Network-based approaches for evaluating ambient assisted living (AAL) technologies

Abstract

A network-based approach for evaluating ambient assisted living (AAL) technologies. Abstract.Ambient assisted living (AAL) technologies could support people experiencing physical or cognitive challenges, to and maintain social identities and complex activities of daily living.Although there has been substantial investment in developing AAL innovation, less effort has been devoted to understanding how to evaluate the impact of AAL on physical and mental health. Taking a theory-based evaluation approach, we suggest that AAL technologies rely on networks of people and organisations to function, and analysing the changing structure of networks can bridge the gap between socio-technological change and individual-level capabilities. We present conceptual arguments for taking a network perspective in AAL evaluations, illustrated with examples from our own group's work on technology use among older people with cognitive impairments. We then discuss the different evaluation questions that could be addressed by 'ego-centred' and 'global' network analysis. Finally, recognising the creative ways people mobilise technology for themselves, and the unanticipated effects of technology, we underline the importance of qualitative, observational, and ethnographic approaches in unpicking the processes of change brought about when new technologies are introduced.

Narrative Review: Technologies in Eldercare

“…It is suggested that user-centred design could help and support the evolution of technology use in eldercare (Hakobyan et al 2013, Sánchez, Taylor, andBing-Jonsson 2017). Design that is based upon an understanding of older users, their tasks, and their environments and that is driven by user involvement is believed to more likely result in the use of technology that responds to the psychosocial and occupational needs of the users (Gomersall et al 2017), if the users are rightly involved (Joyce et al 2016). Lowhanging fruits are easily identified by user-centred design.…”

“…All of these are said to enable a safer, healthier, and more active lifestyle for older people, thereby maximising their independence, quality of life, and well-being (Milligan, Roberts, andMort 2011, Sánchez, Taylor, andBing-Jonsson 2017). It is suggested that monitoring and surveillance technologies (Peek et al 2014), as well as pendant alarms, smoke alarms, and fall detectors and sensors (Sánchez-Criado et al 2014, Bouwhuis, Meesters, and Sponselee 2012, Gomersall et al 2017) can be used to enhance safety, while it is suggested that information and communication technology (e.g. teleconferences, telecare, mobile phones, and portals) can improve social connectedness (Åkerberg, Söderlund, and Lindén 2017), and devices such as blood pressure meters, glucometers, and weighing scales can improve health and increase activity levels Moors 2015, Gherardi 2010) In Scandinavia, the term that is used-welfare technology-is a policy concept that was launched to promote digitalisation (Bygstad and Lanestedt 2017).…”

Complex adaptive systems: a new approach for understanding health practices

“…In the context of health technology research, a lively debate has developed concerning evaluation methods for the new generation of computer-assisted assistive technologies, such as telemedical systems and ambient assisted living devices, which are designed to support illness self-management in the home. Several authors have suggested that the randomised trial approach to evaluation is not fit for purpose to study the impact of these technologies (Gomersall et al, 2017;Greenhalgh, Procter, Wherton, Sugarhood, Hinder, & Rouncefield, 2015;Greenhalgh & Stones, 2010;Mortenson et al, 2015). Rather than treating technology as a simple bounded "intervention" whose effects can be neatly separated out from context and measured, these researchers have argued that health technologies are profoundly context-bound.…”

“…Rather than treating technology as a simple bounded "intervention" whose effects can be neatly separated out from context and measured, these researchers have argued that health technologies are profoundly context-bound. For instance, Gomersall et al, (2017) describe how their participants' technology use was largely determined by the social networks surrounding them. In a similar way, Greenhalgh and colleagues (2013) describe how the use and non-use of telecare was often dependent on the social systems in which the "users" were embedded: One participant never used his monitoring system because the couple he lived with were unable to assist him in sending his readings at the allotted time.…”

“…These characteristics of complex adaptive systems create a number of challenges in studying health changes. Because health practices emerge from local, unplanned, and socially situated interactions happening in real-time (see, e.g., Gomersall et al, 2017;Greenhalgh et al, 2014;Mowles, 2014;Stacey, 2011), it can be difficult to predict and identify the most important processes of change, and researchers must constantly be aware of unintended consequences arising. To say this is not to deny that certain important processes of change can be identified and studied systematically.…”