Co-Creating a Digital Life-integrated Self-Assessment (LiSA) for Older Adults
ABSTRACT
Background:
Older adults are at increased risk of developing health disorders and functional decline. A comprehen-sive geriatric assessment (CGA) to identify early signs of negative trajectories has enormous potential for patients, society and health care system. However, due to time constraints and considerable effort physicians rarely conduct the CGA. If designed properly, digital technologies could identify health risks already at a pre-clinical stage and thereby facilitate preventive efforts and a targeted intervention. For this purpose, a LiSA (Life-integrated Self-Assessment) tablet system will be developed in a structured co-creation process.
Objective:
The aim of the present study was to investigate older adults’ perceptions of (1) different self-assessment domains, (2) components affecting user experience, (3) risks and benefits associated with LiSA, (4) characteristics of potential LiSA users, and (5) the LiSA concept in general.
Methods:
Ten community-dwelling older adults aged ≥70 years were recruited. Six co-creation workshops were held and started with an expert input followed by semi-structured discussion rounds. Participants per-formed “hands-on” activities with a tablet, including testing of pre-installed self-assessment apps. All workshops were audio-recorded and additionally documented by the researchers using flipcharts, notes, and photos. Qualitative content analysis was used to analyze data following a deductive-inductive approach, guided by the Optimized Honeycomb model for user experience (UX).
Results:
The group (mean age 77.8 ± 5.1 years) was heterogeneous in terms of prior technology experience and health status. The mean workshop duration was two hours and an average of eight participants attend-ed each workshop. Eleven thematic categories were identified, covering results on all research ques-tions. Participants emphasized a strong interest in conducting a digital self-assessment of physical activ-ity and function, sensory and cognitive functions, and requested additional features such as recom-mendations for actions or reminders. LiSA was perceived as an empowerment and a motivator to en-gage in active health care planning as well as to enable shared and informed decision making. Concerns and barriers were lack of technical competence, feelings of frustration and fear of being left alone with negative assessment results. In essence, participants expressed a positive attitude towards using LiSA repeatedly and identified it as an option to increase the chances for maintaining independence when growing old.
Conclusions:
The co-creation participants supported the LiSA approach and were interested in performing regular self-assessments on a long-term basis. In their opinion LiSA should include relevant assessments captur-ing physical activity and function, sensory and cognitive functions as well as recommendations for ac-tions. It should be customizable to individual needs. These results will form the basis for a prototype. Iterative development and validation will aim to make LiSA accessible in the public domain as a reliable tablet-based system for self-assessment.
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