TABLE 2.
Details from the selected articles.
| Article | Population | Intervention | Outcomes assessed | Implementation implications |
|---|---|---|---|---|
| a Bail et al., 2022 (Bail et al., 2022) (systematic review) | older adults in long-term care and nursing homes | health information technologies for electronic health record, medication management, skin management, and communication (e.g., telehealth) | facility-level outcomes, nurse outcomes, and resident outcomes for acceptability, satisfaction user perceptions, worker time, timeliness of care, and quality of care | the probability of implementation success is higher when technology systems are co-designed with residents and staff; most of the studies reported technology problems and maintenance issues; the functionality of the technology was poorly communicated and did not meet user needs and expectations; rarely was the same outcome assessed across studies; studies seldom captured the complexity and relatedness of resident care needs |
| Berquist et al., 2020 (Bergquist et al., 2020) | community-dwelling older adults | smartphone app–based self-tests of physical function | usability measures | high error rates due to users misunderstanding instructions |
| *Bieryla et al., 2013 (Bieryla and Dold, 2013) | older adults living independently in a senior living community | Nintendo Wii Fit for improving balance | Berg Balance Scale, Fullerton Advance Balance Scale, Functional Reach test, and Timed Up and Go test | the study did not actually include training in the participants’ homes |
| *Braspenning et al., 2022 (Braspenning et al., 2022) | three stakeholder groups involved in the implementation process of lifestyle monitoring (informal caregivers, healthcare professionals, and healthcare managers) | technology for ambient assisted living | interview guide based on normalization process theory (NPT) constructs (coherence, cognitive participation, collective action, and reflexive monitoring) | barriers to implementation were a perceived inflexibility in how the technology should be used and integrated with organizational workflows; lack of a clear business case for engaging with healthcare managers; and perceived unreliability of the technology |
| Broadbent et al., 2015 (Broadbent et al., 2015) | older adults residing in a retirement village hospital and rest home setting and care staff | multiple healthcare robots | quality of life, depression, and dependency (mobility, activities of daily living, and behaviour) | no safety concerns; staff were more positive toward robots than residents |
| *Cavallo et al., 2015 (Cavallo et al., 2014) | community-dwelling older adults with dementia | technology for ambient assisted living | unvalidated 5-point rating scales about the technology’s usefulness, obtrusiveness, and acceptability, from a multidisciplinary team of clinicians, engineers, psychologists, and therapists | authors stressed the importance of extensive consultation with stakeholders on technical, ethical, legal, clinical, economic, and organizational implications of technology implementation |
| Choukou et al., 2021 (Choukou et al., 2021) (scoping review) | community-dwelling older adults | technology for ambient assisted living | perceived usefulness, ease of use, intention to use, and user acceptance | authors concluded that the methodological quality of research in this area was poor (only one study evaluated all four aspects of the Technology Acceptance Model); need for studies that use a comprehensive evaluation framework that considered the needs and preferences of intended users at each stage of technology development |
| Fan et al., 2017 (Fan et al., 2017) | older adults in long-term care and nursing homes | socially assistive robots (SARs) | user’s acceptance and intention to use new technology based on performance expectancy, effort expectancy, attitude toward using technology, and self-efficacy; level of enjoyment and interest | Authors recommended studies of long-term effect of SARs, including misuse of robots, decreased human contact, loss of control, loss of privacy, and feelings of objectification |
| Fiorini et al., 2021 (Fiorini et al., 2021) | older adults living in long-term care and nursing homes | robots that provide functional assistance (ASTRO robot) | attitudes and beliefs in the ability of the robot to address primary needs; concerns about stigma and replacement of human care | Implementation challenges included the capability of robots to navigate dynamic variation in the physical and social/cultural environments in the longer term, to detect and manipulate a wide variety of objects in different contexts, to act autonomously, and to interpret human emotions and react appropriately in social situations |
| Gettel et al., 2021 (Gettel et al., 2021) (scoping review) | community-dwelling older adults | software apps, augmented and virtual reality, care robots, home monitoring systems, intelligent cognitive assistants, and wearable activity monitors and cameras | measures of behavior, working memory and physical activity | barriers to adoption and implementation included lack of experience with technology, difficulties learning to use technology, privacy concerns, and fears that technology (e.g., social robots) would lead to social isolation; potential users need education and training; implementation studies are badly needed |
| Law et al., 2019 (Law et al., 2019) | community-dwelling older adults with mild cognitive impairment (MCI) or early dementia | home-based healthcare robot | perceived usefulness | implementation challenges included technical problems with the robot and lack of research studies with longitudinal designs and comparison of different robots |
| Lesauskaitė et al., 2019 (Lesauskaitė et al., 2019) | community-dwelling older adults and geriatric in-patients | computers, the internet, smartphones, and fall detectors | self-report questionnaire on the knowledge, readiness to use, and use of technologies | smartphones were less stigmatizing than non-digital technologies; privacy concerns about smart home technology were inversely correlated with user health needs |
| McMahon et al., 2016 (McMahon et al., 2016) | community-dwelling older adults | wearable physical activity monitors (Fitbit One) | questionnaire based on the Technology Acceptance Model (TAM) | the technology was found to be easy to use, useful and acceptable; authors recommended that studies compare several types of monitors, and measure emotional satisfaction and health benefits |
| Moyle et al., 2018 (Moyle et al., 2018) | dementia patients in long-term care | PARO robotic seal | motor activity and sleep patterns (SenseWear® armband) | participants did not tolerate wearing the armbands; devices were often unreliable in their recording; care staff should monitor adherence and remind residents about wearing devices appropriately |
| *Moyle et al., 2021 (Moyle et al., 2021) (scoping review) | community-dwelling older adults with dementia | technology for ambient assisted living | various measures of technology effectiveness | authors recommended that evaluation of the technology should occur only when it is at a level of sufficient development, to avoid ongoing and disruptive technical issues |
| Neal et al., 2021 (Neal et al., 2021) (systematic review) | community-dwelling adults with a diagnosis of dementia or with MCI | digital technology (if it was inherently dependent on any electronic device that comprised, or interfaced with, any kind of computer) | self-management and social participation | study authors made surprisingly few statements about implementation; identified implementation factors were enjoyment from technology use and complexity or limited functionality of technology; the availability of high-quality evidence in this field does not seem to have significantly progressed from previous reviews |
| Orellano-Colón et al., 2016 (Orellano et al., 2016) | community-dwelling older adults | a wide variety of technology devices for aging in place, including digital health technologies | user-perceived challenges, barriers or obstacles for using technology devices | lack of awareness and information about technology, cost, limited coverage of technology by healthcare plans, and perceived complexity of technology |
| Orellano-Colón et al., 2020 (Orellano et al., 2020) | community-dwelling older adults | intervention to overcome barriers to using technologies for aging in place | acceptability, effectiveness, physical and mental health, psychosocial impact, and self-efficacy | self-management and behavioural change techniques for technology users can facilitate implementation |
| *Peek et al., 2017 (Peek et al., 2017) | community-dwelling older adults | a wide variety of technology devices for aging in place, including digital health technologies | reasons for device ownership and frequency of use, and attitudes and perceptions about these devices | factors affecting implementation included: favorable or unfavorable beliefs concerning the reliability, lifespan, power consumption, and costs of purchase and maintenance of technology; positive and negative consequences of using technology for users and caregivers; self-efficacy for using technology; user’s social network, social agencies, and compatibility of the technology with the user’s physical environment |
| *Reeder et al., 2013 (Reeder et al., 2013) | older adults living in a retirement community | technology for ambient assisted living | self-report standardized measures of physical mobility, psychosocial health, and cognitive health, and fall tracking | authors reported significant implementation challenges with the sensor-based monitoring system; recommended that study designs use mature and reliable technology, provide adequate resources for installations, and ensure that participants are informed in advance that there may be technical problems |
| Sánchez et al., 2019 (Sánchez et al., 2019) | community-dwelling older adults | technology for ambient assisted living | attitudes and perceptions | implementation challenges included costs, loss of autonomy and personal dignity, and a preference for human care; participants were not concerned about privacy |
| *Sautter et al., 2021 (Sautter et al., 2021) | older adult with mild and advanced dementia | touch-screen computer applications to enhance social connection, facilitate entertainment, and implement cognitive training | frequency counts of challenging behaviors and cognition (attention, concentration, executive functions, memory, language, conceptual thinking, calculations, and orientation) | authors recommended that studies with participants who have dementia should use ongoing processes for assent and building rapport between study personnel and participants (both older adults and caregivers) |
| Schoon et al., 2020 (Schoon et al., 2018) | community-dwelling older adults | self-management fall prevention program using a wearable gait-speed feedback device | compliance (number of weekly gait speed measurements and reasons for not having a measurement), falls (via telephone), mobility (Timed Up and Go), and disability (Katz-15 scale) | the intervention had good technical feasibility and compliance, but it did not produce overall positive outcomes; authors recommended that future research examine all constructs of the TAM |
| *Selye et al., 2020 (Seelye et al., 2020) | community-dwelling older adults | sensors and software to monitor pill-taking, steps taken, time spent sleeping, and computer use in a real-world assessment of digital health technology in the homes | standardized neuropsychological test, health assessments, and daily function questionnaires | feasibility issues included technical problems with installation and in-home technology maintenance |
| Wang et al., 2020 (Wang et al., 2020) | community-dwelling older adults | an integrated, personalized telehealth monitoring system (steps and sleep data using a Fitbit, and gait and balance status using wearable sensors) | users’ acceptance of the system with respect to attitude, self-efficacy, perceived usefulness, perceived ease of use and behavioural intention | users found the system easy and comfortable to use and useful for improving their health, and intended to use the system in their future health management |
| Wu et al., 2015 (Wu et al., 2015) | community-dwelling older adults | information and communication technologies (ICTs) | attitudes toward ICTs | authors recommended that older adults get appropriate training and support in ICT use through peer-supported training, to improve their technology skills and their attitudes toward technology |
a
Denotes that the authors made explicit reference to the relevance of their research for technology implementation.