Background In a rapidly aging population, new and efficient ways of providing health and social support to older adults are required that not only preserve independence but also maintain quality of life and safety. Objective The NEX project aims to develop an integrated Internet of Things system coupled with artificial intelligence to offer unobtrusive health and wellness monitoring to support older adults living independently in their home environment. The primary objective of this study is to develop and evaluate the technical performance and user acceptability of the NEX system. The secondary objective is to apply machine learning algorithms to the data collected via the NEX system to identify and eventually predict changes in the routines of older adults in their own home environment. Methods The NEX project commenced in December 2019 and is expected to be completed by August 2022. Mixed methods research (web-based surveys and focus groups) was conducted with 426 participants, including older adults (aged ≥60 years), family caregivers, health care professionals, and home care workers, to inform the development of the NEX system (phase 1). The primary outcome will be evaluated in 2 successive trials (the Friendly trial [phase 2] and the Action Research Cycle trial [phase 3]). The secondary objective will be explored in the Action Research Cycle trial (phase 3). For the Friendly trial, 7 older adult participants aged ≥60 years and living alone in their own homes for a 10-week period were enrolled. A total of 30 older adult participants aged ≥60 years and living alone in their own homes will be recruited for a 10-week data collection period (phase 3). Results Phase 1 of the project (n=426) was completed in December 2020, and phase 2 (n=7 participants for a 10-week pilot study) was completed in September 2021. The expected completion date for the third project phase (30 participants for the 10-week usability study) is June 2022. Conclusions The NEX project has considered the specific everyday needs of older adults and other stakeholders, which have contributed to the design of the integrated system. The innovation of the NEX system lies in the use of Internet of Things technologies and artificial intelligence to identify and predict changes in the routines of older adults. The findings of this project will contribute to the eHealth research agenda, focusing on the improvement of health care provision and patient support in home and community environments. International Registered Report Identifier (IRRID) DERR1-10.2196/35277

BACKGROUND In a rapidly ageing population new and efficient ways of providing health and social support to older adults are required that not only preserve independence but also maintain quality of life and safety. OBJECTIVE The NEX project aims to develop an Internet of Things integrated system coupled with Artificial Intelligence to offer unobtrusive health and wellness monitoring to support older adults to live independently in their home environment. The primary objective of this study is to develop and evaluate the technical performance and user acceptability of “The NEX system”. The secondary objective is to apply machine learning algorithms to the data collected via the NEX system to identify and eventually predict changes in the routines of older adults in their own home environment. METHODS Mixed methods research (online survey and focus groups) was conducted with 426 participants including older adults (aged 60 and above), family caregivers, health care professionals and home care workers to inform the development of the NEX system (Phase 1). The primary outcome will be evaluated in two successive trials (the Friendly Trial (Phase 2) and the Action Research Cycle trial (Phase 3). The secondary objective will be explored in the Action Research trial (Phase 3). For the Friendly Trial, 7 older adult participants aged 60 years and above and living alone in their own homes for a 10-week period were enrolled in the trial. Thirty older adult participants aged 60 years and above and living alone in their own homes will be recruited for the Action Research trial for a 10-week period (Phase 3). RESULTS Phase 1 of the project (n=426) participants was completed in December 2020 and Phase 2 (n=7 participants for a 10-week pilot study) was completed in September 2021. The expected completion date for the third project phase (30 participants for 10-week usability study) is June 2022. CONCLUSIONS The NEX project has considered the specific everyday needs of older adults and other stakeholders which have contributed to the design of the integrated system. The innovation of the NEX system lies in the use of IoT technologies and AI to identify and predict changes in the routines of older adults. The findings of this overall project will contribute to the e-Health research agenda focusing on the improvement of healthcare provision and patient support in home and community environments.

Background: There is a need for a broader understanding of the psychological influences impacting healthy older adults' intentions to use assistive smart home technologies if these technologies are to succeed in helping older adults to continue to live independently in their own homes. Objective: This qualitative paper aimed to analyse healthy older adults' intentions to adopt and use assistive smart home technologies using the Theoretical Domains Framework (TDF), which synthesises a large number of theories of psychology and behaviour change. Method: Using a focus group methodology, an in-person workshop presented fictitious personas representing end-user cases to participants, soliciting potential problems that may arise while living independently and solutions that might help. Online Zoom workshops facilitated discussions centred on participant opinions about how various forms of technology could support independent living for older adults. Comments were analysed using a TDF approach. Results: Key domains identified as influencing intention to adopt and use assistive smart home technologies included Knowledge, Skills, Beliefs about Capabilities, Goals, Beliefs about Consequences, Social Influences, Emotions, and Environmental Context and Resources. Conclusion: This paper has identified the eight most relevant TDF domains and mapped these to some of the theories and associated behaviour change strategies most suited to investigating and shaping intentions to use assistive smart home technology. The TDF-based analysis successfully elucidated a broad range of psychological influences driving intentions to adopt and use such technology. Knowledge of these influences can assist those involved in technology design, development, and marketing to ultimately increase the uptake of smart technology by older adults. Key advantages of the TDF include its comprehensive theoretical coverage contained within domains comprising mediators of behaviour change, and its capacity to elicit a wide range of influences with the potential to drive acceptance and adoption of smart technology among community-dwelling older adults.

Background Our institution is currently developing a technology solution to support adults to live well at home for longer. As the system develops, there is an emerging emphasis on strict structure/routine in older adults’ activities of daily living. In contrast, engagement in novel experiences is widely endorsed as a buffer against cognitive decline. Despite this, there is scant research into the perceptions and experiences of novelty in older adults. Understanding older adults’ views on novelty is necessary to inform the advancement of the current project. Methods A multiple-methods, exploratory approach was used. A 90-minute focus group was held with 4 older adults to explore their conceptualisations of novelty, discussing what constitutes a novel experience and gauging the value placed on routine and novelty in daily life. Questionnaires measuring Mental Well-Being (MWB), personality, Novelty-Need Satisfaction (NNS), and preference for routine were subsequently completed by each participant. Results Four main themes emerged from the qualitative data. They comprised the contrast between planned and unplanned novel experiences, the influence of context on the enjoyment of novelty, the value of the vicarious experience of novelty and the challenge associated with change at a social/global level. The quantitative data revealed that 91.9% of the variation in MWB is attributed to its relationship with NNS. Conclusion The focus group served as a strong foundation; especially into the contextual influence of both internal (psychological/attitude-related) and external (environmental/social) factors upon the enjoyment of novelty; as well as indicating that further research is merited into the contrasting views on planned and unplanned novel experiences. The quantitative data corroborate the importance of maintaining novelty in older age. Understanding how to preserve novelty while supporting routines will allow assistive technology projects such as this, to adopt a holistic approach and encourage consideration for this aspect of life, often neglected in the lives of older adults.

Adolescence is an important time in which young people take on type 1 diabetes (T1D) self-management responsibility. Parents are key facilitators of this process. Little is known about parents’ experiences of communicating with their children about T1D during adolescence. Semi-structured interviews were conducted with 32 parents (24 mothers and 8 fathers) of adolescents (11–17 years) living with T1D to explore how parents communicate about T1D and self-management with their adolescent children. Parents were recruited through two national child and adolescent diabetes and endocrine clinics and online advertisement through a national diabetes advocacy organisation. Interviews were transcribed verbatim and thematically analysed. Six themes were identified: parent factors, quality of the parent–adolescent relationship, communication strategies, adolescent factors, communication triggers and family/system factors. Understanding factors that impact communication about self-management between parents and adolescents will enable healthcare professionals to provide support and targeted interventions as parent and adolescent roles change over time.

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