Co-Creating a Digital Life-Integrated Self-Assessment for Older Adults: User Experience Study.

BACKGROUND: Older adults are at increased risk of developing health disorders and functional decline. However, owing to time constraints and considerable effort, physicians rarely conduct comprehensive assessments to detect early signs of negative trajectories. If designed properly, digital technologies could identify health risks already at a preclinical stage, thereby facilitating preventive efforts and targeted intervention. For this purpose, a Life-integrated Self-Assessment (LiSA) tablet system will be developed through a structured co-creation process. OBJECTIVE: This study aims to investigate older adults' perceptions of different self-assessment domains, components affecting user experience, risks and benefits associated with LiSA, characteristics of potential LiSA users, and the LiSA concept in general. METHODS: A total of 10 community-dwelling older adults aged ≥70 years were recruited. In total, 6 co-creation workshops were held and started with expert input followed by semistructured discussion rounds. Participants performed hands-on activities with a tablet, including testing of preinstalled self-assessment apps. All workshops were audio recorded and additionally documented by the researchers using flipcharts, notes, and photos. Qualitative content analysis was used to analyze the data following a deductive-inductive approach guided by the Optimized Honeycomb Model for user experience. RESULTS: The group (mean age 77.8, SD 5.1 years) was heterogeneous in terms of previous technology experience and health status. The mean workshop duration was 2 hours (122.5, SD 4.43 min), and an average of 8 (SD 1.15) participants attended each workshop. A total of 11 thematic categories were identified, covering results on all research questions. Participants emphasized a strong interest in conducting a digital self-assessment of physical activity and function and sensory and cognitive functions and requested additional features such as recommendations for actions or reminders. LiSA was perceived as empowering and a motivator to engage in active health care planning as well as enabling shared and informed decision-making. Concerns and barriers included the lack of technical competence, feelings of frustration, and fear of being left alone, with negative assessment results. In essence, participants expressed a positive attitude toward using LiSA repeatedly and identified it as an option to increase the chances of maintaining independence when growing older. CONCLUSIONS: The co-creation participants supported the LiSA approach and were interested in performing regular self-assessments on a long-term basis. In their opinion, LiSA should include relevant assessments capturing physical activity and function and sensory and cognitive functions as well as recommendations for actions. It should be customizable to individual needs. These results will form the basis for a prototype. Iterative development and validation will aim to make LiSA accessible in the public domain as a reliable tablet-based system for self-assessment.

Digital Gender Gap in the Second Half of Life Is Declining: Changes in Gendered Internet Use Between 2014 and 2021 in Germany.

OBJECTIVES: The main purpose of the study has been to examine changes in Internet use among men and women in 3 age groups (midlife, early old age, and advanced old age) between 2014 and 2021. We tested 2 hypotheses: The complementary hypothesis posits that online activities reproduce gender differences in offline activities. The compensatory hypothesis posits that women are catching up over time in male-typed activities as Internet access approaches saturation for both genders. METHODS: We used representative, longitudinal data from the German Ageing Survey collected in 2014, 2017, 2020, and 2021 (n = 21,505, age range 46-90 years). We ran logistic regressions on Internet access and Internet use for 4 different gender-typed activities: social contact (female-typed), shopping (gender-neutral), entertainment (male-typed), and banking (male-typed). RESULTS: Between 2014 and 2021, women drew level with men in Internet access. Gender differences in all 4 forms of Internet use declined considerably between 2014 and 2021. Women overtook men in using the Internet for social contact. In older age groups, men held the lead regarding online banking. During the coronavirus disease 2019 (COVID-19) crisis, women caught up to men in Internet use, especially for entertainment. DISCUSSION: Overall time trends support the complementary hypothesis. By contrast, the finding that women have been catching up in some male-typed online activities during the COVID-19 pandemic supports the compensatory hypothesis.

Awareness of age-related change is associated with attitudes toward technology and technology skills among older adults.

Despite much research in the context of aging and technology, the role of Views on aging (VoA) for differences in technology use and attitudes among older adults has rarely been studied so far. This study focuses on the associations between a multidimensional measure of VoA and technology use, technology skills, and attitudes toward technology in a sample of older adults (n = 369, age range: 65-93 years, 48.2% male). We apply the concept of Awareness of age-related change (AARC) to examine the role of positive (AARC-Gains) and negative (AARC-Losses) self-perceptions of aging. Bivariate and multivariate regression analyses were conducted. The results showed positive associations of AARC-Gains with technology skills and technology attitudes. For AARC-Losses, we identified negative associations with technology skills, technology attitudes as well as general technology use. In contrast, associations between subjective age (SA) and all technology-related measures were non-significant. The results stress the importance to consider multidimensional measures of VoA to gain a better understanding of the associations between an individuals' experiencing of own aging processes and technology adoption. More research is needed to determine the stability of these findings in other samples and for other kinds of technology use and attitudes.

Which Meso-Level Characteristics of Early Childhood Education and Care Centers Are Associated with Health, Health Behavior, and Well-Being of Young Children? Findings of a Scoping Review.

Characteristics of early childhood education and care (ECEC) centers might be relevant for children's health. This scoping review aims to provide an overview of the association between meso-level characteristics (MLCs) of ECEC centers with children's health, health behavior, and wellbeing. Five databases were searched for quantitative and qualitative research articles published in English or German since 1 January 2000 on health, health behavior, and wellbeing of children aged 0 to 6 years considering MLCs of ECEC centers. Two authors screened 10,396 potentially eligible manuscripts and identified 117 papers, including 3077 examinations of the association between MLCs and children's health indicators (Kappas > 0.91). Five categories of MLCs were identified: (1) structural characteristics, (2) equipment/furnishings, (3) location, (4) facilities/environment, (5) culture/activities/policies/practices, and 6) staff. Only very few studies found an association of MLCs with body weight/obesity, and general health and wellbeing. Especially physical activity and mental health were related to MLCs. In general, the location (rural vs. urban, neighborhood status) seemed to be a relevant health aspect. MLCs of ECEC centers appeared relevant for child health indicators to different degrees. Future research should focus on these associations, in detail, to identify concrete ECEC indicators that can support health promotion in early childhood.