (more benefit for younger adults). We proposed that the outcome will depend on properties of the ES, task, and person.

METHOD

We applied our framework to the domains of language comprehension and human-computer interaction, selecting studies representative of differing outcomes for ES.

RESULTS

In both domains, we found that outcomes depended on ES, task, and person. Age differences were more likely to be reduced by ES that imposed minimal prerequisites for use and targeted processes that needed support.

CONCLUSION

Our review helps refine the ES concept by identifying conditions under which age differences in performance are reduced or magnified by ES.

APPLICATIONS

The framework provides guidance for human factors practitioners to design tasks and environments for older adults.

Aging and human performance

OBJECTIVES

I identify major theoretical and practical contributions to aging and human performance as reflected primarily in the pages of Human Factors.

BACKGROUND

Populations worldwide are aging. True experimental work on aging is not possible because age levels cannot be manipulated. Sophisticated theoretical frameworks and modeling techniques are required to reach valid inferences about age effects and age changes.

METHOD

Citation analysis was used to identify articles in Human Factors dealing with age or aging and to rank them for citation impact.

RESULTS

Special issues on aging were followed by increased publication rates for articles on age or aging, particularly in the 1990s. Most-cited articles deal primarily with age and driving.

CONCLUSIONS

Applied contributions rely on improved measurement of performance and on methodological advances, including simulation and modeling. Design changes that provide environmental support for declining cognitive, perceptual, and psychomotor abilities can serve as a powerful intervention for maintaining and improving older adult performance. Training is also a robust way to improve performance at both the basic ability level and the level of task performance. Human factors specialists can improve quality of life for an aging population.

APPLICATIONS

Guidelines for older users are now being developed by standards bodies and are implemented in domains such as Web design. Much of the focus of human factors research has been on improving efficiency in the performance of aging adults in the workforce, but reducing errors and increasing comfort and satisfaction in health-related activities should receive greater attention.

Meeting the challenges of an aging workforce

BACKGROUND

Demographic, labor market and economic forces are combining to produce increases in the number and percentage of U.S. workers 55 and older. In some ways these workers will be our most skilled and productive employees but in others the most vulnerable.

METHODS

The literature on aging and work was reviewed, including demographic trends, physical and cognitive changes, safety and performance, work ability, and retirement patterns.

RESULTS AND CONCLUSIONS

Older workers have more serious, but less frequent, workplace injuries and illnesses than younger ones. There is evidence that many of these problems can be prevented and their consequences reduced by anticipating the physical and cognitive changes of age. Many employers are aware that such efforts are necessary, but most have not yet addressed them. There is a need for implementation and evaluative research of programs and policies with four dimensions: the work environment, work arrangements and work-life balance, health promotion and disease prevention, and social support. Employers who establish age-friendly workplaces that promote and support the work ability of employees as they age may gain in safety, productivity, competitiveness, and sustainable business practices.

A multilevel modeling approach to examining individual differences in skill acquisition for a computer-based task

This article explores the role of age, cognitive abilities, prior experience, and knowledge in skill acquisition for a computer-based simulated customer service task. Fifty-two participants aged 50-80 performed the task over 4 consecutive days following training. They also completed a battery that assessed prior computer experience and cognitive abilities. The data indicated that overall quality and efficiency of performance improved with practice. The predictors of initial level of performance and rate of change in performance varied according to the performance parameter assessed. Age and fluid intelligence predicted initial level and rate of improvement in overall quality, whereas crystallized intelligence and age predicted initial e-mail processing time, and crystallized intelligence predicted rate of change in e-mail processing time over days. We discuss the implications of these findings for the design of intervention strategies.

Pilot age and expertise predict flight simulator performance: a 3-year longitudinal study

BACKGROUND

Expert knowledge may compensate for age-related declines in basic cognitive and sensory-motor abilities in some skill domains. We investigated the influence of age and aviation expertise (indexed by Federal Aviation Administration pilot ratings) on longitudinal flight simulator performance.

METHODS

Over a 3-year period, 118 general aviation pilots aged 40 to 69 years were tested annually, in which their flight performance was scored in terms of 1) executing air-traffic controller communications; 2) traffic avoidance; 3) scanning cockpit instruments; 4) executing an approach to landing; and 5) a flight summary score.

RESULTS

More expert pilots had better flight summary scores at baseline and showed less decline over time. Secondary analyses revealed that expertise effects were most evident in the accuracy of executing aviation communications, the measure on which performance declined most sharply over time. Regarding age, even though older pilots initially performed worse than younger pilots, over time older pilots showed less decline in flight summary scores than younger pilots. Secondary analyses revealed that the oldest pilots did well over time because their traffic avoidance performance improved more vs younger pilots.

CONCLUSIONS

These longitudinal findings support previous cross-sectional studies in aviation as well as non-aviation domains, which demonstrated the advantageous effect of prior experience and specialized expertise on older adults' skilled cognitive performances.

Factors predicting the use of technology: findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE)

The successful adoption of technology is becoming increasingly important to functional independence. The present article reports findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE) on the use of technology among community-dwelling adults. The sample included 1,204 individuals ranging in age from 18-91 years. All participants completed a battery that included measures of demographic characteristics, self-rated health, experience with technology, attitudes toward computers, and component cognitive abilities. Findings indicate that the older adults were less likely than younger adults to use technology in general, computers, and the World Wide Web. The results also indicate that computer anxiety, fluid intelligence, and crystallized intelligence were important predictors of the use of technology. The relationship between age and adoption of technology was mediated by cognitive abilities, computer self-efficacy, and computer anxiety. These findings are discussed in terms of training strategies to promote technology adoption.

Factors predicting the use of technology: findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE)

The successful adoption of technology is becoming increasingly important to functional independence. The present article reports findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE) on the use of technology among community-dwelling adults. The sample included 1,204 individuals ranging in age from 18-91 years. All participants completed a battery that included measures of demographic characteristics, self-rated health, experience with technology, attitudes toward computers, and component cognitive abilities. Findings indicate that the older adults were less likely than younger adults to use technology in general, computers, and the World Wide Web. The results also indicate that computer anxiety, fluid intelligence, and crystallized intelligence were important predictors of the use of technology. The relationship between age and adoption of technology was mediated by cognitive abilities, computer self-efficacy, and computer anxiety. These findings are discussed in terms of training strategies to promote technology adoption.

Age, ability, and the role of prior knowledge on the acquisition of new domain knowledge: promising results in a real-world learning environment

Prior knowledge, fluid intelligence (Gf), and crystallized intelligence (Gc) were investigated as predictors of learning new information about cardiovascular disease and xerography with a sample of 199 adults (19 to 68 years). The learning environment included a laboratory multimedia presentation (high-constraint-maximal effort), and a self-directed at-home study component (low-constraint-typical performance). Results indicated that prior knowledge and ability were important predictors of knowledge acquisition for learning. Gc was directly related to learning from the video for both domains. Because the trajectory of Gc stays relatively stable throughout the life span, these findings provide a more optimistic perspective on the relationship between aging and learning than that offered by theories that focus on the role of fluid abilities in learning.