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Data for this study was acquired from three separate stakeholder focus group sessions involving nurse case managers (n = 5), social agency caseworkers (n = 5), and rural outreach providers (n = 5). Participants across all groups were asked to address the question: “When it comes to your work, what would you want a smart robot assistant to do for you?” Data from the three sessions were combined, transcribed verbatim, coded, and analyzed for thematic content. Three shared themes emerged, including health monitoring, behavioral intervention, and healthcare literacy. Relative to health monitoring, participants desired a robot that possessed functions in the form of “taking vital signs,” and “tracking water and food intake.” There was also a thematic agreement regarding behavioral intervention capabilities. Most notably, advisory stakeholders acknowledged a need for a smart robotic assistant to provide geriatric care recipients with “an alert or reminder to take medication.” This was viewed as an essential intervention for improving medication adherence. Healthcare literacy emerged as a final theme among advisory groups. In particular, participants noted that a smart robot should assist with bi-directional communication and translation of health care information and instructions as a way to “minimize impediments of care due to language barriers.” Findings will be further used to highlight how future integration of robotic health assistants represents a viable solution in helping geriatric healthcare workers work effectively alongside machines to meet the diverse care needs of older adults in both urban and rural settings.

Email is one of the most common and useful online communication tools. However, older adults tend to have difficulties fully taking advantage of email. Organizing the information in the email software environment and sending a message to selected recipients are examples of common email-related problem-solving. To date, little data are available to understand the email-related problem-solving behaviors of older adults. Nationally representative survey data and log-file data of the U.S. adults (n = 1,341) are derived from the 2012 Program for International Assessment of Adult Competencies (PIAAC), which provides computer-based assessment data on problem-solving skills. The PIAAC respondents used the computer device and solved the problems in the simulated email environment. Descriptive summary showed that those 55 years and older took longer (169 seconds), referred to the help menu (15%) and used the cancel button (26%) more often than younger age groups (e.g., age 25-34; 103 seconds, 3% and 17%, respectively) in one of the tasks. Additionally, binary logistic regression showed that taking longer time (odds-ratio = 0.99, p < 0.05) and using the help menu (odds-ratio = 0.85, p < 0.05) were associated with the incorrect answer to the email problem-solving, although the findings varied across different types of problems. These unique findings from the combination of survey and log-file data analyses suggested that some older adults may benefit from the training for common email-related problems rather than teaching themselves. Detailed descriptions of computer-based assessment log file data and other results are also evaluated in this study.

Older adults (55+) represent one of the fastest growing groups adopting wearable devices (e.g. smartwatches). However, questions remain as to how older adults, healthcare providers and researchers can maximize the ability of these devices to maintain and improve health. The objective of this study was to understand the needs and preferences of older adults in wearable devices, as part of a Florida High Tech Corridor Matching Grant between The Villages Health, Aviv/Xtend Scientific, and The University of South Florida. Six focus groups were conducted with older adults (n=36) living in The Villages, Florida, and were stratified by gender. Topics such as adoption, benefits/concerns, usability, and potential gender differences were explored. Heart rate monitoring, calories burned, and step counting features were most often utilized by current wearable users (43%). Participants reported that the most important benefits of wearables were atrial fibrillation identification, fitness tracking and fall detection. Concerns included privacy, the “learning curve” and too frequent of notifications by the device. Across both genders, choice resonated strongly as a theme. Male and female participants desired personalized, easy to understand outcomes and control over data sharing preferences. Men were interested in continual access to wearable health data, whereas females were interested in daily or weekly summaries. Further, men reported higher on-going use and comfort with smartwatches as compared to females. Participants suggested “low, medium, and high-tech savvy” user profiles and supporting resources (e.g. 1-1 training, paper manuals) to enhance adoption. Recommendations for policy and practice are shared, in light of the findings.

Despite the overall increase in Internet use among older adults, the digital divide within older Americans remains substantial. This trend is particularly true for older adults living in rural areas. Informed by the Social Determinants of Health Framework, our study aims to examine how one’s residential area relates to (1) Internet Access, (2) subtypes of usage patterns, and (3) perceptions on technology use. Cross-sectional data were drawn from the 2012 Health and Retirement Study (HRS). The sample consisted of 18,196 older adults aged 50 and above (47.6% rural residents). A series of linear and logistic regression analyses were performed. Our models controlled for demographic characteristics, socioeconomic status, and health conditions. Compared to older adults living in urban areas, those residing in rural areas had 29% lower odds of internet access. Living in rural areas predicted lower levels of all sub-types of technology use (communication, financial, health, and media technology). In addition, non-users in rural areas showed more unfavorable perceptions of technology than urban residents. They were more likely to conceive technology as “too complicated”, “too hard to learn”, and “too difficult to keep up with all changes.” Our findings suggest that substantial segments of older adults in rural areas are still behind in accessing and adopting digital technology. Targeted intervention efforts are urgently needed to reduce technology inequality including comprehensive plans to expand broadband access and building mobile technology infrastructure for rural communities.

Cross-sectional analyses of internet use patterns among older adults find that the rate of internet use is less with greater physical and memory difficulties. It is not clear, however, how age-cohorts differ in their internet use as physical and memory difficulties increase over time. In addition to factors such as increasing accessibility (cost) and social influences, the expansion and cognitive complexity of functions performed by the internet-enabled devices over time could influence internet use patterns. In this study, we investigate how the association between internet use and episodic memory difficulties over time varies between cohorts. We analyzed longitudinal data from the Health and Retirement Study (N = 15,703 in 2002; Aged 51 and older) between years 2002-2016 using mixed effects logistic regression models. Immediate and delayed word recall measures were used to assess episodic memory. Rate of internet use in the sample increased from 30% in 2002 to 53% in 2016. Rate of internet use among younger age groups was significantly higher in the baseline year. Younger age groups also showed a significantly higher rate of increase in internet use over time. In general, internet use decreased with episodic memory impairment. In addition to these effects, the effect of episodic memory on the rate of increase in internet use over time is lower in younger cohorts. These results indicate that younger cohorts of older adults are more likely to maintain internet use as they continue to age and therefore could better utilize technology for communication, social interactions and health interventions.

Many older adults remain inactive despite the known positive health implications of physical activity (e.g. improved mood, reduced mortality risk). Physical inactivity is a known interdependent phenomenon in couples, but the majority of research identifies determinants of physical inactivity at the individual level. We estimated the average amount of physical inactivity for older adult couples and, using dyadic analysis, identified physical and mental health determinants thereof. Forty-eight heterosexual older adult couples (mean age=70.6, SD=6.63) from the Veterans Integrated Service Network 20 cohort of the Collaborative Aging Research using Technology (CART) initiative were included in this study. Both dyad members wore actigraph devices for a month. The average number per day of inactive periods (defined as no movement or sleep activity for ≥ 30 minutes) was estimated. Multilevel modeling revealed that, within couples, there was no difference between partners in the average number of inactive periods, but on average across couples, males had more inactive periods per day (13.4, SD=4.43) than females (12.3, SD=4.87). For males, older age was the only variable associated with more inactive periods (β=0.13, p=.013). For females, more depressive symptoms in men were associated with fewer inactive periods (β=-0.37, p=.002), and more dependence in completing their own IADLs predicted more inactive periods (β=2.80, p

Gathering health information is among the major motivations for getting online among older adults who want to be better prepared with knowledge to manage their health and personal care. Prior research also showed significant gender differences in health-related use of the Internet. This research examined the effect of Internet use for health information on (a) mistrust of physician, (b) empowerment, (c) self-care, and (d) worry and/or anxiety. The sample (N=710; Mean= 48.82, SD=16.43) was randomly drawn from a national probability-based online panel. We performed gender-stratified sub-sample analyses of older respondents (age ≥60, N= 194). Hierarchical linear regression analyses showed that there is a negative association between older age and feeling empowered because of using the internet for health information (β = -.23, p < .05) and a positive association between older age and mistrust of diagnosis and/or treatment of physician (β = .19, p < .05). Study respondents did not report better self-care as a result of obtaining information from the Internet (β = -.15, p > .05). Lastly, older adults reported less worry and/or anxiety because of information stumbled upon the Internet that may not be accurate (β = -.25, p < .05). Sub-sample analyses showed that there are gender differences. Particularly, older men reported greater mistrust (β = .32, p < .05), and less worry (β = -.44, p ≤ .01) while these associations were not significant among older women. Results call for examination of the synergy of age and gender in perceived benefits of health-related Internet use.

According to Temporal Self-Regulation Theory (TST; Hall & Fong, 2007), adherence motivation can be driven by both positive and negative emotional reactions in which adherence is viewed in relation to gains versus losses. In a sample of 100 older adults (ages 64+), we explored participant-provided feedback related to intervention and game elements participants perceived would increase their adherence across five domains: (1) ability to adjust difficulty; (2) ability to change game design (from the preprogrammed American Western theme); (3) cognitive performance feedback; (4) ability to unlock extra game features (e.g., more levels); and (5) other elements. Ranked in order of frequency of endorsement, 53% endorsed: cognitive performance feedback; 47%: ability to adjust difficulty; 28%: ability to unlock new features; 27%: the ‘Other’ option; and 20% endorsed changing the game’s theme. This work has implications for models of adherence, specifically, the role that expectations of later cognitive feedback might play.

In-home and internet-based smart technologies to improve older adult health has been rapidly developing. Technologies such as in-home sensors and smart homes enable older adults to live independently and age in place. These technologies also assist informal caregivers in their roles, thus reducing caregiver burden. However, technology adoption among older adults and family caregivers has been relatively low and reasons for technology acceptance are complex. Therefore, the purpose of this study was to conduct a systematic review of the literature, examining acceptance and adoption of in-home, internet-based smart technologies that are designed to improve health outcomes of older adults and can assist family caregivers in providing supports. This study utilized the Rew method (2011) and included peer-reviewed research articles published between 1991 and 2019 and available in: ISI Web of Science; PubMed; Scopus; CINAHL; and PsycInfo. A total of 1,227 relevant articles were identified with the search strings used and a final sample of 48 articles were included after the title, abstract, and full article review processes. Findings highlight several facilitators and barriers to technology adoption. Some facilitators to adoption include: technology familiarity, safety/security, personally tailored, non-obtrusive design, easy access, and reduction of caregiver burden. A few barriers include: cost, difficulty to use, time, stigma, privacy, data accuracy, and confidence. Additional findings will also be presented. A more thorough understanding of these facilitators and barriers to acceptance/adoption is crucial for the successful dissemination of in-home, internet-based smart technologies. Increased adoption can improve older adult health and reduce caregiver burden.

Homebound older adults are a hard-to-reach population with a high burden of depression and face substantial access barriers to mental health treatments. Internet-based psychotherapy is a promising strategy to address this persistent treatment gap, but older adults are severely underrepresented in internet-based psychotherapy trials. One challenge to advance this area of research and practice is the recruitment and retention of homebound older adults in clinical trials. Previous research has discussed the challenges of recruiting older adults in behavioral interventions and offered useful recommendations. However, recruiting homebound older adults, who face substantial mobility barriers, poses additional challenges not fully addressed in the literature. The expectation of using technology adds another layer of difficulty. In this presentation, we will discuss our group’s experiences working with community partners to recruit and retain homebound older adults for a study on technology-based mental health treatment. We partnered with home care agencies, senior apartment buildings, and Meals-on-Wheels and experimented with a few different ways to recruit study participants. Issues related to accessibility, trust, and stigma emerged as important considerations when designing recruitment strategies and materials. The discussion will be an integration of our experiences and a review of previous literature on the challenges and recommendations for recruiting older adults in mental health services research.

Few studies have focused on the utility of mindfulness-meditation for well-being in older adults. This study aimed to investigate the feasibility and acceptability of an app-based mindfulness-meditation program for community-based older adults. A convenience sample of 46 participants aged between 63 and 81 (M = 70.85, SD = 4.70) was recruited from the community. Participants were invited to engage with a 30-day app-based mindfulness-meditation program for 10-minutes daily on their smartphones. Each meditation session comprised focusing on the breath, mentally scanning the body, monitoring the mind’s activity, and cultivating a nonjudgmental attitude toward experience. Participants completed psychosocial questionnaires at baseline, day 10, and day 30. On average, participants completed 25 sessions and almost 4 hours of application use across the 30-days. Results of linear mixed effects models showed significant improvements in positive affect, negative affect, and life satisfaction across the study interval, but no meaningful change in total or facet-level mindfulness or perceived stress. Furthermore, relative to high levels of smartphone efficacy, low smartphone efficacy was associated with higher perceived stress and negative affect, and less life satisfaction at baseline; and steeper improvements on these outcomes across the study interval. Results indicated that, on average, older adults found app-based mindfulness-meditation training interesting, enjoyable, valuable, and useful. The findings provide preliminary support for the feasibility and acceptability of an app-based mindfulness-meditation program with community-based older adults and demonstrate potential benefits for well-being. Furthermore, older adults’ perceptions of smartphone competency may play an important role in the outcomes of app-based programs.

Social media platforms allow people to connect and share content online (e.g., Facebook, Twitter). Although older adults are becoming more frequent users of social media, there continue to be mixed views on whether social media positively or negatively impacts well-being. Past studies have mainly focused on cross-sectional analyses for individual differences. However, both the time spent on social media and one’s affect can fluctuate on a daily basis. Thus, it is important to understand how the relationship between daily social media usage and affect varies within individuals from day to day. The current study adds to the literature by examining whether daily variations in time spent with social media are related to daily positive and negative affect and whether there are age differences in these relationships. The current study used an eight-day daily diary from the Midlife in the United States (MIDUS) Refresher dataset for 782 participants (ages 25-75). Multilevel modeling results revealed that age moderated the relationship between daily time spent on social media and negative affect: for younger adults, on days when they spent more time on social media, they had more negative affect. For older adults, on days when they spent more time on social media, they had less negative affect. Surprisingly, daily time spent on social media was not related to daily positive affect, nor did this relationship differ by age. Implications for future research are discussed with a focus on how social media usage can contribute to daily well-being for adults of different ages.

Due to age-related declines, older adults often experience difficulties using the Internet and navigating websites, even among websites specifically designed for them. Subsequently, the National Institute on Aging (NIA) and National Library of Medicine (NLM; 2001) published guidelines to promote website usability among a later life population. Applying quantitative content analysis, this study examined the accessibility of senior resource websites based on NIA and NLM recommendations. Specifically, the relation between the type of organization sponsoring the websites (i.e., governmental, non-profit, or private) and overall accessibility and the relation between the number of resource categories (e.g., housing, financial, etc.) and overall accessibility were investigated. Font size, organization of presented information, and the color and contrast on the websites were coded to determine how they contribute to overall accessibility. Using a sample of the 100 most-searched senior resource websites, a one-way ANOVA indicated that the type of site on overall accessibility was not significant, F(2, 97) = 2.29, p = .11, η2 = .04. The multiple regression model showed that font size (β = .30, p < .001), organization of information (β = .38, p < .001), and color and contrast (β = .45, p < .001) were significant predictors of overall website accessibility and explained 62% of the variance, F(3, 96) = 51.18, p < .001. The findings suggest that various NIA guidelines differentially contribute to a website’s accessibility, and further attention should be paid to cognitive aspects of resource websites.

In this paper, we use time-use data from the US (2003-2018) and the UK (2001-2015) to address important questions about recent trends in social isolation and technology use among older adults aged 65 and over. Do new information, communication and robotic technologies contribute to growing social isolation among older adults or to growing opportunities for social connection? We believe that answers to these questions require a consideration of technologies that are already widely in use. We ask whether TV time is social time or whether people spend most of their time watching TV by themselves, whether this has changed over the past 15 years and what the potential implications are for wellbeing among older adults. The results show that TV time is a mixed experience among older adults. In the US and the UK, a substantial proportion of TV time – around half – is spent alone, with those who are not married, those in rented accommodations and those with poorer self-rated health spending more time watching TV alone. Controlling for demographic and household characteristics, TV time alone has increased in recent years, accompanying an increase in time spent alone in general in the UK and an increase in TV time in general in the US. Analysis of moment-to-moment wellbeing shows that individuals report lower positive affect while watching TV alone than while watching with others, suggesting the increase in time spent watching TV alone may have negative implications wellbeing among older adults.