Technology Devices for Older Adults to Aid Self Management of Chronic Health Conditions
Amritpal Singh Bhachu, Nicolas Hine, John Arnott · 2008 · Proceedings of the 10th International ACM SIGACCESS Conference on Computers and Accessibility (Assets '08) · doi:10.1145/1414471.1414484
Summary
This University of Dundee study investigates older adults' opinions and attitudes toward technology devices that could be used as part of a telecare system for self-managing chronic health conditions. The research was conducted through technology evaluation workshops with a group of older adults (around 60 years and over) from diverse backgrounds including former office workers, manual workers, and an ex-nurse. Participants were introduced to six commercially available devices — a 15-inch touch screen, a digital wireless photo frame, an iPod Touch, a Nokia N95 mobile phone, a Samsung Q1 tablet PC, and an HP iPAQ PDA — and asked to evaluate them for both general usability and suitability for displaying health data. Sample healthcare webpages showing health indicators and trend graphs were demonstrated on each device. The study used Grounded Theory and Thematic Coding methodologies to analyze data collected from flipchart notes, concept maps, facilitator observations, and HD video recordings of group discussions. The workshop was split into morning (general device usability) and afternoon (healthcare-specific) sessions.
Key findings
Several key themes emerged across all devices. Display and icon size were recurring problems — even the 15-inch touch screen was considered to have icons that were too small. The group consistently prioritized portability over screen size, preferring the iPod Touch and Samsung Q1 despite smaller displays. A significant finding was the fear of "breaking" devices, which decreased as participants handled them, suggesting hands-on experience is essential for technology adoption. Social stigma was a dominant concern for health devices: participants compared eAR sensors to early hearing aids that "were so bulky and they felt ashamed," and wanted health devices designed as jewelry, skin-toned, or disguised as fashion items. They suggested that devices designed by major fashion labels would make them more acceptable. Privacy was also critical — participants worried about visitors seeing health data displayed on photo frames or TVs, discussing "locking the screens" and placing devices away from visitor areas. Regarding health data itself, participants expressed concern about becoming obsessive about readings, and noted that data must be contextualized for each individual — "for some people it is enough to just see good or bad." Despite concerns, all were positive about technology for health management: one heart attack survivor said he would "jump through hoops" if doctors recommended it.
Relevance
This study provides essential user-centered insights for designing health technology for older adults with chronic conditions. The findings around stigma, privacy, and data anxiety directly inform how health monitoring devices should be designed and deployed. For accessibility practitioners, the research highlights that older adults are not technology-averse but have specific requirements: devices must be aesthetically acceptable, discreet, use large icons with clear labels, allow experimentation without fear of damage, and present health data in contextualized rather than raw form. The emphasis on social and emotional factors — stigma of wearing health devices, fear of breaking technology, anxiety about health readings — challenges the purely functional approach often taken in assistive technology design. The finding that participants preferred learning touch screens over mice, and that mobile phone technology was already familiar to many, suggests building telecare solutions on existing consumer devices rather than specialized medical equipment.
Tags: aging · telecare · self-management · health technology · older adults · chronic illness · data visualization · user research · grounded theory · participatory design