JMIR Aging最新文献

{"title":"Perceptions and Utilization of Online Peer Support Among Informal Dementia Caregivers: Survey Study.","authors":"Zhijun Yin, Lauren Stratton, Qingyuan Song, Congning Ni, Lijun Song, Patricia Commiskey, Qingxia Chen, Monica Moreno, Sam Fazio, Bradley Malin","doi":"10.2196/55169","DOIUrl":"10.2196/55169","url":null,"abstract":"<p><strong>Background: </strong>Informal dementia caregivers are those who care for a person living with dementia and do not receive payment (eg, family members, friends, or other unpaid caregivers). These informal caregivers are subject to substantial mental, physical, and financial burdens. Online communities enable these caregivers to exchange caregiving strategies and communicate experiences with other caregivers whom they generally do not know in real life. Research has demonstrated the benefits of peer support in online communities, but this research is limited, focusing merely on caregivers who are already online community users.</p><p><strong>Objective: </strong>We aimed to investigate the perceptions and utilization of online peer support through a survey.</p><p><strong>Methods: </strong>Following the Andersen and Newman Framework of Health Services Utilization and using REDCap (Research Electronic Data Capture), we designed and administered a survey to investigate the perceptions and utilization of online peer support among informal dementia caregivers. Specifically, we collected types of information that influence whether an informal dementia caregiver accesses online peer support: predisposing factors, which refer to the sociocultural characteristics of caregivers, relationships between caregivers and people living with dementia, and belief in the value of online peer support; enabling factors, which refer to the logistic aspects of accessing online peer support (eg, eHealth literacy and access to high-speed internet); and need factors, which are the most immediate causes of seeking online peer support. We also collected data on caregivers' experiences with accessing online communities. We distributed the survey link on November 14, 2022, within two online locations: the Alzheimer's Association website (as an advertisement) and ALZConnected (an online community organized by the Alzheimer's Association). We collected all responses on February 23, 2023, and conducted a regression analysis to identifyn factors that were associated with accessing online peer support.</p><p><strong>Results: </strong>We collected responses from 172 dementia caregivers. Of these participants, 140 (81.4%) completed the entire survey. These caregivers were aged 19 to 87 (mean 54, SD 13.5) years, and a majority were female (123/140, 87.9%) and White (126/140, 90%). Our findings show that the behavior of accessing any online community was significantly associated with participants' belief in the value of online peer support (P=.006). Moreover, of the 40 non-online community caregivers, 33 (83%) had a belief score above 24-the score that was assigned when a neutral option was selected for each belief question. The most common reasons for not accessing any online community were having no time to do so (14/140, 10%) and having insufficient online information-searching skills (9/140, 6.4%).</p><p><strong>Conclusions: </strong>Our findings suggest that online peer su","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e55169"},"PeriodicalIF":4.9,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11185190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three Perspectives on Older Adults' Daily Performance, Health, and Technology Use During COVID-19: Focus Group Study.","authors":"Ortal Cohen Elimelech, Sara Rosenblum, Michal Tsadok-Cohen, Sonya Meyer, Simona Ferrante, Naor Demeter","doi":"10.2196/53141","DOIUrl":"10.2196/53141","url":null,"abstract":"<p><strong>Background: </strong>During COVID-19 lockdowns, older adults' engagement in daily activities was severely affected, causing negative physical and mental health implications. Technology flourished as a means of performing daily activities in this complex situation; however, older adults often struggled to effectively use these opportunities. Despite the important role of older adults' social environments-including their families and health professionals-in influencing their technology use, research into their unique perspectives is lacking.</p><p><strong>Objective: </strong>This study aimed to explore the daily activity performance, health, and technology use experiences of healthy independent Israeli adults (aged ≥65 years) during COVID-19 from a 3-dimensional perspective: older adults, older adults' family members, and health professionals.</p><p><strong>Methods: </strong>Nine online focus groups, averaging 6-7 participants per group, were conducted with older adults, family members, and health professionals (N=59). Data were analyzed using thematic analysis and constant comparative methods.</p><p><strong>Results: </strong>The intertwining of daily activity performance and health emerged as a central theme, with differences between the groups. Older adults prioritized their self-fulfilling routines based on motivation and choice, especially in social-familial activities. In contrast, family members and health professionals focused on serious physical and mental health COVID-19-related consequences. A consensus among all three groups revealed the meaningful role of technology use during this period in bridging functional limitations. Participants delved into technology's transformative power, focusing on the need for technology to get engaged in daily activities.</p><p><strong>Conclusions: </strong>This study illustrates the profound interplay between daily activity performances, physical and mental health, and technology use, using a 3-dimensional approach. Its focus on technology's uses and benefits sheds light on what older adults need to increase their technology use. Interventions for improving digital activity performance can be tailored to meet older adults' needs and preferences by focusing on motivational and preference-related activities.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e53141"},"PeriodicalIF":4.9,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11154653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Peer-Supported App Intervention to Promote Physical Activity Among Community-Dwelling Older Adults: Nonrandomized Controlled Trial.","authors":"Kento Tabira, Yuko Oguma, Shota Yoshihara, Megumi Shibuya, Manabu Nakamura, Natsue Doihara, Akihiro Hirata, Tomoki Manabe","doi":"10.2196/56184","DOIUrl":"10.2196/56184","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The use of mobile apps has promoted physical activity levels. Recently, with an increasing number of older adults accessing the internet, app-based interventions may be feasible in older populations. Peer support-based interventions have become a common method for promoting health-related behavior change. To our knowledge, the feasibility of using digital peer support apps (DPSAs) to increase physical activity among older adults and its impact on physical activity and physical function have not been investigated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to assess the feasibility of using DPSAs in older adults and to assess changes in physical activity and physical function in DPSA users.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a nonrandomized controlled trial of older adults aged ≥65 years. We recruited participants for 2 distinct 12-week programs designed to increase physical activity. Participants could choose between an intervention group (app program and exercise instruction) or a control group (exercise instruction only). DPSA creates a group chat for up to 5 people with a common goal, and participants anonymously post to each other in the group. Once a day, participants posted a set of their step counts, photos, and comments on a group chat box. The intervention group used the DPSA after receiving 2 face-to-face lectures on its use. The participants were characterized using questionnaires, accelerometers, and physical function assessments. The feasibility of the DPSA was assessed using retention and adherence rates. Physical activity was assessed using accelerometers to measure the daily step count, light intensity physical activity, moderate to vigorous intensity physical activity (MVPA), and sedentary behavior. Physical function was assessed using grip strength and the 30-second chair-stand test.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The participants in the intervention group were more frequent users of apps, were more familiar with information and communication technology, and had a higher baseline physical activity level. The retention and adherence rates for the DPSA intervention were 88% (36/41) and 87.7%, respectively, indicating good feasibility. Participants in the intervention group increased their step count by at least 1000 steps and their MVPA by at least 10 minutes using the DPSA. There was a significant difference in the interaction between groups and intervention time points in the daily step count and MVPA (step count, P=.04; duration of MVPA, P=.02). The DPSA increased physical activity, especially in older adults with low baseline physical activity levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The feasibility of DPSA was found to be good, with the intervention group showing increases in daily steps and MVPA. The effects of DPSA on step count, physical activity, and physical function in older adults with low baseline physical activity should be investigated using randomized controlled ","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e56184"},"PeriodicalIF":4.9,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11176879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141174145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combating Barriers to the Development of a Patient-Oriented Frailty Website.","authors":"Brian Greeley, Sally Seohyeon Chung, Lorraine Graves, Xiaowei Song","doi":"10.2196/53098","DOIUrl":"10.2196/53098","url":null,"abstract":"<p><strong>Unlabelled: </strong>This viewpoint article, which represents the opinions of the authors, discusses the barriers to developing a patient-oriented frailty website and potential solutions. A patient-oriented frailty website is a health resource where community-dwelling older adults can navigate to and answer a series of health-related questions to receive a frailty score and health summary. This information could then be shared with health care professionals to help with the understanding of health status prior to acute illness, as well as to screen and identify older adult individuals for frailty. Our viewpoints were drawn from 2 discussion sessions that included caregivers and care providers, as well as community-dwelling older adults. We found that barriers to a patient-oriented frailty website include, but are not limited to, its inherent restrictiveness to frail persons, concerns over data privacy, time commitment worries, and the need for health and lifestyle resources in addition to an assessment summary. For each barrier, we discuss potential solutions and caveats to those solutions, including assistance from caregivers, hosting the website on a trusted source, reducing the number of health questions that need to be answered, and providing resources tailored to each users' responses, respectively. In addition to screening and identifying frail older adults, a patient-oriented frailty website will help promote healthy aging in nonfrail adults, encourage aging in place, support real-time monitoring, and enable personalized and preventative care.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e53098"},"PeriodicalIF":4.9,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11150730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the TrueLoo Smart Device to Record Toileting Sessions in Older Adults: Retrospective Validation and Acceptance Study.","authors":"Jordan Glenn, Parmoon Sarmadi, Paul Cristman, Gabrielle Kim, Ting-Hsuan Lin, Vikram Kashyap","doi":"10.2196/50856","DOIUrl":"10.2196/50856","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Because of the relationship between independent living and activities of daily living, care teams spend significant time managing assisted living residents' toileting problems. Recently, the TrueLoo was developed as a connected toilet seat to automatically log and monitor toileting sessions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to demonstrate the validity of the TrueLoo to (1) record and identify toileting sessions with regard to stool and urine events; (2) compare the results with the person-reported, standard-of-care methods; and (3) establish metrics of user acceptability and ease of use in a assisted living facility population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used two phases: (1) initial development of the TrueLoo algorithms to accurately identify urine and stool events and (2) evaluation of the algorithms against person-reported, standard-of-care methods commonly used in assisted living facilities. Phase 2 analyzed data over a 3-day period from 52 devices. Participants' age ranged from 63 to 101 (mean 84, SD 9.35) years. Acceptability and ease-of-use data were also collected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Regarding the development of the TrueLoo algorithm for urine assessment, sensitivity and specificity of 96% and 85% were observed when evaluating a gold-standard labeled data set, respectively (F&lt;sub&gt;1&lt;/sub&gt;-score=0.95). For stool, sensitivity and specificity of 90% and 79% were observed, respectively (F&lt;sub&gt;1&lt;/sub&gt;-score=0.85). Regarding the TrueLoo algorithm in assisted living settings, classification performance statistics for urine assessment revealed sensitivity and specificity of 84% and 94%, respectively (F&lt;sub&gt;1&lt;/sub&gt;-score=0.90), and for stool, 92% and 98%, respectively (F&lt;sub&gt;1&lt;/sub&gt;-score=0.91). Throughout the study, 46 person-reported instances of urine were documented, compared with 630 recorded by the TrueLoo. For stool events, 116 person-reported events were reported, compared with 153 by the TrueLoo. This indicates that person-reported events were captured 7% (46/630) of the time for urine and 76% (116/153) of the time for stool. Overall, 45% (32/71) of participants said that the new toilet seat was better than their previous one, 84% (60/71) reported that using the TrueLoo was easy, and 99% (69/71) said that they believed the system could help aging adults. Over 98% (69/71) of participants reported that they would find alerts related to their health valuable and would be willing to share this information with their doctor. When asked about sharing information with caregivers, 66% (46/71) reported that they would prefer the TrueLoo to send information and alerts to their caregiver, as opposed to the participant having to personally communicate those details.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The TrueLoo accurately recorded toileting sessions compared with standard-of-care methods, successfully establishing metrics of user acceptability and ease of use in assisted living po","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e50856"},"PeriodicalIF":4.9,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11165284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Literacy Training for Low-Income Older Adults Through Undergraduate Community-Engaged Learning: Single-Group Pretest-Posttest Study.","authors":"Lisa M Soederberg Miller, Rachel A Callegari, Theresa Abah, Helen Fann","doi":"10.2196/51675","DOIUrl":"10.2196/51675","url":null,"abstract":"<p><strong>Background: </strong>Digital technology is a social determinant of health that affects older people's ability to engage in health maintenance and disease prevention activities; connect with family and friends; and, more generally, age in place. Unfortunately, disparities in technology adoption and use exist among older adults compared with other age groups and are even greater among low-income older adults.</p><p><strong>Objective: </strong>In this study, we described the development and implementation of a digital literacy training program designed with the dual goals of training low-income older adults in the community and teaching students about aging using a community-engaged learning (CEL) approach.</p><p><strong>Methods: </strong>The training program was embedded within a 10-week CEL course that paired undergraduates (N=27) with low-income older adults (n=18) for 8 weeks of digital literacy training. Older adults and students met weekly at the local senior center for the training. Students also met in the classroom weekly to learn about aging and how to use design thinking to train their older adult trainees. Both older adults and students completed pre- and posttraining surveys.</p><p><strong>Results: </strong>Older adults demonstrated increased digital literacy skills and confidence in the use of digital technology. Loneliness did not change from pre to postassessment measurements; however, older adults showed improvements in their attitudes toward their own aging and expressed enthusiasm for the training program. Although students' fear of older adults did not change, their comfort in working with older adults increased. Importantly, older adults and students expressed positive feelings about the trainee-trainer relationship that they formed during the training program.</p><p><strong>Conclusions: </strong>A CEL approach that brings together students and low-income older adults in the community has a strong potential to reduce the digital divide experienced by underserved older adults. Additional work is needed to explore the efficacy and scalability of this approach in terms of older adults' digital literacy as well as other potential benefits to both older and younger adults.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":" ","pages":"e51675"},"PeriodicalIF":4.9,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11134247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Adoption by an Organization Supporting Informal Caregivers During COVID-19 Pandemic Showing Impact on Service Use, Organizational Performance, and Carers' Well-Being: Retrospective Population-Based Database Study With Embedded User Survey.","authors":"Ala Szczepura, Amir Jahan Khan, Deidre Wild, Sara Nelson, Sonja Woodhouse, Mark Collinson","doi":"10.2196/46414","DOIUrl":"10.2196/46414","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The COVID-19 pandemic has catalyzed a move from face-to-face to digital delivery of services by hospitals and primary care. However, little is known about the impact of digital transformation on organizations supporting unpaid caregivers. Since the start of the COVID-19 pandemic, the value of care provided by such informal caregivers is estimated to be £111 billion (US$ 152.7 billion) in England.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to analyze service uptake patterns (including digital service options) over the pandemic period in an English caregivers' support organization covering a population of 0.98 million; measure changes in organizational performance, service efficiency, and quality; and identify the views of caregivers on service provision and future digital delivery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a retrospective analysis of the use of digital versus nondigital support services (January 2019 to June 2021) by caregivers in city and rural geographic areas. We compared organizational performance and service quality indicators for 2 financial years (2019-2020 and 2020-2021). A survey was conducted to identify barriers and facilitators to digital service uptake, the computer proficiency of caregivers (the Computer Proficiency Questionnaire, 12-item version), and preferences for future digital service provision. Quantitative data were analyzed using Stata 13 (StataCorp LLC). Thematic analysis was used for open-text survey responses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The number of caregivers registered with the organization rose from 14,817 in 2019 to 20,237 in 2021. Monthly contacts rose from 1929 to 6741, with remote contacts increasing from 48.89% (943/1929) to 86.68% (5843/6741); distinctive patterns were observed for city versus rural caregivers. There was an increase in one-to-one contacts (88.8%) and caregiver assessments (20.9%), with no expansion in staffing. Service quality indicators showed an improvement in 5 of 8 variables (all P&lt;.05). The 152 carers completing the survey had similar demographics to all registered caregivers. The Computer Proficiency Questionnaire, 12-item version, mean score of 25.61 (SD 4.40) indicated relatively high computer proficiency. The analysis of open-text responses identified a preference for the organization to continue to offer face-to-face services as well as web-based options. The digital services that were the most highly rated were carers' well-being assessments, support needs checks, and peer support groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our findings show that staff in the caregiver support organization were agile in adapting their services to digital delivery while dealing with increased numbers of registered clients and higher monthly contacts, all without obvious detriment to service quality. Caregivers indicated a preference for blended services, even while recording high computer proficiency. Considering the economic importance of unp","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e46414"},"PeriodicalIF":4.9,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11130774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140916605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tailored Self-Management App to Support Older Adults With Cancer and Multimorbidity: Development and Usability Testing.","authors":"Sang-Wha Sien, Francis Kyerepagr Kobekyaa, Martine Puts, Leanne Currie, Margaret Tompson, Penelope Hedges, Joanna McGrenere, Caroline Mariano, Kristen R Haase","doi":"10.2196/53163","DOIUrl":"10.2196/53163","url":null,"abstract":"<p><strong>Background: </strong>Globally, cancer predominates in adults aged older than 60 years, and 70% of older adults have ≥1 chronic condition. Cancer self-management interventions can improve symptom management and confidence, but few interventions target the complex needs of older adults with cancer and multimorbidity. Despite growing evidence of digital health tools in cancer care, there is a paucity of theoretically grounded digital self-management supports for older adults. Many apps for older adults have not been co-designed with older adults to ensure that they are tailored to their specific needs, which would increase usability and uptake.</p><p><strong>Objective: </strong>We aim to report on the user evaluations of a self- and symptom-management app to support older adults living with cancer and multimorbidity.</p><p><strong>Methods: </strong>This study used Grey's self-management framework, a design thinking approach, and involved older adults with lived experiences of cancer to design a medium-fidelity app prototype. Older adults with cancer or caregivers were recruited through community organizations or support groups to participate in co-designing or evaluations of the app. Data from interviews were iteratively integrated into the design process and analyzed using descriptive statistics and thematic analyses.</p><p><strong>Results: </strong>In total, 15 older adults and 3 caregivers (n=18) participated in this study: 10 participated (8 older adults and 2 caregivers) in the design of the low-fidelity prototype, and 10 evaluated (9 older adults and 1 caregiver) the medium-fidelity prototype (2 older adults participated in both phases). Participants emphasized the importance of tracking functions to make sense of information across physical symptoms and psychosocial aspects; a clear display; and the organization of notes and reminders to communicate with care providers. Participants also emphasized the importance of medication initiation or cessation reminders to mitigate concerns related to polypharmacy.</p><p><strong>Conclusions: </strong>This app has the potential to support the complex health care needs of older adults with cancer, creating a \"home base\" for symptom management and support. The findings from this study will position the researchers to conduct feasibility testing and real-world implementation.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e53163"},"PeriodicalIF":4.9,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11112470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Quality of ChatGPT Responses to Dementia Caregivers' Questions: Qualitative Analysis.","authors":"Alyssa Aguirre, Robin Hilsabeck, Tawny Smith, Bo Xie, Daqing He, Zhendong Wang, Ning Zou","doi":"10.2196/53019","DOIUrl":"10.2196/53019","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) such as ChatGPT by OpenAI holds great promise to improve the quality of life of patients with dementia and their caregivers by providing high-quality responses to their questions about typical dementia behaviors. So far, however, evidence on the quality of such ChatGPT responses is limited. A few recent publications have investigated the quality of ChatGPT responses in other health conditions. Our study is the first to assess ChatGPT using real-world questions asked by dementia caregivers themselves.</p><p><strong>Objectives: </strong>This pilot study examines the potential of ChatGPT-3.5 to provide high-quality information that may enhance dementia care and patient-caregiver education.</p><p><strong>Methods: </strong>Our interprofessional team used a formal rating scale (scoring range: 0-5; the higher the score, the better the quality) to evaluate ChatGPT responses to real-world questions posed by dementia caregivers. We selected 60 posts by dementia caregivers from Reddit, a popular social media platform. These posts were verified by 3 interdisciplinary dementia clinicians as representing dementia caregivers' desire for information in the areas of memory loss and confusion, aggression, and driving. Word count for posts in the memory loss and confusion category ranged from 71 to 531 (mean 218; median 188), aggression posts ranged from 58 to 602 words (mean 254; median 200), and driving posts ranged from 93 to 550 words (mean 272; median 276).</p><p><strong>Results: </strong>ChatGPT's response quality scores ranged from 3 to 5. Of the 60 responses, 26 (43%) received 5 points, 21 (35%) received 4 points, and 13 (22%) received 3 points, suggesting high quality. ChatGPT obtained consistently high scores in synthesizing information to provide follow-up recommendations (n=58, 96%), with the lowest scores in the area of comprehensiveness (n=38, 63%).</p><p><strong>Conclusions: </strong>ChatGPT provided high-quality responses to complex questions posted by dementia caregivers, but it did have limitations. ChatGPT was unable to anticipate future problems that a human professional might recognize and address in a clinical encounter. At other times, ChatGPT recommended a strategy that the caregiver had already explicitly tried. This pilot study indicates the potential of AI to provide high-quality information to enhance dementia care and patient-caregiver education in tandem with information provided by licensed health care professionals. Evaluating the quality of responses is necessary to ensure that caregivers can make informed decisions. ChatGPT has the potential to transform health care practice by shaping how caregivers receive health information.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e53019"},"PeriodicalIF":4.9,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Personalized and Interactive Web-Based Advance Care Planning Intervention for Older Adults (Koda Health): Pilot Feasibility Study.","authors":"R Lynae Roberts, Katelin D Cherry, Desh P Mohan, Tiffany Statler, Eric Kirkendall, Adam Moses, Jennifer McCraw, Andrew E Brown Iii, Tatiana Y Fofanova, Jennifer Gabbard","doi":"10.2196/54128","DOIUrl":"10.2196/54128","url":null,"abstract":"<p><strong>Background: </strong>Advance care planning (ACP) is a process that involves patients expressing their personal goals, values, and future medical care preferences. Digital applications may help facilitate this process, though their use in older adults has not been adequately studied.</p><p><strong>Objective: </strong>This pilot study aimed to evaluate the reach, adoption, and usability of Koda Health, a web-based patient-facing ACP platform, among older adults.</p><p><strong>Methods: </strong>Older adults (aged 50 years and older) who had an active Epic MyChart account at an academic health care system in North Carolina were recruited to participate. A total of 2850 electronic invitations were sent through MyChart accounts with an embedded hyperlink to the Koda platform. Participants who agreed to participate were asked to complete pre- and posttest surveys before and after navigating through the Koda Health platform. Primary outcomes were reach, adoption, and System Usability Scale (SUS) scores. Exploratory outcomes included ACP knowledge and readiness.</p><p><strong>Results: </strong>A total of 161 participants enrolled in the study and created an account on the platform (age: mean 63, SD 9.3 years), with 80% (129/161) of these participants going on to complete all steps of the intervention, thereby generating an advance directive. Participants reported minimal difficulty in using the Koda platform, with an overall SUS score of 76.2. Additionally, knowledge of ACP (eg, mean increase from 3.2 to 4.2 on 5-point scale; P<.001) and readiness (eg, mean increase from 2.6 to 3.2 on readiness to discuss ACP with health care provider; P<.001) significantly increased from before to after the intervention.</p><p><strong>Conclusions: </strong>This study demonstrated that the Koda Health platform is feasible, had above-average usability, and improved ACP documentation of preferences in older adults. Our findings indicate that web-based health tools like Koda may help older individuals learn about and feel more comfortable with ACP while potentially facilitating greater engagement in care planning.</p>","PeriodicalId":36245,"journal":{"name":"JMIR Aging","volume":"7 ","pages":"e54128"},"PeriodicalIF":5.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11089888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}