Multiple Perspectives on the Adoption of SMART Technologies for Improving Care of Older People: Mixed Methods Study.

BACKGROUND: Despite the ever-increasing offering of SMART technologies (ie, computer-controlled devices acting intelligently and capable of monitoring, analyzing or reporting), a wide gap exists between the development of new technological innovations and their adoption in everyday care for older adults. OBJECTIVE: This study aims to explore the barriers and concerns related to the adoption of SMART technologies among different groups of stakeholders. METHODS: Data from 4 sources were used: semistructured in-person or internet-based interviews with professional caregivers (n=12), structured email interviews with experts in the area of aging (n=9), a web-based survey of older adults (>55 years) attending the Virtual University of the Third Age (n=369), and a case study on the adoption of new technology by an older adult care facility. RESULTS: Although all stakeholders noted the potential of SMART technologies to improve older adult care, multiple barriers to their adoption were identified. Caregivers perceived older adults as disinterested or incompetent in using technology, reported preferring known strategies over new technologies, and noted own fears of using technology. Experts viewed technologies as essential but expressed concerns about cost, low digital competency of older adults, and lack of support or willingness to implement technologies in older adult care. Older adults reported few concerns overall, but among the mentioned concerns were lack of ability or interest, misuse of data, and limited usefulness (in specific subgroups or situations). In addition, older adults' ratings of the usefulness of different technologies correlated with their self-rating of digital competency (r=0.258; P<.001). CONCLUSIONS: Older adults appeared to have more positive views of various technologies than professional caregivers; however, their concerns varied by the type of technology. Lack of competence and lack of support were among the common themes, suggesting that educationally oriented programs for both older adults and their caregivers should be pursued.

From intention to behavior: Within- and between-person moderators of the relationship between intention and physical activity.

Intention is a proximal predictor of behavior in many theories of behavior change, but intentions to be physically active do not always translate to actual physical activity. Little research has examined intensive longitudinal changes in physical activity and corresponding within-person moderators needed to elucidate the mechanisms, hurdles, and facilitators of individuals' everyday physical activity behaviors. The present study set out to evaluate the possible moderators of the intention-physical activity relationship across within-person and between-person levels, including cross-level interactions. Data comprise the first intensive measurement burst (14 days) of the longitudinal prospective Healthy Aging in Industrial Environment (HAIE) study, with N = 1135 participants (N = 10,030 person-days), aged 18-65. Physical activity was operationalized as step counts measured objectively using Fitbit Charge 3/4 fitness monitor. Intention, barriers to physical activity, and social support for physical activity were measured daily via smartphone surveys. Stable characteristics, i.e., physical activity habit and exercise identity, were measured using an online questionnaire. A multilevel moderation regression model with Bayesian estimator was fitted. At the within-person level, the relation between intention and steps was weaker on days when barriers were more severe than usual for a given person (Estimate = -0.267; CI95 = [-0.340, -0.196]) and social support was below average for a given person (Est = 0.143; CI95 = [0.023, 0.262]). Additionally, the daily intention-behavior relationship was stronger for people with lower average severity of barriers (Est = -0.153; CI95 = [-0.268, -0.052]), higher exercise identity (Est = 0.300; CI95 = [0.047, 0.546]), men (Est = -1.294, CI95 = [-1.854, -0.707]), and older individuals (Est = 0.042, CI95 = [0.017, 0.064]). At the between-person level, only physical activity habit strengthened the intention-behavior link (Est = 0.794; CI95 = [0.090, 1.486]). Our results underscore the need to separate the between-person differences from the within-person fluctuations to better understand the individual dynamics in physical activity behaviors. Personalized interventions aimed at helping individuals translate intentions to actual physical activity could be tailored and become more intensive when there is a higher risk of intention-behavior gap on a given day for a specific individual (i.e., a day with more severe barriers and less social support), by increasing the dosage or deploying more precisely targeted intervention strategies and components. In addition, interventionists should take gender and age into account when tailoring everyday strategies to help individuals act on their intentions.

Feasibility of Real-time Behavior Monitoring Via Mobile Technology in Czech Adults Aged 50 Years and Above: 12-Week Study With Ecological Momentary Assessment.

BACKGROUND: Czech older adults have lower rates of physical activity than the average population and lag behind in the use of digital technologies, compared with their peers from other European countries. OBJECTIVE: This study aims to assess the feasibility of intensive behavior monitoring through technology in Czech adults aged ≥50 years. METHODS: Participants (N=30; mean age 61.2 years, SD 6.8 years, range 50-74 years; 16/30, 53% male; 7/30, 23% retired) were monitored for 12 weeks while wearing a Fitbit Charge 2 monitor and completed three 8-day bursts of intensive data collection through surveys presented on a custom-made mobile app. Web-based surveys were also completed before and at the end of the 12-week period (along with poststudy focus groups) to evaluate participants' perceptions of their experience in the study. RESULTS: All 30 participants completed the study. Across the three 8-day bursts, participants completed 1454 out of 1744 (83% compliance rate) surveys administered 3 times per day on a pseudorandom schedule, 451 out of 559 (81% compliance rate) end-of-day surveys, and 736 episodes of self-reported planned physical activity (with 29/736, 3.9% of the reports initiated but returned without data). The overall rating of using the mobile app and Fitbit was above average (74.5 out of 100 on the System Usability Scale). The majority reported that the Fitbit (27/30, 90%) and mobile app (25/30, 83%) were easy to use and rated their experience positively (25/30, 83%). Focus groups revealed that some surveys were missed owing to notifications not being noticed or that participants needed a longer time window for survey completion. Some found wearing the monitor in hot weather or at night uncomfortable, but overall, participants were highly motivated to complete the surveys and be compliant with the study procedures. CONCLUSIONS: The use of a mobile survey app coupled with a wearable device appears feasible for use among Czech older adults. Participants in this study tolerated the intensive assessment schedule well, but lower compliance may be expected in studies of more diverse groups of older adults. Some difficulties were noted with the pairing and synchronization of devices on some types of smartphones, posing challenges for large-scale studies.

Who Is Smart with Their Smartphones? Determinants of Smartphone Security Behavior.

Smartphones have recently become a major target for cybercriminals due to large amounts of sensitive data and credentials being stored on the devices. To protect themselves against cyberthreats, users can employ a range of security behaviors. Although research has largely focused on computer security, relatively little is known about personal smartphone security behavior. The goal of our study was to evaluate determinants of smartphone security behavior based on the combination of the Health Belief Model and Protection Motivation Theory. We extended the models by including the construct of general security orientation. We also developed a smartphone security behavior scale that measured various aspects of this behavior. The sample included 331 Czech Android smartphone users aged between 26 and 81 years who were not IT specialists by employment or education. Path analysis showed that individuals who perceived a potential smartphone security threat as more severe, had higher smartphone self-efficacy, and general orientation and interest in digital security, and less personal experience with a digital security incident reported more secure behavior on their smartphones. Perceived susceptibility to security threats and family and friends' previous experience with digital security incidents did not predict smartphone security behavior. General security orientation affected smartphone security behavior also indirectly through perceived severity. These findings have theoretical implications for the models and also emphasize the importance of general digital security awareness as well as smartphone training to increase smartphone security behavior.

Running and Physical Activity in an Air-Polluted Environment: The Biomechanical and Musculoskeletal Protocol for a Prospective Cohort Study 4HAIE (Healthy Aging in Industrial Environment-Program 4).

Far too little attention has been paid to health effects of air pollution and physical (in)activity on musculoskeletal health. The purpose of the Healthy aging in industrial environment study (4HAIE) is to investigate the potential impact of physical activity in highly polluted air on musculoskeletal health. A total of 1500 active runners and inactive controls aged 18-65 will be recruited. The sample will be recruited using quota sampling based on location (the most air-polluted region in EU and a control region), age, sex, and activity status. Participants will complete online questionnaires and undergo a two-day baseline laboratory assessment, including biomechanical, physiological, psychological testing, and magnetic resonance imaging. Throughout one-year, physical activity data will be collected through Fitbit monitors, along with data regarding the incidence of injuries, air pollution, psychological factors, and behavior collected through a custom developed mobile application. Herein, we introduce a biomechanical and musculoskeletal protocol to investigate musculoskeletal and neuro-mechanical health in this 4HAIE cohort, including a design for controlling for physiological and psychological injury factors. In the current ongoing project, we hypothesize that there will be interactions of environmental, biomechanical, physiological, and psychosocial variables and that these interactions will cause musculoskeletal diseases/protection.

The Role of Psychological Factors in Older Adults' Readiness to Use eHealth Technology: Cross-Sectional Questionnaire Study.

BACKGROUND: Information and communication technology (ICT) use among older adults has been on the rise in recent years. However, the predictors and mechanisms behind older adults' acceptance and use of ICT are not clear. OBJECTIVE: This study aimed to systematically describe ICT usage among Czech older adults and to evaluate the factors influencing their ICT use and readiness to use digital technology to promote health (eHealth readiness). The primary focus was on psychological factors and the role of persons close to older adults. METHODS: The research utilized cross-sectional survey data from a quota-based sample of Czech older adults (>50 years) and persons close to them further referred to as close persons (N=250 dyads). A structural equation modeling framework was used to evaluate relationships between psychological factors, ICT use, and eHealth readiness. RESULTS: Czech older adults' use of ICT is low with the exception of cell phone usage (cell phone usage by 173/250, 69.2%; other devices used by 50/250, 20.0% of older adults or less). Apart from age (ß=-.21; P<.001), eHealth readiness was predicted by ICT use (ß=.65; P<.001). eHealth readiness was also indirectly affected by the need for cognitive closure (NFCC): individuals with a high need for closure perceived more barriers to ICT (ß=.23; P=.01) and more reported barriers were linked to lower ICT usage (ß=-.21; P=.001). The expected positive relationships between eHealth readiness of persons close to older adults and ICT use and eHealth readiness of older adults were not significant, but the total effect of eHealth readiness of persons close to older adults on eHealth readiness of older adults was positive and significant (ß=.18; P=.01), indicating some level of influence of persons close to them on older adults' attitudes and behaviors. CONCLUSIONS: This study provided the first systematic examination of Czech older adults' ICT usage and eHealth readiness. Novel predictors (NFCC and close persons' variables) were evaluated and yielded actionable results. More research is needed to clarify the role of persons close to older adults.

GPs' perspectives on eHealth use in the Czech Republic: a cross-sectional mixed-design survey study.

BACKGROUND: Digitalisation of health services is among the top priorities of the European Union (EU), yet take-up of eHealth tools is slower in some EU countries than others. AIM: The aim of this study was to evaluate the use of information communication technology (ICT) and eHealth tools by Czech GPs, to elucidate their motivation and barriers to the adoption of eHealth technologies. DESIGN & SETTING: A cross-sectional, mixed-design survey study, administered online and conducted with GPs from seven randomly selected Czech regions. Of the invited 777 GPs, 196 participants responded (25% response rate) and 153 completed the survey. METHOD: Quantitative (measured using, for example, the eHealth readiness scale) and qualitative (thematic analysis) methods were used. RESULTS: Hierarchical multilinear regression (controling for age, sex, and city size) showed that ICT usage in general practice was predicted by eHealth readiness. Among GPs with their own practice, age and practice size also predicted ICT use. Analysis of barriers specific to mobile health tools identified obstacles on the side of GPs (such as low perceived usefulness), patients (such as lack of interest), and contextual barriers (such as lack of time). CONCLUSION: In addition to system-level change, educating Czech GPs about the benefits of eHealth tools for better patient-provider interaction and quality of care is necessary to facilitate eHealth adoption and usage in the Czech Republic.

Mobile Health Interventions for Physical Activity, Sedentary Behavior, and Sleep in Adults Aged 50 Years and Older: A Systematic Literature Review.

We provide a systematic review of interventions utilizing mobile technology to alter physical activity, sedentary behavior, and sleep among adults aged 50 years and older. A systematic search identified 52 relevant articles (randomized control trial [RCT], quasi-experimental, pre/post single-group design). Of 50 trials assessing physical activity, 17 out of 29 RCTs and 13 out of 21 trials assessed for pre/post changes only supported the effectiveness of mobile interventions to improve physical activity, and 9 studies (five out of 10 RCTs and all four pre/post studies) out of 14 reduced sedentary behavior. Only two of five interventions improved sleep (one out of two RCTs and one out of three pre/post studies). Text messaging was the most frequently used intervention (60% of all studies) but was usually used in combination with other components (79% of hybrid interventions included SMS, plus either web or app components). Although more high-quality RCTs are needed, there is evidence supporting the effectiveness of mHealth approaches in those aged 50 years and older.

"It's Always the Judge's Fault": Attention, Emotion Recognition, and Expertise in Rhythmic Gymnastics Assessment.

In many sports, such as figure skating or gymnastics, the outcome of a performance does not rely exclusively on objective measurements, but on more subjective cues. Judges need high attentional capacities to process visual information and overcome fatigue. Also their emotion recognition abilities might have an effect in detecting errors and making a more accurate assessment. Moreover, the scoring given by judges could be also influenced by their level of expertise. This study aims to assess how rhythmic gymnastics judges' emotion recognition and attentional abilities influence accuracy of performance assessment. Data will be collected from rhythmic gymnastics judges and coaches at different international levels. This study will employ an online questionnaire consisting on an emotion recognition test and attentional test. Participants' task is to watch a set of videotaped rhythmic gymnastics performances and evaluate them on the artistic and execution components of performance. Their scoring will be compared with the official scores given at the competition the video was taken from to measure the accuracy of the participants' evaluations. The proposed research represents an interdisciplinary approach that integrates cognitive and sport psychology within experimental and applied contexts. The current study advances the theoretical understanding of how emotional and attentional aspects affect the evaluation of sport performance. The results will provide valuable evidence on the direction and strength of the relationship between the above-mentioned factors and the accuracy of sport performance evaluation. Importantly, practical implications might be drawn from this study. Intervention programs directed at improving the accuracy of judges could be created based on the understanding of how emotion recognition and attentional abilities are related to the accuracy of performance assessment.