Acceptance of a Digital Assistant (Anne4Care) for Older Adult Immigrants Living With Dementia: Qualitative Descriptive Study (Preprint)

Abstract

BACKGROUND There is a need to develop and coordinate dementia care plans that utilize technology, for vulnerable groups such as immigrant populations. However, immigrant populations are seldom included in various stages of the development and implementation of health technology which does not optimize technology acceptance. OBJECTIVE This study aimed to gain an in-depth understanding of the acceptance of a virtual personal assistant, called Anne4Care, by immigrant older adults living with dementia in their own homes. METHODS This study used a qualitative descriptive research design with naturalistic inquiry. Thirteen (13) older adults participated in this study. The participants were invited for two interviews. After an introduction of Anne4Care, the first interview examined the lives and needs of participants, their expectations, and previous experiences with assistive technology in daily life. Four months later, the second interview sought to understand facilitators and barriers, suggestions for modifications, and the role of health care professionals. Three semi-structured interviews were conducted with health care professionals to examine the roles and challenges they experienced in the use and implementation of Anne4Care. Content analysis, using NVivo11, was performed on all transcripts. RESULTS All 13 participants had an immigration background. Ten male and three females participated, with ages ranging from 52 to 83 years. Participants were diagnosed with a form of dementia or acquired brain injury. None of the older adult participants knew or used assistive technology at the beginning. They obtained assistance from health care professionals and family caregivers who explained and set-up the technology. Six themes were found to be critical aspects of the acceptance of the virtual personal assistant Anne4Care: (1) personal situation, (2) care, (3) use of Anne4Care, (4) positive aspects of Anne4Care, (5) challenges with Anne4Care and (6) expectations. This assistance at first increased the burden of health care professionals and family. After the initial effort, most health care professionals and family experienced that Anne4Care reduced their tasks and stress. Contributions of Anne4Care included companionship, help with daily tasks and opportunities to communicate in multiple languages. On the other hand, some participants expressed anxiety towards the use of Anne4Care. Furthermore, the platform requires internet connection at home and Anne4Care cannot be used outside the home. CONCLUSIONS Although immigrant older adults living with dementia had no experience with technology, the acceptance of the virtual personal assistant, called Anne4Care, by immigrant older adults living with dementia was rather high. The virtual assistant can be further developed to allow for interactive conversations and for use outside of one’s home. Participation of end-users during various stages of the development and implementation of health technology innovations is of utmost importance to maximize technology acceptance.