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      Inclusion of Older Adults in the Research and Design of Digital Technology

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          Abstract

          Digital technology holds a promise to improve older adults’ well-being and promote ageing in place. However, there seems to be a discrepancy between digital technologies that are developed and what older adults actually want and need. Ageing is stereotypically framed as a problem needed to be fixed, and older adults are considered to be frail and incompetent. Not surprisingly, many of the technologies developed for the use of older adults focus on care. The exclusion of older adults from the research and design of digital technology is often based on such negative stereotypes. In this opinion article, we argue that the inclusion rather than exclusion of older adults in the design process and research of digital technology is essential if technology is to fulfill the promise of improving well-being. We emphasize why this is important while also providing guidelines, evidence from the literature, and examples on how to do so. We unequivocally state that designers and researchers should make every effort to ensure the involvement of older adults in the design process and research of digital technology. Based on this paper, we suggest that ageism in the design process of digital technology might play a role as a possible barrier of adopting technology.

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          Most cited references66

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          Factors influencing acceptance of technology for aging in place: a systematic review.

          To provide an overview of factors influencing the acceptance of electronic technologies that support aging in place by community-dwelling older adults. Since technology acceptance factors fluctuate over time, a distinction was made between factors in the pre-implementation stage and factors in the post-implementation stage.
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            Older Adults Talk Technology: Technology Usage and Attitudes.

            Older adults (n = 113) participated in focus groups discussing their use of and attitudes about technology in the context of their home, work, and healthcare. Participants reported using a wide variety of technology items, particularly in their homes. Positive attitudes (i.e., likes) outnumbered negative attitudes (i.e., dislikes), suggesting that older adults perceive the benefits of technology use to outweigh the costs of such use. Positive attitudes were most frequently related to how the technology supported activities, enhanced convenience, and contained useful features. Negative attitudes were most frequently associated with technology creating inconveniences, unhelpful features, as well as security and reliability concerns. Given that older adults reported more positive than negative attitudes about the technologies they use, these results contradict stereotypes that older adults are afraid or unwilling to use technology. These findings also highlight the importance of perceived benefits of use and ease of use for models of technology acceptance. Emphasizing the benefits of technology in education and training programs may increase future technology adoption.
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              Interventions to improve research participants' understanding in informed consent for research: a systematic review.

              Available data suggest that prospective research participants may frequently not understand information disclosed to them in the informed consent process. Little is known about how understanding can be improved. To review research on interventions to improve research participants' understanding of information disclosed in the informed consent process. A search of MEDLINE was performed using the terms informed consent and clinical research and informed consent and (comprehension or understanding) from 1966 to March 2004 , which included randomized controlled trials, longitudinal trials, and controlled trials with nonrandom allocation that compared the understanding of research participants who had undergone only a standard informed consent process to that of participants who had received an intervention to improve their understanding. A comprehensive bibliography of empirical research on informed consent published in January 1999 was also reviewed, as were personal files and all issues of the journals IRB and Controlled Clinical Trials. Study design, quality criteria, population characteristics, interventions, and outcomes for each trial were extracted. The statistical significance of the interventions' effects on understanding were noted, as were mean scores for understanding for each group of each trial. For those trials that measured the secondary outcomes of satisfaction and willingness to enroll, results were also summarized. Thirty studies described 42 trials that met inclusion criteria. Of 12 trials of multimedia interventions, 3 showed significant improvement in understanding. Of 15 trials of enhanced consent forms, 6 showed significant improvement in understanding (all P<.05), but 5 of 6 trials were of limited quality, casting doubt on their practical relevance. Of 5 trials of extended discussion, 3 showed significant improvement in understanding (all P<.001) and 2 showed trends toward improvement (P=.054 and P=.08). Of 5 trials of test/feedback, all showed significant improvement in understanding (all P<.05) but were flawed in that they may have mistaken rote memorization for improvement in understanding. Another 5 trials were put into a miscellaneous category and had varying impact on understanding. Some demographic factors, particularly lower education, were associated with less understanding. Satisfaction and willingness to enroll were never significantly diminished by an intervention . Efforts to improve understanding through the use of multimedia and enhanced consent forms have had only limited success. Having a study team member or a neutral educator spend more time talking one-on-one to study participants appears to be the most effective available way of improving research participants' understanding; however, further research is needed.
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                Author and article information

                Journal
                IJERGQ
                International Journal of Environmental Research and Public Health
                IJERPH
                MDPI AG
                1660-4601
                October 2019
                October 02 2019
                : 16
                : 19
                : 3718
                Article
                10.3390/ijerph16193718
                31581632
                f3d47c2d-80a2-4ddc-be02-cb7c9b1fa84e
                © 2019

                https://creativecommons.org/licenses/by/4.0/

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