JMIR Publications

ABSTRACT

Background:

Older adults (OA) can use wearable devices (WD) to monitor clinically relevant health metrics, improve physical activity, and monitor for falls. Little is known about how this population engages with WDs and no qualitative synthesis exists to describe their shared experiences with long term use of WD.

Objective:

This study attempts to understand the shared experience of OAs who took part in WD trials and the factors that contribute to the acceptance and sustained use of WDs. We aimed to synthesize qualitative studies that analysed the user experience after a multi-day trial with a WD.

Methods:

A systematic search was conducted of CINAHL, APA Psych Info, PubMed, and EMBASE (2015-2020, English) with fixed search terms relating to ‘older adults’ and ‘wearable devices,’ following PRISMA guidelines. An inductive meta-synthesis methodology was employed. Themes were extracted from primary studies, key concepts were identified, and reciprocal and refutational translation techniques were applied; findings were synthesised into third order interpretations and finally, a ‘line-of-argument’ was developed.

Results:

In total, 20 papers were reviewed; two evaluated fall detection devices, one tested an ankle worn step counter, and the remaining 17 tested activity trackers. Duration of wearing ranged from 3 days to 24 months. The views of 349 OAs (age range 51-94), were synthesised. Four key concepts were identified and outlined, namely: 1) motivation for device use, 2) user characteristics (openness to engage and functional ability), 3) integration into daily life, and 4) device features. Our ‘line-of-argument’ model describes how motivation, ease of use, and device purpose determine if a device is perceived to add value to the user’s life, which subsequently predicts if the device will be integrated into the user’s life.

Conclusions:

In order to overcome usability barriers (e.g. limited technical ability), a support structure should be placed around the user that fosters motivation, encourages engagement with peers, and adapts to the user’s preferences. Future research should evaluate our model by conducting long term WD trials that use qualitative methods to comprehensively address the multiple stages of device use and the many factors that contribute to adherence.