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      Engaging Aging Individuals in the Design of Technologies and Services to Support Health and Well-Being: Constructivist Grounded Theory Study

      research-article
      , HDHET, MTech, DTech 1 , , , MSc, DTech 2
      (Reviewer), (Reviewer)
      JMIR Aging
      JMIR Publications
      technology, healthy aging, grounded theory, qualitative research

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          Abstract

          Background

          Changes noted within the aging population are physical, cognitive, as well as emotional. Social isolation and loneliness are also serious problems that the aging population may encounter. As technology and apps become more accessible, many basic services, such as those offered by social services, well-being organizations, and health care institutions, have invested in the development of supportive devices, services, and Web-based interactions. Despite the perceived benefits that these devices and services offer, many aging individuals choose not to engage, or engage in a limited manner. To explore this phenomenon, we developed a theory to describe the condition for engagement.

          Objective

          The main objective of this study was to understand the perceptions of an aging South African population regarding Web-based services and technologies that could support aging in place (AiP). Although the concept of AiP speaks to a great number of everyday activities, this paper explores aspects of health and well-being as being central to AiP.

          Methods

          The study used a grounded theory (GT) methodology, relying on an iterative and simultaneous process of data collection, coding, category development, and data comparisons. Data were collected through qualitative methods, including interviews (13 participants aged between 64 and 85 years), 2 participatory workshops (15 participants), and observations. The study focused on Charmaz’s approach to constructivist GT, which puts forward the premise that theory or knowledge cannot take shape in a purely objective manner. Instead, theory is constructed through the interaction of the researcher and research participant. Coding and data analysis were supported with ATLAS.ti (ATLAS.ti Scientific Software Development GmbH).

          Results

          The study resulted in a substantive theory exploring the process of interaction and engaging factors through user insights and experiences. The emerging design theory, Ageing User Decision-Driven Engagement (AUDDE), explored the elements that support engagement with technology and supportive apps, which could offer access to required health and wellness services.

          Conclusions

          In AUDDE, the perceived value of the interaction is a crucial catalyst for engagement. Aging users continuously make meaning of their experiences, which affects their current and future actions.

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          Most cited references38

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          Digital natives: where is the evidence?

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            The Elderly’s Independent Living in Smart Homes: A Characterization of Activities and Sensing Infrastructure Survey to Facilitate Services Development

            Human activity detection within smart homes is one of the basis of unobtrusive wellness monitoring of a rapidly aging population in developed countries. Most works in this area use the concept of “activity” as the building block with which to construct applications such as healthcare monitoring or ambient assisted living. The process of identifying a specific activity encompasses the selection of the appropriate set of sensors, the correct preprocessing of their provided raw data and the learning/reasoning using this information. If the selection of the sensors and the data processing methods are wrongly performed, the whole activity detection process may fail, leading to the consequent failure of the whole application. Related to this, the main contributions of this review are the following: first, we propose a classification of the main activities considered in smart home scenarios which are targeted to older people’s independent living, as well as their characterization and formalized context representation; second, we perform a classification of sensors and data processing methods that are suitable for the detection of the aforementioned activities. Our aim is to help researchers and developers in these lower-level technical aspects that are nevertheless fundamental for the success of the complete application.
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              Older people and digital disengagement: a fourth digital divide?

              Digital technologies are becoming more pervasive in all areas of society. Enabling everyone to have access and capability to use the Internet and associated digital technologies, summed up in the term 'digital inclusion', is seen to have wide-ranging benefits to the individual, to the economy and to society. For older people, being digitally included can help them to maintain their independence, social connectedness and sense of worth in the face of declining health or limited capabilities, as well as also offering new opportunities to improve their quality of life. At present however, access to the technology and to the benefits is not equally distributed either between or within nations, and older people tend to be on the 'wrong' side of what is termed the 'digital divide'. Governments globally are developing strategies to promote digital inclusion and indeed Internet uptake is increasing steadily, including amongst older people. However, such strategies have focussed on getting people online, and there appears to be an assumption that once someone is online they will remain 'digitally engaged'. In fact statistics show that some users give up using the Internet, and there is emerging evidence that older people are more vulnerable to the factors which can lead to this outcome. The authors see this phenomenon as a potential but largely unrecognised 'fourth digital divide' which has serious implications for social inclusion. The objectives of this article are (a) to raise awareness of the phenomenon of digital disengagement by considering some of the emerging evidence, (b) to explore some of the potential implications of not recognising and therefore not addressing the needs of the digitally disengaged older population, and (c) to reveal the prevailing gap in knowledge which future research should address. Copyright © 2013 S. Karger AG, Basel.
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                Author and article information

                Contributors
                Journal
                JMIR Aging
                JMIR Aging
                JA
                JMIR Aging
                JMIR Publications (Toronto, Canada )
                2561-7605
                Jan-Jun 2019
                20 March 2019
                : 2
                : 1
                : e12393
                Affiliations
                [1 ] Department of Design Faculty of Informatics and Design Cape Peninsula University of Technology Cape Town South Africa
                [2 ] Faculty of Informatics and Design Cape Peninsula University of Technology Cape Town South Africa
                Author notes
                Corresponding Author: Vikki Du Preez dupreezv@ 123456cput.ac.za
                Author information
                http://orcid.org/0000-0002-4169-6847
                http://orcid.org/0000-0002-2615-6519
                Article
                v2i1e12393
                10.2196/12393
                6716485
                31518258
                91fd2935-acd2-4216-b2d6-bf990d938075
                ©Vikki Du Preez, Retha De La Harpe. Originally published in JMIR Aging (http://aging.jmir.org), 20.03.2019.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Aging, is properly cited. The complete bibliographic information, a link to the original publication on http://aging.jmir.org, as well as this copyright and license information must be included.

                History
                : 2 October 2018
                : 27 November 2018
                : 10 January 2019
                : 7 February 2019
                Categories
                Original Paper
                Original Paper

                technology,healthy aging,grounded theory,qualitative research

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