Table 4.

Overview of similarities and differences of barriers/facilitators across the participants for uptake and engagement

Theme	Sub-theme	ATT service factors ‘Users’	ATT service factors ‘non-users’
Decision to use the ATT service at point of referral	Acceptance of old age/health condition	• Most ‘users’ accepted they had a need for equipment • Perception that equipment symbolised a transition to ‘getting old’	• Most ‘non-users’ did not accept they had a need for equipment • Many non-users stated they went along with the referral to please others
	Previous knowledge & awareness of service & equipment	• Only two users had heard of ATT service before referral • Previous knowledge related to knowing of others who had used the service • Main source of information was ‘referrer’ who was most commonly a community health care professional supporting them with specialist care • Users’ often discussed the decision to use the service with the referrer, often a healthcare professional before making the decision • Had a preference for receiving information about service face-to face • ‘Users’ generally felt in charge of the decision to use the service	• None of the non-users had heard about ATT service before referral • Main source of information was ‘referrer’ who was most commonly a community health care professional supporting them with specialist care • Had a preference for receiving information about service face-to face • Some ‘non-users’ felt that they did not have enough information to make an informed decision and some feeling of being ‘pressurised’ • Many ‘non-users’ went along with the referral to keep the referrer happy, particularly their healthcare specialist
	Perceived usefulness of equipment	• “Users’ perceived that the ATT equipment would be useful • TH equipment was viewed as useful to monitor health • TC equipment perceived as useful to communicate with carer, remind them to take medication, to get help in an emergency	• Non-users did perceive the equipment as useful or feel that it would add any value
	Attitudes and perceptions towards ATT equipment	• Many ‘users’ felt that they would find the equipment easy to use and felt that they had the confidence to use it. • Older patients demonstrated more apprehension than younger ‘users’	• Many older patients lacked confidence and experience to use technology • Viewed equipment/technology as time consuming • Equipment was viewed as complex and difficult to use • Concerns around functionality and/or support with functionality from service
Engagement and use of ATT service	Usability	• Users overall found equipment relatively easy to use and set up • Pendant and pager, fall detectors and TH equipment viewed as easy to use • There were some difficulties for older patients who were using medication reminders and changing batteries • Some ‘users’ fund instructions difficult to follow	• Found equipment difficult to use and/or difficult to set up • TH users found equipment inconvenient e.g. readings at a set time • Some TC users found equipment time consuming and inconvenient e.g. stocking up medication reminders • Instructions difficult to follow
	Actual usefulness of equipment	• Most participants felt that the equipment was suitable to meet an unmet need • TC users found equipment useful and met an unfulfilled purpose • TH users felt equipment was useful as it enabled them to monitor their health and check readings were within the set parameters	• Majority of non-users stated that they did not find the equipment useful and was cited as a core reason for non-engagement • Reasons related to no perceived need or a change of need • Some felt equipment did not meet specific requirements
	Functionality of equipment	• TH users felt equipment was reliable and were confident it would work as intended/readings were accurate • TC users felt confident equipment would work in an emergency • Some issues surrounded equipment functionality but valued instant support	• Concerns relating to functional equipment • Felt unsupported to deal with technical issues • Unsure what to do when equipment was not functioning properly
	Threat to identity and independence	• Perceived stigma to using equipment in public • Acceptance of getting older or that life cannot continue the same	• Concern about loosing independence and being dependent on others