(St)aging in place: Information and communication technologies for a health-centered agile dwelling unit.

As the number of older adults is growing rapidly in the U.S., the need for personalized, innovative, and sustainable Information and Communication Technologies (ICTs) solutions is critical to support individuals' social, emotional, and physical health. Such technology can significantly help older adults' ability to live independently in their homes despite the challenges the aging process may present, referred to as aging or staging in place. In this study, we explored ways to integrate ICTs into Agile Dwelling Units (AgDUs) through affordable, innovative, technology-enabled tools and practices that can be adapted to respond to individual's needs while supporting independent, secure, and engaged healthy living. The technology-enabled and human-centered AgDUs organically transform in response to users' needs. This approach offers a viable solution for older adults at different stages throughout their lifespan to transition into an intimate, technologically-enhanced living environment while allowing for (1) customization to user's needs; (2) cost optimization and maintenance; and (3) accessibility that minimizes gaps in compliance from a provider and user perspectives. Integrating ICTs in AgDUs to support health monitoring and management could reduce forthcoming pressure on the healthcare system and care providers to accommodate the needs of older adults. This approach is described through a collaborative multidisciplinary lens that highlights a partnership between academia, industry experts, and key stakeholders to advance healthy living and extend lifespan through design-build and technology integration. The main goal of this approach is to increase access to health services and optimize healthcare costs.

Understanding Home Activities Challenges of Older Adults Aging with Long-term Mobility Disabilities: Recommendations for Home Environment Design.

As age-related changes progress, individuals with long-term mobility disabilities experience more challenges in engaging with everyday activities. This archival analysis identified common activity challenges older adults with long-term mobility disabilities report and the type of strategies they employed to respond to these challenges, using the interview data (n=60) from the ACCESS Study. We discovered that activity challenges come from intrinsic factors (i.e., mobility limitations, strength, health conditions) as well as extrinsic factors (transferring and physical access). With these challenges in mind, we constructed home environment design strategies that could meet the needs of people aging with mobility disabilities.

Interactions in Sociotechnical Systems: Achieving Balance in the Use of an Augmented Reality Mobile Application.

OBJECTIVE: We explore relationships between barriers and facilitators experienced by users to understand dynamic interactions in sociotechnical systems and improve a mobile phone-based augmented reality application that teaches users about the contents of a standardized pediatric code cart. BACKGROUND: Understanding interactions between performance obstacles and facilitators can provide guidance to (re)designing sociotechnical systems to improve system outcomes. Clinicians should know about contents and organization of code carts, and an augmented reality mobile application may improve that knowledge but changes the sociotechnical system in which they learn. Prior work identified barriers and facilitators impacting the use of this application-participants described dimensions together, indicating interactions that are explored in the current study. METHOD: We conducted four focus groups (number of clinicians = 18) and two interviews with clinicians who used the application. We performed a secondary analysis of focus group data exploring interactions between previously identified barriers and facilitators to application use. We used epistemic network analysis to visualize these interactions. RESULTS: Work system barriers interacted with barriers and facilitators interacted with facilitators to amplify cumulative negative or positive impact, respectively. Facilitators balanced barriers, mitigating negative impact. Facilitators also exacerbated barriers, worsening negative impact. CONCLUSION: Barriers and facilitators interact and can amplify, balance, and exacerbate each other-notably, positives are not always positive. To obtain desired outcomes, interactions must be further considered in sociotechnical system design, for example, the potential improvements to the application we identified.

Walking the line: balancing performance barriers and facilitators in an augmented reality mobile application for paediatric code cart training.

An augmented reality (AR) mobile smartphone application was developed for clinicians to improve their knowledge about the contents and organisation of a standardised paediatric code cart, an important tool in safe, effective paediatric resuscitations. This study used focus groups and interviews with 22 clinicians to identify work system barriers and facilitators to use of the application. We identified twelve dimensions of barriers and facilitators: convenience, device ownership, device size and type, gamification, interface design, movement/physical space, perception of others, spatial presence, technological experience, technological glitches, workload, and the perception and attitude towards code cart and resuscitation. These dimensions can guide improvement efforts, e.g. redesigning the interface, providing non-AR modes, improving the tutorial. We propose nine principles to guide the design of other digital health technologies incorporating AR. In particular, the workload demands created by using AR must be considered and accounted for in the design and implementation of such technologies. Practitioner summary: Augmented reality (AR) may prepare workers for situations that do not occur frequently. This study investigates barriers and facilitators to using an AR mobile smartphone application developed to improve clinician knowledge about code carts, leading to improvements to the application and principles to guide the design of other AR-based technologies.

Developing an Instructional Suite for the Amazon Echo to Support Novice Older Adults' Use.

Digital home assistants (e.g., Amazon Echo) hold great potential to support older adults across a wide range of abilities to improve or maintain their quality of life. However, these devices and other related environmental control applications are not equipped with sufficient support for successful technology adoption among older adults. Without useful and usable information for guidance during the initial and continued use of these technologies (i.e., facilitating conditions), older adults may not sufficiently learn how to best utilize them, which is a primary barrier to technology adoption among this population. Our goal was to iteratively develop and test an instructional suite to support set up and use of an Amazon Echo Show and related connected technologies by older adults. Our human factors approach provides a roadmap to inform future instructional development for older adults to learn smart and connected technologies.

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.