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Romon I, Gonzalez-Barrera S, Coello de Portugal C, Ocio E, Sampedro I. Brave new world: expanding home care in stem cell transplantation and advanced therapies with new technologies. Front Immunol 2024; 15:1366962. [PMID: 38736880 PMCID: PMC11082320 DOI: 10.3389/fimmu.2024.1366962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 04/12/2024] [Indexed: 05/14/2024] Open
Abstract
Hematopoietic stem cell transplantation and cell therapies like CAR-T are costly, complex therapeutic procedures. Outpatient models, including at-home transplantation, have been developed, resulting in similar survival results, reduced costs, and increased patient satisfaction. The complexity and safety of the process can be addressed with various emerging technologies (artificial intelligence, wearable sensors, point-of-care analytical devices, drones, virtual assistants) that allow continuous patient monitoring and improved decision-making processes. Patients, caregivers, and staff can also benefit from improved training with simulation or virtual reality. However, many technical, operational, and above all, ethical concerns need to be addressed. Finally, outpatient or at-home hematopoietic transplantation or CAR-T therapy creates a different, integrated operative system that must be planned, designed, and carefully adapted to the patient's characteristics and distance from the hospital. Patients, clinicians, and their clinical environments can benefit from technically improved at-home transplantation.
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Affiliation(s)
- Iñigo Romon
- Transfusion Section, Hematology Department, University Hospital “Marques de Valdecilla”, Santander, Spain
| | - Soledad Gonzalez-Barrera
- Home Hospitalization Department, University Hospital “Marques de Valdecilla” - Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain
| | | | - Enrique Ocio
- Hematology Department, University Hospital “Marques de Valdecilla” - IDIVAL, Santander, Spain
| | - Isabel Sampedro
- Home Hospitalization Department, University Hospital “Marques de Valdecilla” - Instituto de Investigación Valdecilla (IDIVAL), Santander, Spain
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Cao X, Zhang H, Zhou B, Wang D, Cui C, Bai X. Factors influencing older adults' acceptance of voice assistants. Front Psychol 2024; 15:1376207. [PMID: 38515974 PMCID: PMC10956694 DOI: 10.3389/fpsyg.2024.1376207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Introduction Voice assistants (VAs) have the potential to uphold and enhance the quality of life for older adults. However, the extent to which older adults accept and benefit from VAs may be relatively modest. Methods This study developed a comprehensive model combined with product and personal characteristics to explain the acceptance of VAs among older adults, using semi-structured interviews (Study 1) and questionnaires (Study 2). Results Results revealed that in terms of product characteristics, perceived usefulness and perceived enjoyment significantly affect behavior intention. Regarding personal characteristics of older adults, technological self-efficacy and dispositional resistance to change significantly affect behavior intention. However, no direct impact of perceived ease of use and perceived trust on behavior intention. Additionally, perceived enjoyment influenced both perceived ease of use and perceived usefulness. Discussion Results suggested the significant role of technology self-efficacy and dispositional resistance to change in predicting the acceptance of VAs among older adults. Our newly developed model offers valuable insights for tailoring VAs to this demographic during design and implementation.
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Affiliation(s)
- Xiancai Cao
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
- Tianjin Social Science Laboratory of Students' Mental Development and Learning, Tianjin, China
| | - Hao Zhang
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| | - Bolin Zhou
- School of Management, Tianjin Normal University, Tianjin, China
| | - Dahua Wang
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Chenhong Cui
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| | - Xuejun Bai
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
- Tianjin Social Science Laboratory of Students' Mental Development and Learning, Tianjin, China
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Moreno A, Scola MC, Sun H, Durce H, Couve C, Acevedo K, Gutman GM. A systematic review of gerontechnologies to support aging in place among community-dwelling older adults and their family caregivers. Front Psychol 2024; 14:1237694. [PMID: 38327502 PMCID: PMC10847552 DOI: 10.3389/fpsyg.2023.1237694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 12/31/2023] [Indexed: 02/09/2024] Open
Abstract
Objective Paucity of information concerning the efficacy of gerontechnologies to support aging in place among community-dwelling older adults prevents potential users, healthcare professionals, and policymakers from making informed decisions on their use. The goal of this study was to identify gerontechnologies tested for home support in dyads of community-dwelling older adults with unimpaired cognition and their family caregivers, including their benefits and challenges. We also provide the level of evidence of the studies and recommendations to address the specific challenges preventing their use, dissemination, and implementation. Methods We conducted a systematic review of the literature published between 2016 and 2021 on gerontechnologies tested for home support in dyads. Two independent reviewers screened the abstracts according to the inclusion/exclusion criteria. A third reviewer resolved eligibility discrepancies. Data extraction was conducted by two independent reviewers. Results Of 1,441 articles screened, only 13 studies met the inclusion criteria with studies of moderate quality. Mostly, these gerontechnologies were used to monitor the older adult or the environment, to increase communication with family caregivers, to assist in daily living activities, and to provide health information. Benefits included facilitating communication, increasing safety, and reducing stress. Common challenges included difficulties using the technologies, technical problems, privacy issues, increased stress and dissatisfaction, and a mismatch between values and needs. Conclusion Only a few gerontechnologies have proven efficacy in supporting community-dwelling older adults and their family caregivers. The inclusion of values and preferences, co-creation with end users, designing easy-to-use technologies, and assuring training are strongly recommended to increase acceptability and dissemination. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=310803, identifier CRD42022310803.
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Affiliation(s)
- Alexander Moreno
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
- Notre-Dame Hospital, Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal (CCSMTL), Montréal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Maria-Cristina Scola
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC, Canada
- Department of Psychoeducation, Université de Montréal, Montréal, QC, Canada
| | - Hua Sun
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Henrick Durce
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Célia Couve
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Kelly Acevedo
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montréal, QC, Canada
| | - Gloria M. Gutman
- Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada
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Varela-Aldás J, Avila-Armijos W, Palacios-Navarro G. Internet of things (IoT)-based assistive system for patients with spinal muscular atrophy (SMA): a case report. Disabil Rehabil Assist Technol 2024:1-8. [PMID: 38217485 DOI: 10.1080/17483107.2023.2300045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 12/22/2023] [Indexed: 01/15/2024]
Abstract
PURPOSE Assistive technologies based on IoT can contribute to improve quality of living of patients with severe motor difficulties by providing partial or total independence. The aim of this work was to analyse the usability and performance of an assistive system based on the IoT when is evaluated by a child patient with spinal muscular atrophy type 1 (SMA-I). MATERIALS AND METHODS The study involved a child with SMA-I and his caregiver. The materials used include an M5Stack Core2 kit, a mobile app, and a smart switch based on the ESP-01S card. The patient sends requests to the caregiver from the app installed on the M5Stack Core2 to a mobile app, and controls smart switches located in the rooms. The system was tested by the participants for a period of 30 days to later evaluate its usability and performance. RESULTS The results show that the control function of smart switches is the most used and there is no decrease in interactions over the days for the system in general. In addition, the scores obtained from both usability tests (patient and caregiver) were 87.5% and 90%, respectively. The average performance of the entire system was 93.33%. CONCLUSION The application of assistive technologies based on the IoT allows obtaining a practical solution that improves the development of daily activities in a patient with SMA-I.
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Affiliation(s)
- José Varela-Aldás
- Centro de Investigaciones de Ciencias Humanas y de la Educación (CICHE), Universidad Indoamérica, Ambato, Ecuador
| | - William Avila-Armijos
- Centro de Investigaciones de Ciencias Humanas y de la Educación (CICHE), Universidad Indoamérica, Ambato, Ecuador
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Ding D, Morris L, Messina K, Fairman A. Providing mainstream smart home technology as assistive technology for persons with disabilities: a qualitative study with professionals. Disabil Rehabil Assist Technol 2023; 18:1192-1199. [PMID: 34752169 DOI: 10.1080/17483107.2021.1998673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 10/16/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE Mainstream smart home technology (MSHT) is becoming increasingly powerful, affordable, and relevant to improving environment control, independence, and participation of people with disabilities. This study examined how MSHT is delivered as assistive technology (AT) by practitioners of various disciplines and roles and collected their perspectives on the challenges and important considerations during the delivery process. METHODS Practitioners with at least 1 year of experience providing MSHT as AT were interviewed individually or in small groups of 2-3 participants. Researchers developed guiding questions based on the AT service delivery process and applied an inductive qualitative analysis to generate common themes from the data. RESULTS While all 15 participants confirmed the potential benefits of MSHT to people with disabilities, most followed an informal service delivery process and encountered various challenges, including challenges related to technology updates and compatibility, difficulty in keeping up with technology changes and advancement, funding for MSHT and services, client Wi-Fi/Internet access and quality, and security and privacy concerns. Participants also emphasised the importance of assessment and technology trialling during the delivery process and shared strategies for device customisation and client training. CONCLUSIONS This study provides first-hand information about the current practice of MSHT service delivery, as well as insights into areas where support is likely needed. The results could inform the development of new tools and resources to support MSHT service delivery. More research is required to develop and evaluate viable service delivery models for mainstream technologies to be used as AT.IMPLICATIONS FOR REHABILITATIONPractitioners who have experience delivering MSHT as AT confirmed the benefits of MSHT for improving independence, safety, and social connection of people with disabilities.Practitioners emphasised the importance of assessment prior to device selection even though MSHT can be readily purchased off the shelf.Practitioners need support for device trialling, installation, troubleshooting, and keeping up with constantly evolving MSHT.More research is needed to develop and evaluate service delivery models for mainstream technologies as AT for people with disabilities.
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Affiliation(s)
- Dan Ding
- Human Engineering Research Laboratories, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA
- VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Lindsey Morris
- Human Engineering Research Laboratories, University of Pittsburgh, Pittsburgh, PA, USA
- VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Kristin Messina
- Occupational Therapy Program, Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA
| | - Andrea Fairman
- Human Engineering Research Laboratories, University of Pittsburgh, Pittsburgh, PA, USA
- Occupational Therapy Program, College of Health & Wellness, Johnson & Wales University, Providence, RI, USA
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Corbett CF, Bowers DC, Combs EM, Parmer M, Jones K, Patel K, Owens OL. Using Virtual Home Assistants to Address Vulnerable Adults' Complex Care Needs: An Exploratory Feasibility Study. J Gerontol Nurs 2023; 49:33-40. [PMID: 37256755 DOI: 10.3928/00989134-20230512-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Harnessing technology has been proposed as one strategy to meet the social and health needs of older adults who prefer to age in place, but solutions remain elusive. In the current study, we evaluated the feasibility of using voice-activated virtual home assistants (VHAs; i.e., Amazon Echo "Alexa" devices) with older adults participating in the Program for All-Inclusive Care of the Elderly (PACE) over 4 months. Study methods included process evaluations, tracking participants' VHA use, and qualitative feedback from PACE participants and staff. The most common VHA activities were voice-activated smart lighting and asking for information. Participants infrequently used VHA activities that could promote physical or cognitive function (e.g., chair yoga, word recall game). Participants enjoyed using the VHAs, and PACE staff were enthusiastic about the potential for VHAs to facilitate aging in place and provided recommendations to increase participants' use of functional health activities. [Journal of Gerontological Nursing, 49(6), 33-40.].
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Aggar C, Sorwar G, Seton C, Penman O, Ward A. Smart home technology to support older people's quality of life: A longitudinal pilot study. Int J Older People Nurs 2023; 18:e12489. [PMID: 35785517 PMCID: PMC10078149 DOI: 10.1111/opn.12489] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 05/04/2022] [Accepted: 06/07/2022] [Indexed: 01/15/2023]
Abstract
AIM This pilot study aimed to explore the impact of Smart Home technology to support older people's quality of life, particularly for those who live alone. BACKGROUND There has been an increased interest in using innovative technologies and artificial intelligence to enable Smart Home technology to support older people to age independently in their own homes. METHODS This study used a pre-and post-test design. The seven item Personal Wellbeing Index was used to measure participants' subjective quality of life across seven quality of life domains. Participants (n = 60) aged between 68 and 90 years (M = 80.10, SD = 5.56) completed a 12-week personalised Smart Home technology program. RESULTS Approximately half of the participants lived alone (48.3%). Participants' quality of life significantly increased (p = 0.010) after Smart Home use. Two domains, "achieving in life" (p = 0.026) and "future security" (p = 0.004), were also significantly improved after participating in the Smart Home technology program. Improvements in quality of life did not vary as a function of living arrangement (all ps > .152, all η p 2 > .00). CONCLUSION The current study provides preliminary evidence for the role of Smart Home technology in supporting older people's quality of life, particularly their sense of achieving in life and future security.
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Affiliation(s)
- Christina Aggar
- Faculty of Health, Southern Cross University, Bilinga, QLD, Australia
| | - Golam Sorwar
- Faculty of Health, Southern Cross University, Bilinga, QLD, Australia
| | - Carolyn Seton
- Faculty of Health, Southern Cross University, Bilinga, QLD, Australia
| | - Olivia Penman
- Faculty of Health, Southern Cross University, Bilinga, QLD, Australia
| | - Anastasia Ward
- Faculty of Health, Southern Cross University, Bilinga, QLD, Australia.,Feros Care, Tweed Heads, NSW, Australia
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Lifset ET, Charles K, Farcas E, Weibel N, Hogarth M, Chen C, Johnson JG, Draper M, Nguyen AL, Moore AA. Ascertaining Whether an Intelligent Voice Assistant Can Meet Older Adults' Health-Related Needs in the Context of a Geriatrics 5Ms Framework. Gerontol Geriatr Med 2023; 9:23337214231201138. [PMID: 37790195 PMCID: PMC10542316 DOI: 10.1177/23337214231201138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/14/2023] [Accepted: 08/23/2023] [Indexed: 10/05/2023] Open
Abstract
The Geriatrics 5Ms: Medications, Mind, Mobility, what Matters most and Multicomplexity is a framework to address the complex needs of older adults. Intelligent Voice Assistants (IVAs) are increasingly popular and have potential to support health-related needs of older adults. We utilized previously collected qualitative data on older adults' views of how an IVA may address their health-related needs and ascertained their fit into the Geriatrics 5Ms framework. The codes describing health challenges and potential IVA solutions fit the framework: (1) Medications: difficulty remembering medications. SOLUTION reminders. (2) Mind: isolation, anxiety, memory loss. SOLUTION companionship, memory aids. (3) Mobility: barriers to exercise. SOLUTION incentives, exercise ideas. (4) Matters most: eating healthy foods. SOLUTION suggest and order nutritious foods, (5) Multicomplexity; managing multimorbidity. SOLUTION symptom tracking and communicating with health care professionals. Incorporating the 5Ms framework into IVA design can aid in addressing health care priorities of older adults.
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Affiliation(s)
| | | | | | - Nadir Weibel
- University of California San Diego, La Jolla, USA
| | | | - Chen Chen
- University of California San Diego, La Jolla, USA
| | | | - Mary Draper
- University of California San Diego, La Jolla, USA
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Ma T, Zhang S, Zhu S, Ni J, Wu Q, Liu M. The new role of nursing in digital inclusion: Reflections on smartphone use and willingness to increase digital skills among Chinese older adults. Geriatr Nurs 2022; 48:118-126. [PMID: 36155310 DOI: 10.1016/j.gerinurse.2022.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/02/2022] [Accepted: 09/02/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study explores the willingness of older adults to use smartphones and improve their digital skills and encourages nursing to actively participate in bridging the digital divide. METHODS Subject analysis was used to conduct qualitative research, and 23 older adults were interviewed. RESULTS We identified four themes: (1) the current situation of smartphone use; (2) the digital dilemma of smartphone use; (3) social support for digital skills; and (4) the willingness to learn digital skills. Older adults in China are willing to accept and use smartphones for simple operations, and peer learning may be an effective way to improve their digital skills. CONCLUSION Community support is necessary to develop the digital skills of older adults with smartphones and reduce the digital divide to the greatest extent possible. Nursing may play a role in promoting digital inclusion for older adults.
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Affiliation(s)
- Tianjiao Ma
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang District, Changchun, Jilin 130012, People's Republic of China
| | - Siyu Zhang
- School of Journalism and Communication, Jilin University, No.2699, Qianjin Street, Chaoyang District, Changchun, Jilin 130012, People's Republic of China
| | - Siying Zhu
- School of Journalism and Communication, Jilin University, No.2699, Qianjin Street, Chaoyang District, Changchun, Jilin 130012, People's Republic of China
| | - Jingqi Ni
- School of Journalism and Communication, Jilin University, No.2699, Qianjin Street, Chaoyang District, Changchun, Jilin 130012, People's Republic of China
| | - Qiqi Wu
- School of Journalism and Communication, Jilin University, No.2699, Qianjin Street, Chaoyang District, Changchun, Jilin 130012, People's Republic of China
| | - Mingzheng Liu
- School of Journalism and Communication, Jilin University, No.2699, Qianjin Street, Chaoyang District, Changchun, Jilin 130012, People's Republic of China.
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Gustafson DH, Mares ML, Johnston DC, Landucci G, Pe-Romashko K, Vjorn OJ, Hu Y, Gustafson DH, Maus A, Mahoney JE, Mutlu B. Using Smart Displays to Implement an eHealth System for Older Adults With Multiple Chronic Conditions: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e37522. [PMID: 35511229 PMCID: PMC9121223 DOI: 10.2196/37522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 11/29/2022] Open
Abstract
Background Voice-controlled smart speakers and displays have a unique but unproven potential for delivering eHealth interventions. Many laptop- and smartphone-based interventions have been shown to improve multiple outcomes, but voice-controlled platforms have not been tested in large-scale rigorous trials. Older adults with multiple chronic health conditions, who need tools to help with their daily management, may be especially good candidates for interventions on voice-controlled devices because these patients often have physical limitations, such as tremors or vision problems, that make the use of laptops and smartphones challenging. Objective The aim of this study is to assess whether participants using an evidence-based intervention (ElderTree) on a smart display will experience decreased pain interference and improved quality of life and related measures in comparison with participants using ElderTree on a laptop and control participants who are given no device or access to ElderTree. Methods A total of 291 adults aged ≥60 years with chronic pain and ≥3 additional chronic conditions will be recruited from primary care clinics and community organizations and randomized 1:1:1 to ElderTree access on a smart display along with their usual care, ElderTree access on a touch screen laptop along with usual care, or usual care alone. All patients will be followed for 8 months. The primary outcomes are differences between groups in measures of pain interference and psychosocial quality of life. The secondary outcomes are between-group differences in system use at 8 months, physical quality of life, pain intensity, hospital readmissions, communication with medical providers, health distress, well-being, loneliness, and irritability. We will also examine mediators and moderators of the effects of ElderTree on both platforms. At baseline, 4 months, and 8 months, patients will complete written surveys comprising validated scales selected for good psychometric properties with similar populations. ElderTree use data will be collected continuously in system logs. We will use linear mixed-effects models to evaluate outcomes over time, with treatment condition and time acting as between-participant factors. Separate analyses will be conducted for each outcome. Results Recruitment began in August 2021 and will run through April 2023. The intervention period will end in December 2023. The findings will be disseminated via peer-reviewed publications. Conclusions To our knowledge, this is the first study with a large sample and long time frame to examine whether a voice-controlled smart device can perform as well as or better than a laptop in implementing a health intervention for older patients with multiple chronic health conditions. As patients with multiple conditions are such a large cohort, the implications for cost as well as patient well-being are significant. Making the best use of current and developing technologies is a critical part of this effort. Trial Registration ClinicalTrials.gov NCT04798196; https://clinicaltrials.gov/ct2/show/NCT04798196 International Registered Report Identifier (IRRID) PRR1-10.2196/37522
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Affiliation(s)
- David H Gustafson
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, United States.,Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, WI, United States
| | - Marie-Louise Mares
- Department of Communication Arts, University of Wisconsin-Madison, Madison, WI, United States
| | - Darcie C Johnston
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, United States
| | - Gina Landucci
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, United States
| | - Klaren Pe-Romashko
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, United States
| | - Olivia J Vjorn
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, United States
| | - Yaxin Hu
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States
| | - David H Gustafson
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, United States
| | - Adam Maus
- Center for Health Enhancement Systems Studies, University of Wisconsin-Madison, Madison, WI, United States
| | - Jane E Mahoney
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI, United States
| | - Bilge Mutlu
- Department of Computer Sciences, University of Wisconsin-Madison, Madison, WI, United States
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11
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Tennant R, Allana S, Mercer K, Burns CM. Caregiver Expectations for Interfacing with Voice Assistants to Support Complex Home Care: Mixed-Methods Study (Preprint). JMIR Hum Factors 2022; 9:e37688. [PMID: 35771594 PMCID: PMC9284358 DOI: 10.2196/37688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/11/2022] [Accepted: 05/31/2022] [Indexed: 12/03/2022] Open
Abstract
Background Providing care in home environments is complex, and often the pressure is on caregivers to document information and ensure care continuity. Digital information management and communication technologies may support care coordination among caregivers. However, they have yet to be adopted in this context, partly because of issues with supporting long-term disease progression and caregiver anxiety. Voice assistant (VA) technology is a promising method for interfacing with digital health information that may aid in multiple aspects of being a caregiver, thereby influencing adoption. Understanding the expectations for VAs to support caregivers is fundamental to inform the practical development of this technology. Objective This study explored caregivers’ perspectives on using VA technology to support caregiving and inform the design of future digital technologies in complex home care. Methods This study was part of a larger study of caregivers across North America on the design of digital health technologies to support health communication and information management in complex home care. Caregivers included parents, guardians, and hired caregivers such as personal support workers and home care nurses. Video interviews were conducted with caregivers to capture their mental models on the potential application of VAs in complex home care and were theoretically analyzed using the technology acceptance model. Interviews were followed up with Likert-scale questions exploring perspectives on other VA applications beyond participants’ initial perceptions. Results Data were collected from 22 caregivers, and 3 themes were identified: caregivers’ perceived usefulness of VAs in supporting documentation, care coordination, and person-centered care; caregivers’ perceived ease of use in navigating information efficiently (they also had usability concerns with this interaction method); and caregivers’ concerns, excitement, expected costs, and previous experience with VAs that influenced their attitudes toward use. From the Likert-scale questions, most participants (21/22, 95%) agreed that VAs should support prompted information recording and retrieval, and all participants (22/22, 100%) agreed that they should provide reminders. They also agreed that VAs should support them in an emergency (18/22, 82%)—but only for calling emergency services—and guide caregivers through tasks (21/22, 95%). However, participants were less agreeable on VAs expressing a personality (14/22, 64%)—concerned they would manipulate caregivers’ perceptions—and listening ambiently to remind caregivers about their documentation (16/22, 73%). They were much less agreeable about VAs providing unprompted assistance on caregiving tasks (9/22, 41%). Conclusions The interviews and Likert-scale results point toward the potential for VAs to support family caregivers and hired caregivers by easing their information management and health communication at home. However, beyond information interaction, the potential impact of VA personality traits on caregivers’ perceptions of the care situation and the passive collection of audio data to improve user experience through context-specific interactions are critical design considerations that should be further examined.
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Affiliation(s)
- Ryan Tennant
- Department of Systems Design Engineering, Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Sana Allana
- Department of Systems Design Engineering, Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Kate Mercer
- Department of Systems Design Engineering, Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada
- Library, University of Waterloo, Waterloo, ON, Canada
| | - Catherine M Burns
- Department of Systems Design Engineering, Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada
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12
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Corbett CF, Wright PJ, Jones K, Parmer M. Voice-Activated Virtual Home Assistant Use and Social Isolation and Loneliness Among Older Adults: Mini Review. Front Public Health 2021; 9:742012. [PMID: 34708017 PMCID: PMC8542756 DOI: 10.3389/fpubh.2021.742012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/23/2021] [Indexed: 11/15/2022] Open
Abstract
A lack of social connectedness is common among older adults due to living alone, loss of loved ones, reduced mobility, and, more recently, social distancing created by the global Covid-19 pandemic. Older adults are vulnerable to social isolation and loneliness, which pose significant health risks comparable to those of smoking, obesity, physical inactivity, and high blood pressure. A lack of social connectedness is also correlated with higher mortality rates even when controlling for other factors such as age and comorbid conditions. The purpose of this mini review was to explore the emerging concepts of older adults' use of commercially available artificial intelligent virtual home assistants (VHAs; e.g., Amazon Echo, Google Nest), and its relationship to social isolation and loneliness. A secondary purpose was to identify potential areas for further research. Results suggest that VHAs are perceived by many older adult users as “companions” and improve social connectedness and reduce loneliness. Available studies are exploratory and descriptive and have limited generalizability due to small sample sizes, however, similar results were reported across several studies conducted in differing countries. Privacy concerns and other ethical issues and costs associated with VHA use were identified as potential risks to older adults' VHA adoption and use. Older adults who were using VHAs expressed the need and desire for more structured training on device use. Future research with stronger methods, including prospective, longitudinal, and randomized study designs are needed. Public education, industry standards, and regulatory oversight is required to mitigate potential risks associated with VHA use.
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Affiliation(s)
- Cynthia F Corbett
- College of Nursing, University of South Carolina, Columbia, SC, United States.,Advancing Chronic Care Outcomes through Research and Innovation Center, College of Nursing, University of South Carolina, Columbia, SC, United States
| | - Pamela J Wright
- College of Nursing, University of South Carolina, Columbia, SC, United States.,Advancing Chronic Care Outcomes through Research and Innovation Center, College of Nursing, University of South Carolina, Columbia, SC, United States
| | - Kate Jones
- College of Nursing, University of South Carolina, Columbia, SC, United States
| | - Michael Parmer
- Prisma Health Senior Care Program for All-Inclusive Care for the Elderly, Greenville, SC, United States
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13
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Corbett CF, Combs EM, Chandarana PS, Stringfellow I, Worthy K, Nguyen T, Wright PJ, O'Kane JM. Medication Adherence Reminder System for Virtual Home Assistants: Mixed Methods Evaluation Study. JMIR Form Res 2021; 5:e27327. [PMID: 34255669 PMCID: PMC8317037 DOI: 10.2196/27327] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/08/2021] [Accepted: 05/31/2021] [Indexed: 12/31/2022] Open
Abstract
Background Medication nonadherence is a global public health challenge that results in suboptimal health outcomes and increases health care costs. Forgetting to take medicines is one of the most common reasons for unintentional medication nonadherence. Research findings indicate that voice-activated virtual home assistants, such as Amazon Echo and Google Home devices, may be useful in promoting medication adherence. Objective This study aims to create a medication adherence app (skill), MedBuddy, for Amazon Echo devices and measure the use, usability, and usefulness of this medication-taking reminder skill. Methods A single-group, mixed methods, cohort feasibility study was conducted with women who took oral contraceptives (N=25). Participants were undergraduate students (age: mean 21.8 years, SD 6.2) at an urban university in the Southeast United States. Participants were given an Amazon Echo Dot with MedBuddy—a new medication reminder skill for Echo devices created by our team—attached to their study account, which they used for 60 days. Participants self-reported their baseline and poststudy medication adherence. MedBuddy use was objectively evaluated by tracking participants’ interactions with MedBuddy through Amazon Alexa. The usability and usefulness of MedBuddy were evaluated through a poststudy interview in which participants responded to both quantitative and qualitative questions. Results Participants’ interactions with MedBuddy, as tracked through Amazon Alexa, only occurred on half of the study days (mean 50.97, SD 29.5). At study end, participants reported missing their medication less in the past 1 and 6 months compared with baseline (χ21=0.9 and χ21=0.4, respectively; McNemar test: P<.001 for both). However, there was no significant difference in participants’ reported adherence to consistently taking medication within the same 2-hour time frame every day in the past 1 or 6 months at the end of the study compared with baseline (χ21=3.5 and χ21=0.4, respectively; McNemar test: P=.63 and P=.07, respectively). Overall feedback about usability was positive, and participants provided constructive feedback about the skill’s features that could be improved. Participants’ evaluation of MedBuddy’s usefulness was overwhelmingly positive—most (15/23, 65%) said that they would continue using MedBuddy as a medication reminder if provided with the opportunity and that they would recommend it to others. MedBuddy features that participants enjoyed were an external prompt separate from their phone, the ability to hear the reminder prompt from a separate room, multiple reminders, and verbal responses to prompts. Conclusions The findings of this feasibility study indicate that the MedBuddy medication reminder skill may be useful in promoting medication adherence. However, the skill could benefit from further usability enhancements.
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Affiliation(s)
- Cynthia F Corbett
- College of Nursing, University of South Carolina, Columbia, SC, United States.,Center for Advancing Chronic Care Outcomes through Research and Innovation, College of Nursing, University of South Carolina, Columbia, SC, United States
| | - Elizabeth M Combs
- College of Nursing, University of South Carolina, Columbia, SC, United States.,Center for Advancing Chronic Care Outcomes through Research and Innovation, College of Nursing, University of South Carolina, Columbia, SC, United States
| | - Peyton S Chandarana
- Center for Advancing Chronic Care Outcomes through Research and Innovation, College of Nursing, University of South Carolina, Columbia, SC, United States.,College of Engineering and Computing, University of South Carolina, Columbia, SC, United States
| | - Isabel Stringfellow
- Center for Advancing Chronic Care Outcomes through Research and Innovation, College of Nursing, University of South Carolina, Columbia, SC, United States.,Arnold School of Public Health, University of South Carolina, Columbia, SC, United States.,South Carolina Honors College, Columbia, SC, United States
| | - Karen Worthy
- College of Nursing, University of South Carolina, Columbia, SC, United States
| | - Thien Nguyen
- College of Nursing, University of South Carolina, Columbia, SC, United States.,Center for Advancing Chronic Care Outcomes through Research and Innovation, College of Nursing, University of South Carolina, Columbia, SC, United States
| | - Pamela J Wright
- College of Nursing, University of South Carolina, Columbia, SC, United States.,Center for Advancing Chronic Care Outcomes through Research and Innovation, College of Nursing, University of South Carolina, Columbia, SC, United States
| | - Jason M O'Kane
- Center for Advancing Chronic Care Outcomes through Research and Innovation, College of Nursing, University of South Carolina, Columbia, SC, United States.,College of Engineering and Computing, University of South Carolina, Columbia, SC, United States
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Schlomann A, Wahl HW, Zentel P, Heyl V, Knapp L, Opfermann C, Krämer T, Rietz C. Potential and Pitfalls of Digital Voice Assistants in Older Adults With and Without Intellectual Disabilities: Relevance of Participatory Design Elements and Ecologically Valid Field Studies. Front Psychol 2021; 12:684012. [PMID: 34276507 PMCID: PMC8282355 DOI: 10.3389/fpsyg.2021.684012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/01/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Anna Schlomann
- Network Aging Research, Heidelberg University, Heidelberg, Germany
- Institute for Educational Sciences, Heidelberg University of Education, Heidelberg, Germany
| | - Hans-Werner Wahl
- Network Aging Research, Heidelberg University, Heidelberg, Germany
- Institute of Psychology, Heidelberg University, Heidelberg, Germany
| | - Peter Zentel
- Institute of Prevention, Integration and Rehabilitation Research, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Vera Heyl
- Institute for Special Needs Education, Heidelberg University of Education, Heidelberg, Germany
| | - Leonore Knapp
- Institute for Educational Sciences, Heidelberg University of Education, Heidelberg, Germany
| | | | - Torsten Krämer
- Institute for Educational Sciences, Heidelberg University of Education, Heidelberg, Germany
| | - Christian Rietz
- Institute for Educational Sciences, Heidelberg University of Education, Heidelberg, Germany
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