BackgroundInformal support is essential for enabling many older people to age in place. However, there is limited research examining the information needs of older adults’ informal support networks and how these could be met through home monitoring and information and communication technologies.ObjectiveThe purpose of this study was to investigate how technologies that connect older adults to their informal and formal support networks could assist aging in place and enhance older adults’ health and well-being.MethodsSemistructured interviews were conducted with 10 older adults and a total of 31 members of their self-identified informal support networks. They were asked questions about their information needs and how technology could support the older adults to age in place. The interviews were transcribed and thematically analyzed.ResultsThe analysis identified three overarching themes: (1) the social enablers theme, which outlined how timing, informal support networks, and safety concerns assist the older adults’ uptake of technology, (2) the technology concerns theme, which outlined concerns about cost, usability, information security and privacy, and technology superseding face-to-face contact, and (3) the information desired theme, which outlined what information should be collected and transferred and who should make decisions about this.ConclusionsOlder adults and their informal support networks may be receptive to technology that monitors older adults within the home if it enables aging in place for longer. However, cost, privacy, security, and usability barriers would need to be considered and the system should be individualizable to older adults’ changing needs. The user requirements identified from this study and described in this paper have informed the development of a technology that is currently being prototyped.
Aotearoa New Zealand's public health crisis communication approach amidst the COVID-19 pandemic effectively mobilized the nation into swift lockdown, significantly reducing community transmission. This communication approach has been applauded around the world. How did communities situated amongst the "margins of the margins" in Aotearoa New Zealand navigate through the existing structural barriers to health during the pandemic? In this study, we use a culture-centered analysis to foreground the structural context of disenfranchisement amidst the COVID-19 lockdown. Drawing on in-depth interviews with participants in a larger ethnographic project on poverty and health across three communities in Aotearoa New Zealand, we attend to the ways in which health is negotiated amidst the COVID-19 outbreak and lockdown response at the "margins of the margins." The narratives point out that health communication interventions to prevent COVID-19 in the context of Aotearoa New Zealand furthered the marginalization of communities at the margins, and community voices were largely erased from the enactment of interventions. With the extant structures failing to recognize these aspects of everyday struggles of health at the margins, the health and access challenges were further magnified during COVID-19. Our attention to communication situated in relationship to structures builds a register for health communication scholarship in the context of COVID-19 that is committed to disrupting the behaviorally based hegemonic health communication literature and transforming the unequal terrains of health experiences. The trajectories of COVID-19 (C19) as well as the preventive policy responses to it have disproportionately impacted the global margins (Dutta et al., 2020). Across countries, regions, and communities, those at the gendered, raced, and classed margins have borne largely the effects of the pandemic (Patel et al., 2020). Aotearoa New Zealand has been globally recognized for its decisive leadership and the overarching effectiveness of its science-based C19 response, accompanied by clear communication and state-led welfare support (Cousins, 2020; Dutta et al., 2020; PRovoke Media, 2020). How then do inequities in health play out amidst this effective model of C19 response? Traditionally, Māori, Pasifika, and refugee communities have borne the greatest burdens of poor health outcomes in Aotearoa New Zealand (Mahony et al., 2017; McIntosh & Mulholland, 2011; Ministry of Health, 2014). These features of raced/citizenship-based identity intersect with poverty to produce marginalization (Bowleg, 2020). In this essay, we draw on our ethnographic fieldwork embedded in the culture-centered approach (CCA) with Māori, Pasifika, and refugee communities across three sites in Aotearoa New Zealand to examine the interplays of culture, structure, and agency at the margins in constituting the everyday negotiations of health and wellbeing amidst the C19 outbreak (Dutta, 2020). Our emphasis here is on foregrounding the structural context of margina...
Since the colonisation of Aotearoa by the British, Māori have experienced health disparities in comparison to non-Māori. While there have been numerous policies and initiatives to improve the diaspora, this is forecasted to continue for the Māori population. The source of this health disparity is complex, being embedded in historic and contemporary inequities. However, one prominent issue which continues to be reported, is the less than adequate health treatment received by Māori in comparison to those of non-Māori or non-Pacific origin. According to the Ministry of Health, this is adversely contributing to Māori health inequalities. This paper discusses the difficulties confronted by Māori when accessing health care services.
Background Smart home and telemonitoring technologies have often been suggested to assist health care workers in supporting older people to age in place. However, there is limited research examining diverse information needs of different groups of health care workers and their access to appropriate information technologies. Objective The aim of this study was to investigate the issues associated with using technologies that connect older people to their health care providers to support aging in place and enhance older people’s health and well-being. Methods Seven focus group discussions were conducted comprising 44 health care professionals who provided clinic-based or in-home services to community-dwelling older people. Participants were asked about their information needs and how technology could help them support older people to age in place. The recordings of the sessions were transcribed and thematically analyzed. Results The perspectives varied between the respondents who worked in primary care clinics and those who worked in community-based services. Three overarching themes were identified. The first theme was “access to technology and systems,” which examined the different levels of technology in use and the problems that various groups of health care professionals had in accessing information about their patients. Primary care professionals had access to good internal information systems but they experienced poor integration with other health care providers. The community-based teams had poor access to technology. The second theme was “collecting and sharing of information,” which focused on how technology might be used to provide them with more information about their patients. Primary care teams were interested in telemonitoring for specific clinical indicators but they wanted the information to be preprocessed. Community-based teams were more concerned about gaining information on the patients’ social environment. The third theme was that all respondents identified similar “barriers to uptake”: cost and funding issues, usability of systems by older people, and information security and privacy concerns. Conclusions The participants perceived the potential benefits of technologies, but they were concerned that the information they received should be preprocessed and integrated with current information systems and tailored to the older people’s unique and changing situations. Several management and governance issues were identified, which needed to be resolved to enable the widespread integration of these technologies into the health care system. The disconnected nature of the current information architecture means that there is no clear way for sensor data from telemonitoring and smart home devices to be integrated with other patient information. Furthermore, cost, privacy, security, and usability barriers also need to be resolved. This study highlights the importance and the complexity of management and governance of systems to collect and disseminate such information. Further research into the requirements of all stakeholder groups and how the information can be processed and disseminated is required.
Research has shown that patient portals can improve patient-provider communication and patient satisfaction. Yet few studies have examined patient portals in New Zealand. In this study, GPs from nine primary care practices were interviewed using a semi-structured interview technique to ascertain how they thought patient portals influence the delivery of primary healthcare. The interviews were transcribed and thematically analysed. The three themes detected were: patient portal usage, health information seeking and the changing consultation. Although most of the participants indicated that patient portals are not being effectively utilised, they were optimistic about the role of information technology in primary healthcare for providing accurate information and to connect with patients in modern terms. Participants reported that some patients have become more informed and compliant with medical treatments and interventions after using patient portals. It seems that patient portals have the potential to enhance patient-provider relationships and help patients manage more aspects of their health care.
No abstract
Little academic attention has been focused on the experiences of communities situated at the margins in receiving nonprofit services. In this essay, we draw on the culture-centered approach to critically interrogate the concept of engagement among a range of nonprofit organizations. We analyze ethnographic fieldwork conducted in a low income suburban area in Aotearoa New Zealand, in which narrative accounts of 60 residents formed the basis of our deliberations with an advisory board. Our findings indicate that many nonprofit organizations are constructed as spaces of othering that do not attend to the cultural norms or needs of those situated at the margins. Alternatively, the Head Hunters outlaw motorcycle gang and Destiny’s Church, both vilified in mainstream media outlets, were sites of significant community engagement. Our study illuminates the impact of dialogic group engagement and of initiatives being developed and driven by the community.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.