Older people's attitudes toward interactive voice response systems.

BACKGROUND: Interactive voice response (IVR) systems are computer programs that interact with people to provide a number of services from business to healthcare. The healthcare applications are particularly relevant to older adults because they are important consumers of medical services. However, research has found that older adults can experience significant difficulties with IVR and have more negative attitudes toward the technology. SUBJECTS AND METHODS: Seniors' attitudes appear to be related to their most recent experiences with IVR systems. The objective of this study was to examine attitudes toward four commercial or governmental IVR systems and how these attitudes relate to participants' ability to interact with the technology in a sample of 185 community-dwelling older (>65-year-old) adults. We also examined the effects of several demographic factors on both success and attitudes toward automated systems. RESULTS: We found a significant positive correlation between IVR success and attitudes toward IVR. However, a large subset of our sample gave high ratings despite experiencing significant difficulties with the systems. These participants tended to have lower full scale IQ. No gender differences emerged in terms of attitudes and ability to interact with IVR systems. CONCLUSIONS: Results also indicated that older adults in our sample viewed the IVR interaction as particularly demanding on attention and concentration abilities.

Administration of neuropsychological tests using interactive voice response technology in the elderly: validation and limitations.

Interactive voice response (IVR) systems are computer programs, which interact with people to provide a number of services from business to health care. We examined the ability of an IVR system to administer and score a verbal fluency task (fruits) and the digit span forward and backward in 158 community dwelling people aged between 65 and 92 years of age (full scale IQ of 68-134). Only six participants could not complete all tasks mostly due to early technical problems in the study. Participants were also administered the Wechsler Intelligence Scale fourth edition (WAIS-IV) and Wechsler Memory Scale fourth edition subtests. The IVR system correctly recognized 90% of the fruits in the verbal fluency task and 93-95% of the number sequences in the digit span. The IVR system typically underestimated the performance of participants because of voice recognition errors. In the digit span, these errors led to the erroneous discontinuation of the test: however the correlation between IVR scoring and clinical scoring was still high (93-95%). The correlation between the IVR verbal fluency and the WAIS-IV Similarities subtest was 0.31. The correlation between the IVR digit span forward and backward and the in-person administration was 0.46. We discuss how valid and useful IVR systems are for neuropsychological testing in the elderly.

Improving older adults' experience with interactive voice response systems.

BACKGROUND: Interactive voice response (IVR) systems use computer-based voice recognition and software algorithms to conduct human/computer interactions. In recent years, there has been a proliferation of IVR applications in business and healthcare. The available evidence suggests that older people have negative attitudes towards IVR and experience significant difficulties using these systems. OBJECTIVE: The goal of this project was to identify areas of difficulties in IVR use by older people and propose strategies for improvement. MATERIALS AND METHODS: During two focus groups, we examined older people's perceptions of IVR systems and the most common difficulties experienced by seniors in interacting with these systems. We also recorded their suggestions for improvement of IVR. RESULTS: Frequency and chi square analyses were performed on the focus groups data. Some of the difficulties reported by participants in this study were congruent with previous findings, but we also uncovered some additional problems, such as frustration for not being able to reach an operator, being asked to wait too long on hold, being unable to recover from mistakes, and an absence of shortcuts in the systems. In addition, significant number of participants indicated that they prefer a system that adjusts to them automatically as opposed to a system that allows for adjustment. CONCLUSION: Generally, our findings suggest that the poor acceptability of IVR systems by older people could be improved by designing IVR algorithms that detect difficulties during an ongoing IVR exchange and direct people to different algorithms adapted for each person.