Article
Older adults’ perception of and interaction with digital health technologies in a guided lifestyle intervention for Type 2 Diabetes and chronic ischaemic heart disease: results from a qualitative study of LeIKD
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Authors
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Felix Freigang
- Privates Institut für angewandte Versorgungsforschung GmbH, Berlin, Deutschland
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Janosch Krotz
- Privates Institut für angewandte Versorgungsforschung GmbH, Berlin, Deutschland
| Published: | September 25, 2020 |
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Outline
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Background and current state of (inter)national research: Digital health technologies provide novel means for self-monitoring and the promotion of health information. However, age as a moderating factor for the employment of digital health technologies remains understudied. The randomized controlled trial LeIKD (DRKS00015140) aims to assess the potential of a combined exercise/nutrition telemedical lifestyle intervention program for Type 2 Diabetes Mellitus (T2DM) and Chronic Ischaemic Heart Disease (CIHD). We report on qualitative trial data demonstrating how older program participants perceive, articulate barriers to, and interact with digital health technologies such as smartphone apps and digital pedometers.
Research questions and objectives: How do older participants of a telemedical lifestyle intervention program for T2DM and CIHD interact with digital health technologies?
Methods: Seven program participants (age 52 to 71) with varying background in using digital technologies participated in an initial focus group discussion. A guide for semi-structured interviews was designed based on the explorative focus group results. Eleven subsequent semi-structured interviews were conducted with other program participants (age 58 to 79). In-depth content analysis was then applied to the interview material, focusing on the participants’ perceived barriers and facilitators for using the digital technologies. Sample limitations will be addressed.
Results: Three main barriers for older participants’ interaction with the digital health technologies have been identified:
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- problems in understanding the technological affordances;
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- difficulties in managing interoperability;
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- difficulties in assessing the quality of self-monitoring data.
The interview material suggests, however, that older participants’ technological pre-knowledge and a supportive social environment are pivotal for a successful employment of digital health technologies.
Discussion: The ways in which older adults benefit from telemedical lifestyle intervention programs that employ digital health technologies to support individual self-monitoring practices and/or to provide health information depends chiefly on their ability to navigate the technologies at hand. Prior knowledge and curiosity as well as a supportive social environment are among the contextual factors that contribute to a successful adoption of and regular interaction with digital health technologies in older adults. Digital literacy can not be taken for granted.
Practical implications: Our findings may have implications for researchers and health care providers planning and improving telemedical lifestyle intervention programs for older adults that make use of digital health technologies. For instance, in order to assess participants’ digital literacy, their affinity for technologies should be tested upon intervention start using a standardized questionnaire (e.g., TA-EG). Furthermore, and possibly depending on the test results, a guided initialization phase should support the participants in learning to use the technological devices.
