A Multi-Generational Approach to Introducing Technologies for Assessing and Supporting Cognitive Health in a Rural, Underresourced Setting.

Rural, older racially and ethnically diverse residents in rural areas in the southern U.S. have reported a strong sense of community, and desire to pursue healthy behaviors that promote aging in place. However, the ability to monitor health habits through wireless fitness devices is hindered in this underresourced area by lack of access and reduced literacy of mobile technology. A partnership between high school students, local faith-based health educators and older adults was developed, with the hypothesis that this approach would result in acceptance and use of the technology to monitor and improve health. Ecological momentary assessment (EMA) was used to administer health survey questions (e.g., In the past two hours, how much social contact have you had?) through the smartwatch 4x per day in this pilot study (n = 33 older adults). Paper and pencil measures included brief screening for cognition, health literacy, and technology competence. Feasibility rates and Pearson correlational analyses were used to examine relationships between screening measures and smartwatch use. Results included that 91% of older adults responded to the smartwatch prompts (response rate = 77.80%). Response rates were unrelated to health literacy, technology self-efficacy, self-reported cognition, education, age, or rural living. Social contact was positively related to physical activity, being mentally engaged, and "mind as sharp as usual." The training process and smartwatches functioned for participants across a continuum of skill levels with technology and health literacy. Strengths, barriers, and opportunities for improvement to this intergenerational approach, as reported by participants and researchers, are shared.