Prediction of (Non)Participation of Older People in Digital Health Research: Exergame Intervention Study

Poli, Arianna; Kelfve, Susanne; Klompstra, Leonie; Strömberg, Anna; Jaarsma, Tiny; Motel-Klingebiel, Andreas

doi:10.2196/17884

Cited by 32 publications

(34 citation statements)

References 47 publications

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“…personality traits of the caregivers like level of self-esteem, neuroticism, confidence in the caregiver role and coping strategies [ 8 ]. Last but not least, despite the accurate sampling process and the careful recruitment process, the risk of the typical sampling bias should still be mentioned, as for instance, healthier and more educated older caregivers are more likely to participate in research studies (especially those involving technologies, such as TECH@HOME and UP-TECH [ 68 ]. Nonetheless we have minimized the likelihood of such risk, adjusting our analysis using available socio-economic variables.…”

Section: Discussionmentioning

confidence: 99%

Self-reported symptoms of depression and anxiety among informal caregivers of persons with dementia: a cross-sectional comparative study between Sweden and Italy

Wulff

Fänge

Lethin

et al. 2020

BMC Health Serv Res

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Background Around 50 million people worldwide are diagnosed with dementia and this number is due to triple by 2050. The majority of persons with dementia receive care and support from their family, friends or neighbours, who are generally known as informal caregivers. These might experience symptoms of depression and anxiety as a consequence of caregiving activities. Due to the different welfare system across European countries, this study aimed to investigate factors associated with self-reported depression and anxiety among informal dementia caregivers both in Sweden and Italy, to ultimately improve their health and well-being. Methods This comparative cross-sectional study used baseline data from the Italian UP-TECH (n = 317) and the Swedish TECH@HOME (n = 89) studies. Main outcome variables were the severity of self-reported anxiety and depression symptoms, as measured by the Hospital Anxiety and Depression Scale (HADS). HADS scores were investigated using descriptive and bivariate statistics to compare means and standard deviations. Linear regressions were used to test for associations between potential factors and self-reported symptoms of depression and anxiety. Results Italian informal caregivers reported more severe symptoms of depression and anxiety than Swedish caregivers. In Italy, a higher number of hours of caregiving was associated with anxiety symptoms (β = − 1.205; p = 0.029), being 40–54 years-old with depression symptoms (β = − 1.739; p = 0.003), and being female with symptoms of both depression (β = − 1.793; p < 0.001) and anxiety (β = 1.474; p = 0.005). In Sweden, a higher number of hours of caregiving and being < 39 years-old were associated with depression symptoms (β = 0.286; p < 0.000; β = 3.945; p = 0.014) and a higher number of hours of caregiving, the lack of additional informal caregivers and dementia severity were associated with anxiety symptoms (β = 0.164; p = 0.010; β = − 1.133; p = 0.033; β = − 1.181; p = 0.031). Conclusion Multiple factors are associated with self-reported symptoms of depression and anxiety among informal caregivers in Sweden and Italy. Factors found in this study partly differ between the two countries, suggesting the important role of cultural and social factors affecting the experience of caregiving. A deeper knowledge of these factors may increase the knowledge on potential protective and risk factors, provide information to policymakers and ultimately improve the psychological well-being of informal caregivers to people with dementia across Europe.

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Section: Discussionmentioning

confidence: 99%

Self-reported symptoms of depression and anxiety among informal caregivers of persons with dementia: a cross-sectional comparative study between Sweden and Italy

Wulff

Fänge

Lethin

et al. 2020

BMC Health Serv Res

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“…Consequently, selection bias may be present as individuals uncomfortable using these digital technologies may have self-selected out. Moreover, a previous study showed that people who agree to participate in digital studies, compared to those who do not, are younger; mostly male; and have better health, quality of life, socioeconomic status, and digital skills [ 15 ]. Therefore, our study included women of all ages.…”

Section: Discussionmentioning

confidence: 99%

Improving Efficiency of Clinical Studies Using a Total Digital Approach: Prospective Observational Study

Schenck‐Gustafsson¹,

Carnlöf²,

Jensen‐Urstad³

et al. 2021

JMIR Form Res

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Background In general, most clinical studies have long recruitment periods. Signing the informed consent is particularly time-consuming when the participant must meet physically with the researchers. Therefore, introducing fully web-based techniques with the use of eAuthentication (BankID) and new digital electrocardiogram (ECG) monitoring could speed up inclusion time, increase adherence, and also reach out to more remote regions. Objective The objectives of this study were to explore whether inclusion of a large number of participants could be realized quickly by using a total digital approach both for information and signing of informed consent, along with ECG monitoring and instant feedback on a mobile device. We also explored whether this approach can increase adherence in registration of ECG recordings and answering questionnaires, and if it would result in a more geographically uniform distribution of participants covering a wide age span. Methods Women with palpitations were intensively studied over 2 months by means of a handheld ECG monitoring device (Coala Heart Monitor). The device connects to a smartphone or tablet, which allows the participants to obtain the results immediately. Recruitment, study information, and signing the informed consent form with the help of BankID were performed in a completely digital manner. Results Between March and May 2018, 2424 women indicated their interest in participating in the study. On June 19, 2018, presumptive participants were invited to log in and register. After 25 days, 1082 women were included in the study; among these, 1020 women fulfilled the inclusion criteria, 913 of whom completed all phases of the study: recording ECG using the handheld device, completion of the prestudy questionnaires, and completion of the poststudy questionnaires 2 months after the ECG recordings. The dropout rate was 9%. In total, 101,804 ECG recordings were made. The mean age was 56 (SD 11) years (range 21-88 years) and 35 participants were 75 years or older. The participants were evenly distributed between living in the countryside and in cities. Conclusions Total digital inclusion recruitment of 1082 participants was achieved in only 25 days, and resulted in a good geographical distribution, excellent adherence, and ability to reach a vast age span, including elderly women. Studies using a total digital design would be particularly appealing during a pandemic since physical contact should be avoided as much as possible. Trial Registration ISRCTN Registry ISRCTN22495299; http://www.isrctn.com/ISRCTN22495299

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“…Older people should be involved in the studies which conduct design and evaluations of digital health technologies that are relevant to them (Östlund 2015). It is especially relevant that participation of older people in evaluations of digital technologies is not selective, and that study participants reflect the full heterogeneity of the target populations (Merkel and Kucharski 2018;Poli et al 2019;Allemann and Poli 2020;Poli et al 2020). Policies, in turn, should go beyond the mere promotion of digital health by actively shaping and impacting on key barriers and factors preventing full opportunities for older users (Melchiorre et al 2018b).…”

Section: Conclusion: Towards a Conceptual Framework On Old-age Digitamentioning

confidence: 99%

“…Digital health technologies can have exclusionary and inequality effects on older people (Poli et al 2019;Poli et al 2020). Such effects must represent a major concern for research, policy and practice, as digital health technologies are increasingly utilized in health systems and evolve rapidly.…”

Section: Conclusion: Towards a Conceptual Framework On Old-age Digitamentioning

confidence: 99%

Receiving Care Through Digital Health Technologies: Drivers and Implications of Old-Age Digital Health Exclusion

Poli

Kostakis

Barbabella

2021

International Perspectives on Aging

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The transition from traditional to progressively digitised health systems is leading to new forms of care including, for instance, telehealth and mobile health (mHealth) solutions. On the one hand, such solutions hold the potential for allowing easier, quicker and remote access to health care. On the other hand, digital health technologies can set new challenges for older people, especially for those who are not familiar with such technologies, in terms of receiving the care they need through good access and level of use of services. Furthermore, these services do not necessarily reflect everyone’s preferences and needs. This chapter aims to conceptualise and systematically discuss old-age digital health exclusion. First, we highlight key structural, environmental, individual and socio-technical drivers of the non-use and low-use of digital technologies, considering also the aspect of agency and personal preferences. Second, we point out the main individual and societal implications of old-age digital health exclusion. Third, we provide a conceptual framework for old-age digital health exclusion which includes older people, drivers and implications. Finally, we offer some reflections about digital health technologies in health care, highlighting related issues, risks and challenges for ageing societies.

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Prediction of (Non)Participation of Older People in Digital Health Research: Exergame Intervention Study

Cited by 32 publications

References 47 publications

Self-reported symptoms of depression and anxiety among informal caregivers of persons with dementia: a cross-sectional comparative study between Sweden and Italy

Self-reported symptoms of depression and anxiety among informal caregivers of persons with dementia: a cross-sectional comparative study between Sweden and Italy

Improving Efficiency of Clinical Studies Using a Total Digital Approach: Prospective Observational Study

Receiving Care Through Digital Health Technologies: Drivers and Implications of Old-Age Digital Health Exclusion

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