How Well Do Older Adult Fitness Technologies Match User Needs and Preferences? Scoping Review of 2014-2024 Literature.

Background: The population is aging, and research on maintaining older adult independent living is growing in interest. Digital technologies have been developed to support older adults' independent living through fitness. However, reviews of current fitness technologies for older adults indicate that the success is considerably limited.

Objective: This scoping review investigates older adult fitness by comparing current interventions to known needs and preferences of older adults from older adult-specific technology acceptance research, barriers and enablers to physical activity, and qualitative research on fitness technologies. The review questions are (1) How well do current older adult fitness technologies align with known preferences? (2) How well do current research methodologies evaluate the known needs and preferences?

Methods: Research papers from the last 10 years were searched in the ACM Digital Library, IEEE Xplore, Medline, and PsycINFO databases using keywords related to older adults, technology, and exercise. Papers were only included if they specifically evaluated fitness technologies, focused on older adults, and mentioned a specific technology used in the intervention. To evaluate the fitness interventions, an assessment tool, the Older Adult Fitness Technology Translation Assessment tool, was synthesized through literature on technology acceptance, barriers and enablers to physical activity, and qualitative research on fitness technologies. Interventions were scored by 5 reviewers using a dual-review approach.

Results: A total of 43 research papers were selected:16 from medical journals, 15 from engineering journals, 7 from human-computer interaction journals, 3 from public health, and 2 from combined computing and engineering journals. The Older Adult Fitness Technology Translation Assessment tool contained six assessment factors: (1) compatibility with lifestyle, (2) similarity with experience, (3) dignity and independence, (4) privacy concerns, (5) social support, and (6) emotion. The average scores of the 6 factors were 2.93 (SD 0.86) on compatibility with lifestyle, 3.10 (SD 0.74) on similarity to experience, 3.49 (SD 0.64) on dignity and independence, 3.17 (SD 0.86) on privacy concerns, 3.74 (SD 0.81) on short-term outcomes, 2.75 (SD 1.21) on long-term outcomes, 2.79 (SD 0.88) on social support, and 3.17 (SD 1.19) on emotion. No research paper scored a 3 or above on all 6 factors.

Conclusions: The results show a lack of alignment between the known preferences of older adults and the design and assessment of current older adult fitness technologies. Areas for growth include (1) alignment between the needs of older adults and fitness technology intervention design, (2) translation of findings from older adult design work to designs in practice, and (3) explicit usage of older adult-specific factors in research. We hypothesize that the proposed Older Adult Fitness Technology Translation Assessment tool can help bridge the gap between technological capability and real-world applicability, ultimately fostering greater acceptance, respect, and long-term success.