Thai Le

Examining health information-seeking behaviors of older adults.

This study aims to examine which resources older adults utilize for their health information needs, how trustworthy and reliable they find these resources, and the difficulties they face in obtaining health-related information. A 41-item survey designed to understand the information-seeking characteristics of older adults was developed and distributed to retirement communities. Some items were taken from the Health Information National Trends Survey. Of 1520 surveys, 403 were returned completed (26.6%). Respondents’ mean age was 77.65 years. Average scores indicated respondents trusted particular sources of health information in the following order (highest to lowest): health care providers, pharmacists, friends and relatives, retirement community staff, newspapers, the Internet, television, and the radio. In conclusion, older adults have a greater amount of trust in a person with whom they are able to actively discuss their health as opposed to a nonliving source, which they have to access or manipulate, such as the Internet. Efforts must be made to help older adults better navigate and utilize the Internet and recognize dependable online sources so that they may increase their trust in its use, thereby increasing satisfaction with their own ability to seek and use sources of health information.

Older adults’ acceptance of a community-based telehealth wellness system

The development of ongoing assessment tools to monitor older adult health and wellness can support improved quality of life and independence. These technologies have often been employed within private residences. Our work describes a telehealth kiosk system implemented within a community setting, which reduces the costs of installing and maintaining individual systems. Though user acceptance of telehealth systems has been studied within the context of home residences, this has yet to be addressed for community-based systems. Older adults in a retirement community were recruited to use a telehealth system including assessment of vital signs and cognitive performance. With a series of focus groups (N = 12, average age 79.3 years), we examined user perceptions of the telehealth kiosk, addressing issues of usability, effectiveness and privacy. Older adults were favorable towards the collection of health monitoring information, recognizing the utility of these data sources. There were issues of usability, especially regarding ergonomics of the telehealth kiosk. We found no concerns over privacy, with some participants expressing increased preference for the social interactions afforded through the community setting. Understanding the social, technical and human factors involved with a community-based telehealth system can inform the design of cost-effective health monitoring systems.

Health Providers’ Perceptions of Novel Approaches to Visualizing Integrated Health Information

OBJECTIVES We evaluated the design of three novel visualization techniques for integrated health information with health care providers in older adult care. Through focus groups, we identified generalizable themes related to the visualization and interpretation of health information. Using these themes we address challenges with visualizing integrated health information and provide recommendations for designers. METHODS We recruited ten health care providers to participate in three focus groups. We applied a qualitative descriptive approach to code and extract themes related to the visualization of graphical displays. RESULTS We identified a set of four common themes across focus groups related to: 1) Trust in data for decision-making; 2) Perceived level of detail for visualization (subthemes: holistic, individual components); 3) Cognitive issues (subthemes: training and experience; cognitive overload; contrast); and 4) Application of visual displays. Furthermore, recommendations are provided as part of the iterative design process for the visualizations. CONCLUSIONS Data visualization of health information is an important component of care, impacting both the accuracy and speed of decision making. There are both functional and cognitive elements to consider during the development of appropriate visualizations that integrate different components of health.

An Evaluation of Wellness Assessment Visualizations for Older Adults

BACKGROUND Smart home technologies provide a valuable resource to unobtrusively monitor health and wellness within an older adult population. However, the breadth and density of data available along with aging associated decreases in working memory, prospective memory, spatial cognition, and processing speed can make it challenging to comprehend for older adults. We developed visualizations of smart home health data integrated into a framework of wellness. We evaluated the visualizations through focus groups with older adults and identified recommendations to guide the future development of visualizations. MATERIALS AND METHODS We conducted four focus groups with older adult participants (n=31) at an independent retirement community. Participants were presented with three different visualizations from a wellness pilot study. A qualitative descriptive analysis was conducted to identify thematic content. RESULTS We identified three themes related to processing and application of visualizations: (1) values of visualizations for wellness assessment, (2) cognitive processing approaches to visualizations, and (3) integration of health data for visualization. In addition, the focus groups highlighted key design considerations of visualizations important towards supporting decision-making and evaluation assessments within integrated health displays. CONCLUSIONS Participants found inherent value in having visualizations available to proactively engage with their healthcare provider. Integrating the visualizations into a wellness framework helped reduce the complexity of raw smart home data. There has been limited work on health visualizations from a consumer perspective, in particular for an older adult population. Creating appropriately designed visualizations is valuable towards promoting consumer involvement within the shared decision-making process of care.

Design of smart home sensor visualizations for older adults.

BACKGROUND Smart home sensor systems provide a valuable opportunity to continuously and unobtrusively monitor older adult wellness. However, the density of sensor data can be challenging to visualize, especially for an older adult consumer with distinct user needs. OBJECTIVE We describe the design of sensor visualizations informed by interviews with older adults. The goal of the visualizations is to present sensor activity data to an older adult consumer audience that supports both longitudinal detection of trends and on-demand display of activity details for any chosen day. METHODS The design process is grounded through participatory design with older adult interviews during a six-month pilot sensor study. Through a secondary analysis of interviews, we identified the visualization needs of older adults. We incorporated these needs with cognitive perceptual visualization guidelines and the emotional design principles of Norman to develop sensor visualizations. RESULTS We present a design of sensor visualization that integrate both temporal and spatial components of information. The visualization supports longitudinal detection of trends while allowing the viewer to view activity within a specific date. CONCLUSIONS Appropriately designed visualizations for older adults not only provide insight into health and wellness, but also are a valuable resource to promote engagement within care.

Download Alert: Understanding Gastroenterology Patients' Perspectives on Health-Related Smartphone Apps.

Objectives:The aims of this study were to understand patients’ willingness to use different types of health-related smartphone apps and to explore their attitudes on the overall value, usability, feasibility, credibility, intrusiveness, and obtrusiveness of these apps.Methods:Questionnaires were distributed to adult patients presenting to gastroenterology clinics at an academic medical center. The 25-question survey consisted of 5-point Likert-type scale statements, multiple-choice questions, and open-ended questions.Results:Participants were mainly White (N=94, 78%) and smartphone owners (N=125, 93%). The mean age was 40.8 years (N=121, s.d.=13.2). Participants were willing to use most types of apps unless it monitored their location or social networking activity. Half were less willing to use an app if it required a visible accessory. Most participants were willing to use a health-related app up to 5 min a day indefinitely but unwilling to pay out-of-pocket for it. Participants generally disagreed that an app would be hard to learn how to use, interfere with their daily routine, or be embarrassing to use in public. Overall, participants felt that health-related apps could help them and their doctors better manage their medical problems, but were neutral in trusting their quality. Most worried that personal information used for an app would fall into the wrong hands.Conclusion:Gastroenterology patients were willing to use and valued most types of health-related apps. They perceived this technology as feasible, usable, and relatively unobtrusive unless a visible accessory was required. However, many were concerned about their privacy.

Integrated data visualisation: an approach to capture older adults' wellness.

Informatics tools can help support the health and independence of older adults. In this paper, we present an approach towards integrating health-monitoring data and describe several techniques for the assessment and visualisation of integrated health and well-being of older adults. We present three different visualisation techniques to provide distinct alternatives towards display of the same information, focusing on reducing the cognitive load of data interpretation. We demonstrate the feasibility of integrating health-monitoring information into a comprehensive measure of wellness, while also highlighting the challenges of designing visual displays targeted at multiple user groups. These visual displays of wellness can be incorporated into personal health records and can be an effective support for informed decision-making.

Older Adults' Perceptions of Fall Detection Devices.

A third of adults over the age of 65 are estimated to fall at least once a year. Perhaps as dangerous as the fall itself is the time spent after a fall if the person is unable to move. Although there are many devices available to detect when a person has fallen, little is known about the opinions of older adults regarding these fall detection devices (FDDs). We conducted five focus groups with 27 older adults. Transcripts from sessions were coded to generate themes that captured participants’ perceptions. Themes were identified that related to two topics of interest: (a) personal influences on the participants’ desire to have a FDD, including perceived need, participant values, and cost, and (b) participant recommendations regarding specific features and functionalities of these devices such as automation, wearable versus non-wearable devices, and device customization. Together, these themes suggest ways in which FDDs may be improved so that they are suitable for their intended population.

A Comparison of Health Visualization Evaluation Techniques with Older Adults

Aging-associated changes in visual acuity, cognition, and motor control in addition to attitudinal and affective perceptions of technology impact the design of information systems for older adults. Although design guidelines and cognitive theories on information visualization exist, they are often understudied for use with older adults. In an effort to evaluate interactive health visualizations with older adults, the authors applied and compared a benchmark evaluation, an insight-based evaluation, and a subjective usability questionnaire. They were unable to identify statistically significant differences between visualizations using the benchmark evaluation, but found moderate differences with the perceived usability scale and more granular differences through the insight evaluation.

Engaging older adults in the visualization of sensor data facilitated by an open platform for connected devices

BACKGROUND The use of smart home sensor systems is growing primarily due to the appeal of unobtrusively monitoring older adult health and wellness. However, integrating large-scale sensor systems within residential settings can be challenging when deployment takes place across multiple environments, requiring customization of applications, connection across various devices and effective visualization of complex longitudinal data. OBJECTIVE The objective of the study was to demonstrate the implementation of a smart home system using an open, extensible platform in a real-world setting and develop an application to visualize data real time. METHODS We deployed the open source Lab of Things platform in a house of 11 residents as a demonstration of feasibility over the course of 3 months. The system consisted of Aeon Labs Z-wave Door/Window sensors and an Aeon Labs Multi-sensor that collected data on motion, temperature, luminosity, and humidity. We applied a Rapid Iterative Testing and Evaluation approach towards designing a visualization interface engaging gerontological experts. We then conducted a survey with 19 older adult and caregiver stakeholders to inform further design revisions. RESULTS Our initial visualization mockups consisted of a bar chart representing activity level over time. Family members felt comfortable using the application. Older adults however, indicated it would be difficult to learn to use the application, and had trouble identifying utility. A key for older adults was ensuring that the data collected could be utilized by their family members, physicians, or caregivers. CONCLUSIONS The approach described in this work is generalizable towards future smart home deployments and can be a valuable guide for researchers to scale a study across multiple homes and connected devices, and to create personalized interfaces for end users.