The concept of Enhanced Activities of Daily Living (EADL) recognizes that older adults engage in activities that go beyond the basic and instrumental ADLs. EADLs contribute to health, well-being, and social engagement, which are critical for successful aging. However, they are understudied using the ADL framework, including what older adults consider EADLs. We conducted an online survey wherein participants chose four EADLs from 31 activities (e.g., arts and crafts, working, hiking) developed based on the literature and prior interviews. Then, they rated their satisfaction and challenges for each activity (1 = strongly disagree to 5 = strongly agree). The final sample was 106 participants (age M = 70.6, SD = 6, range=60-92) who were 66% female, 86% with a bachelor’s or higher degree, and 87% White. Half had an impairment in vision, hearing, mobility, or cognition (53%). Most participants chose from the activities provided, with only 14 of 424 responses (3%) selecting others. We identified two new activities from the open-ended responses for others (family time, spiritual or religious). The most frequently chosen activities were exercise (n = 35), followed by reading (n = 28), volunteering (n = 28), and music (n = 27). Participants were generally satisfied (M = 4, SD = 0.5) and reported few challenges to engaging in EADLs (M = 1.8, SD = 0.5). In conclusion, despite the diversity in our sample’s functional capacity, our activity list was comprehensive, and participants showed high EADL satisfaction. These data provide insights about the range of activities that contribute to the quality of life for older adults and will guide the development of an EADL satisfaction measurement scale.

The likelihood of developing a cognitive impairment (CI) increases with age. Older adults with CI experience difficulties performing a range of everyday activities and are at risk for social isolation. Technology-based interventions have the potential to improve everyday functioning. Artificial intelligence capabilities can be harnessed to tailor solutions to the unique and changing needs of older adults with CI. Most prior efforts focused on cognitive training or rehabilitation but have not included other aspects of functioning such as everyday activities or social engagement. Our goal is to develop and evaluate an innovative intelligent adaptive software system to support personal activities and reinforce cognition (SPARC). The system will be designed to adapt to the needs and abilities of the user with CI, following the CREATE model of user-centered design. We started with interviews with subject matter experts to assess older adults’ needs for activity support in their homes and identify potential technology solutions. We interviewed both clinicians and technical experts to obtain guidance for the initial system design. In this presentation, we will present results of focus group interviews with older adults who have CI wherein we present prototype images of SPARC and explore their perceptions of usefulness, ease of use, preferences for instructional support, and ideas for specific content that would be of interest to them. This multi-faceted needs assessment approach will guide design of SPARC to support everyday activities, primarily in the home environment. Our findings inform design of other technologies and interventions to support older adults with CI.

Social isolation affects nearly one in four older adults, and virtual reality (VR) has emerged as a promising tool for fostering social connection and engagement. To better understand its potential, we have conducted a needs assessment study with older adults to explore the usability, acceptance, and perceived benefits of VR applications across multiple sites. Analysis of the data from one site (n = 16, aged 65–79, M = 71.56, SD = 4.18) showed that majority of the participants (88%) rated enjoyability, engagement, and appeal between 7 and 10 on a 10-point scale, indicating strong enthusiasm for VR as a novel technology offering a fun alternative to support cognitive engagement and leisure activities. Additionally, participants emphasized the social potential of VR and its ability to facilitate meaningful connection with distant family members, particularly grandchildren, through gaming and collaborative activities. They expressed excitement about experiences that transcend physical limitations, such as virtual travel, noting that immersive VR offers a compelling alternative for exploring new places with friends and family as travel becomes difficult with age. Participants also preferred interactive over passive experiences, highlighting a desire for activities that enabled active engagement within the VR environment. Although some participants initially found the VR applications challenging due to unfamiliarity, they emphasized the need for practice rather than additional training. Many expressed a willingness to adapt and highlighted the importance of home access to support continued use. These findings challenge ageist assumptions about older adults and technology, underscoring the need for inclusive VR design that enhances engagement and quality of life.

Many people aging with mobility disabilities experience barriers engaging in exercise programs and social events in-person and could benefit from virtual programs that make participation more accessible. The Tele Tai Chi clinical trial is assessing the acceptability and effectiveness of an evidence-based in-person Tai Chi program for older adults, Tai Chi for Arthritis and Fall Prevention (seated version), when adapted to be an online group intervention (via videoconferencing) with moderated social time for individuals aging with mobility disabilities. Specifically, we are examining the intervention efficacy for the target population for increasing physical activity and social connectedness, which are the primary outcome measures. Secondary outcome measures include exercise self-efficacy, falls efficacy, depression, quality of life, and pain. The participant sample (N = 60) includes community-dwelling adults (60-77 years of age) with a self-identified mobility disability (i.e., using a mobility aid or having serious difficulty walking or climbing stairs) for at least 10 years. Follow-up assessments occurred at the end of the 8-week intervention and 1 month thereafter. This methods-focused paper highlights our novel, user-centered, technology-mediated approach to adapting an in-person intervention for individuals aging with mobility disabilities, which can be used as a roadmap for researchers and practitioners launching similar trials or programs. ClinicalTrialsgov no:NCT04696887.

Background: Digital home assistants can support older adults with a range of daily activities and reduce their needs for support. These benefits are only possible if the older adults can successfully learn how to use them and maintain their use over time. Research is needed to explore older adults’ perspectives on learning to use digital home assistants to uncover the factors that influence their experience. Research aim: The purpose of this study was to explore the perspectives of older adults regarding the factors that impacted their experience learning to use digital home assistants. Methods: Participants were 35 community-dwelling older adults between the ages of 60 and 81 who reported owning a digital home assistant. This mixed-method study included questionnaires (demographics, technology experience, mobile device proficiency, technology readiness, digital home assistant usage), and a semi-structured interview designed to explore participants’ attitudes, experiences, and preferences for learning to use their device based on components from the Personalized Instruction and Continued Support (PICS) Framework (i.e., user profile, environmental characteristics, and technology characteristics; Blocker, 2022). Results: Participants discussed facilitators and barriers related to their user profile (abilities, age, attitudes and motivations); environmental characteristics (stressors, learning environment, social support); and technology characteristics (complexity, novelty, usability). Perceived barriers included instructions not being designed for their age group, memory demands, stress and distraction, lack of social support, as well as technology novelty and complexity. Perceived facilitators included general technology proficiency; expectations from others; benefits of use; ease of use; learning efficiency and memorability; as well as satisfaction and enjoyment of use. Conclusions: The findings highlighted the need to increase the availability of education and training to support older adults’ use of smart home technologies. We have provided guidelines developed from the results to provide direction for the design of instructional protocols, including specifications for intelligent instructional software.

Tai chi is a mind-body exercise that involves a series of slow gentle movements, meditation, and controlled breathing. It has been shown to have a variety of evidence-based benefits, including improvements in balance, mobility, strength, flexibility, and relaxation, as well as reductions in falls, depression, and pain. While tai chi programs have grown in popularity and availability for older adults, many adults aging with mobility disabilities experience barriers participating in these exercise classes, including lack of transportation, appropriate exercise modifications, and building accessibility. The TechSAge Tele Tai Chi intervention was designed to address these barriers with 1) an evidence-based tai chi program (Tai Chi for Arthritis) that offers modifications appropriate for our target population (e.g., seated, movement adaptations) and 2) a translation to an interactive, online class via Zoom videoconferencing. We chose Tai Chi for Arthritis because it is a Title III-D (Highest Tier) Evidence-Based Health Promotion/Disease Prevention Program, endorsed by the Administration for Community Living. The intervention also includes moderated social time before and after the lesson as this population is at increased risk for social isolation. In this session, we will present outcomes from the 8-week clinical trial conducted with small-group cohorts of community-dwelling older adults aging with mobility disabilities (N = 60). Significant outcomes include increases in physical activity and social connectedness and decreases in loneliness. The findings of the clinical trial provide evidence that older adults with mobility disabilities can receive physical and social benefits from a group online tai chi program.

Background: Digital home assistants (DHAs) can provide support for a wide range of everyday activities. They may be particularly useful for people who are aging, especially those with mobility disabilities, as they are voice-activated. However, barriers such as concerns about privacy could prevent older users from taking advantage of the full po- tential of DHAs. Research Aim: Understanding the attitudes of those aging with mobility disabilities re- garding privacy and DHAs. Methods: Participants were 14 community-dwelling older adults who self-identified as having a long-term mobility disability (i.e., 10 years or more). This mixed-method study included questionnaires and a semi-structured interview administered after 10 weeks of using a DHA. Results: Participants reported using their DHAs for a range of activities, including sup- porting leisure, hobby, entertainment, and health monitoring and maintenance activities. Most had at least some knowledge about how their device worked and how it stored and used their data. Most participants held the belief that control over their personal informa- tion was important and that privacy was highly valued. They expressed nuanced attitudes about privacy issues related to their DHAs. Privacy themes included the idea that their data was not of interest or value; there are no conspiracies directed toward data; there is a need to build confidence or trust with a device and an acknowledgement and acceptance of some risk. A common theme among participants was their appreciation for the benefits of using DHAs despite concerns about privacy risks. Conclusions: Older adults with long-term mobility disabilities reported using their DHAs for a wide variety of activities and perceived benefits from doing so. They reported a range of attitudes about privacy, from a lack of concern to some strong concerns. The findings suggest that increased education and training about privacy risks and protective strategies could facilitate use, given the high value participants placed on privacy.

As people live longer with disabilities acquired early in life, the additive effects of aging create unique challenges at the intersection of aging and disability. Technology interventions can minimize barriers and create facilitators to support performance of activities integral to health and quality of life. The absence of a theoretical framework to guide such interventions, in either gerontology or rehabilitation, created gaps in the knowledge base required to meet the needs of these individuals. We proposed the TechSAge Technology Intervention Model (TechSAge-TIM) to support activity engagement of older adults aging with long-term disabilities through technology design that bridges the gap between intrinsic capabilities and functional abilities (Mitzner, T. L., Sanford, J. A., & Rogers, W. A. (2018). Closing the capacity-ability gap: Using technology to support aging with disability. Innovation in Aging, 2(1), igy008. https://doi.org/10.1093/geroni/igy008). We have since utilized the model to advance understanding of technology-based supports for persons aging with long-term mobility, hearing, and vision disabilities. We describe herein applications involving people with mobility disabilities. We identified unmet needs by exploring lived experiences and used the TechSAge-TIM to guide research and development of a seated Tele Tai Chi program for exercise/social engagement, smart bathroom technologies, and an automatic fall detection system for wheelchair users. These applications advanced the field of aging and disability and provided a roadmap for future research and development efforts.

Background and Objectives There are growing numbers of older adults with long-term vision impairment who are likely to experience everyday activity challenges from their impairment in conjunction with age-related changes. Technology has potential to support activity engagement. To develop effective technologies and interventions, we need to understand the context of activity challenges and identify unmet support needs. Research Design and Methods The Aging Concerns, Challenges, and Everyday Solution Strategies (ACCESS) study is a mixed-method approach to explore everyday challenges of people aging with long-term disabilities. Participants included 60 adults aging with long-term vision impairment (63% female; M age = 67, SD = 4.6) who completed in-depth, structured interviews exploring the nature of everyday challenges and their unmet support needs for activity engagement. We conducted a content analysis using a deductive and inductive approach to build a detailed coding scheme of challenge codes and subcodes. Results The analyses provided detailed insights about the nature of challenges people aging with vision impairment experience when performing specific instrumental activities of daily living (IADLs) in the context of home maintenance, transportation, shopping/finance, and managing health. Vision-related challenges and participation restrictions were identified for several activities that require reading, navigation, and identification (e.g., shopping, medication management, public transportation). Emergent challenge themes for performing IADLs included personal limitations (e.g., physical, cognitive, financial) and environmental barriers (e.g., accessibility, technology, transportation). Discussion and Implications Contextual examples of IADL challenges among individuals aging with vision impairment highlight opportunities for technology design and innovation to support participation in everyday activities.

Abstract Long-term adoption of technology is influenced both by the design of the technology itself as well by the users’ attitudes towards the technology. Technology acceptance models have long indicated that individual differences in perceptions of ease of use and perceptions of usefulness are critical predictors of acceptance and use. Additional predictive factors include perceived enjoyment, facilitating conditions (e.g., instructional materials, social support), demographics (e.g., age, sex) and psychographics (e.g., personality, technology readiness). For PRISM 1.0 and PRISM 2.0 we implemented mixed methods to assess technology acceptance factors. We adapted standard survey measures of technology acceptance that were administered at baseline and after extended system use. We developed an interview that was administered at the end of the study to explore usage patterns, preferences, facilitators and barriers. Data from the technology acceptance assessments from PRISM 1.0 informed redesign decisions for the PRISM 2 system. We will present an overview of the quantitative and qualitative data to illustrate the value of the mixed methods approach and to provide insights about acceptance and adoption of novel technology system to older adults.

Abstract ‘Telewellness’ programs use technology (e.g., video conferencing software) to facilitate remote participation in exercise classes. These programs hold great potential to expand access to physical and mental health benefits of group exercise classes for older adults, especially those with mobility disabilities. We translated the Tai Chi for Health Institute’s in-person, evidence-based tai chi program, Tai Chi for Arthritis, to be a virtual experience (via Zoom) that is both socially engaging and inclusive of people with a mobility disabilities. The ‘Tele Tai Chi’ clinical trial (NCT04696887) explored to what extent this program may increase social interaction and positive health behaviors among older adults with long-term mobility disabilities; data analysis is in progress. The next phase of this project is focused on delivering our Tele Tai Chi program in real world, community-based settings (e.g., senior centers, senior living communities). This session will present findings from interviews with subject matter experts (e.g., senior center coordinators, administrators from Area Agencies on Aging, tai chi instructors) on perceived barriers to delivering Telewellness classes (e.g., safety, staffing, demands, technical support), as well as potential facilitators to address them. We will also discuss the need for different models of Telewellness (e.g., hybrid classes with attendees both in-person and online) that align with the community’s unique characteristics, preferences, and support needs.

Abstract Individuals aging with long-term mobility disabilities encounter a range of significant barriers to participating in physical and social activities, from challenges with transportation, to lack of accessibility and access to appropriate instruction. We developed a Tai Chi telewellness intervention to facilitate both physical and social wellness through accessible, virtual group classes. The intervention translated an in-person, evidence-based tai chi program (Tai Chi for Health Institute’s Tai Chi for Arthritis) to be 1) a virtual experience (via Zoom) that includes a social component and 2) accessible and appropriate for those aging with mobility disabilities. We conducted the TechSAge Tele Tai Chi clinical trial to examine the effect of the intervention on physical activity and social connectedness (primary outcomes), as well as exercise self-efficacy, falls efficacy, depression, quality of life, and pain (secondary outcomes) for this population. The participant sample was community-dwelling adults (60-80 years of age) with a self-identified mobility disability (i.e., using a mobility aid or having serious difficulty walking or climbing stairs) for at least 10 years. The presentation will describe the rationale for the study, as well as the study design, methodology, and baseline data for the trial. We will also highlight the user-centered, iterative design approach we used in the design and evaluation of the intervention protocol.

ISSUE Gerontechnologies have potential to improve the wellbeing of aging adults, yet there is a significant lag in adoption of technology by older cohorts.Part of the reason may lie in inefficient strategies for disseminating research and product development to end users: aging adults living in communities.CONTENT Our symposium will discuss strategies adopted by university-specific and federally-funded USA Centers to disseminate research findings both to the scientific community and to aging populations.It will highlight: 1) methodologies in common across centers; 2) different challenges for locally funded and nationally funded centers; and 3) evaluation processes to assess dissemination plans and strategies.STRUCTURE Czaja discusses the evolution of the CREATE center, a five-times funded (National Institutes of Health) interdisciplinary group with over 20 years of experience in humanfactors-guided development of gerontechnology.Boot discusses the dissemination plan in a new Rehabilitation Engineering Research Center, ENHANCE, funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR), that provides formal training about product development and marketing to principal investigators.Sanford discusses a mature NIDILRR center, TechSAge, and provides examples of how TechSAge disseminates its findings.Charness discusses the mission of the Institute for Successful Longevity, a relatively young university-based Center, and how it provided community support during the initial lockdown stage of the COVID-19 pandemic.Finally, Rogers discusses a relatively new University center, CHART, and the role of partnerships in developing community linkages.CONCLUSION Bridging the gulf between academic research and product development requires linking academic research, product developers, and community members to ensure that gerontechnologies suit diverse aging populations.We provide specific examples of how both academic and federally funded research centers can develop effective dissemination strategies to ensure that both developers and aging adults partner effectively in the development and dissemination of gerontechnology products.Such partnerships are crucial for bridging the digital technology divide.

Vision loss can impact the health of older adults on multiple domains, including physically (e.g., mobility challenges), psychologically (e.g., depression), and socially (e.g., isolation). Older adults with vision loss, and particularly those with long-term vision loss, are likely to experience challenges in performing Instrumental Activities of Daily Living (IADLs), as these activities often require abilities like reading, fine motor movements, and navigating. We conducted structured interviews with 60 older adults aged 60-79 with vision loss for at least 10 years about their challenges with select IADLs (e.g., household tasks, transportation, shopping, finances, and managing health). An analysis of in-depth interview data revealed specific challenge themes associated with engaging in different IADLS, such as challenges with accessibility, physical limitations, assistance from others, communication, and finances. Findings highlight opportunities for technology solutions to support IADL participation and independence for people aging with vision loss.

Telehealth holds much potential for supporting older adults' physical and social health. In particular, telewellness interventions to support the physical and social wellness of older adults are needed to overcome participation barriers with in-person programs. This paper presents guidelines for delivering telewellness interventions to older adults, which were informed by a human factors approach to developing a Tele Tai Chi intervention for older adults with mobility disabilities, including reviewing user needs literature and conducting user-centered needs assessment research. From these findings, we developed a protocol and support materials for delivering a telewellness intervention and conducted a feasibility study. We also established an adaptation committee to provide recommendations on the intervention. The outcome of our human factors approach was the establishment of research-driven design guidelines for delivering group exercise programs to older adults using videoconferencing. The guidelines provide direction for designing a telewellness protocol, supporting remote participation, and promoting socialization and engagement. These guidelines can be used to deliver interventions that increase access to socially-engaging, physical activity programs for older adults, which can ultimately help support their physical health, mental health, and quality of life.

Many older adults, particularly those with mobility disabilities, experience barriers to participation in exercise classes, including lack of accessibility and transportation. Tele-technologies (e.g., Zoom) provide an opportunity to facilitate both physical and social wellness through remote group classes. We developed the TechSAge Telewellness tool to provide guidelines for designing wellness classes delivered via video-conferencing for older adults with and without disabilities. The protocols and guidelines presented within it have been tested for usability and acceptance with older adults with long-term mobility disabilities. Throughout the tool, we present examples from the TechSAge Tele Tai Chi study as a case study to provide helpful insights on developing a Telewellness program. The tool includes guidance on selecting a software, safety considerations, class organization and logistics, social time, and tech support. The contents of the tool provide insights for research and design regarding telehealth technology, as well as health and wellness interventions.

Mobile applications are high-potential tools to aid in the self-management of health and behavioral change, especially for those with chronic health conditions. Though mHealth applications are easily accessible, there may be barriers to adoption, particularly for older adults disproportionally affected by chronic health conditions. We undertook a human factors approach to designing instructional materials to comprehensively guide older adults in utilizing features within MEDSReM, an mHealth application that supports self-management of hypertension. The instructional materials will support older adults in learning to use MEDSReM by reducing the cognitive burden when onboarding and using features available within the system. The systematic approach presented can serve as a model for designing a wide variety of mobile applications for older adult users.

Abstract Discovering a composite of measures of executive function/working memory predicted everyday medication adherence among older adults, led to the development of a behavioral intervention, the Multifaceted Prospective Memory Intervention (MPMI) to improve hypertension medication adherence. The intervention resulted in a 35% improvement in adherence compared to an active education and attention control condition. However, adherence slowly declined over an additional five months of adherence monitoring without the presence of interventionists in the home. We proposed that the use of technology might help individuals maintain the prospective memory strategies, resulting in sustained adherence. An interdisciplinary team was formed to translate the behavioral intervention to technology, resulting in the first version of the MEDSReM system. In this presentation we describe the evolution of the project, from the components of the successful MPMI to the design and initial testing of MEDSReM. These efforts provide general insights about translating interventions into technology tools.

Abstract Appropriate instruction is critical for ensuring the MEDSReM-2 system (i.e., smartphone app, blood pressure monitor, online portal) will be easily and effectively used and will, therefore, be more likely to be adopted. We will present our iterative processes for developing instructional support for MEDSReM 2 using human factors design principles (e.g., task analyses, comparative analyses, expert evaluation of mock-ups with screen flows). The instructional supports include user manuals, videos, as well as instructions within the MEDSReM 2 app. We will also highlight design principles used to empower the user and the benefits of using an interdisciplinary approach (i.e., gerontology, cognitive psychology, educational psychology, design, community health) to develop instructional support for older adult users.

Abstract Individuals with Mild Cognitive Impairment (MCI) face many challenges, including cognitive declines and reduced independence which are associated with poor health outcomes. Although there is no cure for MCI, mind-body exercise classes may improve cognitive function and reduce risk of falls (Wayne, Yeh, & Mehta, 2018). However, such classes are often not accessible for individuals with MCI due to lack of transportation, fear of being stigmatized, or inability to find instructors who have experience working with individuals with MCI (Hobson & Middleton, 2008; Rimmer, 2005). Tele-technology, such as video-conferencing software, has the potential to remove barriers to participation by allowing individuals to attend classes from home. The goal of this study was to assess the feasibility of using tele-technology to deliver mind-body classes to individuals with MCI. We evaluated technology acceptance and usability for OneClick.chat, a web-based video-conferencing platform designed for older adults. Stakeholders (4 subject matter experts, 2 individuals with MCI, and 2 care partners) participated in a user study that included questionnaires and a short interview. The technology acceptance data indicate that OneClick.chat was perceived as easy to use. Some individuals expressed privacy and security concerns which could be addressed with additional education and support. These findings have implications for interface design, education, and training for deployment of tele-technology delivered mind-body classes for those with MCI.