Self-management via Health Kiosk by Community-residing Older Adults

University Of Pittsburgh At Pittsburgh, Pittsburgh PA

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Abstract

DESCRIPTION (provided by applicant): Many potentially effective e-health technologies fail to enjoy widespread adoption by older adults due to the dearth of accessible, user-friendly, delivery platforms. Multi-user health kiosks located in convenient community locations offer a way to bolster older adults' self-management capabilities and enhance communication with their PCPs, regardless of personal resources or distance from health services. This project entails investigation of older adults' perceptions of, motivations to use, and patterns of use of an adaptive, community-based, multi-user health kiosk. The overarching objective is to understand factors influencing older adults' use of the health kiosk as a measurement and intervention delivery system, relative to their identified needs for a healthier lifestyle and improved self-management of chronic disease. Kiosks capable of adaptive interaction with users will be deployed in nine congregate sites in southwestern Pennsylvania, enabling older adults to measure and track their own physical, physiological, and psychological data, communicate through secure messaging with primary care providers, and engage with e-health interventions designed to improve self-management, patient-provider communication, sleep, mobility and balance, physical activity and nutrition, bladder health, and mood. The specific aims of the project are to (1) describe the self-management needs, motivations, design preferences, and patterns of health kiosk use among diverse community-residing older adults in congregate settings; (2) determine factors that influence intensity of kiosk use among older adults with a range of needs for a healthier lifestyle and improved self-management of chronic disease; and (3) explore use of primary care, emergency room visits, and hospitalization during kiosk access. Over 18 months of study participation, older adults' interactions with the kiosk and the kiosk's adaptations to its users will be tracked. Frequent queries will explore motivations for using the kiosk and preferences for its interface design and content. Congruence will be evaluated between needs identified at baseline, 6, 12, and 18 months and use of kiosk measures and modules throughout the study. Assessment of self-management confidence and capability and healthcare use will also occur at 6, 12, and 18 months. Factors influencing differences in intensity of kiosk use and differences in the change in healthcare use based on levels of intensity will be examined. In-depth interviews will be conducted with a subsample of ten individuals per site (n=90) purposively selected to represent high and low intensity kiosk users and those with high and low levels of need.