Presentation
DH15 - Understanding Information Management and Technology Use Among Older Veterans in Arizona: A Focus Group Study
SessionPoster Session 2
DescriptionAdvancements in Technology are rapidly transforming various industries, with innovations reshaping the way we interact, work, and access services (Hunter et al., 2023.) The growing availability of innovative and affordable Internet of Things (IoT) devices, particularly wearables and smart technologies like smartphones and digital home assistants, enhances daily efficiency, health monitoring, social engagement, and home automation (Harris et al., 2022). They also offer extensive opportunities for regular monitoring of cognitive, social, emotional, and health indicators by providing real-time alerts and personalized recommendations for self-managed care (Heo et al., 2015).
These technologies can benefit older veterans significantly because of their unique physical and physiological challenges. Older veterans are more likely to have physical disabilities (such as vision or mobility impairments), cognitive disabilities (due to PTSD, traumatic brain injury, etc.), and sleep disorders (Agha et al., 2000) Aging is one of the most common and complex challenges that people are facing and can include chronic health issues, mobility issues, and the need to maintain social connectedness. Related to aging, a concern that comes with advancing technologies is the digital divide between younger and older populations and a lack of understanding of how older populations can get acquainted with these technologies that might help them with managing information, accessing services, and connecting with others (Luger et al., 2016). Older adults and older veterans differ in certain unique ways due to their training, interaction with technology, strict data-sharing policies, and time to adapt to technological progress ( Amanda et al., 2016 ). Many veterans have varied exposure to technological advancements during their service, which can potentially influence their current technology management. Veterans have access to a distinct healthcare system with its own technological infrastructure and challenges (Rasmussen et al., 2023), such as navigating complex electronic health records (EHRs), issues with the interoperability of systems across VA and non-VA care providers, making it harder to coordinate care effectively. These challenges impact their use of technology and are problematic as this population may have the most to gain from these technologies. Thus, it becomes critical to identify the factors that hinder the use of technology and design technological solutions so that older veterans can quickly adapt to improve their functionality, experience, and performance.
The main aim of this study is to understand the specific challenges older veterans in metropolitan Phoenix, Arizona face and to assess whether there could be a data-driven, IoT-based solution for high-quality, low-cost, socially relevant self-managed care. To do so, we needed a better understanding of how older veterans in the Phoenix metropolitan area currently manage their health information and well-being-associated activities and currently use information technologies from paper calendars to smart devices. We adapted data gathering and transformation processes from the Contextual Design methodology (Beyer & Holtzblatt, 1998), which focuses on understanding current work processes and the need to develop tailored solutions. Our overarching research question was how older veterans perceive and use technology in their day-to-day lives and what insights can be derived to develop an IoT-based solution to ease information.
The interview question items were designed to elicit observations or insights about participants’ daily technology usage, perceptions and experiences of existing solutions, their goals and goal-setting practices, the importance and role of their family and friends in technology usage, and the physical, emotional, and social barriers they face in managing their health and health information. Seven focus groups and one workshop were conducted with 20 older veterans, 7 care partners, and 7 healthcare physicians. Three project team members served as moderators to drive the focus group sessions. The interviews were audio recorded, initially transcribed using Zoom, checked for accuracy, and edited manually as needed. Data cleaning of the revised transcripts was completed in Google Sheets to organize relevant utterances from the interviews, highlight novel qualitative insights, categorize them, and prepare them for further analysis. After completing this for each of the seven focus group transcripts, a virtual design session was held on Zoom with 8 project team members representing the different disciplinary backgrounds involved in this project: psychology, computer science, and human systems engineering. The diversity of the project team members involved in the design session helped to gather multiple perspectives.
The design session started by briefly reviewing highlights from each of the transcripts via screenshare. Next, the group used Miro, a collaborative software platform, to collectively create digital “sticky notes” that visualized insights from the interview data so that they could be discussed and then grouped into different themes and patterns that informed our research objective in an abridged affinity diagram. Affinity diagramming was used to identify recurring themes, patterns, and opportunities to enhance technology management and user experience for older veterans. Abductive reasoning was applied to generate hypotheses. Common themes or patterns that arose from our affinity diagram include barriers to adoption due to complexities and overwhelm, skepticism and trust issues, privacy concerns, limited adaptability to technology. This task helped us to understand the unmet needs and expectations of older veterans and the areas where there is scope for technological improvements.
Next, based on our insights derived from the transcripts and affinity diagram, work models (Beyer & Holtzblatt, 1998) were constructed to help us understand the user workflows, how the users interact with various technological devices, factors that influence their use, and how technology is integrated into their daily lives. Given our project focus and abridged project timeline, three work models were selected: the cultural model visualizes the cultural barriers and perceptions of technological use, analyzing positive and negative effects for each factor and suggesting potential interventions for each negative effect; the artifact model focused on mapping various social media apps and technologies that older veterans used, identifying where they encounter challenges; the sequence model identified the steps to perform a particular task, like creating an account for an online app/platform, and analyzed to see where inefficiencies occurred. Each of these models focused on the relationship between technology and aging and was designed to highlight the specific barriers, behaviors, and needs of the older veterans’ group, offering a deeper understanding of how cultural, social, and technological factors converge to influence their interactions with technology.
Information management and technology use among older adults is well-studied and has abundant practical applications. However, the specific subgroup of older veterans remains under-researched. The study aims to explore this demographic's knowledge gap regarding technology usage. The results from our initial design session highlighted a few critical areas for improvement in designing and implementing technological systems for our specific population. Affinity diagrams allow for a more nuanced understanding of older veterans’ specific experiences and challenges with technology, unlike the traditional qualitative analysis methods that mainly rely on statistical or generalized data. The qualitative analysis through affinity diagrams is particularly useful (Courage & Baxter, 2007) because it captures rich and subjective insights like participants' emotions, personal experiences, and perspectives on the challenges related to lack of information and knowledge that leads to overcoming distrust in technology. Work models helped us understand specific breakdowns in older veterans’ technology use, such as difficulties navigating complex interfaces and reliance on support systems. This perspective is crucial for understanding how older veterans integrate technology into their lives, which is often influenced by their unique backgrounds and service experiences. Furthermore, while many studies on technology use among older adults may focus on usability testing or user satisfaction surveys, the combination of affinity diagrams and work models offers a more diverse and comprehensive perspective (Cha et al., 2023) by addressing both personal and systemic challenges in technology use.
These technologies can benefit older veterans significantly because of their unique physical and physiological challenges. Older veterans are more likely to have physical disabilities (such as vision or mobility impairments), cognitive disabilities (due to PTSD, traumatic brain injury, etc.), and sleep disorders (Agha et al., 2000) Aging is one of the most common and complex challenges that people are facing and can include chronic health issues, mobility issues, and the need to maintain social connectedness. Related to aging, a concern that comes with advancing technologies is the digital divide between younger and older populations and a lack of understanding of how older populations can get acquainted with these technologies that might help them with managing information, accessing services, and connecting with others (Luger et al., 2016). Older adults and older veterans differ in certain unique ways due to their training, interaction with technology, strict data-sharing policies, and time to adapt to technological progress ( Amanda et al., 2016 ). Many veterans have varied exposure to technological advancements during their service, which can potentially influence their current technology management. Veterans have access to a distinct healthcare system with its own technological infrastructure and challenges (Rasmussen et al., 2023), such as navigating complex electronic health records (EHRs), issues with the interoperability of systems across VA and non-VA care providers, making it harder to coordinate care effectively. These challenges impact their use of technology and are problematic as this population may have the most to gain from these technologies. Thus, it becomes critical to identify the factors that hinder the use of technology and design technological solutions so that older veterans can quickly adapt to improve their functionality, experience, and performance.
The main aim of this study is to understand the specific challenges older veterans in metropolitan Phoenix, Arizona face and to assess whether there could be a data-driven, IoT-based solution for high-quality, low-cost, socially relevant self-managed care. To do so, we needed a better understanding of how older veterans in the Phoenix metropolitan area currently manage their health information and well-being-associated activities and currently use information technologies from paper calendars to smart devices. We adapted data gathering and transformation processes from the Contextual Design methodology (Beyer & Holtzblatt, 1998), which focuses on understanding current work processes and the need to develop tailored solutions. Our overarching research question was how older veterans perceive and use technology in their day-to-day lives and what insights can be derived to develop an IoT-based solution to ease information.
The interview question items were designed to elicit observations or insights about participants’ daily technology usage, perceptions and experiences of existing solutions, their goals and goal-setting practices, the importance and role of their family and friends in technology usage, and the physical, emotional, and social barriers they face in managing their health and health information. Seven focus groups and one workshop were conducted with 20 older veterans, 7 care partners, and 7 healthcare physicians. Three project team members served as moderators to drive the focus group sessions. The interviews were audio recorded, initially transcribed using Zoom, checked for accuracy, and edited manually as needed. Data cleaning of the revised transcripts was completed in Google Sheets to organize relevant utterances from the interviews, highlight novel qualitative insights, categorize them, and prepare them for further analysis. After completing this for each of the seven focus group transcripts, a virtual design session was held on Zoom with 8 project team members representing the different disciplinary backgrounds involved in this project: psychology, computer science, and human systems engineering. The diversity of the project team members involved in the design session helped to gather multiple perspectives.
The design session started by briefly reviewing highlights from each of the transcripts via screenshare. Next, the group used Miro, a collaborative software platform, to collectively create digital “sticky notes” that visualized insights from the interview data so that they could be discussed and then grouped into different themes and patterns that informed our research objective in an abridged affinity diagram. Affinity diagramming was used to identify recurring themes, patterns, and opportunities to enhance technology management and user experience for older veterans. Abductive reasoning was applied to generate hypotheses. Common themes or patterns that arose from our affinity diagram include barriers to adoption due to complexities and overwhelm, skepticism and trust issues, privacy concerns, limited adaptability to technology. This task helped us to understand the unmet needs and expectations of older veterans and the areas where there is scope for technological improvements.
Next, based on our insights derived from the transcripts and affinity diagram, work models (Beyer & Holtzblatt, 1998) were constructed to help us understand the user workflows, how the users interact with various technological devices, factors that influence their use, and how technology is integrated into their daily lives. Given our project focus and abridged project timeline, three work models were selected: the cultural model visualizes the cultural barriers and perceptions of technological use, analyzing positive and negative effects for each factor and suggesting potential interventions for each negative effect; the artifact model focused on mapping various social media apps and technologies that older veterans used, identifying where they encounter challenges; the sequence model identified the steps to perform a particular task, like creating an account for an online app/platform, and analyzed to see where inefficiencies occurred. Each of these models focused on the relationship between technology and aging and was designed to highlight the specific barriers, behaviors, and needs of the older veterans’ group, offering a deeper understanding of how cultural, social, and technological factors converge to influence their interactions with technology.
Information management and technology use among older adults is well-studied and has abundant practical applications. However, the specific subgroup of older veterans remains under-researched. The study aims to explore this demographic's knowledge gap regarding technology usage. The results from our initial design session highlighted a few critical areas for improvement in designing and implementing technological systems for our specific population. Affinity diagrams allow for a more nuanced understanding of older veterans’ specific experiences and challenges with technology, unlike the traditional qualitative analysis methods that mainly rely on statistical or generalized data. The qualitative analysis through affinity diagrams is particularly useful (Courage & Baxter, 2007) because it captures rich and subjective insights like participants' emotions, personal experiences, and perspectives on the challenges related to lack of information and knowledge that leads to overcoming distrust in technology. Work models helped us understand specific breakdowns in older veterans’ technology use, such as difficulties navigating complex interfaces and reliance on support systems. This perspective is crucial for understanding how older veterans integrate technology into their lives, which is often influenced by their unique backgrounds and service experiences. Furthermore, while many studies on technology use among older adults may focus on usability testing or user satisfaction surveys, the combination of affinity diagrams and work models offers a more diverse and comprehensive perspective (Cha et al., 2023) by addressing both personal and systemic challenges in technology use.
Event Type
Poster Presentation
TimeTuesday, April 14:45pm - 6:15pm EDT
LocationFrontenac Foyer