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ICT-Based Fall Prevention System for Older Adults: Qualitative Results from a Long-Term Field Study
(2016)
Falls and their consequences are arguably most important events for transition from independent living to institutional care for older adults. Information and communication technology (ICT)-based support of fall prevention and fall risk assessment under the control of the user has a tremendous potential to, over time, prevent falls and reduce associated harm and costs. Our research uses participative design and a persuasive health approach to allow for seamless integration of an ICT-based fall prevention system into older adults’ everyday life. Based on a 6-month field study with 12 participants, we present qualitative results regarding the system use and provide insights into attitudes and practices of older adults concerning fall prevention and ICT-supported self-management of health. Our study demonstrates how it can lead to positive aspects of embodiment and health literacy through continuous monitoring of personal results, improved technical confidence, and quality of life. Implications are provided for designing similar systems.
Background: Falls and fall-related injuries are a serious public health issue. Exercise programs can effectively reduce fall risk in older people. The iStoppFalls project developed an Information and Communication Technology-based system to deliver an unsupervised exercise program in older people’s homes. The primary aims of the iStoppFalls randomized controlled trial were to assess the feasibility (exercise adherence, acceptability and safety) of the intervention program and its effectiveness on common fall risk factors.
Methods: A total of 153 community-dwelling people aged 65+ years took part in this international, multicentre, randomized controlled trial. Intervention group participants conducted the exercise program for 16 weeks, with a recommended duration of 120 min/week for balance exergames and 60 min/week for strength exercises. All intervention and control participants received educational material including advice on a healthy lifestyle and fall prevention. Assessments included physical and cognitive tests, and questionnaires for health, fear of falling, number of falls, quality of life and psychosocial outcomes.
Results: The median total exercise duration was 11.7 h (IQR = 22.0) over the 16-week intervention period. There were no adverse events. Physiological fall risk (Physiological Profile Assessment, PPA) reduced significantly more in the intervention group compared to the control group (F1,127 = 4.54, p = 0.035). There was a significant three-way interaction for fall risk assessed by the PPA between the high-adherence (>90 min/week; n = 18, 25.4 %), low-adherence (<90 min/week; n = 53, 74.6 %) and control group (F2,125 = 3.12, n = 75, p = 0.044). Post hoc analysis revealed a significantly larger effect in favour of the high-adherence group compared to the control group for fall risk (p = 0.031), postural sway (p = 0.046), stepping reaction time (p = 0.041), executive functioning (p = 0.044), and quality of life (p for trend = 0.052).
Conclusions: The iStoppFalls exercise program reduced physiological fall risk in the study sample. Additional subgroup analyses revealed that intervention participants with better adherence also improved in postural sway, stepping reaction, and executive function.
Background: Falls are common in older adults and can result in serious injuries. Due to demographic changes, falls and related healthcare costs are likely to increase over the next years. Participation and motivation of older adults in fall prevention measures remain a challenge. The iStoppFalls project developed an information and communication technology (ICT)-based system for older adults to use at home in order to reduce common fall risk factors such as impaired balance and muscle weakness. The system aims at increasing older adults’ motivation to participate in ICT-based fall prevention measures. This article reports on usability, user-experience and user-acceptance aspects affecting the use of the iStoppFalls system by older adults.
Methods: In the course of a 16-week international multicenter study, 153 community-dwelling older adults aged 65+ participated in the iStoppFalls randomized controlled trial, of which half used the system in their home to exercise and assess their risk of falling. During the study, 60 participants completed questionnaires regarding the usability, user experience and user acceptance of the iStoppFalls system. Usability was measured with the System Usability Scale (SUS). For user experience the Physical Activity Enjoyment Scale (PACES) was applied. User acceptance was assessed with the Dynamic Acceptance Model for the Re-evaluation of Technologies (DART). To collect more detailed data on usability, user experience and user acceptance, additional qualitative interviews and observations were conducted with participants.
Results: Participants evaluated the usability of the system with an overall score of 62 (Standard Deviation, SD 15.58) out of 100, which suggests good usability. Most users enjoyed the iStoppFalls games and assessments, as shown by the overall PACES score of 31 (SD 8.03). With a score of 0.87 (SD 0.26), user acceptance results showed that participants accepted the iStoppFalls system for use in their own home. Interview data suggested that certain factors such as motivation, complexity or graphical design were different for gender and age.
Conclusions: The results suggest that the iStoppFalls system has good usability, user experience and user acceptance. It will be important to take these along with factors such as motivation, gender and age into consideration when designing and further developing ICT-based fall prevention systems.
Falls are a serious problem in aging societies. A sedentary life style and low levels of physical activity are major factors aggravating older adults’ fall risk. Information and communication technology (ICT)-based fall prevention interventions are a promising approach to counteract the fall risk of this target group. For some time now, fall prevention interventions have put emphasize to video game based solutions, as video games have become more popular and accepted among older adults. Studies show that such ICT-based fall prevention interventions significantly reduce fall risk in older adults. Nevertheless, the population of older adults is fairly heterogeneous, and factors like gender, age, fitness, sociability, and so on may influence the use of such systems.
Dementia not only affects the cognitive capabilities, especially memory and orientation, but also physical capabilities, which are associated with a decrease of physical activities. Here, ICT can play a major role to improve health, quality of life and wellbeing in older adults suffering from dementia and related stakeholders, such as relatives, professional and informal caregivers. The aim of the presented system is to increase physical and cognitive capabilities of people with dementia and their caregivers to support them in daily life activities, reduce the strain of the caregivers and improve both their wellbeing.
As a result of ageing societies, the prevalence of dementia, and accordingly the need of care is increasing rapidly. Here, the use of ICT-based technologies may facilitate and promote a self-sustaining life-style for people with dementia and their caregivers. The presented poster describes early findings from the project MobiAssist and outlines the ICT-based training system. The system aims to increase the physical and cognitive capabilities of people with dementia, relief the caregivers and improve wellbeing of involved parties.
This chapter concerns with the accessibility of Business Process Modelling tools (BPMo tools) and Business Process Modelling languages (BPMo languages). Therefore, the reader is introduced to accessibility first. The authors provide definitions, standards, and a status quo on accessibility. Afterwards, the chapter concerns business process management. The reader learns definitions for processes and advantages and disadvantages of modelling languages. The BPM section is closed with the selection of a proper modelling notation for the accessibility evaluation. In form of two separate analyses, the authors evaluate the accessibility of two BPM tools. The results and recommendations for actions are presented after each analysis.
This article concerns with human-computer-interaction (HCI) from a neuroscientific perspective. The motivation for this perspective is the demographic transition, which shifts population structures of industrial nations. The authors will explain consequences of the demographic transition in terms of HCI and establish a hypothesis for these research activities. To evaluate this hypothesis the authors develop an approach, which combines different disciplines. This approach examines the effects of IT-accessibility on human cognitive processing. Therefore, required methodologies and instruments will be explained, discussed and selected. Possible effects of IT-accessibility on human cognitive processing will be illustrated with an acknowledged cognition model. The result of this article will be a concept, which enables the measurement of IT-accessibility impacts on human cognitive processing.
Need for care and accordingly the prevalence of dementia is increasing rapidly. Information and communication technologies (ICT) may have the potential to support collaboration and cooperation between people with dementia and their caregivers and thus promote independency, wellbeing and quality of life of involved parties. In this context, the authors investigated the potential of an ICT-based videogame system to generate and facilitate social experiences of people with dementia and their caregivers. 26 people with dementia and their caregivers participated in a 16 month participatory design study. Results suggest that collaboration and cooperation among involved parties increased by using the system. Further, the study revealed positive and negative social experiences triggered by the videogame based system. This article will report on these results and provide implications that may support researchers to design similar systems with the potential to increase collaboration and cooperation among people with dementia and their caregivers.
IT-accessiblity is often treated as an orphan in companies. Even though the proportion of disabled people is substantial and people become older and more susceptible to disabilities. Besides cost factors, companies often do not have a plan how to implement and control IT-accessibility successfully. However, most companies are familiar with IT-maturity frameworks to evaluate and improve their own IT-infrastructure. It would facilitate dealing with IT-accessibility, if IT-maturity frameworks consider IT-accessibility and provide recommendations and solutions for a successful implementation. Therefore, this article conducts a review of an acknowledged IT-maturity framework with regard to its capability to enable implementation of IT-accessibility in an organization. The first part of this article will illustrate the motivation and background for the authors concern with such a topic. Afterwards the authors will introduce the reader to the reviewed IT-maturity framework and provide basic knowledge on IT-accessibility. The main part of the article will deal with the review of the applied IT-maturity framework and outline examples of critical capabilities for successfully implementing IT-accessibility in an organization. The final section will derive implications and close with planned future research activities in this field.
This article concerns the design and development of Information- and Communication Technology, in particular computer systems in regard to the demographic transition which will influence user capabilities. It is questionable if current applied computer systems are able to meet the requirements of altered user groups with diversified capabilities. Such an enquiry is necessary based on actual forecasts leading to the assumption that the average age of employees in enterprises will increase significantly within the next 50-60 years, while the percentage of computer aided business tasks, operated by human individuals, rises from year to year. This progress will precipitate specific consequences for enterprises regarding the design and application of computer systems. If computer systems are not adapted to altered user requirements, efficient and productive utilisation could be negatively influenced. These consequences constitute the motivation to extend traditional design methodologies and thereby ensure the application of computer systems that are usable, independent of user capabilities.
Daryoush Daniel Vaziri illustrates that the use of mixed methods designs may support the induction of more subtle and complete theories about older adults’ use of technologies for the support of active and healthy aging. The results show that older adults’ social contexts and environments considerably affect their perspectives, practices and attitudes with respect to health, quality of life, well-being and technology use for active and healthy aging support. Results were collected with older adults aged 60+ as well as relevant secondary stakeholders like caregivers, policy makers or health insurance companies.
Dieser Artikel befasst sich mit der Akzeptanz von Gesundheitstechnologien in der Bevölkerung älterer Menschen. In diesem Kontext wurden qualitative und quantitative Daten bei Teilnehmern eines EU-geförderten Forschungsprojektes erhoben, die über einen Zeitraum von 24 Wochen einen Aktivitätsmonitor eingesetzt haben. Während die qualitativen Daten einen detaillierten Einblick in Praktiken und Einstellungen der Zielgruppe hinsichtlich der Nutzung solcher Technologien schaffen sollten, wurde mithilfe quantitativer Messungen das Akzeptanzverhalten älterer Menschen im Hinblick auf den Aktivitätsmonitor beschrieben. Die Kombination qualitativer und quantitativer Ergebnisse zeigt, dass Gesundheitstechnologien wie Aktivitätsmonitore grundsätzlich auf Interesse bei der älteren Bevölkerung stoßen, allerdings Merkmale wie das Design, die Bedienung sowie der Nutzen solcher Geräte maßgeblich zur Akzeptanz beitragen und diese Merkmale während Design- und Entwicklungsphasen priorisiert werden sollten.
People are getting older because of the demographic changes and the rate of disabled people is also going up. This article shows the challenge for BPMTool developer due to these circumstances. It illustrates how these changes impact the usage of BPM-Tools based on an Evaluation of an exemplary BPMTool (Cooper & Patterson, 2007) in terms of IT-Usability and IT-Accessibility. This evaluation was conducted in a research laboratory at the university.
