Longitudinal Coadaptation of Older Adults With Wearables and Voice-Activated Virtual Assistants: Scoping Review.

BACKGROUND: The integration of smart technologies, including wearables and voice-activated devices, is increasingly recognized for enhancing the independence and well-being of older adults. However, the long-term dynamics of their use and the coadaptation process with older adults remain poorly understood. This scoping review explores how interactions between older adults and smart technologies evolve over time to improve both user experience and technology utility. OBJECTIVE: This review synthesizes existing research on the coadaptation between older adults and smart technologies, focusing on longitudinal changes in use patterns, the effectiveness of technological adaptations, and the implications for future technology development and deployment to improve user experiences. METHODS: Following the Joanna Briggs Institute Reviewer's Manual and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines, this scoping review examined peer-reviewed papers from databases including Ovid MEDLINE, Ovid Embase, PEDro, Ovid PsycINFO, and EBSCO CINAHL from the year 2000 to August 28, 2023, and included forward and backward searches. The search was updated on March 1, 2024. Empirical studies were included if they involved (1) individuals aged 55 years or older living independently and (2) focused on interactions and adaptations between older adults and wearables and voice-activated virtual assistants in interventions for a minimum period of 8 weeks. Data extraction was informed by the selection and optimization with compensation framework and the sex- and gender-based analysis plus theoretical framework and used a directed content analysis approach. RESULTS: The search yielded 16,143 papers. Following title and abstract screening and a full-text review, 5 papers met the inclusion criteria. Study populations were mostly female participants and aged 73-83 years from the United States and engaged with voice-activated virtual assistants accessed through smart speakers and wearables. Users frequently used simple commands related to music and weather, integrating devices into daily routines. However, communication barriers often led to frustration due to devices' inability to recognize cues or provide personalized responses. The findings suggest that while older adults can integrate smart technologies into their lives, a lack of customization and user-friendly interfaces hinder long-term adoption and satisfaction. The studies highlight the need for technology to be further developed so they can better meet this demographic's evolving needs and call for research addressing small sample sizes and limited diversity. CONCLUSIONS: Our findings highlight a critical need for continued research into the dynamic and reciprocal relationship between smart technologies and older adults over time. Future studies should focus on more diverse populations and extend monitoring periods to provide deeper insights into the coadaptation process. Insights gained from this review are vital for informing the development of more intuitive, user-centric smart technology solutions to better support the aging population in maintaining independence and enhancing their quality of life. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/51129.

Addressing Aging-in-Place Policy Challenges in Canada: A Call to Action.

Aging in place (AIP) has emerged as a critical priority in policy to support older adults living in their homes and communities. However, achieving equitable support for older adults demands a multi-faceted approach that embraces their choices, capabilities and lived experiences while considering that place is a dynamic concept. This commentary explores the challenges older adults may encounter while AIP and identifies technological and policy areas to explore. Drawing insights from the UK, policy makers in Canada are urged to adopt inclusive definitions of AIP, prioritize technological solutions for recognized challenges and actively involve older adults in policy development.

The landscape of spiritual health and spirituality in Canada: A scoping review protocol.

INTRODUCTION: Currently, literature on spiritual health remains limited. Even more so, literature on spiritual health remains limited in Canada. This is exacerbated by the fact that spiritual health is a term that remains widely contested with no concrete definition. Meanwhile, the semantic connection between "religion" and "spirituality" remains ambiguous in the West and scholars hold different positions. In this paper, we outline our scoping review protocol to describe the current landscape of spiritual health and spirituality (in relation to health) research in Canada, including the meaning and understanding behind these two concepts. METHODS AND ANALYSIS: This protocol for our scoping review is documented in accordance with the PRISMA-P reporting guidelines and adheres to Arksey and O'Malley's scoping review methodology. We will conduct a search strategy across select electronic databases and review the reference lists of chosen papers. Two reviewers, HMB and MM, will independently and blindly screen all title/abstracts and full-text studies for eligibility. Any Canadian-situated studies that centrally mention and focus on "spirituality" or "spiritual health" will be included. Relevant variables will be extracted through an iterative process, with the data charting being continuously reviewed and refined. Findings from this scoping review will support the future of health research and conceptual expansion of health beyond the mental, physical and social. Approval from a research ethics board is not required, nor has it been obtained, as the data is derived from journal articles and academic publications.

Strategies for equity, diversity and inclusion in geriatric healthcare professional curricula: A scoping review protocol.

INTRODUCTION: The pursuit of Equity, Diversity and Inclusion (EDI) in healthcare education has garnered significant attention in recent years, reflecting a broader societal imperative for equitable healthcare delivery. However, existing curricula within geriatric healthcare education may not adequately address these diverse needs within their educational frameworks, inadvertently resulting in disparities in care delivery and outcomes. Within the realm of geriatric healthcare, addressing EDI is particularly crucial due to the diverse needs of older adult populations and the imperative for healthcare professionals to deliver culturally humble care. This review provides a comprehensive overview of strategies and curricular strategies, actions and/or initiatives to promote EDI within geriatric healthcare professional education. METHODS: This paper presents a protocol for a forthcoming scoping review. The methodology for this scoping review adheres to the framework outlined in the Joanna Briggs Institute (JBI) Manual, encompassing four main stages: (1) formulation of a search strategy, (2) screening and selection of evidence, (3) data extraction, and (4) analysis. We will conduct a comprehensive search of peer-reviewed and empirical literature. Additionally, we will explore the reference lists of included studies to identify any relevant sources. The synthesis of findings will be conducted through a narrative approach. Reporting of the methods and results will adhere to the guidelines provided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). DISCUSSION: Healthcare professionals must possess the knowledge, skills, and attitudes necessary to deliver culturally humble care that respects and responds to diverse older adults' unique needs and preferences. The review aims to fill a crucial gap in the literature by providing a comprehensive overview of strategies and curricular interventions designed to promote EDI within geriatric healthcare professional education. By mapping these strategies, actions and/or initiatives, the review seeks to identify trends, challenges, and opportunities for advancing EDI within geriatric care. The forthcoming review serves as a call to action for educators, healthcare institutions, and decision makers to prioritize EDI within geriatric healthcare education. The review identifies effective strategies and interventions for promoting EDI, providing actionable insights to inform the development of inclusive curricula, training programs, and institutional policies, which can contribute to cultivating a healthcare workforce better equipped to address the complex and evolving needs of aging populations equitably and compassionately.

Developing a Healthcare Technology Acceptance Model (H-TAM) for Older Adults with Hypertension.

Older adults with a chronic health condition (e.g., hypertension) use various self-management methods. Healthcare technologies have the potential to support health self-management. However, it is necessary to understand the acceptance of these technologies as a precursor to older adults' adoption and integration into their health plan. Our focus was on the factors older adults with hypertension initially consider when introduced to three new healthcare technologies that might support their health self-management. We compared their considerations for a blood pressure monitor, an electronic pillbox, and a multifunction robot to simulate incrementally more complex technologies. Twenty-three participants (aged 65-84) completed four questionnaires and a semi-structured interview. The interview transcripts were analyzed using a thematic analysis approach. We identified the factors that were frequently mentioned among the participants for each of the three healthcare technologies. The factors that older adults initially considered were familiarity, perceived benefits, perceived ease of use, perceived need for oneself, relative advantage, complexity, and perceived need for others. Upon further reflection, participants considered advice acceptance, compatibility, convenience, facilitating conditions, perceived usefulness, privacy, subjective norm, and trust. We integrated the factors that older adults considered into the Healthcare Technology Acceptance Model (H-TAM), which elucidates the complexity of healthcare technology acceptance and provides guidance for future explorations.

Coadaptation Between Smart Technologies and Older Adults Over Time: Protocol for a Scoping Review.

BACKGROUND: The Internet of Things (IoT) has gained significant attention due to advancements in technology and has potential applications in meeting the needs of an aging population. Smart technologies, a subset of IoT, can support older adults in aging in place, promoting independent living and improving their quality of life. However, there is a lack of research on how older adults and smart technologies coadapt over time to maximize their benefits and sustain adoption. OBJECTIVE: We will aim to comprehensively review and analyze the existing scientific literature pertaining to the coadaptation between smart technologies and older adults. The primary focus will be to investigate the extent and nature of this coadaptation process and explore how older adults and technology coevolve over time to enhance older adults' experience with technology. METHODS: This scoping review will follow the methodology outlined in the Joanna Briggs Institute Reviewer's Manual and adhere to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews) guidelines for reporting. Peer-reviewed articles will be searched in databases like Ovid MEDLINE, OVID Embase, PEDro, OVID PsycINFO, EBSCO CINAHL, the Cochrane Library, Scopus, IEEE Xplore, Web of Science, and Global Index Medicus. The research team will create a data extraction form covering study characteristics, participant characteristics, underlying models and frameworks, research findings, implications for technology coadaptation, and any identified study limitations. A directed content analysis approach will be used, incorporating the Selection, Optimization, and Compensation framework and Sex- and Gender-Based Analysis Plus theoretical framework. RESULTS: The results of this study are expected in January 2024. CONCLUSIONS: This scoping review endeavors to present a thorough overview of the available evidence concerning how smart technologies interact with older adults over an extended period. The insights gained from this review will lay the groundwork for a research program that explores how older adults adapt to and use smart technologies throughout their lives, ultimately leading to improved user satisfaction and experience and facilitating aging in place with tailored support and user-centered design principles. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/51129.

Defining Aging in Place: The Intersectionality of Space, Person, and Time.

Aging in place (AIP) is a term that is commonly used and defined in a plethora of ways. Multiple disciplines take a different stance on the definition of AIP, and its definition has evolved over time. Such diverse ways to define AIP could be a barrier to reach a shared expectation among multiple stakeholders when formulating research studies, making policy decisions, developing care plans, or designing technology tools to support older adults. We conducted a scoping review for the term AIP to understand specifically how it has been defined across time and disciplines. We collected exemplary definitions of AIP from 7 databases that represent different fields of study; namely, AgeLine, Anthropology Plus, Art and Architecture Source, CINAHL, PsycINFO, PubMed, and SocINDEX. We conducted a thematic analysis to identify the common concepts that emerged across the definitions identified in the scoping review. We developed 3 main categories from the themes: space, person, and time to illustrate the root of meaning across the definitions. Intersectionality across the categories yielded a comprehensive understanding of AIP, which does not constrain its definition to a place-related phenomenon. We propose that AIP be defined as "One's journey to maintain independence in one's place of residence as well as to participate in one's community." With this shared understanding of the term AIP, policymakers, researchers, technology designers, and caregivers can better support those who aim to age in the place of their choice.