The role of assistive technology in addressing social isolation, loneliness and health inequities among older adults during the COVID-19 pandemic.

PURPOSE: Assistive technology (AT) is an effective tool to promote social connectedness among older adults affected by the COVID-19 pandemic; however, its role in reducing loneliness and health inequities is not well understood. The goal of this scoping review was to construct a model for how technologies may be deployed to mitigate the impact of the COVID-19 pandemic on social isolation, loneliness and health inequities for older adults. METHODS: PubMed, SCOPUS and PsychINFO were searched from 2010 to 2020 for the following keywords: "social isolation," "loneliness," "social support," "resilience," "technology," "pandemic" and "health inequit*." Articles selected for full analysis attempted to understand how technology alleviates social isolation and/or loneliness among older adults. RESULTS: Eighteen articles met the criteria for selection and data extraction. Six were review-type studies, seven were observational, three were randomized control trials, one opinion piece and one case study. ATs have been shown to reduce loneliness and social isolation, strengthen social support, and promote resilience among older adults. AT reduces loneliness both directly and indirectly, by affecting social isolation. There is insufficient evidence to determine technology's relationship to health inequities experienced by older adults. CONCLUSIONS: The model we have proposed should help advance research on the relationship between ATs and health inequities among older adults that may be aggravated by the COVID-19 pandemic. We hypothesize that AT interventions for social support and functional competence should be sequenced to reduce health disparities.Implications for rehabilitationThe social distancing and quarantine measures as a result of the COVID-19 pandemic can be linked to adverse health outcomes among older adult populations.Technology is an effective tool to promote social connectedness among older adults affected by the pandemic.Assistive technology (AT) interventions for social support and functional competence should be sequenced in order to have best effects on reducing health disparities.

Towards improving the quality of assistive technology outcomes research.

BACKGROUND: The Assistive Technology Device Outcomes Research (ATDOR) checklist was developed as a reporting guideline for researchers to enhance the quality of research in this field. The checklist contains 13 items that cover outcome domains unique to assistive technology devices (ATDs). The ATDOR was intended to be an adjunct to existing publication guidelines for outcomes research. PURPOSE: The aim of this investigation was to examine the ability of the ATDOR checklist to identify strengths and weaknesses in ATD outcomes research publications that may not be detected using another publication guideline designed for outcomes research. METHODS: Twenty original ATD outcome studies were scored using the Template for Intervention Description and Replication (TIDieR) checklist, and the ATDOR in two evaluation rounds. In the first round, articles were scored using the TIDieR alone. In the second round, they were scored using the TIDieR and ATDOR together. The difference in percentage scores between the two evaluation rounds was examined using the Wilcoxon signed rank-sum test for paired data. RESULTS: There was a statistically significant difference in the percentage scores between the two evaluation rounds (Wilcoxon statistic = 10, Z = -3.547, p<.000). CONCLUSION: When used alongside the TIDieR, the ATDOR adds significant value to evaluations of reporting quality on assistive technology outcomes research. As this field continues to grow, researchers are invited to join in efforts to standardise reporting to promote healthier outcomes for ATD users.Implications for rehabilitationReporting guidelines that evaluate research studies enhance their reporting quality and promote healthier outcomes for ATD users.The Assistive Technology Device Outcomes Research (ATDOR) checklist was shown to be a useful tool for achieving a minimum standard of reporting in the field of assistive technology.As the field of assistive technology continues to explore different methodologies, ongoing efforts to develop and update reporting guidelines are necessary in order to capture the future needs of this research area.

Toward guidelines for reporting assistive technology device outcomes.

PURPOSE: The aim of this study was to develop and pilot-test reporting guidelines for manuscripts describing studies of assistive technology device outcomes, with the hopes of improving the overall quality of research in this field. METHODS: The research is presented in two stages. In Stage 1, a literature review was completed to identify the essential components of a conceptual framework for reporting guidelines and to create a checklist. In Stage 2, two independent reviewers evaluated twenty articles using the checklist to identify any short-comings of the tool and produce an estimate of interrater reliability. Two items of the original checklist were revised after reconciling disagreements between the two raters. RESULTS: The Cohen's Kappa value of the checklist was 0.887 (p < .000), reflecting excellent interrater agreement. The overall percent agreement was 94.6%. CONCLUSIONS: Reporting guidelines for studies of assistive technology device outcomes appear to be reliable. Although the checklist may require periodic updating, it has potential for advancing outcomes research. Researchers are invited to share comments and criticisms to aid in the efforts of enhancing the quality of reporting in this field.Implications for rehabilitationReporting checklists and guidelines are effective tools for achieving a minimum standard of reporting quality in all areas of rehabilitation research.This study presents a preliminary reporting checklist for the field of assistive technology device outcomes that has potential for advancing outcomes research.Authors and journal editors are encouraged to adopt and adhere to reporting guidelines in order to enhance the clarity and completeness of prospective studies.

Understanding adherence to assistive devices among older adults: a conceptual review.

Purpose: The aim of this study was to identify and examine how existing literature has conceptualized adherence to assistive devices (ADs) among older adults. Methods: English articles were searched in MEDLINE, PubMed, and CINAHL (January 1990 to October 2017) for the key words "acceptance", "adherence", "assistive devices", "compliance", "concept," and relevant synonyms. Bibliographies of selected articles were also examined. Articles were analyzed if the following conditions were met conjointly: (1) attempted to define or conceptualize adherence to some degree; (2) were concerned with any AD for older adults; (3) were concerned with adults aged 65 years or older. Results: Sixteen of the 484 articles were included. Adherence to ADs among older adults seemed to be conceptualized under three core themes: psychological, contextual, and functional factors; each with their own unique considerations related to adherence that are analyzed in this study. Conclusion: This review identified a large gap in knowledge about adherence to ADs. Adherence is multi-factorial and highly specific to the individual's circumstances and their relationship with their health care practitioner. Further empirical research should focus on how the three core themes of adherence interact with and influence each other. Implications for rehabilitation Health care professionals who assess for, and recommend ADs should foster a shared decision-making relationship with their clients This review identifies some of the key themes that practitioners should consider when developing and implementing AD regimens with older adults Conceptualizing AD adherence among older adults will help improve monitoring of and quality of care for AD users.

Assessing the stigma content of urinary incontinence intervention outcome measures.

The goal of this narrative review is to evaluate the efficacy of available questionnaires for assessing the outcomes of "continence difficulty" interventions and to assess the selected questionnaires concerning aspects of stigmatization. The literature was searched for research related to urinary incontinence, as well as questionnaires and rating scale outcome measurement tools. The following sources were searched: Cochrane Library, EMBASE, Medline, and PubMed. The following keywords were used separately or in combination: "Urinary incontinence," "therapy," "treatment outcome," "patient satisfaction," "quality of life," "systematic reviews," "aged 65+ years," and "questionnaire." The search yielded 194 references, of which 11 questionnaires fit the inclusion criteria; 6 of the 11 questionnaires did not have any stigma content and the content regarding stigma that was identified in the other five was very limited. A representative model of how stigma impacts continence difficulty interventions was proposed. While the 11 incontinence specific measurement tools that were assessed were well researched and designed specifically to measure the outcomes of incontinence interventions, they have not been used consistently or extensively and none of the measures thoroughly assess stigma. Further studies are required to examine how the stigma associated with continence difficulty impacts upon health care interventions.