Comfort and Attitudes Towards Robots Among Young, Middle-Aged, and Older Adults: A Cross-Sectional Study.

PURPOSE: To explore the social impact of, comfort with, and negative attitudes towards robots among young, middle-aged, and older adults in the United States. DESIGN: Descriptive, cross-sectional. Conducted in 2014-2015 in an urban area of the western United States using a purposive sample of adults 18 years of age or older. METHODS: Respondents completed a survey that included the Negative Attitudes Toward Robots Scale (NARS) and two questions taken or modified from the European Commission's Autonomous System 2015 Report. Analyses were conducted to compare perceptions and demographic factors by age groups (young adults:18-44, middle-aged adults: 45-64, and older adults: >65 years old). FINDINGS: Sample included 499 individuals (n = 322 age 18-44 years, n = 50 age 45-64 years, and n = 102 age 65-98 years). There were no significant differences between age groups for 9 of the 11 items regarding social impact of robots and comfort with robots. There were no significant differences by age groups for 9 of the 14 items in the NARS. Among those items with statistically significant differences, the mean scores indicate similar sentiments for each group. CONCLUSIONS: Older, middle-aged, and younger adults had similar attitudes regarding the social impact of and comfort with robots; they also had similar negative attitudes towards robots. Findings dispel current perceptions that older adults are not as receptive to robots as other adults. This has implications for nurses who integrate supportive robots in their practice. CLINICAL RELEVANCE: Nurses working in clinical and community roles can use these findings when developing and implementing robotic solutions. Understanding attitudes towards robots can support how, where, and with whom robots can be used in nursing practice.

Mobile text messaging for health: a systematic review of reviews.

The aim of this systematic review of reviews is to identify mobile text-messaging interventions designed for health improvement and behavior change and to derive recommendations for practice. We have compiled and reviewed existing systematic research reviews and meta-analyses to organize and summarize the text-messaging intervention evidence base, identify best-practice recommendations based on findings from multiple reviews, and explore implications for future research. Our review found that the majority of published text-messaging interventions were effective when addressing diabetes self-management, weight loss, physical activity, smoking cessation, and medication adherence for antiretroviral therapy. However, we found limited evidence across the population of studies and reviews to inform recommended intervention characteristics. Although strong evidence supports the value of integrating text-messaging interventions into public health practice, additional research is needed to establish longer-term intervention effects, identify recommended intervention characteristics, and explore issues of cost-effectiveness.

Older Adults' Use of Online and Offline Sources of Health Information and Constructs of Reliance and Self-Efficacy for Medical Decision Making.

We know little about older adults' use of online and offline health information sources for medical decision making despite increasing numbers of older adults who report using the Internet for health information to aid in patient-provider communication and medical decision making. Therefore we investigated older adult users and nonusers of online and offline sources of health information and factors related to medical decision making. Survey research was conducted using random digit dialing of Florida residents' landline telephones. The Decision Self-Efficacy Scale and the Reliance Scale were used to measure relationships between users and nonusers of online health information. Study respondents were 225 older adults (age range = 50-92 years, M = 68.9, SD = 10.4), which included users (n = 105) and nonusers (n = 119) of online health information. Users and nonusers differed in frequency and types of health sources sought. Users of online health information preferred a self-reliant approach and nonusers of online health information preferred a physician-reliant approach to involvement in medical decisions on the Reliance Scale. This study found significant differences between older adult users and nonusers of online and offline sources of health information and examined factors related to online health information engagement for medical decision making.

Heart failure patients' perceptions and use of technology to manage disease symptoms.

BACKGROUND: Technology use for symptom management is beneficial for both patients and physicians. Widespread acceptance of technology use in healthcare fuels continued development of technology with ever-increasing sophistication. Although acceptance of technology use in healthcare by medical professionals is evident, less is known about the perceptions, preferences, and use of technology by heart failure (HF) patients. This study explores patients' perceptions and current use of technology for managing HF symptoms (MHFS). MATERIALS AND METHODS: A qualitative analysis of in-depth individual interviews using a constant comparative approach for emerging themes was conducted. Fifteen participants (mean age, 64.43 years) with HF were recruited from hospitals, cardiology clinics, and community groups. RESULTS: All study participants reported use of a home monitoring device, such as an ambulatory blood pressure device or bathroom scale. The majority of participants reported not accessing online resources for additional MHFS information. However, several participants stated their belief that technology would be useful for MHFS. Participants reported increased access to care, earlier indication of a worsening condition, increased knowledge, and greater convenience as potential benefits of technology use while managing HF symptoms. For most participants financial cost, access issues, satisfaction with current self-care routine, mistrust of technology, and reliance on routine management by their current healthcare provider precluded their use of technology for MHFS. CONCLUSIONS: Knowledge about HF patients' perceptions of technology use for self-care and better understanding of issues associated with technology access can aid in the development of effective health behavior interventions for individuals who are MHFS and may result in increased compliance, better outcomes, and lower healthcare costs.

Acceptance and perceived usefulness of robots to assist with activities of daily living and healthcare tasks.

As the number of older adults living with chronic conditions continues to rise, they will require assistance with activities of daily living (ADL) and healthcare tasks to continue living independently in their homes. One proposed solution to assist with the care needs of an aging population and a shrinking healthcare workforce is robotic technology. Using a cross-sectional survey design, we purposively sampled adults (≥18 years old) to assess generational acceptance and perceived usefulness of robots to assist with ADLs, healthcare tasks, and evaluate acceptance of robotic healthcare assistance across different settings. A total of 499 adults (age range [years] 18-98, Mean = 38.7, SD = 22.7) responded to the survey. Significant differences were found among young, middle-aged, and older adults on perceived usefulness of robots for cleaning, escorting them around town, acting as companionship, delivering meals, assessing sadness and calling for help, providing medical advice, taking vital sign assessments, and assisting with personal care (p < 0.05). The majority of younger adults reported that they would like a robot to provide healthcare assistance in the hospital, compared to middle-aged and older adults (p < 0.001). Results of this study can guide the design of robots to assist adults of all ages with useful tasks.

Fast and accurate medication identification.

Much of the AI work in healthcare is focused around disease prediction in clinical settings, which is an important application that has yet to deliver in earnest. However, there are other fundamental aspects like helping patients and care teams interact and communicate in efficient and meaningful ways, which could deliver quadruple-aim improvements. After heart disease and cancer, preventable medical errors are the third leading cause of death in the United States. The largest subset of medical errors is medication error. Providing the right treatment plan for patients includes knowledge about their current medications and drug allergies, an often challenging task. The widespread growth of prescribing and consuming medications has increased the need for applications that support medication reconciliation. We show a deep-learning application that can help reduce avoidable errors with their attendant risk, i.e., correctly identifying prescription medication, which is currently a tedious and error-prone task. We demonstrate prescription-pill identification from mobile images in the NIH NLM Pill Image Recognition Challenge dataset. Our application recognizes the correct pill within the top-5 results at 94% accuracy, which compares favorably to the original competition winner at 83.3% for top-5 under comparable, though not identical configurations. The Institute of Medicine claims that better use of information technology can be an important step in reducing medication errors. Therefore, we believe that a more immediate impact of AI in healthcare will occur with a seamless integration of AI into clinical workflows, readily addressing the quadruple aim of healthcare.

Visualization approaches to support healthy aging: A systematic review.

BACKGROUND: Health technologies have the potential to support the growing number of older adults who are aging in place. Many tools include visualizations (data visualizations, visualizations of physical representations). However, the role of visualizations in supporting aging in place remains largely unexplored. OBJECTIVE: To synthesize and identify gaps in the literature evaluating visualizations (data visualizations and visualizations of physical representations), for informatics tools to support healthy aging. METHODS: We conducted a search in CINAHL, Embase, Engineering Village, PsycINFO, PubMed, and Web of Science using a priori defined terms for publications in English describing community-based studies evaluating visualizations used by adults aged ≥65 years. RESULTS: Six out of the identified 251 publications were eligible. Most studies were user studies and varied methodological quality. Three visualizations of virtual representations supported performing at-home exercises. Participants found visual representations either (a) helpful, motivational, and supported their understanding of their health behaviors or (b) not an improvement over alternatives. Three data visualizations supported understanding of one's health. Participants were able to interpret data visualizations that used precise data and encodings that were more concrete better than those that did not provide precision or were abstract. Participants found data visualizations helpful in understanding their overall health and granular data. CONCLUSIONS: Studies we identified used visualizations to promote engagement in exercises or understandings of one's health. Future research could overcome methodological limitations of studies we identified to develop visualizations that older adults could use with ease and accuracy to support their health behaviors and decision-making.

Cardiovascular Risk Assessment and Management in Prerenal Transplantation Candidates.

Cardiovascular (CV) assessment in prerenal transplant patients varies by center. Current guidelines recommend stress testing for candidates if ≥ 3 CV risk factors exist. We evaluated the CV assessment and management in 685 patients referred for kidney transplant over a 7-year period. All patients had CV risk factors, and the most common cause of end-stage renal disease was diabetes. Thirty-three percent (n = 229) underwent coronary angiography. The sensitivity of stress testing to detect obstructive coronary artery disease (CAD) was poor (0.26). Patients who had no CAD, nonobstructive CAD, or CAD with intervention had significantly higher event-free survival compared with patients with obstructive CAD without intervention. There were no adverse clinical events (death, myocardial infarction, stroke, revascularization, and graft failure) within 30 days post-transplant in patients who had preoperative angiography (n = 77). Of the transplanted patients who did not have an angiogram (n = 289), there were 8 clinical events (6 myocardial infarctions) in the first 30 days. In conclusion, our results indicate that stress testing and usual risk factors were poor predictors of obstructive CAD and that revascularization may prove beneficial in these patients.

The digital health divide: evaluating online health information access and use among older adults.

OBJECTIVE: Innovations in health information technology (HIT) provide opportunities to reduce health care spending, improve quality of care, and improve health outcomes for older adults. However, concerns relating to older adults' limited access and use of HIT, including use of the Internet for health information, fuel the digital health divide debate. This study evaluated the potential digital health divide in relation to characteristic and belief differences between older adult users and nonusers of online health information sources. METHODS: A cross-sectional survey design was conducted using a random sample of older adults. A total of 225 older adults (age range = 50-92 years, M = 68.9 years, SD = 10.4) participated in the study. RESULTS: Seventy-six percent of all respondents had Internet access. Users and nonusers of online health information differed significantly on age (M = 66.29 vs. M = 71.13), education, and previous experience with the health care system. Users and nonusers of online health information also differed significantly on Internet and technology access, however, a large percentage of nonusers had Internet access (56.3%), desktop computers (55.9%), and laptop computers or netbooks (43.2%). Users of online health information had higher mean scores on the Computer Self-Efficacy Measure than nonusers, t(159) = -7.29, p < .0001. CONCLUSION: This study found significant differences between older adult users and nonusers of online health information. Findings suggest strategies for reducing this divide and implications for health education programs to promote HIT use among older adults.

How to Design Tobacco Prevention and Control Games for Youth and Adolescents: A Qualitative Analysis of Expert Interviews.

OBJECTIVE: Games for health, including digital videogames and gaming-based approaches, are increasingly being used in health promotion research and practice. Recently published research has shown that videogames have significant potential to promote healthy behaviors among youth and adolescents. Yet, there is a lack of available evidence-based resources to guide practitioners on the integration of games into tobacco prevention and smoking cessation interventions. To address this gap, expert researchers and game developers were interviewed to further define games for health, explore the current research, and provide recommendations for developing, evaluating, and promoting effective anti-tobacco games. MATERIALS AND METHODS: Nationally recognized experts on game development, games for health, tobacco, and health behavior were asked to participate. A qualitative analysis of 25 in-depth individual interviews using a constant comparative approach for emerging themes was conducted. RESULTS: Main themes that emerged from the data analysis included the following: (1) the current state of games for health research to facilitate health behavior change, (2) strategies for how to develop and evaluate games for quality and impact, and (3) recommendations for how to effectively design tobacco prevention and smoking cessation educational videogames that engage youth and adolescents. CONCLUSIONS: The synthesized findings identified through these expert interviews offer stakeholders strategies for how to incorporate games for health within their current and future work. Specific recommendations are presented for developers and researchers to consider when developing and evaluating videogames for tobacco prevention and smoking cessation targeted at youth and adolescents.

Older Adults' Current and Potential Uses of Information Technologies in a Changing World: A Theoretical Perspective.

Technologies have become a major force in people's lives. They change how people interact with the environment, even as the environment changes. We propose that technology use in the setting of changing environments is motivated by essential needs and tensions experienced by the individual. We apply three developmental and behavioral theories (Erikson's stages of psychosocial development, Maslow's hierarchy of needs, and Bronfenbrenner's ecological model) to explain technology-related behaviors among older adults. We consider how technology use has addressed and can address major ecological changes, in three areas: health promotion, natural disasters, and disparities. We propose that considering these theories can help researchers and developers ensure that technologies will help promote a healthier world for older adults.

Health Benefits of Digital Videogames for Older Adults: A Systematic Review of the Literature.

OBJECTIVE: This article is a systematic review conducted of the research literature on digital videogames played by older adults and health outcomes associated with game play. Findings from each study meeting the inclusion criteria were analyzed and summarized into emergent themes to determine the impact of digital games in promoting healthy behaviors among older adults. MATERIALS AND METHODS: A systematic review of the research literature was conducted through multiple academic databases for works, published between the years 2000 and 2011, looking at digital videogame interventions with adults 65 years of age and older. Multiple combinations of search terms and Boolean operators relevant to digital videogames and older adults were queried. A criteria matrix was created to code and evaluate studies. RESULTS: Thirteen studies met specific criteria for inclusion and were analyzed in the final review. Significant mental, physical, and social health factors, type of digital game platform, study design, and measurements are among emergent themes summarized from the reviewed research literature. Significant mental health outcomes of digital game interventions were found in the majority of the reviewed studies, followed by physical and lastly social health outcomes in older adults. CONCLUSIONS: A majority of the studies revealed significant positive effects on health outcomes associated with digital videogame play among older adults. With current advancements in technology, including advanced motion sensing, digital game platforms have significant potential for positive health impact among older populations. More robust and rigorous research designs are needed to increase validity and reliability of results and establish stronger causal relationships on the health benefits of digital videogame play for older adults.