Lack of Diversity in Personal Health Record Evaluations with Older Adult Participants: A Systematic Review of Literature

Kneale, Laura; Demiris, George

doi:10.14236/jhi.v23i4.881

Cited by 8 publications

(20 citation statements)

References 23 publications

(90 reference statements)

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“…However, among the papers reviewed, there was not enough evidence to understand whether there are inequities in access to technology that in turn influence older adults’ portal use, skill, and quality of health care at a broader level. As noted by Kneale and Demiris (2017) [ 41 ], evaluations of patient portals often lack diversity or fail to report differences based on race, ethnicity, and gender. Generally, evaluations that report demographics conduct evaluations primarily with younger, white, non-Hispanic males who are highly educated [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

“…As noted by Kneale and Demiris (2017) [ 41 ], evaluations of patient portals often lack diversity or fail to report differences based on race, ethnicity, and gender. Generally, evaluations that report demographics conduct evaluations primarily with younger, white, non-Hispanic males who are highly educated [ 41 ]. Further evaluation of socioeconomic, racial, and gender disparities is necessary.…”

Section: Discussionmentioning

confidence: 99%

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Patient Portal Use and Experience Among Older Adults: Systematic Review

Sakaguchi-Tang¹,

Bosold²,

Choi³

et al. 2017

JMIR Med Inform

118

167

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Patient Portal Use and Experience Among Older Adults: Systematic Review

Sakaguchi-Tang¹,

Bosold²,

Choi³

et al. 2017

JMIR Med Inform

118

167

View full text Add to dashboard Cite

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“…126 Smart Home and other technologies do not involve diverse gender needs in research studies and products which can lead to less adoption than if these needs were considered. [127][128][129][130][131] Prior research was gender biased and it historically led researchers to carry out their observations on males in biomedical, social, or behavioral research. This has resulted in the death of information focused on females ranging from organisms, well-being, governments, to polices.…”

Section: Stigma Social Pressure Awareness and Other Issuesmentioning

confidence: 99%

Ethics and acceptance of smart homes for older adults

Pirzada

Wilde

Doherty

et al. 2021

Informatics for Health and Social Care

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Societal challenges associated with caring for the physical and mental health of older adults worldwide have grown at an unprecedented pace, increasing demand for health-care services and technologies Despite the development of several assistive systems tailored to older adults, the rate of adoption of health technologies is low. This review discusses the ethical and acceptability challenges resulting in low adoption of health technologies specifically focused on smart homes for older adults. The findings have been structured in two categories: Ethical Considerations (Privacy, Social Support, and Autonomy) and Technology Aspects (User Context, Usability, and Training). The findings conclude that older adults community is more likely to adopt assistive systems when four key criteria are met. The technology should: be personalized toward their needs, protect their dignity and independence, provide user control, and not be isolating. Finally, we recommend researchers and developers working on assistive systems to: (1) provide interfaces via smart devices to control and configure the monitoring system with feedback for the user, (2) include various sensors/devices to architect a smart home solution in a way that is easy to integrate in daily life, and (3) define policies about data ownership.

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“…We identified existing PHRs using MyPHR.com [19], a systematic literature review [20], and the webpages on Healthit.gov [21]. These sites were chosen to identify systems developed for both commercial and research purposes.…”

Section: Methodsmentioning

confidence: 99%

“…Due to the focus on actors and actions, scenarios promote work-oriented design and a focus on specific functionalities [26]. An initial scenario was created for the HOA persona based on a previous literature review of PHR use among older adults [20]. Our scenarios for the caregiver and home health nurse were created using previous PHR literature reviews that were focused on general adult population use [27–29] and descriptions of home health scenarios [2, 30].…”

Section: Methodsmentioning

confidence: 99%

Using scenarios and personas to enhance the effectiveness of heuristic usability evaluations for older adults and their care team

Kneale

Mikles

Choi

et al. 2017

Journal of Biomedical Informatics

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Objective Using heuristics to evaluate user experience is a common methodology for human-computer interaction studies. One challenge of this method is the inability to tailor results towards specific end-user needs. This manuscript reports on a method that uses validated scenarios and personas of older adults and care team members to enhance heuristics evaluations of the usability of commercially available personal health records for homebound older adults. Materials and Methods Our work extends the Chisnell and Redish heuristic evaluation methodology by using a protocol that relies on multiple expert reviews of each system. It further standardizes the heuristic evaluation process through the incorporation of task-based scenarios. Results We were able to use the modified version of the Chisnell and Redish heuristic evaluation methodology to identify potential usability challenges of two commercially available personal health record systems. This allowed us to: 1) identify potential usability challenges for specific types of users, 2) describe improvements that would be valuable to all end-users of the system, and 3) better understand how the interactions of different users may vary within a single personal health record. Conclusions The methodology described in this paper may help designers of consumer health information technology tools, such as personal health records, understand the needs of diverse end-user populations. Such methods may be particularly helpful when designing systems for populations that are difficult to recruit for end-user evaluations through traditional methods.

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Lack of Diversity in Personal Health Record Evaluations with Older Adult Participants: A Systematic Review of Literature

Cited by 8 publications

References 23 publications

Patient Portal Use and Experience Among Older Adults: Systematic Review

Patient Portal Use and Experience Among Older Adults: Systematic Review

Ethics and acceptance of smart homes for older adults

Using scenarios and personas to enhance the effectiveness of heuristic usability evaluations for older adults and their care team

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