JMIR Publications

ABSTRACT

Background:

Falls are a leading cause of injury and death among aging adults. They represent a tremendous financial burden on a nation’s healthcare system. There is a need to develop and implement fall prevention and detection systems (FPDSs) to mitigate falls in residential and hospital settings. Despite advances in FPDS development, less is known about the factors that influence users’ decision to accept and adopt this technology.

Objective:

The purpose of this scoping review was to uncover and synthesize users’ perceptions of FPDSs, the facilitators and barriers associated with their adoption, and offer recommendations for future research and development.

Methods:

Articles were extracted from six databases (PubMed, CINAHL, EMBASE, Scopus, IEEE Xplore, ACM Library, and Web of Science). The criterion for inclusion was that the articles must be user studies that dealt with the perception, acceptance, and/or adoption of FPDSs, be written in English, peer-reviewed, and published between 2011 and 2020.

Results:

This review identified 38 factors across 15 articles that may impact the adoption of FPDSs. The identified factors were grouped into seven thematic categories: utility, social-cognitive factors, ethical concerns, usability, technology design, stakeholder support, and alarms/alerts. Of the 38 elicited factors, privacy concern (53%, 8/15) turned out to be the most frequent factor affecting FPDS adoption, followed by perceived usefulness (47%, 7/15), perceived ease of use (40%, 6/15), and perceived comfort (33%, 5/15). Moreover, the review found that 53% of the studies were conducted in Europe, 40% in North America, and 7% in Australia.

Conclusions:

The findings suggest that FPDSs should be designed to prioritize privacy protection, usefulness, ease of use, and comfort (in the case of wearables). Addressing these barriers can improve the effectiveness and adoption of FPDSs among caregivers and patients. Most of the reviewed studies focus on helping seniors age in place in home settings rather than hospital settings. It is yet to be seen from a financial perspective whether there is more to be gained for technology companies to have FPDSs in multiple individual homes vs a hospital setting, and how this is driving how and what technology is being developed. Finally, there is a need to conduct studies (including cross-cultural studies) on technology adoption in underrepresented continents such as Africa, Asia, and South America to uncover the generalizability of the current findings.