Usability of an Adaptive Computer Assistant that Improves Self-care and Health Literacy of Older Adults

Abstract

SummaryObjectives-We developed an adaptive computer assistant for the supervision of diabetics' selfcare, to support limiting illness and need for acute treatment, and improve health literacy. This assistant monitors self-care activities logged in the patient's electronic diary. Accordingly, it provides context-aware feedback. The objective was to evaluate whether older adults in general can make use of the computer assistant and to compare an adaptive computer assistant with a fixed one, concerning its usability and contribution to health literacy.Methods-We conducted a laboratory experiment in the Georgia Tech Aware Home wherein 28 older adults participated in a usability evaluation of the computer assistant, while engaged in scenarios reflecting normal and health-critical situations. We evaluated the assistant on effectiveness, efficiency, satisfaction, and educational value. Finally, we studied the moderating effects of the subjects' personal characteristics.Results-Logging self-care tasks and receiving feedback from the computer assistant enhanced the subjects' knowledge of diabetes. The adaptive assistant was more effective in dealing with normal and health-critical situations, and, generally, it led to more time efficiency. Subjects' personal characteristics had substantial effects on the effectiveness and efficiency of the two computer assistants.Conclusions-Older adults were able to use the adaptive computer assistant. In addition, it had a positive effect on the development of health literacy. The assistant has the potential to support older diabetics' self care while maintaining quality of life.

Health–Related ICT Solutions of Smart Environments for Elderly–Systematic Review

“…In this regard, ICT solutions of smart homes for the elderly population may be categorized in relation to the context of use: (1) resident activity monitoring [36]- [46] and (2) resident health monitoring and/or managing [38], [44], [47]- [57]. They give older adults the opportunity to use wearables and/or environmental sensors and devices which are intended to monitor and/or manage various health conditions, i.e., ischaemic heart disease [47], stroke [39], [49], [50], [58], Alzheimer's disease and other dementia [4], [34], [36], [37], [41]- [46], [48], [59], chronic obstructive pulmonary disease [34], [52], [53], [60] diabetes mellitus [38], [55]- [57], and physical disabilities [51]. With this approach they can improve the coordination among caregivers, emergency response teams, and intervention effectiveness, which contributes to cost savings and better QoL for older people living with chronical conditions.…”

“…The summary above shows that existing ICT solutions have a twofold purpose, i.e., (1) prolonging and supporting the independent living of older people [37]- [40], [44], [45], [47], [49]- [51], [55], [57], [58], [60] and (2) providing help and simplifying activities for caregivers [38], [41]- [44], [46], [48], [52], [53], [56]. The ultimate goal is to build a smart ecosystem based on technological infrastructure including the following components: (1) sensors and devices; (2) connectivity and communications; (3) services and application; (4) security and privacy; and (5) data management and analytics [61].…”

“…One trend is also to use multicomponent interventions and smartphones/PDAs, whereas wearables, biosensor devices, and computer systems as the sole technological solution are not in vogue now. This indicates an ability to use ICT technologies in elderly living environments, including smartphones, wearables and any devices they can have [55].…”

National Action Plan to Improve Health Literacy

“…Interventions have taken many forms (e.g., computer-based participatory processes, in-person Saturday school classes, and plain language and pictogram medication sheets) and have had many positive results, demonstrating that limited health literacy can be successfully addressed. 47,48,49,50 Adopting User-Centered Design…”

A computer assistant for remote collaborative troubleshooting of domestic medical instruments

“…To validate our hypotheses, we conducted a laboratory experiment at the TNO Experience Lab, with older adults, playing the role of patient, and younger adults, playing the role of technical specialist, performing activities according to scenarios. A benefit of this Smart Home Environment is the opportunity to facilitate natural behavior in a controlled environment [9].…”