Laurel Person Mecca

Ethical perspectives on emerging assistive technologies: insights from focus groups with stakeholders in long-term care facilities.

Assistive technologies are relatively novel tools for research and daily care in long-term care (LTC) facilities that are faced with the burgeoning of the older adult population and dwindling staffing resources. The degree to which stakeholders in LTC facilities are receptive to the use of these technologies is poorly understood. Eighteen semi-structured focus groups and one interview were conducted with relevant groups of stakeholders at seven LTC facilities in southwestern Pennsylvania. Common themes identified across all focus groups centered on concerns for privacy, autonomy, cost, and safety associated with implementation of novel technologies. The relative importance of each theme varied by stakeholder group as well as the perceived severity of cognitive and/or physical disability. Our findings suggest that ethical issues are critical to acceptance of novel technologies by their end users, and that stakeholder groups are interdependent and require shared communication about the acceptance of these emerging technologies.

A Type 2 Diabetes Prevention Website for African Americans, Caucasians, and Mexican Americans: Formative Evaluation

Background The majority of Americans now access the Internet, thereby expanding prospects for Web-based health-related education and intervention. However, there remains a digital divide among those with lower income and education, and among Spanish-speaking populations in the United States. Additional concerns are the low eHealth literacy rate among these populations and their interest in Internet-delivered interventions with these components. Given these factors, combined with the prevalence of type 2 diabetes among low socioeconomic status and Spanish-speaking Americans, strides need to be taken to reach these populations with online tools for diabetes prevention and management that are at once accessible and efficacious. Objective Using a formative evaluation of an eHealth diabetes prevention and control website, we tested the extent to which African Americans, Caucasians, and Mexican Americans at risk for type 2 diabetes gained knowledge and intended to modify their dietary intake and physical activity subsequent to viewing the website. We also examined their general Internet use patterns related to type 2 diabetes. Methods A mixed methods approach was undertaken. The diabetes prevention and control website provided educational and behavioral change information in English and Spanish. For this study, eligible participants (1) completed a prequantitative survey, (2) interacted with the website, (3) completed a qualitative interview, and (4) completed a postquantitative survey. Results After finding a significant differences in posttest diabetes knowledge scores (P<.001), a regression analysis controlling for pretest score, health literacy, ethnicity, Transtheoretical Model Stage for exercise and fruit and vegetable consumption, and Internet literacy was conducted. Internet literacy score (P=.04) and fruit and vegetable consumption stage (P<.001) were significantly associated with posttest scores indicating that those in precontemplation stage and with low Internet literacy scores were less likely to show improved diabetes knowledge scores. We found significant difference in posttest intention to eat a healthy diet each day in the next 2 months after controlling for pretest score, health literacy, ethnicity, Transtheoretical Model Stage for fruit and vegetable consumption and Internet literacy. Those in the Action stage of the Transtheoretical model for exercise were significantly less likely (P=.023) to improve the posttest score for intention to eat a healthy diet compared to those in the Preparation stage for exercise. We also found that health information is sought commonly across ethnic groups, but that diabetes-related information is less commonly sought even among those at risk. Other specific ethnic usage patterns were identified in the qualitative data including content sought on Web searches and technology used to access the Internet. Conclusions This study provides in-depth qualitative insight into the seeking, access, and use of Web-based health information across three ethnic groups in two languages. Additionally, it provides evidence from pre-post measures of exposure to Web-based health content and related changes in diabetes knowledge and intention to eat a healthy diet.

Preferences and concerns for quality of life technology among older adults and persons with disabilities: National survey results

Efforts to develop novel technologies that address the everyday challenges faced by older adults and persons with disabilities are constrained by limited understanding of their perspectives as potential end-users. We conducted a national, web-based survey with a non-probability sample of 1,610 adults (68% female; 47% age 45–64; 47% age 65+) with and without disability, to learn their views about technologies in development that will be capable of both discerning when and how to accommodate an individual’s need and desire for assistance and providing that desired assistance as appropriate. In the survey we described four families of engineered systems that could provide cognitive and physical support for personal and instrumental activities of daily living, including personal care, home management, and driving. Here we summarize respondents’ views about quality of life technologies in general and each family of engineered systems in particular. We also describe the recurring themes evident in respondents’ answers to our query about technologies that should be developed in the near future.

Analyzing the Practice of Life Cycle Assessment

Life cycle assessment (LCA) is a quantitative tool used to evaluate the environmental impacts of products or processes. With respect to buildings, LCA can be used to evaluate the environmental impacts of an entire buildings life cycle. Currently LCA in the building area is used in a limited capacity, primarily to select building products. In order to determine the causality for the lack of whole‐building LCAs, focus groups with members of the architecture, engineering, and construction (AEC) communities were held. This article investigates the current level of knowledge of LCA in the AEC community and then discusses the benefits and barriers to the practice of LCA. In summary, the goal of the research was to identify why LCA is not used to its fullest potential in a whole‐building LCA. In an open forum and moderated setting, focus group participants were asked individually to self‐identify their experience with LCA, a brief education session on LCA was held, and then benefits and barriers to LCA were discussed. The focus group sessions were transcribed and systematically coded by social researchers in order to analyze the results. Hybrid flow and radar charts were developed. From the focus group results, the most important benefit to LCA was “provides information about environmental impacts.” The results did not identify a prominent barrier; however, building‐related metrics were ascertained to be one of the more crucial barriers. The benefits and barriers classified by this analysis will be utilized to develop a subsequent online survey to further understand the LCA and AEC community.

Optimizing a Text Message Intervention to Reduce Heavy Drinking in Young Adults: Focus Group Findings

Background Recent trial results show that an interactive short message service (SMS) text message intervention, Texting to Reduce Alcohol Consumption (TRAC), is effective in reducing heavy drinking in non-treatment-seeking young adults, but may not be optimized. Objective To assess the usability of the TRAC intervention among young adults in an effort to optimize future intervention design. Methods We conducted five focus groups with 18 young adults, aged 18-25 years, who had a history of heavy drinking and had been randomized to 12 weeks of the TRAC intervention as part of a clinical trial. A trained moderator followed a semistructured interview guide. Focus groups were audiotaped, transcribed, and analyzed to identify themes. Results We identified four themes regarding user experiences with the TRAC intervention: (1) ease of use, (2) comfort and confidentiality, (3) increased awareness of drinking behavior, and (4) accountability for drinking behavior. Participants’ comments supported the existing features of the TRAC intervention, as well as the addition of other features to increase personalization and continuing engagement with the intervention. Conclusions Young adults perceived the TRAC intervention as a useful way to help them reduce heavy drinking on weekends. Components that promote ease of use, ensure confidentiality, increase awareness of alcohol consumption, and increase accountability were seen as important.

Older adults' and case managers' initial impressions of community-based telehealth kiosks.

Community-based (multi-user) telehealth interventions may be beneficial for older adults, but there is little research regarding such interventions. As a first step in feasibility assessment, we used a qualitative descriptive approach to examine the acceptability and perceived value of community-based telehealth kiosks with regard to current health self-management practices of community-dwelling older adults. Participants included residents (n = 6) and community agency case managers (n = 3) of a U.S. Department of Housing and Urban Development-subsidized senior apartment building. Both positive impressions from and concerns of each group are presented. Findings helped guide plans for future telehealth kiosk implementation and training.

Wearable Technology to Garner the Perspective of Dementia Family Caregivers

Family caregivers of individuals with dementia typically have limited opportunity during brief clinical encounters to describe the dementia-related behaviors and interactions they find difficult to handle. Lack of objective data depicting the nature, intensity, and impact of these manifestations of the underlying disease further constrains the extent to which strategies recommended by nurses or other health care providers can be tailored to the situation. The current article describes a prototype wearable camera system used to gather image and voice data from the caregivers perspective in a pilot feasibility intervention study conducted with 18 caregiving dyads. Several scenarios are presented that include salient events (i.e., behaviors or interactions deemed difficult by the caregiver or identified as concerning by the research team during screening) captured in the resulting video. The current authors anticipate future wearable camera systems and software will automate screening for salient events, providing new tools for assessment and intervention by nurses.