Correction: Insights Into the Use of a Digital Healthy Aging Coach (AGATHA) for Older Adults From Malaysia: App Engagement, Usability, and Impact Study.

[This corrects the article DOI: 10.2196/54101.].

Insights Into the Use of a Digital Healthy Aging Coach (AGATHA) for Older Adults From Malaysia: App Engagement, Usability, and Impact Study.

BACKGROUND: Digital inclusion is considered a pivotal social determinant of health, particularly for older adults who may face significant barriers to digital access due to physical, sensory, and social limitations. Avatar for Global Access to Technology for Healthy Aging (AGATHA) is a virtual healthy aging coach developed by the World Health Organization to address these challenges. Designed as a comprehensive virtual coach, AGATHA comprises a gamified platform that covers multiple health-related topics and modules aimed at fostering user engagement and promoting healthy aging. OBJECTIVE: The aim of this study was to explore the perception and user experience of Malaysian older adults in their interactions with the AGATHA app and its avatar. The focus of this study was to examine the engagement, usability, and educational impact of the app on health literacy and digital skills. METHODS: We performed a qualitative study among adults 60 years and older from suburban and rural communities across six states in Malaysia. Participants were purposefully recruited to ensure representation across various socioeconomic and cultural backgrounds. Each participant attended a 1-hour training session to familiarize themselves with the interface and functionalities of AGATHA. Subsequently, all participants were required to engage with the AGATHA app two to three times per week for up to 2 weeks. Upon completion of this trial phase, an in-depth interview session was conducted to gather detailed feedback on their experiences. RESULTS: Overall, the participants found AGATHA to be highly accessible and engaging. The content was reported to have a comprehensive structure and was delivered in an easily understandable and informative manner. Moreover, the participants found the app to be beneficial in enhancing their understanding pertaining to health-related issues in aging. Some key feedback gathered highlighted the need for increased interactive features that would allow for interaction with peers, better personalization of content tailored to the individual's health condition, and improvement in the user-experience design to accommodate older users' specific needs. Furthermore, enhancements in decision-support features within the app were suggested to better assist users in making health decisions. CONCLUSIONS: The prototype digital health coaching program AGATHA was well received as a user-friendly tool suitable for beginners, and was also perceived to be useful to enhance older adults' digital literacy and confidence. The findings of this study offer important insights for designing other digital health tools and interventions targeting older adults, highlighting the importance of a user-centered design and personalization to improve the adoption of digital health solutions among older adults. This study also serves as a useful starting point for further development and refinement of digital health programs aimed at fostering an inclusive, supportive digital environment for older adults.

Blockchain technology diffusion in tourism: Evidence from early enterprise adopters and innovators.

The use cases of blockchain as an innovative technology have increasingly captured the attention of tourism enterprises. To date, the literature tends to discuss blockchain's advantages rather than how early enterprise adopters and innovators experience and perceive the technology. As such, the extent of technology diffusion is not well understood. This study critically explores the factors influencing blockchain diffusion in tourism and how blockchain innovation is diffused in tourism. We conducted semistructured interviews with founders and senior executives of tourism enterprises in the United States and Europe who are early adopters and innovators of blockchain in tourism. From the thematic analysis, our empirical findings indicate that blockchain has much to offer despite the nascent link between blockchain's business value to an enterprise's strategic plans and the limited success of use cases in tourism. We summarize the findings in a conceptual framework and offer propositions based on the antecedents (motivators and drivers and challenges and barriers) of blockchain diffusion of innovation for enterprises to achieve competitive advantage. The propositions provide a research agenda to guide the strategic implementation of blockchain.

What drives low-income older adults' intention to use mobility applications?

AIM: Mobility applications have the potential to support low-income older adults in facing mobility challenges. However, there is a generally lower uptake of technology in this segment. To understand factors affecting the intention to use a mobility app, we drew upon the Protection Motivation Theory, and tested a model of low-income older adults' technology adoption. METHODS: A cross-sectional survey was conducted across seven states in Malaysia among community-dwelling low-income older adults aged ≥60 years old (n = 282). Measurement items were adapted from pre-validated scales and 7-point Likert Scales were used. Partial least squares structural equation modeling was utilized to assess the hypothesized model. RESULTS: Mobility technology awareness was found to shape an individual's threat and coping appraisals associated with their intention to use a mobility app. The decision of a low-income older adult to adopt a mobility app as a protective action is not a direct function of threat and coping appraisals but is indirect, and mediated by the underlying cost-benefit perceptions of non-adoption and adoption of the mobility app. In terms of technology perceptions, perceived usefulness is a significant predictor, but not perceived ease of use. CONCLUSIONS: This study entails a new model by uncovering the psychological factors encompassing mobility technology awareness, threat-coping appraisals, and cost-benefit perceptions on Technology Acceptance Model studies. These insights have important implications for the development and implementation of a mobility app among low-income older adults. Geriatr Gerontol Int 2024; 24: 342-350.

The Association of Self-Perception of Aging and Quality of Life in Older Adults: A Systematic Review.

BACKGROUND AND OBJECTIVES: Self-perception of aging is an important psychosocial factor that can influence quality of life in older age. This review aimed to synthesize findings on the association between self-perception of aging and quality of life among older adults aged 60 and above. RESEARCH DESIGN AND METHODS: A systematic search was conducted in 4 electronic databases (Ovid Medline, PsycInfo, CINAHL, and Web of Science). Studies conducted in English and including measures on the perception of aging and quality of life were included in this review. A total of 32 observational studies (21 cross-sectional, 8 longitudinal, 2 mixed-method, and 1 qualitative) met the inclusion criteria. Outcomes reported in the included studies were quality of life, physical health and functioning, psychological health, mental health, and general well-being. RESULTS: Overall, 20 quantitative studies indicated a strong association between positive perception of aging and increased quality of life. Similarly, 9 quantitative studies demonstrated that negative perception of aging is associated with lower quality of life. Results of the mixed-method and qualitative studies indicated that older adults with higher morale and good physical capability had more positive perceptions of health. DISCUSSION AND IMPLICATIONS: These results suggest that promoting a positive perception of aging and a self-care attitude would help to enhance older adults' quality of life and should be incorporated into future health promotions and interventions.

Factors influencing technology use among low-income older adults: A systematic review.

As the world's aging population increases, leveraging technology to support aging is proving advantageous. Notably, technology adoption studies among older adults have received increasing scholarly attention, but findings from these studies do not reflect the context of low-income older adults. Studies focusing on low-income older adults were relatively few and it remains unclear which factors influence this group's technology use. This systematic review aims to synthesize findings on factors influencing technology use among low-income older adults to provide directions and opportunities for future research in information systems. Observing the literature through the lens of Social Cognitive Theory, we identified avenues for future research and further integrated the framework with Maslow's hierarchy of needs to elucidate the phenomenon. Findings from this systematic review suggest that both personal and environmental factors, such as cognitions, affects, sociodemographic characteristics, technological and social environment are significant predictors of technology use among low-income older adults. Specifically, factors related to accessibility and affordability, such as income, perceived cost, and accessibility to technology are salient in a resource-limited setting. More importantly, the technology usage behavior elucidate the embeddedness of fundamental human needs which plays a central role underlying technology use among this segment. However, more research is needed to understand the interaction between person, environment and behavior determinant shaping technology use among low-income older adults from diverse economic and cultural setting. This study also sheds light on disciplinary gaps and the lack of investigations anchored on theoretical foundations, and suggests avenues for future research and implications for practice.

Cognitive Frailty and Functional Disability Among Community-Dwelling Older Adults: A Systematic Review.

Background and Objectives: This review aimed to summarize the association between cognitive frailty (presence of frailty and cognitive impairment) and the risk of disabilities in activities of daily living (ADL), instrumental ADL (IADL), mobility, or other functional disabilities among older adults. Research Design and Methods: PubMed, Embase, CINAHL Plus, and PsycINFO were searched from January 2001 to May 14, 2022, for observational studies that reported cognitive frailty among community-dwelling individuals aged 60 years and above. Results were narratively synthesized. Results: Eleven studies encompassing 44 798 participants were included, with a prevalence of cognitive frailty ranging from 1.4% to 39.3%. Individuals with cognitive frailty were more likely to develop disabilities in ADL and IADL compared to robust (absence of frailty and cognitive impairment) individuals. Significant disability burden and elevated risk of combined ADL/IADL disability or physical limitation among participants with cognitive frailty were reported. There was limited evidence on the association between cognitive frailty and mobility disability. Discussion and Implications: Individuals with cognitive frailty were likely at higher risk of developing functional disability and incurring higher disability burden than robust individuals, but evidence remains limited for those with prefrailty with cognitive impairment. Further research on this gap and standardization of cognitive frailty assessments would facilitate comparisons across populations. PROSPERO Registration: CRD42021232222.

Development of Virtual Surveys for the COVID-19 Wave of the AGELESS Longitudinal Study in Malaysia.

BACKGROUND: Rapid population aging occurring in developing nations necessitates innovation to ensure we continue to gain ground on aging research despite pandemic threats. While developed nations have resorted to virtual communications, this is challenging in developing nations due to poor internet connectivity and digital literacy. OBJECTIVES: The aim of this study was to determine the feasibility of virtual data collection for a longitudinal study of aging assessing cognitive frailty in a middle-income Southeast Asian country. METHODS: The Transforming Cognitive Frailty into Later-Life Self-Sufficiency (AGELESS) longitudinal study of aging involved community-dwelling participants aged 60 years and above. A semi-structured focus group discussion was conducted via videoconferencing with selected representatives from existing participants. The survey instrument was compiled during a hybrid meeting and refined using a virtual Delphi process involving 51 AGELESS investigators. The final draft survey and recruitment strategy were then piloted among selected participants. RESULTS: Twelve individuals participated in the virtual focus group interview. Smartphone, tablet computer, laptops, and desktop personal computers were used for information gathering, communication, banking, shopping, leisure, religion, and education, within this group. The survey instrument was redacted from 362 items in 18 sections to 141 items in 12 sections through 3 virtual Delphi rounds facilitated by email, social media messaging, and videoconferencing which attracted 213 comments. Of 45 participants selected for the pilot survey, 30 were successfully contacted after one attempt and 18 completed the survey. Cognitive frailty was present in 13%, cognitive impairment in 20%, frailty in 20%, and 47% were robust. CONCLUSION: A virtual survey instrument was developed for the AGELESS longitudinal survey of aging which was vital for determining the effects of the COVID-19 pandemic on our older population as well as sustaining research into aging despite barriers posed by the pandemic.

Key enablers and barriers of solar paver technologies for the advancement of environmental sustainability.

Global initiatives to improve environmental sustainability have centered on reducing energy consumption and developing technological solutions for greener power generation. Current insights on innovations for environmental sustainability are primarily from developed countries, with limited studies originating from developing countries. This study focuses on solar paver technology, a potential innovation for sustainable generation of power. The interest in this technology lies in its dual-purpose ability to enable both functional road surfaces and the use of solar roadways that can generate electricity to power other road infrastructure such as electric lights. To maximize the potential of success of deployment of solar pavers, it is important to investigate the practicalities of solar pavers and understand the perceptions of stakeholders that will be responsible for the implementation of solar pavers. This research addresses this gap in knowledge. Thirty construction industry stakeholders in Malaysia were interviewed through focus group discussions and interviews. This study applied the diffusion of innovation theory to develop an understanding of the nuances of solar pavers. The findings identified three superordinate categories (motivation, opportunity, and ability) and nine categories (compliance with green initiatives, promote corporate social responsibility, dual functionality, financial incentives, sunny climate, increased environmental awareness, green experience, experts network and familiarity with solar technology) as the key enablers. Key barriers constitute two superordinate categories (challenges and weaknesses) and ten categories (reluctant authority, vandalism, complexity of installation and maintenance, high humidity and rainfall, negative environmental impact, high cost, design flaws, low efficiency, questionable practicality, and better comparative opportunities). There is an acceptance of solar pavers by the stakeholders and cost and ownership structures are the key to the deployment. The findings provide fresh insights into a new form of sustainable solar paver engendering new streams of research in construction engineering and technology management. Implications for management and organizational research are discussed.

The Interplay of Socioecological Determinants of Work-Life Balance, Subjective Wellbeing and Employee Wellbeing.

Today's workers are struggling to achieve a balance between their work and personal life roles because of both specific needs and limited resources. This study explored the socioecological factors that influence work-life balance (WLB) and how they operate. The relationships between WLB, subjective wellbeing, employee wellbeing and quality time allocation were examined. A total of 1063 responses were received, using an online survey. The results show that relational, community and societal factors directly influenced the individual factors and were indirectly associated with perceived WLB. Individual factors (i.e., personal feelings, behaviours and health) were found to be the crucial determinants of an individual's perceived WLB. It was found that WLB positively correlated with employee wellbeing and quality and quantity of personal life-time. Subjective wellbeing was found to be a significant moderator in the relationship between WLB and its outcomes. This study demonstrated the process of how workers determine their own WLB by applying the socioecological framework for categorising the determinants and suggested new avenues that improve the whole wellbeing of workers and also foster long-term development of organisations.

"Suiting Up" to Enhance Empathy Toward Aging: A Randomized Controlled Study.

Background: Healthcare professionals who have a positive attitude and who are more empathetic toward older adults are in a better position to deliver quality healthcare. This study examines the impact of using an aging simulation suit on undergraduate pharmacy students' empathy levels. Methods: One hundred and twenty first-year students enrolled in the Bachelor of Pharmacy course were randomized to either a medication review polypharmacy workshop (control) or an immersive aging simulation suit and medication review polypharmacy workshop (intervention). Intervention participants donned the aging suit and performed a series of tasks, including walking up a flight of stairs and filling up a form to simulate the physical limitations experienced by an older adult. The workshop was delivered at week 10 of semester. Both groups also completed a medication review polypharmacy workshop at week 12 of semester. The primary outcome was a measurement of change on the Jefferson Empathy Scale-Healthcare Professional Questionnaire among both groups at week 12 of semester. Secondary outcomes include the longitudinal impact of intervention after 3 months of the workshop and perceptions on learning. Results: The use of a simulation suit did not increase participants' self-rated empathy compared to control. However, the suit enhanced the ability of participants to understand the physical limitations and visual issues associated with aging. Participants also felt that it enhanced their health advocacy, as it taught them the importance of listening, patience and respect for older adults. Conclusion: The use of an immersive aging suit can be a useful adjunctive tool to help enhance students' understanding of the physical limitations and visual limitations of aging. Further research is needed to understand how these limitations affect other healthcare students. Trial Registration: ClinicalTrials.gov identifier: NCT04133727.

The Systematic Impact of Personal Characteristics on Entrepreneurial Intentions of Engineering Students.

The impact of personal characteristics on entrepreneurial intention is a classic topic in the field of entrepreneurship research. Previous research mostly used simple linear models, leading to a gap in the study on the interrelationship among personal characteristics and their systematic influence on entrepreneurial intention. This study investigates the interrelationship among the four specific entrepreneurial characteristics (i.e., need for achievement, locus of control, risk-taking propensity, and creativity) and their systematic influence on the entrepreneurial intention of engineering students. The research data is from 210 engineering students via a survey. Logistic regression and path analysis were used for data analysis. The findings suggest that creativity and risk-taking directly influence entrepreneurial intention while the need for achievement and the locus of control influence it indirectly. Implications for entrepreneurship education are finally discussed.

How Is Work-Life Balance Arrangement Associated with Organisational Performance? A Meta-Analysis.

The impacts of the work-life balance arrangement on organisational performance is a growing concern amongst researchers and practitioners. This study synthesised 202 records from 58 published papers to evaluate the relationship between the work-life balance arrangement and organisational performance by means of a meta-analysis. The organisational performance was measured based on six perspectives, including career motivation, employee attendance, employee recruitment, employee retention, organisational commitment, and productivity. The results showed a positive relationship between the work-life balance arrangement and organisational performance (OR: 1.181, 95% CI: 1.125-1.240, p < 0.001). Of the six perspectives, only career motivation, employee attendance, employee recruitment, and employee retention were significantly associated with the work-life balance arrangement. The moderators affecting the relationship between the work-life balance arrangement and organisational performance were gender, sector, and employee hierarchy. The results provide theoretical suggestions on the effectiveness of the work-life balance arrangement in terms of the six perspectives related to organisational performance.