BackgroundThe older adult population (65 years or older) in the United States is growing, and it is important for communities to consider ways to support the aging population. Patient portals and electronic personal health records (ePHRs) are technologies that could better serve populations with the highest health care needs, such as older adults.ObjectiveThe aim of this study was to assess the existing research landscape related to patient portal and ePHR use and experience among older adults and to understand the benefits and barriers to older adults’ use and adoption of patient portals and ePHRs.MethodsWe searched six pertinent bibliographic databases for papers, published from 2006 to 2016 and written in English, that focused on adults 60 years or older and their use of or experience with patient portals or ePHRs. We adapted preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to review papers based on exclusion and inclusion criteria. We then applied thematic analysis to identify key themes around use, experience, and adoption.ResultsWe retrieved 199 papers after an initial screening and removal of duplicate papers. Then we applied an inclusion and exclusion criteria, resulting in a final set of 17 papers that focused on 15 separate projects. The majority of papers described studies involving qualitative research, including interviews and focus groups. They looked at the experience and use of ePHRs and patient portals. Overall, we found 2 main barriers to use: (1) privacy and security and (2) access to and ability to use technology and the Internet. We found 2 facilitators: (1) technical assistance and (2) family and provider advice. We also reported on older adults’ experience, including satisfaction with the system and improvement of the quality of their health care. Several studies captured features that older adults wanted from these systems such as further assistance managing health-related tasks and contextual health advice and tips.ConclusionsMore research is needed to better understand the patient portal experience among older adults from initial use to adoption. There are also opportunities to explore the role of design in addressing barriers and supporting facilitators to patient portal and ePHR use. Finally, the future use of these systems by older adults should be anticipated and considered in the design process.
Co-design methods have involved older adults in the design process to fill the knowledge gap that younger adult designers might encounter when designing for an aging population. A focus of co-design means establishing equal and equitable relationships between users and designers. To understand the factors that contribute to equal collaborations between older adults and student designers, we conducted 12 co-design sessions with 16 older adults and 11 student designers. We examined their interactions by adapting a framework initially aimed to understand the child-adult design partnership. We also analyzed student designers' reflections to understand their experiences and learnings from designing with older adults. Our findings demonstrate that developing a design partnership is complex. The framework helped surface factors like sharing life experiences and role ownership that influenced balanced or unbalanced interactions. Through the student designers' reflections, we found that student designers identified challenges they encountered and the assumptions they had about the older adult population. We believe that immersing students in a co-design experience with older adults and leveraging reflection activities provides an educational and meaningful experience to the design students.
Parenting comes with many responsibilities, one of which is making ongoing decisions affecting a child's health. While today's parents have access to an abundance of parenting advice and data-both offline and online-little is known about their lived experience with these resources and how it interacts with other aspects of decision-making like intuition. Drawing on a survey of 65 parents and interviews with 12 parents of children aged 0-5 in the United States, we provide the following contributions: an analysis of parents' experiences and needs when using different resources to make health and wellbeing decisions for their child; a definition of parents' lived experiences with intuition throughout the decision-making process; and a discussion of tensions and opportunities for designing in this sensitive space. Our findings can inform new design directions for interactive technology-based parenting support, particularly the potential to consider intuition and make parenting information and data more socially oriented.
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