How age and health status impact attitudes towards aging and technologies in care: a quantitative analysis.

BACKGROUND: Increasing proportions of geriatric patients pose tremendous challenges for our society. Developments in assistive technologies have the potential to support older and frail people in aging and care. To reach a sustainable adoption of these technologies, the perceptions and wishes of future users must be understood. In particular, the relationships between individual health-related factors, and the perceptions of aging and using assistive technologies in severe health situations must be empirically examined. METHODS: Addressing this research gap, our quantitative study (N = 570) investigates the impact of diverse future users' age and health status on their a) perceptions of aging, b) perceptions and acceptance of using assistive technologies in aging and care, as well as c) end-of-life decisions regarding technology usage. For this, four groups were segmented for the comparison of younger (< 50 years) healthy, younger chronically ill, older (50 + years) healthy, and older chronically ill participants. RESULTS: The results revealed that health status is more decisive for age-related perceptions compared to age. The technology-related perceptions were slightly impacted by either chronological age or health status. The end-of-life decisions showed the most striking differences in the willingness to use assistive technologies, revealing older chronically ill participants to have more restrained attitudes towards technology usage than older healthy as well as all younger participants. CONCLUSIONS: The findings suggest that the benefits of assistive technologies in private or professional care contexts should be communicated and implemented tailored to the respective user group's needs. Moreover, the results allow us to derive practical implications within the geriatric care context.

Shapes of You? Investigating the Acceptance of Video-Based AAL Technologies Applying Different Visualization Modes.

An aged population, increasing care needs, and a lack of (in)formal caregivers represent major challenges for our society today. Addressing these challenges fuels efforts and developments in innovative technologies leading to various existing AAL applications aiming at improving autonomy, independence, and security in older age. Here, the usage of video-based AAL technologies is promising as detailed information can be obtained and analyzed. Simultaneously, this type of technology is strongly connected with privacy concerns due to fears of unauthorized data access or inappropriate use of recorded data potentially resulting in rejection and non-use of the applications. As privacy-preserving visualizations of video data can diminish those concerns, this empirical study examines the acceptance and privacy perceptions of video-based AAL technology applying different visualization modes for privacy preservation (n = 161). These visualization modes differed in their degrees of visibility and identifiability, covering different levels of privacy preservation (low level: "Blurred" mode; medium level: "Pixel" and "Grey" modes; high level: "Avatar" mode) and are specifically evaluated based on realistic video sequences. The results of our study indicate a rather low acceptance of video-based AAL technology in general. From the diverse visualization modes, the "Avatar" mode is most preferred as it is perceived as best suitable to protect and preserve the users' privacy. Beyond that, distinct clusters of future users were identified differing in their technology evaluation as well as in individual characteristics (i.e., privacy perception, technology commitment). The findings support the understanding of potential users' needs for a successful future design, development, and implementation of video-based, but still privacy-preserving AAL technology.

Interdisciplinary perspectives on privacy awareness in lifelogging technology development.

Population aging resulting from demographic changes requires some challenging decisions and necessary steps to be taken by different stakeholders to manage current and future demand for assistance and support. The consequences of population aging can be mitigated to some extent by assisting technologies that can support the autonomous living of older individuals and persons in need of care in their private environments as long as possible. A variety of technical solutions are already available on the market, but privacy protection is a serious, often neglected, issue when using such (assisting) technology. Thus, privacy needs to be thoroughly taken under consideration in this context. In a three-year project PAAL ('Privacy-Aware and Acceptable Lifelogging Services for Older and Frail People'), researchers from different disciplines, such as law, rehabilitation, human-computer interaction, and computer science, investigated the phenomenon of privacy when using assistive lifelogging technologies. In concrete terms, the concept of Privacy by Design was realized using two exemplary lifelogging applications in private and professional environments. A user-centered empirical approach was applied to the lifelogging technologies, investigating the perceptions and attitudes of (older) users with different health-related and biographical profiles. The knowledge gained through the interdisciplinary collaboration can improve the implementation and optimization of assistive applications. In this paper, partners of the PAAL project present insights gained from their cross-national, interdisciplinary work regarding privacy-aware and acceptable lifelogging technologies.

Analyzing technology acceptance and perception of privacy in ambient assisted living for using sensor-based technologies.

People increasingly use various technologies that enable them to ease their everyday lives in different areas. Not only wearable devices are gaining ground, but also sensor-based ambient devices and systems are increasingly perceived as beneficial in supporting users. Especially older and/or frail persons can benefit from the so-called lifelogging technologies assisting the users in different activities and supporting their mobility and autonomy. This paper empirically investigates users' technology acceptance and privacy perceptions related to sensor-based applications implemented in private environments (i.e., passive infrared sensors for presence detection, humidity and temperature sensors for ambient monitoring, magnetic sensors for user-furniture interaction). For this purpose, we designed an online survey entitled "Acceptance and privacy perceptions of sensor-based lifelogging technologies" and collected data from N = 312 German adults. In terms of user acceptance, statistical analyses revealed that participants strongly agree on the benefits of such sensor-based ambient technologies, also perceiving these as useful and easy to use. Nevertheless, their intention to use the sensor-based applications was still rather limited. The evaluation of privacy perceptions showed that participants highly value their privacy and hence require a high degree of protection for their personal data. The potential users assessed the collection of data especially in the most intimate spaces of domestic environments, such as bathrooms and bedrooms, as critical. On the other hand, participants were also willing to provide complete data transparency in case of an acute risk to their health. Our results suggest that users' perceptions of personal privacy largely affect the acceptance and successful adoption of sensor-based lifelogging in home environments.

Acceptance and Preferences of Using Ambient Sensor-Based Lifelogging Technologies in Home Environments.

Diverse sensor-based technologies can be used to track (older and frail) people's movements and behaviors in order to detect anomalies and emergencies. Using several ambient sensors and integrating them into an assisting ambient system allows for the early identification of emergency situations and health-related changes. Typical examples are passive infrared sensors (PIR), humidity and temperature sensors (H&T) as well as magnetic sensors (MAG). So far, it is not known whether and to what extent these three specific sensor types are perceived and accepted differently by future users. Therefore, the present study analyzed the perception of benefits and barriers as well as acceptance of these specific sensor-based technologies using an online survey (reaching N=312 German participants). The results show technology-related differences, especially regarding the perception of benefits. Furthermore, the participants estimated the costs of these sensors to be higher than they are, but at the same time showed a relatively high willingness to pay for the implementation of sensor-based technologies in their home environment. The results enable the derivation of guidelines for both the technical development and the communication and information of assisting sensor-based technologies and systems.

Insights Into the Older Adults' World: Concepts of Aging, Care, and Using Assistive Technology in Late Adulthood.

The ongoing demographic change forces different stakeholders to cope with increasing needs in nursing care and the economic costs. Consequences arising from the population aging can be supported by assistive technologies to maintain older individuals' autonomy. However, older adults' opinions on the assistance of health-related technologies and their attitudes toward aging and care largely remain underexplored. This paper provides a geriatric and socio-technical perspective, investigating individual perceptions of (a) aging, (b) nursing care, and (c) the adoption of assistive technologies in a cross-national subject group. For this purpose, N = 384 individuals (60+ years) participated in an online survey. Findings indicate that most older adults are open to assistive technologies and that individual care preferences contribute to a successful adoption of these technologies. Among individual factors, health status, and gender affect respondents' opinions the most. Our findings help to understand older adults' acceptance of assistive technologies and contribute to the research on the nursing care in private and professional environments.

Telemedical versus conventional heart patient monitoring: a survey study with German physicians.

OBJECTIVES: In this study, we explored crucial factors that explain a person's attitude toward and his or her assessment of telemedical systems. Special focus lies on the link between the perspective of physicians (telemedicine users) and technicians (telemedicine designers) to find potential barriers hindering the broad application of telemedical systems in hospitals and doctors' offices. METHODS: A survey among medical professionals (n = 34), technical professionals (n = 39), and a control group (n = 44) was conducted. The collected data were assessed in terms of domain knowledge, attitudes toward telemedicine, and potential implementation barriers. RESULTS: Participants favored the conventional method over telemedical monitoring in regards to privacy, security, and time efficiency. In contrast, telemedicine was preferred with reference to efficiency of data analysis, long-term care, and emergency adequacy. Significant differences between the professional groups were found regarding perceived cost effectiveness, patients' compliance, privacy protection, and false alarm sensitivity. Medical professionals exhibited the most reluctance toward using telemedical treatments. CONCLUSIONS: The perceived drawbacks are attributed to a general uncertainty about the reliability of telemedical systems, in combination with concerns about personal data privacy, security, and loss of control. The reported fear of not being able to correctly use and handle the systems assumes a low usability of devices. To acquaint medical professionals with the benefits and limitations of telemedical systems, telemonitoring and tele-treatment should be included in the education of medical personnel at an early stage.

Privacy and data security in E-health: requirements from the user's perspective.

In this study two currently relevant aspects of using medical assistive technologies were addressed-security and privacy. In a two-step empirical approach that used focus groups (n = 19) and a survey (n = 104), users' requirements for the use of medical technologies were collected and evaluated. Specifically, we focused on the perceived importance of data security and privacy issues. Outcomes showed that both security and privacy aspects play an important role in the successful adoption of medical assistive technologies in the home environment. In particular, analysis of data with respect to gender, health-status and age (young, middle-aged and old users) revealed that females and healthy adults require, and insist on, the highest security and privacy standards compared with males and the ailing elderly.

Integrated home monitoring and compliance optimization for patients with mechanical circulatory support devices.

This article presents an integrated, automatic home-monitoring, and assist system for patients suffering from end-stage heart failure, particularly patients with implanted mechanical circulatory support devices, such as ventricular assist devices and total artificial hearts. The system incorporates various biosensors to monitor the vital parameters of the patient unobtrusively in the home environment. Recorded data can be accessed online and in real time by a supervising physician, and these data serve as a means for immediate diagnosis of emergency events. The retrieved information can also be continuously analyzed to generate suggestions for medication, nutrition, and exercise for the patient to optimize their rehabilitation and overall health. An experimental environment (the Future Care Lab) was set up at RWTH Aachen University to serve as a testing environment for the development and evaluation of this novel integrated system. The Future Care Lab was not only used as a platform for technically testing the monitoring system, but also more concretely demonstrating to users the integration of these new medical technologies in a home. Thus, the Future Care Lab provides a unique environment for an interdisciplinary research approach consisting of iterative cycles of system development and evaluation of user acceptance.